Further, pricing ought to be based on sound actuarial principles, supporting data considering all the relevant aspects of pricing such as morbidity experience by gender, by age group, by occupation, by group size etc, expenses, terminations, overall revenue apart from any other important criteria.
“Insurers must justify the rates and terms wanted to any group to the authority, if called after to take action,” the draft said.
On servicing norms for the insurers and master policyholders, the draft suggested that all group health insurance policies having named beneficiaries should have ID cards issued to permit them obtain cashless services, wherever applicable.
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