214k views
0 votes
When a health insurance provider in Indiana becomes insolvent, which entity will pay the company's claims?

User Adnan Toky
by
7.8k points

1 Answer

4 votes

Final answer:

In the event of an insolvency of a health insurance provider in Indiana, the state's guaranty association is responsible for paying the company's claims. Insurance companies can keep costs down by negotiating for lower rates due to their large clientele.

Step-by-step explanation:

When a health insurance provider in Indiana becomes insolvent, the entity that typically steps in to pay the company's claims is the state's guaranty association. Pension benefits are similarly protected by the PBGC which steps in when companies fail to pay promised pensions.

These associations are designed to protect policyholders in the event that an insurance company fails. In the case of insurance companies managing large groups of clients, they have the ability to negotiate lower rates with healthcare providers, benefiting consumers and reducing the insurer's expenses for claim payouts.

However, if an insurance company only charges the actuarially fair premium to the entire group instead of pricing for each group based on their specific risks, it may experience financial difficulties due to insufficient premiums to cover higher-risk groups' claims.



User HGB
by
8.2k points