Health Insurance Authority publishes its 2015 Annual Report
Private health insurance market is the largest non-life market with total premiums of €2.45 billion in 2015
The market returned to a recovery phase during 2015 with an increase in the total number of lives insured to 2.12 million or 46% of the population, an increase of 97,000 on 2014
Claims paid per insured person increased by 6.5%
Significant regulatory developments occurred during 2015 including introduction of Lifetime Community Rating and changes to discounted premium rates for young adults, reduced waiting periods for older ages and full cover for adopted children
A new Risk Equalisation Scheme for the period 2016 to 2020 was notified to the European Commission without objections
Thursday, 28 July, 2016 – The Health Insurance Authority (“the Authority”) has published its Annual Report and Accounts for 2015. The Report provides information about the operation of the private health insurance market during 2015 and the work of the Authority in regulating the community-rated private health insurance market in Ireland. The Report and Accounts have been submitted to the Minister for Health, Simon Harris TD and have been laid before the Houses of the Oireachtas, as provided for under Section 33(2) of the Health Insurance Act 1994 and in accordance with Section 12 of the Code of Practice for the Governance of State Bodies.
Commenting on the Report, Health Insurance Authority CEO, Don Gallagher, said: “2015 was a notable year for the regulation of the private health insurance market in Ireland. Lifetime community premium loadings came into force on 1 May to encourage people to take out private health insurance at a younger age and thereby help improve the sustainability of the market and help control premium inflation.
Improvements in the wider economy helped the market for private health insurance. The number insured at the end of 2015 was 2.12 million, or 46% of the population. This was an increase of 97,000 on the previous year. This turnaround was due to a combination of factors including rising employment in the economy and the introduction of Lifetime Community Rating.”
“The average premium paid fell by 2% to €1,173. However, a number of factors underlie this reduction including the increase in the numbers of people taking out private health insurance for the first time in advance of the introduction of Lifetime Community Rating premium loadings on 1 May 2015. Many of these availed of lower cost introductory private health insurance (‘PHI’) products providing limited cover. Also, consumers have shopped around, opting for products providing reduced levels of cover at lower cost. Other factors may have increased claim costs which could work their way through to premium levels in time, including changes to charging rates for patients with PHI cover in public hospitals,” he added.
Research commissioned by the Authority and conducted during the latter part of the year showed an improvement in satisfaction levels among consumers with all aspects of health insurance. Other research revealed strong support for community rating in the private health insurance market and the policy which prevents financial discrimination on the basis of age, health or gender with three quarters of respondents agreeing that the policy should continue.
While the private health insurance market has continued to age with 33% of the population in the age category 18-29 years holding PHI compared with 43% coverage across all ages and 52% coverage across the ages of 60-74 years, this trend appears to have slowed due to a number of factors including the introduction of age related loadings introduced with Lifetime Community Rating.
VHI had the largest overall share with 53% of the PHI market but 83% of the insured population over 80 years of age. Its market share of premiums was 61% and 67% of claims paid.
Mr. Gallagher said: “At the end of 2015 there were 360 private health insurance products being marketed, a marginal increase on 355 at the end of 2014. A number of these were low cost products introduced in the run in to the introduction of Lifetime Community Rating on 1 May 2015. Notwithstanding this, the number and range of products available means that consumers continue to need support to work out which products best meet their needs.
A core function of the Authority is to provide information to consumers about private health insurance and their rights within our community-rated market. During the year, the Authority had approximately 435,000 consumer contacts, most of which were through its website at www.hia.ie which provides the only comprehensive comparison tool of all health insurance plans in the market. It allows consumers select and compare products for benefits and pricing.”
“Consumers should really be checking their current cover and pricing at least every two to three years to make sure they are receiving value from the market,” he added.
The Authority monitors and regulates the private health insurance market in Ireland. The market is community rated which aims to ensure that private health insurance does not cost more for those that need it most. Consumers have certain entitlements within the private health insurance regulatory system including open enrolment, lifetime cover, minimum benefit and the entitlement to switch health insurance provider without penalty for the same level of cover.
The Authority operates a system of risk equalisation which aims to address differences in insurers’ claim costs that arise due to variations in the health status of their members. This involves payments to and from insurers related to the risk profile of their membership.
The terms of appointment for all five outgoing Authority Members finished on 31 January, 2016. Ms. S. Malin was reappointed to the Authority and now serves alongside newly appointed Members Mr. S. Coyle, Dr. F. Kiernan and Mr. J. A. McNamara from 1 February 2016 and Mr. I. Britchfield from 20 June 2016. The Authority wishes to acknowledge the work and dedication of the outgoing Members of the Authority, Mr. J. Joyce (Chairman), Mr D. Curtin, Prof. A. Staines and Mr P. Turpin and thanks them for their tenure of service.
The Health Insurance Authority Annual Report 2015 is available to download from the Authority’s website at www.hia.ie.
For reference, issued on behalf of the HIA by FTI Consulting. For media queries, contact:
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Notes to Editors
Health Insurance Authority Annual Report 2015 - Overview
Private Health Insurance Market in Ireland
Largest non-life insurance market in Ireland.
Total premium income in 2015 of €2.45 billion
2.12 million insured as the end of 2015 or 46% of the population – an increase of 97,000 on the previous year.
Return to a rising market during 2015; previous peak of 2.3 million or 50.9% of the population in 2008. Numbers ceased falling in the third quarter of 2014.
The total number of private health insurance products being marketed grew to 360 as at 31 December 2015 (355 at the end of 2014).
While the private health insurance (‘PHI’) market continues to age, this trend appears to be slowing somewhat as a result of a combination of factors, including the introduction of Lifetime Community Rating and discounts for young adults.
Those over age 60 pay, on average, premiums that are 31% higher than the premiums paid by those aged under 60 years; this is due to older insured persons opting for higher cost PHI products that confer higher levels of cover.
Four open membership undertakings operated in the market, namely VHI Healthcare, Laya Healthcare, Aviva Health and GloHealth.
In December 2015, VHI Healthcare’s market share was 51%, Laya Healthcare 26%, Aviva Health 14% and GloHealth 5%. Restricted Membership Undertakings have a combined market share of 4%.
Market shares vary significantly by the ages of the insured, e.g. at the end of 2015, VHI Healthcare insured 69% (72% at the end of 2014) of those aged 70-79 years. However, the high proportions of the oldest age cohorts insured by VHI Healthcare were gradually declining.
Premiums and claims
The average gross premium paid in 2015 was €1,173, a decline of 2% on €1200 in 2014. Average premiums increased by 4% in 2014 and 10% in 2013. Underlying factors included -
the introduction of low cost private health insurance products with a limited range of benefits during the run up to introduction of Lifetime Community Rating
recovery in the total numbers insured
introduction of young adult discounts
Gross premiums charged to consumers are reduced by income tax relief of 20% up to a maximum of €200.
Average claims paid per insured person increased by 6.5% in 2015 following an increase of 3% in 2014. Factors underlying this increase included changes to charging rates for patients with PHI cover in public hospitals. Average rate of increase in claims between 2008 and 2012 was 12.6%. Consumer price and health sector inflation was near zero during 2014 and 2015.
Average benefits per insured person were €1,125; average market treatment days per insured person were 1.14.
Changes to charging rates for patients with PHI cover in public hospitals wherein patients could waive their entitlements to be treated as a public patient came into effect from January 2014. These changes entitle public hospitals to charge €813 per night for a private patient.
Nearly 1 in 4 have switched health insurer at some time with a quarter of those having switched more than once. The main reason for switching is cost saving (65%).
The Authority participated in a project to cost a ‘basket of services’ in relation to a Universal Health Insurance (“UHI”) system. A report presented to the Minister costed an adult premium in UHI at between €2,228 and €3,232 per annum, depending on the basket of services that would be a mandatory standard in UHI.
Lifetime Community Rating (‘LCR’)
Introduced with effect from 1 May 2015
Introduces an age-related loading of 2% per year of age over 34 years when a person first takes out private health insurance
5,000 insured persons paid a total of €711,000 in LCR loadings in 2015.
Young Adult Rates
A sliding scale of young adult discount rates applicable to those aged 18-25 years
With effect from 1 May 2015, insurers choosing to apply these rates must apply the full range of discounts
With effect from 1 May 2015, the waiting period for older ages has been reduced to the same duration as that applying to younger ages
With effect from 1 May, full PHI cover is available immediately for adopted children
Risk Equalisation Scheme
Essential part of the community rated PHI market in Ireland
The Authority received notification in February 2016 that the European Commission was not raising any objections to the Risk Equalisation Scheme for the period 2016 to 2020.
Total consumer contacts of 435,000 approx. during 2015, most of which were through the Authority’s website www.hia.ie. The website contains a product comparison tool which assists consumers select and compare features and pricing of all products available on the market.