Recent data from the first two waves of the Health and Retirement Study are analyzed to evaluate prevalence of different types of health insurance, characteristics of different plan types, and change sin coverage as individuals approach retirement age. Although overall rates of coverage are quite high among the middle-aged, the risk of noncoverage is high within many disadvantaged groups, inclu...

BACKGROUND The moral hazards and poor public image of the insurance industry, arising from insurance agents' unethical behavior, affect both the normal operation of an insurance company and decrease applicants' confidence in the company. Contrarily, these scandals may demonstrate that the organizations were "bad barrels" in which insurance agents' unethical decisions were supported or encourage...

Established in 1984, the Wharton Risk Management and Decision Processes Center develops and promotes effective corporate and public policies for low‐probability events with potentially catastrophic consequences through the integration of risk assessment, and risk perception with risk management strategies. Natural disasters, technological hazards, and national and international security issues ...

Fraud is a significant problem in many industries, such as banking, insurance, telecommunication, and public service. Detecting and preventing fraud is difficult, because fraudsters develop new schemes all the time, and the schemes grow more and more sophisticated to elude easy detection. Many organizations have implemented fraud detection and prevention systems based on SAS data mining to help...

A consumer-driven health plan (CDHP), also known as a consumer-directed health plan, is a health insurance plan design increasingly prevalent in the United States. CDHPs are a specific type of high-deductible health plan generally including a health savings account (HSA) or a health reimbursement arrangement (HRA). Compared to traditional commercial health plans—such as a health maintenance org...

Meaghan Duetsch The United States has experienced many changes over the past two decades in the way health care is managed, such as the shift from primarily fee-for-service type health insurance coverage to coverage through health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Health care expenditures, as a proportion of all expenditures, have increased over the l...

introduction: the rapid increase in health costs across the world has forced governments to use insurance programs. uncontrolled costs would reduce the financial ability of insurance organizations in providing services. abuse of health insurance wastes 3-15% of the health budget annually. this study was conducted to determine cases of violating the rules and regulations of medical services insu...

there are fragmentations in iran’s health insurance system. multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. also fra...