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The growth rate and percent of GDP spend on health care has brought necessary attention to discussions on cost and quality within the health industry. This research posits that in order to tackle issues within these cost and quality-conscious discussions, consumers require increased literacy in the health insurance shopping and utilization processes. Health insurance literacy is relatively new terminology. In regard to consumer literacy measures in purchasing, the findings in Chapter 1 demonstrate that studies on health insurance literacy are inconsistent, with no consensus on which metrics are most appropriate to measure health insurance literacy. While there is a generally agreed upon definition of health insurance literacy, there is currently no standard scale to determine one’s literacy level. Additionally, literacy, in a broader construct, can assist consumers in making better informed choices about how to engage with and manage their health insurance. One particular example of a poor utilization habit is the use of the Emergency Room (ER) for non-emergent conditions. The findings in Chapter 2 demonstrate that educated consumers can be influenced to choose alternative sites for ER care. This research suggests that taking measures to advance health insurance literacy can improve both shopping and utilization behavior and, in turn, positively impact health care costs and efficiencies. The conclusion of this research theorizes on the best approach to influence literacy in health insurance; ultimately furthering the body of research that moves toward a more efficient, effective, and literate health insurance industry. / Business Administration/Interdisciplinary

The first part of the dissertation investigates cost experience in the US life and health insurance industry over the period 1998-2012. We generally test the difference in expenses among different distribution systems, which mainly consists of independent agency, broker, career agency, exclusive agency, and direct writing. We check to see if cost, revenue and profit efficiency differences are associated with different distribution methods. Cost, revenue, and profit efficiencies are estimated by Data Envelopment Analysis. Unlike the results in the property and liability insurance industry, the cost difference is insignificant among distribution systems. Results on cost efficiency and revenue efficiency support the market imperfection hypothesis, which says that the market imperfections such as entry barriers, price regulation, or search costs cause the coexistence of different distribution systems. The second part of the dissertation examines the relationship between mergers and acquisitions (M&As), and underwriting cycles in the P-L insurance industry. In a soft market, capital is relatively high. This leads to an increase in the number of M&A transactions and the probability that managers conduct non-value-increasing M&As. We test this proposition by analyzing the associations between volumes of M&A deals, and returns associated with M&As and underwriting cycle. The results show that the numbers of M&As are negatively related with the premium rate changes and positively related with changes in the combined ratio. We also find that the cumulative abnormal returns around the announcement date of M&As are smaller for the shareholders of insurer acquirers in a soft market. Even more, we find that the market reaction of M&As is less sensitive to agency problems in a hard market than in a soft market. / Business Administration/Risk Management and Insurance

This thesis is missing page 168. The other copies do not have this page. -Digitization Centre / The Canadian Health Insurance program has been in place for quite some time now and it has always been said that Canadians have some of the best healthcare in the world. Canadian healthcare is very well known throughout the world because every Canadian citizen has the right to healthcare without having to pay for it. The benefits of this program are quite well known but some benefits one might think would result, just might not be there. This paper looks at whether the inception of Canadian Health Insurance has had an effect on the mortality rates of Canadians. Through a statistical analysis, this paper shows that there is no evidence that the Canadian Health Insurance program has had an effect on Canadian aggregate mortality rates. This paper shows that Canadian mortality rates follow a trend to that of the United States. To say Canadians have a similar trend in mortality rate to the United States is perhaps surprising since Canadians are supposed to have a far superior healthcare system. / Thesis / Master of Science (MS)

This study was undertaken to determine whether the curricula of the colleges and universities are meeting the needs of the growing insurance industry. This study will determine, first, whether the insurance curricula of the accredited four-year colleges and universities in the state of Texas fulfill the needs of the insurance industry as reported by 100 selected insurance companies operating in the state of Texas. Second, this study will compare the insurance program at North Texas State College with the programs of other accredited colleges and universities in Texas. Third, from the foregoing analysis this study will attempt to determine whether the insurance program at North Texas State College could be improved. As a final consideration, this study will determine whether the insurance companies desire colleges and universities to offer special short courses for their insurance personnel.

Thesis (MBA (Business Management))--Stellenbosch University, 2008. / Financial services and in particular the insurance industry, has been exposed to large-scale pressures and challenges from various fronts. For the past few decades, the life insurance industry has been self-regulated through the Life Offices Association (LOA). The LOA, representing life insurers, however never succeeded in keeping the industry abreast of market, and the needs of the role players' (authors' opinion based on interaction with in the industry and supported by the implementation of consumer-driven legislation). The LOA together with a range of other financial services industry bodies have since been disbanded (2008) and will in future form part of the greater industry body ASISA (Association for savings & investment South Africa) Over the past 10 years the slow transformation caught up with the insurance industry. Life insurers wanting to satisfy their shareholders focussed on the generation of new business, often to the detriment of the consumer. Consumer understanding of what they bought increased at a faster rate than the knowledge of many of the brokers selling these products, partly due to the information era and the free availability of information. Lack of transparency, misrepresentations and bad advice from insurers and brokers have been exposed at an increasing rate since the late 1990s. The South African government decided to correct the wrongs of the past by taking control of the situation, copying the UK model on Financial Services. Government instituted the Financial Services Board and implemented a number of regulations to ensure compliance to set criteria. If compared to the regulatory model and processes applied in the UK (FSA), the insurance industry can expect more regulatory pressures in the immediate future. The increased regulation will increase the cost of doing business for all role-players. A reduction in broker numbers can also be expected. Insurers will have to find new ways of increasing production with a reduced distribution capacity. Insurers need to produce sufficient returns on investment for their shareholders to ensure continued capital. By being creative and partnering existing distribution structures, such as distribution networks, bank brokerages, etc., insurers will be able to lock-in distribution capacity without incurring excessive costs. It is undeniable that insurers will have to revisit their distribution strategies if they are to survive the next few years. At the current cost of distribution, insurers will not survive the changing environment. Distribution through existing internal distribution structures will continue to be under severe cost pressures in servicing brokers with low to average production levels. If the international trends are to filter through into the South African insurance industry, larger number of brokers will join networks merely to limit the impact the changing environment has on their practices. Such a move works in favour of all role players: • Insurers are able to reduce/restructure their costs and lock-in distribution capacity through singular points of entry. • Brokers are less fragmented and so improve their ability of being heard, through a greater unified voice. • Regulators can drive change and compliance through singular points of access to multiple brokers. • The industry is able to retain the knowledge and expertise to deliver their products and improve its overall public image. • Government are assured of a larger part of the population having access to financial services and in particular life insurance. • Clients would experience improved and standardised service levels from the brokers. Insurers unable to lock-in distribution capacity will find it extremely difficult to survive the changing climate. Insurers have been locking-in distribution capacity by means of: • agency forces that write products of the specific insurer • bank-assurance agreements where insurers and banks have cross shareholding • franchise agreements where the sales people are in fact agents of the franchisee • call centres either owned by the insurer or having dedicated seats selling products of the insurer • loyalty programmes aimed at gaining a larger portion of the brokers production • recently the formation of distribution networks provide insurers on the network platform access to affiliated brokers. The formation of networks and distribution networks counteracts the constrictions these structures place on broker independence by providing increased operational freedom to their affiliated brokers. The choice of partnering a distribution network needs to be supported by the following: • The choice of partner • A cost-benefit analysis • The timing of entering the partnership • The resources and supporting structures • The communication of the change • The preparation for the change • An approach in support of the partnership Partnering with a network is a strategic initiative as it involves outsourcing what was previously thought to be a core function of the insurer. This change in approach impacts many of the current structures and various people at all levels of the operation. How to approach partnering and implementing a model to support outsourcing to external distribution networks is dealt with in this study. The success of partnering with external distributors is reliant upon eight identified critical factors. These relate to: • fit, management, formalities and relationships of the partnership • systems, processes and support structures in support of the partnership • management of risk, control and growth within the partnership. The changing business environment will continue to increase the attractiveness of distribution networks to brokers. A shift in distribution capacity demographics towards distribution networks can thus be expected. In order to maximise their distribution capacity life insurers will need to embrace the change and adapt their approach towards the partnership. Without understanding, managing and finding solutions to each of the critical success factors (CSFs) an insurer will find it extremely difficult competing and increasing market share within the distribution network. The findings indicate a realistic probability that insurers are able to adapt to the changing environment. This however requires a change in style of management from one of control towards one of influence. Effectively, each partner should be treated as partners.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / abstract / Statistics and Actuarial Science / Master / Master of Philosophy