Risk Pooling & Plan Funding
How are health plans funded and managed to cover the cost of care and mitigate risk?
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Risk Pool
Policy Definition: A health insurance risk pool is a method to group individuals whose medical costs are combined to calculate premiums. Pooling risk allows the higher costs of the less healthy to be offset by the relatively lower costs of the healthy. In general, the larger the risk pool, the more predictable and stable the premiums can be. source
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Plan Funding
Policy Definition: Plan funding is the method used to finance and administer a health benefit plan. There are multiple ways a plan can be funded in order to provide health care and control overall costs. source
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