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 ?
Each insurer is to contribute an equal sum to the risk pool.
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.
The number of employers in the Assigned Risk Pool peaked at 18,000 in 1994, declined to 7,000 in 2000 and has since climbed back above 10,000.
using Self insure operating funds or paying deductibles) High Insurance Insurance Self insure Self insure Risk pool Risk pool
Estimate the size of each risk pool for the next 12 months:
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.