4143.0: Tuesday, November 14, 2000 - 12:50 PM

Abstract #16964

Underinsurance in the Group Insurance Market: New Estimates of an Old

Jon Gabel1, Jeremy Pickreign, MS1, Heidi Whitmore, MPP1, Jim Mays2, Cathi Callihan3, Stephen Long4, and Susan Marquis4. (1) AHA-Health Research and Educational Trust, 325 7th Street N.W, Washington, DC 20004, 202-626-2688, jgabel1@aha.org, (2) Acturial Research Corp, (3) Acturial Research Corporation, (4) RAND

Previous research suggests as many as one-fourth of Americans with group coverage were underinsured in 1977, and 20 percent were underinsured in 1987. Underinsurance may cause severe financial and access to care problems. In general, underinsurance is the probability that an individual in a given state of health will incur medical expenses exceeding x percent of income (usually six percent). Using data from the 1997 RWJ Employer Health Insurance Survey, this paper provides new estimates about the extent of underinsurance. The study will provide actuarial estimates of the value of plans offered by 21,000 employers. From this national sample, we will estimate likely out-of-pocket expenses if an individual were stricken with one of five serious medical conditions: (1) severe depression (2) breast cancer (3) premature birth requiring neo-natal intensive care (4) multiple complex fractures from an automobile accident (5) COPD. The analysis will identify characteristics of firms and plans providing low actuarial value and underinsuring their employees.

Learning Objectives: To identify characteristics of firms and plans providing low actuarial value and underinsuring their employees

Keywords: Health Insurance,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA