adverse selection

(redirected from Antiselection)
Also found in: Dictionary, Financial.
Related to Antiselection: Adverse selection

Adverse Selection

Clinical genetics An event in which an insurer avoids underwriting a person whose genetic profile indicates a high chance of suffering an "expensive" condition in the future—e.g., Huntington’s disease (Armed with such information, an insurance carrier may deny coverage—i.e., adversely select—a person with a high risk of suffering the disease in question; alternatively, that person may take out a large insurance policy on standard terms).
Health insurance The tendency of those with greater-than-average health risks to apply for, or maintain, insurance coverage.
Managed Care
(1) A stance adopted by health care insurers, which fiercely compete among themselves to insure the healthiest and wealthiest segment of a particular population, and thus adversely select the population which they target for selling insurance policies.
(2) The selection of a health plan, whether indemnity or managed care, over other plans by those enrollees who are more likely to file claims and use services, causing an inequitable proportion of enrollees requiring more medical services in that plan.

adverse selection

Managed care
1. A stance adopted by health care insurers, which fiercely compete among themselves to insure the healthiest and wealthiest segment of a particular population, and thus adversely select the population which they target for selling insurance policies. See 'Safety net' hospital.
2. A health plan, whether indemnity or managed care, is selected over other plans by enrollees who are more likely to file claims and use services, causing an inequitable proportion of enrollees requiring more medical services in that plan.

adverse selection

The enrollment in a health plan of those who are sicker or use more health care services than the general population.
See also: selection

adverse selection,

n a statistical condition within a group when there is a greater demand for dental services and/or more services necessary than the average expected for that group.
Mentioned in ?
References in periodicals archive ?
The availability of an insurance alternative and the built-in prejudice against reducing incomes have acted even apart from the REA to intensify the pressure of antiselection on the pension trust.
Some experts told the GAO that producers could reduce the risk of antiselection by encouraging many people, including uninsured people, to sign up for health coverage, including the new, subsidized health plans that are supposed to be sold through a new system of health insurance exchanges, Dicken says in the letter to Nelson.
Today, health insurers are saying that off-exchange distributors seem to be doing a better job of enforcing the rules for the "special enrollment period" system, a system that gives insurers some protection against antiselection, than the PPACA exchanges are.
Current rules may make antiselection pressures so great that private carriers will inevitably give way to a government-run, "single payer" alternative, Fleet said.
Another argument against the proposals is that the employers with the youngest, healthiest employers will probably leave the programs, and that antiselection will eventually kill the programs.
The antiselection has been an even more difficult problem in the health insurance market than in other types of markets, such as the life insurance market, because concerns about ethics and privacy make efforts to have the buyers, the sellers, the exchange managers or government entities develop and enforce standards particularly challenging.
Companies also should consider how changing their underwriting requirements might influence the risk of antiselection and how antiselection may change the frequency of an impairment among those applying for insurance.
Congress also created the three R's protect the insurers, and the PPACA ban on medical underwriting, from the antiselection forces that have destroyed most earlier efforts to give patients a choice of plans while letting sick patients pay the same rates that healthy patients pay.
AHIP member companies are open to providing coverage on a guaranteed-issue basis-if the government prevents antiselection by creating an enforceable requirement that individual consumers have health coverage, Ignagni said.
Thus, in addition to precluding whole life and other more complicated forms of insurance, we do not allow for stochastic mortality rates or antiselection effects that might complicate the insurance purchase problem.
The insurers and regulators implementing the Patient Protection and Affordable Care Act (PPACA) restrictions on medical underwriting tried to use an open enrollment calendar system to keep antiselection forces from tearing the new system apart.