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Discounts for family number of components, frequency in the low payment and service utilization. Annually the Health Minister announces the average increase for health insurance premiums following the Government’s assessment of applications from health insurers.
This background note provides an overview of rises in private health insurance premiums in recent years, outlines possible reasons for these increases and for variations in the increases experienced by individual funds, and outlines recent changes to the regulation of private health insurance that may affect how premium rises are assessed and how they are reported. Health insurers wanting to increase their premiums are required under legislation to seek regulatory approval.
Over time there have been changes to the procedures governing the approval of premium rises. In 2007, legislative changes affecting the process for seeking premium increases were made with the passage of the Private Health Insurance Act 2007.
In addition, the new Act altered the way premium increases are notified; it is no longer a requirement that information on premium rises granted to individual insurers be tabled in Parliament. The new Act also included changes to the articulation of the objectives of the industry regulator, the Private Health Insurance Administration Council (PHIAC). Generally, average premium rises in recent years have been well above the CPI, as shown in Table 1.
Premium increases can vary across the sector with some insurers applying for and being granted higher premium increases than others. In the past, details of the approved average premium increase to be applied to the range of insurance products offered by individual funds had been publicly released.
In the lead up to the 2009 announcement of premium increases, the Minister warned health insurers not to propose large increases to premiums as a result of legislative changes that saw increases to the Medicare Levy Surcharge (MLS) income thresholds.[22] Significantly, the Minister also indicated she was considering making changes to the level of consumer information about premium increases by publishing the details of the average premium rise for each individual fund, rather than the usual practice of only publishing the industry-wide average. Over the last five years, increases to private health insurance premiums have averaged around 6 per cent—that these have been well above CPI increases has attracted some public concern.
Nevertheless there has been considerable variation in the increases of individual funds, some being substantially higher than the average. Other legislative changes introduced in 2007 may however continue to affect the Government’s process for considering premium increases. In such an environment, transparency about the premium-setting process and the availability of consumer information about premium rises and the drivers of those rises are likely to become of greater import.
Among approximately 172 million persons under age 65 years with private health insurance, the majority of persons (73%) had some type of dental coverage. About 8 out of 10 persons under age 65 years with employment-based private health insurance had dental coverage compared with about 3 out of 10 persons with directly purchased insurance. Among persons under age 65 years with private health insurance, non-Hispanic black persons were more likely to have dental insurance than non-Hispanic white persons, non-Hispanic Asian persons, or Hispanic persons. Among persons under age 65 years with private health insurance, as income level increased, the percentage having dental insurance increased. Adults with at least some college education were more likely to have dental insurance than those with less education among those aged 25-64 years with private health insurance. About 8 out of 10 persons with employment-based private health insurance had dental coverage compared with about 3 out of 10 persons with directly purchased insurance. Non-Hispanic black persons were more likely to have dental insurance than non-Hispanic white persons, non-Hispanic Asian persons, or Hispanic persons. Among persons under age 65 years with private health insurance who had some type of dental insurance, about one out of two persons had dental coverage through a single-service dental plan, either alone or in addition to dental coverage through their comprehensive health insurance plan (Figure 1).
Among persons under age 65 years, persons with employment-based private health insurance were about two to three times as likely as persons with directly purchased insurance to have dental coverage through all types of plans, including a single-service dental plan only, a comprehensive plan only, or both single-service and comprehensive plans combined (Figure 2). Among persons under age 65 years with private health insurance, poor persons at less than 100% of poverty level were more likely than higher income persons at 400% or more of poverty level to have dental coverage through a comprehensive plan only (Figure 4). As income increased, the percentage having dental insurance through a single-service dental plan, either alone or in addition to a comprehensive plan, increased. Among adults aged 25-64 years with private health insurance, as education level increased, there was an increase in the percentage of adults with dental insurance through a single-service dental plan only (Figure 5).


College graduates were less likely than adults with less education to have dental insurance through a comprehensive plan only.
About three out of four persons under age 65 years with private health insurance had some type of dental coverage. Approximately 45 million persons under age 65 years with private health insurance did not have dental coverage in 2008. Comprehensive plan: A health insurance plan or policy that covers a variety of medical services.
Directly purchased coverage: Private insurance that was originally obtained through direct purchase or through other means not related to employment.
Employment-based coverage: Private insurance that was originally obtained through a present or former employer, a union, or a professional association. Poverty status or percentage of poverty level: Is based on family income, family size, and the number of children in the family, and, for families with two or fewer adults, on the age of the adults in the family. Private insurance: Is indicated when respondents report they were covered by private health insurance through an employer, union, or individual purchase. NHIS is designed to yield a nationally representative sample, and this analysis uses weights to produce national esti-mates. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.
One reason for this increase is that society increasingly given more importance to their health and therefore appreciates the advantages of having private health insurance.
Applications for premium increases can be made by a health insurer at any time; however, the practice of applying for an annual increase early in the year remains the norm. The notification period whereby a health insurer can seek approval from the Minister to increase its premiums has been lengthened from 14 days to 60 days—allowing health insurers a longer time to make applications.
However, premium increases higher than CPI can be expected into the future as there remain a range of cost drivers pushing up the costs of health services; such as an ageing population, advances in expensive medical technologies and treatments, and the impact of the economic downturn, to name a few.
Competition and consumer choice between these funds have not been assisted by recent legislative changes to the reporting requirements of premium increases that have meant that that there is now less information publicly available on the premium increases of individual funds. 218; see also, A Elliot, Regulation of private health insurance premiums, Research Note no.
CPI annual percentage increase to June 2009 is the estimate from the Reserve Bank of Australia, February 2009 Statement on Monetary Policy. Private Health Insurance Administration Council, Operations of the Private Health Insurers Annual Report 2007–08, PHIAC, Canberra, 2008, p.
Department of Health and Ageing, Report on private health insurance premium increases 2002, Department of Health and Ageing, Canberra, 2002. Previous studies have shown that persons with private dental insurance have more dental visits in the previous year than persons without private dental insurance (1). Among persons with dental insurance, more than one-half had a single-service dental plan only, or in addition to dental coverage through their comprehensive health insurance plan. About 7 out of 10 persons who directly purchased their own private health insurance plan had no dental coverage compared with about 2 out of 10 persons with employment-based insurance. These plans are designed to cover general medical expenses such as blood work or visits to a doctora€™s office and health catastrophes such as heart attacks and cancer. The poverty level is based on definitions originally developed by the Social Security Administration. Private health insurance includes managed care such as health maintenance organizations (HMOs). Cohen are with the Centers for Disease Control and Preventiona€™s National Center for Health Statistics, Division of Health Interview Statistics. Multiple imputation of family income and personal earnings in the National Health Interview Survey: Methods and examples [PDF - 813 KB]. Dental insurance for persons under age 65 years with private health insurance: United States, 2008.


Other recent regulatory changes affecting the MLS and the private health insurance rebate may also influence insurers’ decisions to seek increases to the level of their premiums. The Government’s recent announcement that from 2010 it will make available consumer information on individual private health insurance premium increases should alleviate this situation. See Report on premium increases with date of effect in the quarter ending June 2007, viewed 6 April 2009.
Non-Hispanic white persons were more likely to have dental insurance through a single- service dental plan only than non-Hispanic black, non-Hispanic Asian, or Hispanic persons. About 40% of persons with less than a high school education had no dental insurance of any kind. Census Bureau for the Centers for Disease Control and Preventiona€™s National Center for Health Statistics (NCHS). Except in the case of public interest, the other former criteria for disallowing increases are no longer specified in the Act. An overview of the debate on private health insurance and pressure on public hospitals, Private Health Insurance Administration Council, Operations of the Private Health Insurers Annual Report [various years]. The Childrena€™s Health Insurance Program (CHIP) requires states to provide limited dental coverage for enrolled children up to age 19 (2). Poor persons (less than 100% of poverty level) were more likely than higher income persons (400% or more of poverty level) to have dental coverage through a comprehensive plan only.
Families or individuals with income below their appropriate thresholds are classified as below the poverty level.
NHIS collects information about the health and health care of the civilian, noninstitutionalized U.S.
Current population reports, P60-235, Income, poverty, and health insurance coverage in the United States, 2007 [PDF - 2.9 MB]. If the Minister does not allow an increase the reasons for this have to be publicly disclosed.[7] Effectively, this represents a significant shift away from the onus being on insurers to ensure that their proposed increases are compatible with specified criteria, to the onus being on the Minister to show cause for not approving an increase. An overview of the debate on private health insurance and pressure on public hospitals, Research Note no. The Medicaid program requires states to provide limited dental services for most Medicaid-eligible individuals under the age of 21, but there is no assistance to provide dental services to individuals aged 21 and over (3). All estimates shown in this report meet the NCHS standard of reliability (relative standard error less than or equal to 30%).
This report analyzes dental insurance status for persons under age 65 years who have private health insurance because of the limited or nonexistent public coverage for dental care.
Interviews are conducted in respondentsa€™ homes, but follow-ups to complete interviews may be conducted over the telephone. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level.
Questions about health insurance coverage are asked of family respondents in the family component of the survey. Terms such as a€?higher thana€? and a€?less thana€? indicate statistically significant differences. In 2008, information was collected on a total of 65,495 persons under age 65 years on the family core component. Terms such as a€?similara€? and a€?no differencea€? indicate that the statistics being compared were not significantly different. Therefore, family income was imputed for 31.4% of persons in 2008 using the National Health Interview Survey imputed income files (5).
Lack of comment regarding the difference between any two statistics does not necessarily suggest that the difference was tested and found to be not significant.



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