Please note: The algorithm descriptions in English have been automatically translated. Errors may have been introduced in this process. For the original descriptions, go to the Dutch version of the Algorithm Register.
Risk equalisation
- Publication category
- Other algorithms
- Impact assessment
- DPIA
- Status
- In use
General information
Theme
Begin date
Contact information
Link to publication website
Responsible use
Goal and impact
A health insurer must accept any person liable to pay insurance who wishes to take out health insurance with it. This is stipulated in the Health Insurance Act. That law also stipulates that the premium charged by the health insurer for such health insurance may not be tailored to the health risk or other characteristics of the insured. Without further measures, the consequence of the underwriting obligation and the prohibition of premium differentiation is that health insurers with a relatively large number of unhealthy policyholders in their health insurance portfolio are at a disadvantage compared to health insurers with a relatively healthy population, because, given their population, they are forced to charge a higher premium than their competitor with a healthier population. This inequality, created by differences in the risk profile of the insured portfolio, undermines the level playing field on which competition between health insurers should take place. Based on the risk equalisation model, health insurers estimate the risks of the insured on the basis of characteristics related to the health status of the insured as best as possible and are compensated accordingly.
Considerations
Human intervention
Risk management
Legal basis
Article 32 Health Insurance Act
Links to legal bases
Impact assessment
Operations
Data
Official Gazette 2024, 256 | Overheid.nl > Official notices (officielebekendmakingen.nl)
Technical design
Official Gazette 2024, 256 | Overheid.nl > Official notices (officielebekendmakingen.nl)
External provider
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