**Thomas Cox ^{}**

- Contents
- Introduction
- Insurance Risk Transferring Health Care Finance Mechanisms
- Why Does Insurance Work?
- Basic Insurance Principles
- Insurer Operating Results
- Insurer Revenues
- Claims Costs
- Insurer Population Loss Ratio Estimates
- Insurer Operating Expense Ratios

- Insurer Operating Results By Population Loss Ratio Estimate
- Insurer Operating Results By Population Loss Ratio Estimate - Profits
- Insurer Operating Results By Population Loss Ratio Estimate - Losses

- Efficient Insurer Portfolio Selections Are Random Samples
- Paradigm insurer
- Quantitative Analysis of Insurer Operations
- Insurer Standard Errors by Portfolio Size
- Insurer Probabilities of Profits by Portfolio Size
- Insurer Probabilities of Operating Losses by Portfolio Size

- Insurer Risk and Surplus Requirements
- Solvency Preserving Loss Ratio
- Surplus Requirements by Portfolio Size
- Aggregate Surplus by Portfolio Size

- Insurer Risk and Maximum Sustainable Benefits
- Maximum Sustainable Benefits for Profits of 5 Percent
- Maximum Sustainable Benefits to Avoid Operating Losses

- Risk Adjusted Premiums
- Portfolio Risk Adjusted Premiums - Matching PI's Profit Probabilities
- Portfolio Risk Adjusted Premiums - Matching PI's Loss Avoidance Probabilities

- Reinsurance - How PI Can Eliminate Risk and Lock In Profits
- Profit Adjusted Premiums - PI Transfers Risks to Insurer B or NHI
- Loss and Risk Adjusted Premiums - PI Transfers Risks to Insurer B and NHI

- The Impact of Case Mix Adjusted Capitation Rates on Risk Bearing Providers
- Conclusions and Recommendations
- References
- About this document ...

Thomas Cox PhD RN 2013-02-23