risk pool


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risk pool

A government-administered health insurance program for people who cannot obtain insurance privately, e.g., because of costly preexisting medical conditions.
See also: pool

risk pool,

n a portion of provider fees or capitation payments withheld as financial reserves to cover unanticipated utilization of services in an alternative benefits plan.
References in periodicals archive ?
The court squarely rejected the LGC's claim that the members of the boards of directors of risk pools have discretion to set contingent reserves and thereby control what is to be returned to members as surplus.
Since high risk pool premiums are indexed to the standard risk rate in the individual insurance market, they are legally mandated to follow these benchmarks that have risen over time.
Furthermore, these dynamics make even existing risk pools in the individual and small group markets unstable and limit the type of insurance products available.
Insurers use underwriting to maintain a predictable and stable level of risk within their risk pools.
A principal focus of this analysis is the role of size in a risk pool with moral hazard.
BOB formats vary among companies, but all EOBs should list the agreed-to-pay fee, the amount of the patient's copayment (copay), the amount of money the physician pays to the risk pool, and the amount of money the company actually pays the physician (amount paid).
Provide subsidies to individuals whose incomes fall below 250 percent of the federal poverty level to enable them to purchase private insurance, participate in the high risk pool and buy into expanded public programs.
Gramm would place those with pre-existing conditions in a high risk pool, then allow insurance companies to bid for their business.
My book is The Risk Pool by Richard Russo (Vintage Contemporaries Edition, 1989,479 pages, $8.
A bill to establish a health insurance risk pool has passed the state House of Representatives but is coming under increasing fire as "nothing more than a tax subsidy for the rich.
In 1976, CA helped establish the first high risk pool in Minnesota, and CA has been involved with the development of risk pools in many of the 34 other states that have since developed high risk pools.