About the project that will be launched
The project is one mechanism of the financial risks equalization and distribution program (funding) in the health insurance for individuals who are suffering from high medical costs on the entire population groups.
The goals of the project
- Not burdening the parties of the insurance relationship with additional financial costs, especially small and medium-sized enterprises.
- Universal Health Coverage (UHC) of value and efficiency.
- Verifying the risks distribution in order to achieve cooperation.
- Twinning to implement the Risk Equalization trategy for out-of-cover portfolios (EBP).
The outcomes
- An analytical actuarial study of the numbers and costs of health cases that exceeded the maximum coverage according to the Unified Document.
- The criteria of qualifying the cases which will be covered by the fund.
- A work plan and an estimated budget for the necessary funding for five years.
- Qualification criteria for the fund's health claims management body.
- Executive Regulations and the Fund Manual of Policies and Procedures.
