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With the Solvency II deadline approaching, and full implementation expected from January 2016, affected entities are at varying states of readiness with embedding Solvency II into everyday practices becoming a major focus. Programme stakeholder communications needs to be robust to secure compliance and buy-in on both internal and external fronts. If your CEO fails to communicate to the markets your organization's ability to deliver on the EU Directive, or if a local Regulator finds that your Board has failed to embed a risk culture that is aligned with Solvency II, your ability to operate in the Solvency II world will be questioned. Solvency II: Stakeholder Communications and Change explains how to negate such risks. Gabrielle O'Donovan demonstrates how to approach stakeholder communications and change management in a structured and disciplined way, framed by the EU Directive's governance requirements. She demonstrates how to use a variety of tools and techniques to engage people with change and embed new ways of doing things. She reveals how to embed risk consciousness into your culture, helping you secure Solvency II approval and operate successfully in the Solvency II world. Based on the author's original research and the latest industry developments, Solvency II: Stakeholder Communications and Change is well-structured, readable and above all essential for all involved in Solvency II implementation.

This Article explores the potential value of insurance as a substitute for government regulation of safety. Successful regulation of behavior requires information in setting standards, licensing conduct, verifying outcomes, and assessing remedies. In various areas, the private insurance sector has technological advantages in collecting and administering the information relevant to setting standards and could outperform the government in creating incentives for optimal behavior. We explore several areas that are regulated more by private insurance than by government. In those areas, the role of the law diminishes to the administration of simple rules of absolute liability or no liability, and affected parties turn to insurers for both risk coverage and safety instructions. This Article examines the methods used in regulation-through-insurance, and then explores the potential regulatory role of insurance in additional, yet unutilized, areas: (I) consumer protection, (2) food safety, and (3) financial statements.

Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health insurance plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this article, we examine whether mandated insurance coverage for infertility treatment affects utilization. We allow utilization effects to differ by age and education, since previous research suggests that older, more-educated women should be more likely to be directly affected by the mandates than younger women and less-educated women, both because they are at higher risk of fertility problems and because they are more likely to have private health insurance, which is subject to the mandate. We find robust evidence that the mandates do have a significant effect on utilization for older, more-educated women that is larger than the effects found for other groups. These effects are largest for the use of ovulation-inducing drugs and artificial insemination.

During the 1990s, as the researchers working on the Human Genome Project were racing to map and sequence the human genome, many members of the public were concerned that predictive genetic information could be used to discriminate in employment and various forms of insurance, including life, health, disability, and long-term care.1 By the end of the decade, 48 states had enacted laws prohibiting genetic discrimination in health insurance2 and 35 states prohibited genetic discrimination in employment.3 In 2008, Congress enacted the Genetic Information Nondiscrimination Act (GINA),4 which outlawed discrimination based on genetic information in health insurance and employment. There has been little meaningful legislation enacted at the state or federal level to limit the use of genetic information in other types of insurance, including life insurance. Most state laws on genetics and life insurance merely require insurers to obtain informed consent before performing genetic tests5 or prohibit the use of genetic information in underwriting unless there is a sound actuarial justification.6There are several reasons why neither Congress nor state legislatures have enacted significant laws prohibiting genetic discrimination in life insurance. Generally speaking, there has been inadequate public demand for such legislation and entrenched industry opposition. This article argues that sound public policy demands an end to the use of genetic test results in underwriting by life insurance companies. The article addresses the main rationales invoked for resisting any change from the status quo and presents the public policy considerations supporting an end to the use of genetic test results.The article distinguishes genetic test results from predictive genetic information. Genetic test results refers to both diagnostic and predictive test results on a single gene test, multiplex gene panel, whole genome sequencing (WGS), whole exome sequencing (WES), or comparable genetic or genomic tests. Predictive genetic information refers to genetic information obtained from an individual's medical record or the health histories of family members supplied by the applicant. There have been no reports of any American life insurance companies requiring genetic testing as a condition of applying for life insurance coverage, but all life insurers may obtain and use genetic test results from the clinical records of applicants. Life insurers also may learn an applicant's genetic information or genetic risks from his or her health history in clinical records as well as from the family health history supplied by the applicant.

Health care expenditures can be financed through a mix of public resources and private spending. Private spending is a much larger share of total health spending in low- and middle-income countries than in higher income countries. Moreover, a significant percentage of private spending in those countries is out-of-pocket direct payments for health care services by individuals. Out of pocket expenditures account for more than 60 percent of the total health care spending in low-income countries and 40 percent of total health care spending in middle-income countries. A growing number of low- and middle-income governments are considering private health insurance as a way of both reducing the risk that individuals will have a catastrophic financial burden and achieving other public health care goals. Among these goals are reducing the financial burden on overstretched public health financing, achieving more equitable access to health care, and improving quality and efficiency in the delivery of health care services. An important component of a successful private health insurance market, however, is its legal framework. As discussed in detail later in this book, countries regulate insurance companies to counter systemic market failures that lead to an inefficient and inequitable market. In particular, insurance laws are designed to prevent insurers from becoming insolvent and from engaging in unfair practices and discriminatory behavior. When private health insurance serves as a significant source of financing in a nation's health care system, usually insurance laws also include a range of consumer protection laws that enhance both access to the services covered by private health insurers and the adequacy of the benefits provided by the insurer. This chapter provides a general overview of private health insurance. It begins with a discussion of the definition of private health insurance and the potential roles of private health insurance as part of a nation's health care financing system. In addition, the chapter reviews the variety of entities that sell private health insurance.

One of the great ironies about information privacy law is that the primary regulation of privacy in the United States has barely been studied in a scholarly way. Since the late 1990s, the Federal Trade Commission (FTC) has been enforcing companies' privacy policies through its authority to police unfair and deceptive trade practices. Despite over fifteen years of FTC enforcement, there is no meaningful body of judicial decisions to show for it. The cases have nearly all resulted in settlement agreements. Nevertheless, companies look to these agreements to guide their privacy practices. Thus, in practice, FTC privacy jurisprudence has become the broadest and most influential regulating force on information privacy in the United States—more so than nearly any privacy statute or any common law tort. In this Article, we contend that the FTC's privacy jurisprudence is functionally equivalent to a body of common law, and we examine it as such. We explore how and why the FTC, and not contract law, came to dominate the enforcement of privacy policies. A common view of the FTC's privacy jurisprudence is that it is thin, merely focusing on enforcing privacy promises. In contrast, a deeper look at the principles that emerge from FTC privacy \"common law\" demonstrates that the FTC's privacy jurisprudence is quite thick. The FTC has codified certain norms and best practices and has developed some baseline privacy protections. Standards have become so specific they resemble rules. We contend that the foundations exist to develop this \"common law\" into a robust privacy regulatory regime, one that focuses on consumer expectations of privacy, extends far beyond privacy policies, and involves a full suite of substantive rules that exist independently from a company's privacy representations.

Parity in coverage for mental health services has been a longstanding policy aim at the state and federal levels and is a regulatory feature of the Affordable Care Act. Despite the importance and legislative effort involved in these policies, evaluations of their effects on patients yield mixed results. I leverage the Employee Retirement Income Security Act and unique claims-level data that includes information on employers' self-insurance status to shed new light in this area after the implementation of two state parity laws in 2007 and federal parity a few years later. My empirics reveal evidence of strategic avoidance on behalf of insurers in both states prior to the passage of state parity, as well as positive increases in mental health care utilization after parity laws are implemented - but context matters. Policy heterogeneity across states and strategic behaviors by employers and commercial insurers substantively shape the benefits that ultimately flow to patients. Insights from this research have broad relevance to ongoing health policy debates, particularly as states retain great discretion over many health coverage decisions and as federal policy continues to evolve.

The Patient Protection and Affordable Care Act (ACA) of 2010 has been one of the most controversial laws in decades. The ACA relies extensively on the cooperation of states for its implementation, offering opportunities for both local adaptation and political roadblocks. Health insurance exchanges are one of the most important components of the for achieving its goal of near-universal coverage. Despite significant financial support from the federal government, many governors and legislatures have taken actions that have blocked or delayed significant progress in developing their exchanges. However, many state commissioners of insurance have played constructive roles in moving states forward in exchange planning through their expertise, leadership, and pragmatism, sometimes in spite of strong political opposition to the from governors and legislatures.

This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view. All the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into three main themes and 11 subthemes. The main themes include three kinds of requirements at three level of third party insurer, health care provider and citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.