community rating

English - Turkish

Definition of community rating in English Turkish dictionary

Related Terms

adjusted community rating

düzeltilmiş topluluk rating

English - English

Definition of community rating in English English dictionary

A system of billing for insurance costs on the basis of average claims experience for the general population as opposed to the claims experience of the particular employer For example most HMOs use a community-rated billing system based on the entire client population of the HMO See also experience rating

Using the same premium rates for a specific group without considering loss experience

Method of establishing health insurance premiums on a communitywide rather than group-specific basis The premium is based on a blend of the average cost of actual and anticipated health services use by all enrollees in a geographic area or industry and does not consider variables such as claims experience, age, sex, or health status of the covered population Community rating spreads the cost of illness more evenly over the whole community Federally qualified HMOs must community rate

Under this rating system, the charge for insurance to all insureds depends on the medical and hospital costs in the community or area to be covered Individual characteristics of the insureds are not considered at all (H)

A method of determining premiums for health insurance which ensures that all subscribers or a particular class of subscribers pay the same rate for the same level of benefits and that anticipated costs are spread evenly among all contracts; setting health insurance premiums based on the average cost of providing medical services to all people in a geographic area, without adjusting for each individual's medical history or likelihood of using such services

[Health] a method of rating that produces identical rates for all members of an identified pool or class, based on the expected costs for these members as a group; the principle of equal rates for all members of the community may vary only by certain broad classifications within the community, such as family status (single versus family coverage), and occasionally by wide geographic areas [similar to ASOP No 18]

A rating method that determines a single average premium based on the characteristics and claims experience of an entire membership such as an HMO or an insurance pool Age, lifestyle, industry, health factors and gender are not used to determine rates (See Adverse Selection )

Insuring everyone in a specific region for about the same price Premiums are based on the potential health risks or claims experience of the entire population in the area

A method for determining health insurance premiums based on actual or anticipated costs in a specific geographic location as opposed to an experience rating that looks at individual characteristics of the insureds

Calculating the price of health insurance premiums according to the characteristics or utilization of the entire community, not just the insured population Today, insurers frequently charge higher rates for less healthy individuals With community rating, everyone who lives in the same area pays an equal amount for health insurance

the practice of using the same rate structure for all subscribers to a medical expense plan, regardless of their past or potential loss experience and regardless of whether coverage is written on an individual or a group basis

Setting insurance rates based on the average cost of providing health services to all people in a geographic area, without adjusting for each individual's medical history or likelihood of using medical services

Determining HMO capitation rates without respect to characteristics or utilization of the subject population HMOs can vary premium offerings according to benefit packages, but not by health status Thus, an employed group with characteristics likely to lead to high utilization cannot be charged a higher rate than a group without such characteristics

Setting insurance rates based on the average cost of providing health services to all people in a geographic area without adjusting for each individual's medical history or likelihood of using medical services

– Setting insurance rates based on the average cost of providing health care services to all people in a geographic area, without adjusting for each individual’s medical history or likelihood of using medical services

In medical insurance plans, the evaluation method used to determine premiums charged by service-plan insurers by averaging the charge for the insurance among all insureds according to hospital and medical costs in the community, without differentiation among insureds in terms of the individual risk assumed by the insurer The communitywide rate is a flat sum, varying only with the amount of benefits, regardless of age, sex, occupation or condition of health (See also: Blue Cross )

Community rating is a method of HMO rate calculation where the rate charged to a group or to an individual for HMO coverage is based on the profit or loss experience of the HMO’s entire population

a situation in which all members of an insurance pool are charged the same premium, regardless of their risk status

The rating methodology required of federally qualified HMOs and of HMOs under the laws of many states, and occasionally indemnity plans under certain circumstances The HMO must obtain the same amount of money per member for all members in the plan, Community rating does allow for variability by allowing the HMO to factor in differences for age, sex, mix (average contract size), and industry factors; not all factors are necessarily allowed under state laws, however (also see Experience rating)

A rating method that sets premiums for financing medical care according to the health plan's expected costs of providing medical benefits to the community as a whole rather than to any sub-group within the community Both low-risk and high-risk classes are factored into community rating, which spreads the expected medical care costs across the entire community

A rating system for establishing capitated rates based upon the average costs of providing health services to all individuals within a geographic region Community rating is fairly basic, in that it does not adjust for each individual's medical history or the likelihood an individual will use medical services

A method of calculating health plan premiums using the average cost of actual or anticipated health services for all subscribers within a specific geographic area The premium does not vary for different groups or subgroups of subscribers to reflect their specific claims experience or health status Under modified community rating (the most common form), rates may vary based on subscribers' specific demographic characteristics (such as age and gender), but rate variation based on individuals' health status, claims experience, or policy duration is prohibited "Pure" community rating prohibits rate variation based on demographic as well as health factors, and all subscribers in an area pay the same rate

A method for setting health insurance rates in which everyone in a specific area is charged the same premium rather than having it adjusted individually according to a person's health history The rate is usually based on the average cost of delivering health care to people living in that area

Hyphenation

com·mu·ni·ty rat·ing

Turkish pronunciation

kımyunıti reytîng

Pronunciation

/kəˈmyo͞onətē ˈrātəɴɢ/ /kəˈmjuːnətiː ˈreɪtɪŋ/