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Instructions for Health Insurance
Survey Report
Calendar Year 1999
General
Do not round dollar amounts or counts. Report
in whole numbers.
Return all 3 pages of the survey form (Survey
2000). If no business is written, respond with "NONE."
Coverage Type
Individual insurance
means non-group health insurance and coverage issued to
an individual under a trust, employer or other similar group
of individuals, regardless of the situs of delivery of the
policy or contract, if the individual pays the premium and
is not being covered under the policy or contract pursuant
to continuation of benefits provisions. Individual insurance
does not include health insurance coverage issued through
a bona fide association. Individual insurance includes conversions
from group health coverage.
Small Employer Group insurance means
health insurance offered, delivered, issued for delivery
or renewed to small employers that employed an average of
at least 2 but not more than 50 employees on the business
days during the preceding calendar year and that employ
at least 2 employees on the first day of the health insurance
plan year. Small employer group insurance includes health
insurance coverage purchased through associations by small
employers.
Other Group insurance means health
insurance offered, delivered, issued for delivery or renewed
to large employers that employed an average of at least
51 employees on the business days during the preceding calendar
year and that employs at least 2 employees on the first
day of the health insurance plan year. Other group includes
association health insurance plans that provide coverage
for eligible individual non-employer members and their dependents.
Product Definitions
Accident: coverage singly or in combination, for death,
dismemberment, disability, or hospital and medical care
caused by an accident and includes accident only, travel
accident, accidental death and dismemberment, student accident,
blanket accident, specified accident.
Dental: stand-alone dental coverage.
If dental benefits are part of a comprehensive medical plan,
then include data in comprehensive medical plan. Include
in product data in the PPO category only if the insured
is responsible for reduced cost sharing when the insured
uses a provider with which the insurer has an agreement.
Disability Income: loss of time coverage
but does not include credit disability
Hospital Expense: coverage only for
hospital confinement expenses including hospital outpatient
expenses
Hospital Indemnity: daily benefits
for hospital confinement on an indemnity basis only
Long Term Care: coverage for at least
12 consecutive months for diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services,
provided in a setting other than an acute care unit of a
hospital and includes products that provide benefits for
cognitive impairment or loss of functional capacity. This
line should include products providing only nursing home
care, home health care, community based care or any combination.
Comprehensive Medical: coverage for
hospital, medical, and surgical expenses (not supplemental
coverage and may include dental and vision benefits). Include
product data in the PPO category only if the insured is
responsible for reduced cost sharing when the insured uses
a provider with which the insurer has an agreement.
Medicare Supplement: coverage designed
as a supplement to reimbursement under Medicare for hospital,
medical or surgical expenses of a person eligible for Medicare
Medical Expense: coverage only for
surgical, anesthesia and in-hospital medical expenses rendered
by a physician.
Specified Disease: coverage for diagnosis
and treatment of a specifically name disease such as cancer.
Vision: stand-alone vision coverage.
If vision benefits are part of a comprehensive medical plan
then include data in comprehensive medical plan. Include
product data in the PPO category only if the insured is
responsible for reduced cost sharing when the insured uses
a provider with which the insurer has an agreement.
Other: supplemental or limited-benefit
products that provide health insurance coverage not meeting
one of the above product definitions.
Data Category
# Policies In Force Beg of Year:
number of policies in force on December 31, 1998. In the
case of group coverage (employer or association), if no
policies are actually in force in Alaska, but individuals
in Alaska are covered under a group policy in force in another
state, record 0 policies in force.
# Individuals Covered Beg of Year:
number of Alaskan’s covered under all (not just those in
force in Alaska) policies in force on December 31, 1998
as reported in the prior column. For example, a family policy
covering two parents and 2 children would count as 4 individuals
covered, an employer health plan that covers 25 employees
and their 40 dependents would count as 65 individuals covered
(1 policy).
# New Policies Issued During the Year:
number of policies (not individuals covered) newly issued
during 1999 (do not include renewed policies).
# Individuals Newly Issued Coverage During
the Year: number of people newly issued coverage during
the 1999. For example, new employees and their dependents
covered under an existing health insurance plan would count
as individual newly issued coverage during the year, even
though the policy was not newly issued during the year.
# Policies Terminated During the Year:
number of policies terminated during 1999.
# Covered Individuals Terminated During
the Year: number of people whose coverage terminated
during 1999.
# Policies In Force End of Year:
number of policies in force on December 31, 1999. In the
case of group coverage (employer or association), if no
policies are actually in force in Alaska, but individuals
in Alaska are covered under a group policy in force in another
state, record 0 policies in force. This total should balance
to # Policies In Force Beg of Year + # New Policies Issued
During the Year - # Policies Terminated During the Year.
# Individuals Covered End of Year:
number of people covered under policies in force on December
31, 1999 as reported in the prior column. For example, a
family policy covering 2 parents and 2 children would count
as four individuals covered, an employer health plan that
covers 25 employees and their 40 dependents would count
as 65 individuals covered (1 policy). This total should
balance to # Individuals Covered Beg of Year + # Individuals
Newly Issued Coverage During the Year - # Covered Individuals
Terminated During the Year.
Earned Premium and Incurred Claims:
premiums and claims incurred during 1999 by product and
data category.
Individual Health Insurance
For Life and Health Insurance Companies,
earned premium and incurred claims total should balance
to 1999 Alaska State Page, Accident and Health Insurance
section, Collectively Renewable Policies + Other Individual
Policies.
For Property and Casualty Insurance Companies,
earned premium and incurred claims total should balance
to the 1999Alaska State Page, Accident and Health lines
(15.1-15.6).
Small Employer and Other Group Health
Insurance
F or Life and Health Insurance Companies, the sum of the
Small Employer Group and the All Other Group earned premium
and incurred claims should balance to 1999 Alaska State
Page, Accident and Health Insurance section, Line 23, Group
Policies.
For Property and Casualty Insurance Companies,
the sum of the Small Employer Group and the All Other Group
earned premium and incurred claims should balance to the
1999 Alaska State Page, Group Accident and Health line (13)
plus any employer or stop loss reported in the liability
lines.
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