Premium Levels Research Articles

Socioeconomic disparity in utilization of transcatheter aortic valve replacement

Abstract Introduction Transcatheter aortic valve replacement (TAVR) is a major therapeutic option, rapidly replacing surgical aortic valve replacement (SAVR) in patients with aortic stenosis (AS) in recent years. However, the use of TAVR may vary with the socioeconomic status (SES) since new technologies are more likely to have the lower accessibility in some medico-social environments. In South Korean patients with AS, we investigated the difference in the use of TAVR based on SES and whether the difference influences clinical outcomes of patients with AS. Methods Between 2010 and 2020, 30,142 patients newly diagnosed with AS in a tertiary or regional center were investigated through the Korean National Health Insurance System (KNHIS). Patients were received either medical, SAVR or TAVR therapy for AS. The patients were categorized into 3 groups based on the insurance premium level (IPL) of the KNHIS (IPL1, <100 KW; IPL2, 100-249 KW; IPL3, ≥250KW). AS-related death was defined as death by AS, heart failure or ventricular arrhythmia. Cardiovascular (CV) death was defined as AS-related death or death by myocardial infarction or stroke. The study period was divided at year 2015, when the partial coverage for TAVR was implemented by the KNHIS. Results The numbers of patients referred to the tertiary/regional centers have continuously grown for the 11 years but the referring rate has grown even faster since 2015. The proportions of TAVR has increased while that of SAVR has decreased since 2015. TAVR was more frequently chosen by patients with a higher IPL (5.5%, 8.0% and 12.5%, respectively in the IPL1, IPL2 and IPL3, p<0.001), whereas the medical therapy appeared not affected by the IP levels. The patients in the IPL2 (odd ratio [OR] 1.33 [1.20-1.47]) and IPL3 (OR 1.65 [1.45-1.86]) had a higher chance to undergo TAVR than those in the IPL1 whereas the patients in the IPL3 was a lower chance to undergo SAVR than those in the IPL1 (OR 0.86 [0.78-0.94]). In patients with severe AS, the disparities between the IPL1 and IPL3 exaggerated (OR 1.99 [1.70-2.33]) (Figure 1). Higher IPLs were associated with lower risks of CV death and AS-related death. Time-varying Cox proportional hazard models showed that TAVR was associated with a lower risk of CV death than both medical therapy and SAVR in the entire study period and in year 2015 or later, whereas TAVR was associated with a lower risk of AS-related death than the both only in year 2015 or later, after adjustment of relevant covariates including the IPL (Figure 2). The choice of TAVR significantly medicated the associations between IPLs and the risk of CV death (responsible for 3.0% in the IPL2 and 4.1% in the IPL3). Conclusion The SES based on the IPL is independently associated with the choice of TAVR in patients with AS and the association has become stronger since 2015. The disparity in use of TAVR could mediate more frequent CV deaths in patients with the lower IPL.Figure 1Figure 2

An experimental study on premium measurement in response to residents' willingness to pay for green housing in urban areas

As the market continues to progress, the provision of green housing will inevitably increase, leading to a rising significance of residents' willingness to pay in determining the premium pricing and market promotion of these residences. This research measures residents' willingness to pay response experimentally, examining the driving mechanisms behind willingness to pay for green housing and the associated premium levels. Experiments revealed the following findings: (1) Intervention experiments on key driver factor (the mediating variable operational trust) of the theoretical model showed that willingness to pay among experimental group residents (green housing neighborhoods) increased from 269 to 291 CNY/m² (an 8 % increase), while the control group residents (residential building neighborhoods) experienced an increase from 170 to 236 CNY/m² (a 39 % increase). (2) Thirty scenario experiments on key driving factors (the mediating variable informational appeal) in the theoretical model demonstrated that, with information intervention, residents' willingness to pay increased by 27.5 %, which is less than the result derived from direct inquiry (29.4 %). Policy recommendations are based on the conclusions of the study.

Accelerated Pension Fund Calculations Using the Individual Level Premium Method and the Projected Unit Credit Method Case Study: PT. Dirgantara Indonesia

Accelerated Pension Fund Calculations Using the Individual Level Premium Method and the Projected Unit Credit Method Case Study: PT. Dirgantara Indonesia

Pension Fund Calculations for Regular Retirees Using the Projected Unit Credit Method and the Individual Level Premium Method in the Case Study PT Dynacast Indonesia.

Pension Fund Calculations for Regular Retirees Using the Projected Unit Credit Method and the Individual Level Premium Method in the Case Study PT Dynacast Indonesia.

Willingness to Pay for Cattle Insurance in Nepal: A Double-Hurdle Model Perspective

Since the adoption of the Crop and Livestock Insurance Directives in 2013, the adoption of livestock insurance has gained popularity in Nepal. In the eight years since implementation, adoption rates have remained low, even with 80% government premium subsidies. This study uses a double-hurdle model for quantitative analysis and focuses on the determinants of willingness to pay (WTP) for cattle insurance. The research identifies significant factors influencing insurance adoption decision, including positive impacts from farmer’s age, education, livestock loss history, awareness of insurance, dairy farm income, number of cattle, and loan access. However, male gender, extensive cattle rearing experience, and larger households negatively affect willingness to insure. A number of factors affect premium determination, including age, size of household, livestock loss, off-farm income, number of cattle, and loan accessibility; on the other hand, factors that have a negative impact on premium levels include breed type, marital status, and revenue from dairy farms. According to the findings, the annual WTP for cattle insurance among dairy farmers varies from $48 to $71 (NRs. 6315-9341), with an average of $58 (NRs. 7631). Interestingly, the majority of farmers demonstrate their commitment to risk management by accepting premiums equal to 5% of the value of the cattle. The research contributes to understanding livestock insurance premiums in developing countries, specifically in Nepal, and suggests a scope for extending insurance programs, while also noting a gap in awareness among dairy farmers regarding government subsidy programs.

Calculation of Pension Funds for TNI Group IIIA Using the Individual Level Premium Method

Prosperity in retirement is one of the important aspects to achieve in the career path of every individual, including the Indonesian National Army (TNI) which relies on pension funds as a source of post-retirement income. Pension funds manage programs that promise financial benefits to participants after they retire. In this context, the study aims to present the calculation of pension funds for TNI class IIIA using the Individual Level Premium method. This method allocates the total pension benefit equally each year. As a result, it is found that the Individual Level Premium method provides a greater pension benefit value than the benefit value using the proportion of salary from ASABRI. This shows that this method is effective in calculating retirement benefits.

Willingness to pay for a multi-level animal husbandry label: an analysis of German meat consumers

PurposeThe use of multi-level labels can enhance product visibility by enabling labeling of various items. Moreover, it can better accommodate the diversity on both the producer and consumer sides. However, studies on the willingness to pay (WTP) for premium levels of those animal welfare labels are scarce.Design/methodology/approachWe investigate consumers’ WTP for a four-level animal husbandry label introduced to the market by German retailers in 2019 by conducting an online survey with 1,223 German meat consumers using Van Westendorp’s price sensitivity meter (PSM).FindingsThere is a significant increase in WTP for level 3 of the husbandry label, but only a slight increase for level 4. One explanation is that consumers may have the mistaken belief that level 3 already includes outdoor access for animals. As a result of this expectation, consumers may not perceive much added value in level 4, which is reflected in their reluctance to pay a higher price. This is reinforced by the finding that once informed of the criteria, 18% of the participants reduced their WTP for level 3, whereas only 6% considered a discount for level 4. Furthermore, 40% were prepared to pay more for level 4 after being informed of the respective criteria than they had previously stated.Originality/valueTo the best of our knowledge, this study is the first to analyze and emphasize the importance of clear label communication, particularly for multi-level animal husbandry labels.

Epidemic modelling and actuarial applications for pandemic insurance: a case study of Victoria, Australia

Abstract With the recent outbreak of COVID-19, evaluating the epidemic risk appears to be a pressing issue of global concern and one of the major challenges recently. In the fight against pandemics, the ability to understand, model, and forecast the transmission dynamics of infectious diseases plays a crucial role. This paper provides an overview of foundational compartment models and introduces the Susceptible-Exposed-Infected-Containing-3-Substates-Recovered-Dead model to study the dynamics of COVID-19. A meticulous data calibration procedure is employed to study the evolution trend of an actual pandemic using real-world data from Victoria, Australia. Additionally, the paper discusses innovative applications of epidemic models to the insurance industry, which are currently under investigation. Through the use of the newly developed analytically tractable model, insurance companies are able to determine fair premium levels during an outbreak. Moreover, the paper provides practical guidance for insurance companies by examining the variation in reserve levels over time.

Transmission Mechanism and Extreme Time-Varying Spillover Effects between China and International Gas Markets

This study uses the quantile connectedness model to study the transmission mechanism between China and the international natural gas market from August 2017 to February 2024. The time-varying spillover effects under extreme market conditions. The empirical results emphasize the following key points: (a) China mainly acts as an information receiver in the overall market. (b) The spillover effect of the European natural gas market is significantly stronger during the extreme downturn, indicating that the spillover effect is asymmetric. (c) The natural gas futures market plays a central role in market dynamics that affect upward return shocks. (d) System connectivity is highly sensitive to market conditions and increases significantly under extreme market conditions. According to the research results, we should make more efforts to promote the liberalization and marketization of the domestic natural gas market, and strive to improve the bargaining power in the international market to reduce the import premium level. Improve energy efficiency and reduce China ’s dependence on natural gas imports; from the perspective of the global natural gas market, risk contagion between markets should be alleviated under different market conditions and a differentiated risk early warning mechanism should be established.

Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea.

This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients' first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

Traffic light nutrition labeling preferences among children

ObjectiveThis study evaluates the effects of traffic light (TL) nutritional label attributes on children’s food choices. Data were collected from a survey of 1179 Ecuadorian students attending public middle and high school in three major cities in the country’s southern region (Machala, Loja, and Zamora). The survey instrument included two sets of choice experiments: one with yogurt products and the other with soft drinks (sodas and juices). In the choice scenarios, children were presented with two products that differed in price and the TL label colors for sugar, salt, and fat. Children’s product selections in the choice experiments were analyzed using mixed logit models. The results indicate that labels affect food choices. Additionally, children are willing to pay increasing premium levels for products with yellow, green, and “does not contain” labels compared to products with red labels. Overall, the study’s findings offer evidence that TL labels are effective in helping children make food choices consistent with their preferences for food products with TL labels representing healthier alternatives.

Hidden Tax Analysis of Premium Level for Sanitary Napkins and Adult Diapers

As the social attention on womens dilemma, some unfair regulations have raised a heated discussion, and the pink tax which is a hidden tax levied on homogeneous products consumed by women, and most of those products have the same quality and raw material, but higher prices when it is marketed as female-targeted goods. In this paper, unlike the previous researches focusing on pink tax in united industry, it shows the price disparities also exist on conventional women commodity, and mainly investigate the similarity and difference of sanitary napkins and adult diapers. By analyzing the costs of raw material, comprehensive applications and market prices of both kinds of products, calculating and comparing the net profit margins of the two industries, the results confirm the existence of price disparity on these two goods under similar costs, but because of the lack of database and specific cases, further researches are necessary for verification. This work may widen peoples horizon on pink tax, which is not limited on the comparison of opposite genders products, but the price bias on feminine goods, and it can promote Economics gender equality.

The Effect of Farmers' Exchange Rates on Rice Prices in 2017-2019

This research aims to predict the price of rice in the mill according to quality (Rupiah/Kg) at a premium, medium and low levels in Indonesia. Then also to find out whether there is an effect of farmer exchange rates on the price of rice in mills at a premium level. The study used purposive sampling, namely samples in Indonesia. Data analysis using simple linear regression. The results showed that there was an effect of the farmer's exchange rate on the price of rice in the mill at the premium level of 69.16%, the farmer's exchange rate affected the price of the rice in the mill according to the quality (Rupiah/Kg) at the premium level. The recommendation that can be given is that the government can take steps to maintain the stability of farmers' currency exchange rates, especially in the face of global economic fluctuations. Appropriate fiscal and monetary policies can help reduce the risk of exchange rate volatility and have an impact on rice price stability at the mill. A robust monitoring system is needed to monitor exchange rate fluctuations and rice prices on a regular basis.

Research of the influence of automobile purchase restriction policy on the pricing of motor vehicles in judicial appraisal enterprises

PurposeThe purpose of this paper is to take second-hand vehicles at judicial auctions in China as the primary research direction and to explore the impact of purchasing restriction policy and city size on the relationship between the appraisal price and transaction price of second-hand motor vehicles in the context of auto purchase restriction in China from a microscopic angle. It attempts to broaden the pricing ideas of judicial appraisal enterprises in providing appraisal prices of second-hand motor vehicles and to put forward suggestions for the optimization of appraisal prices and appraisal standards of judicial appraisal enterprises.Design/methodology/approachWith the help of Python, this paper crawls 59,038 lines of valid data from three leading internet judicial auction platforms, namely “Ali Auction,” “China Beijing Equity Exchange” and “Gong Pai Wang,” as research samples. Besides, this paper forms a database containing judicial auction used car appraisal prices, transaction prices, motor vehicle purchase restrictions and whether the motor vehicle carries a license plate. By constructing a multiple regression model, the impact of automobile purchase restriction policy on the price of motor vehicles appraised by judicial appraisal enterprises is investigated.FindingsWith the help of the multivariate regression model, it found that under the same condition, the city where the auction took place implemented the automobile purchase restriction before the end of the auction. The court has specified that the buyer could directly obtain the license plate after the auction. The transaction price and the evaluation price ratio will be statistically larger, which proves that the license plate has an evident value in the transaction and is traded as subject matter by the residents, and consequently brings a higher premium to the price of automobile transaction in internet judicial auction. Meanwhile, the purchase restriction policy in the first-tier cities has resulted in a significant premium on automobile license plates, which is much higher than the automobile license plate premium level in non-first-tier cities under the same conditions.Social implicationsCar ownership continues to rise with rapid economic development worldwide. Control the growth of car ownership, some countries and regions mainly restrict the issuance of motor vehicle license plates, which indirectly leads to vehicle license plate indicators becoming a scarce resource. National laws permit judicial auction as a means for the people's courts to settle creditors' claims in enforcement procedures of civil cases. In the judicial auction process, the People's Court introduces third-party evaluation enterprises to appraise, assess and audit the subject and obtain the appraisal price, which guides the bidding behavior of used car buyers and indirectly affects the transaction price of used cars.Originality/valueAs the only subject capable of assessing the value of used cars at judicial auctions, judicial appraisal enterprises have received widespread attention for their appraisal results. This paper researches this field by screening the factors affecting the ratio of motor vehicle transaction price to the appraised price. It also analyzes how the ratio of motor vehicle transaction price to appraised price is affected by motor vehicle purchase restrictions and the situation with license plates. This paper examines the existence of premiums for motor vehicle transactions with license plates, evaluates the purchase restrictions in cities with motor vehicle purchase restrictions and verifies that the premiums for motor vehicles at judicial auctions are affected by purchase restriction policies as well as the influence of city class. These studies have important implications for judicial appraisal enterprises to establish reasonable appraisal mechanisms and optimize appraisal prices. They also provide new ideas and methods for appraisal enterprises to assess the value of used vehicles at judicial auctions.

Resource allocation based on differentiated user services for indoor hybrid multi-color VLC/WiFi networks

Multi-color visible light communication (VLC) and wireless fidelity (WiFi) networks provide a promising solution for the indoor wireless communication, while the hybrid networks face the challenge of imbalanced access point (AP) load and resource allocation. A resource allocation method based on user service differentiation (RAMUSD) is proposed for multi-color VLC/WiFi hybrid networks. In our design, the user’s premium level is defined according to the user’s channel conditions and requested data rate. The heterogeneous network selects the service AP for the users according to its premium level, user with high premium level is served by one of VLC access points (APs), while user with low premium level is served by WiFi AP. Then, the average satisfaction is used as the load index to adjust the number of users served by the WiFi AP or the VLC AP to achieve load balance among APs. Furthermore, the RAMUSD uses the potential game theory to optimize user’s migration and resource allocation among APs for improving the load balancing index. In the potential game, user can improve its return value by changing access AP. So, it makes user who pursue more resources give up the congested APs. Simulation results show that the proposed RAMUSD can achieve better system throughput and user satisfaction than an enhanced proportional fairness algorithm based on evolutionary game theory (EPF-EGT).

Association of Medicare Advantage Premiums With Measures of Quality and Patient Experience

Quality of care varies substantially across Medicare Advantage plans. The price information that Medicare Advantage enrollees are most likely to consider when selecting a Medicare Advantage plan is the monthly premium. Enrollees may select plans to minimize premium or, alternatively, use premium as a proxy for quality and select plans with higher premiums; however, quality implications of these choices are unknown. To determine the extent to which the quality of care offered by Medicare Advantage plans varies within vs across premium levels. This was a retrospective cross-sectional study of the population enrolled in Medicare Advantage plans in 2016 to 2017 using clinical quality measures from the Healthcare Effectiveness Data and Information Set (HEDIS), patient experience measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, and administrative data. Data were analyzed from March 2021 to March 2022. Medicare Advantage monthly premium. Ten publicly reported 2017 HEDIS measures and 5 publicly reported 2017 CAHPS measures linearly transformed to a 0 to 100 scale. The 168 968 Medicare Advantage CAHPS respondents were representative of the enrollee population (14% were <65 years old and eligible through disability; 24% ≥80 years old; sex and race/ethnicity data were not considered); 40% were in 591 plans with no monthly premiums and less than 6% were in 144 plans with monthly premiums of $120 or more. There were from 77 054 to 2 139 422 enrollees by HEDIS measure. Among all Medicare Advantage enrollees, 79% were in plans with either a $0 premium or a low monthly premium (≤$60); patient experience and clinical quality were generally similar in these 2 categories of plans. To a small extent, enrollees in moderately high ($60-$120) and high (≥$120) premium plans reported better patient experience (+1.4 [95% CI, 0.7-2.1] and 2.2 [95% CI, 1.5-2.9] points) and received better clinical care (1.4 [95% CI, 0.3-2.5] to 3.3 [5% CI, 2.1-4.5] percentage points on most measures than those with $0 and low-premium plans. Quality differences within each premium level category were substantial; the within-premium category plan-level SDs were 6.5 points and 7.2 percentage points for patient experience and clinical quality, respectively. A plan at the 50th percentile of clinical quality and patient experience in the high premium category would fall in the 65th and 62nd percentile within the $0-premium category, respectively. This population-based cross-sectional study found that although quality of care and patient experience were slightly higher with higher-premium plans, quality varied widely within each premium category. High-quality care and patient experience were found in each price category. Thus, paying higher premiums is not necessary for higher quality care in Medicare Advantage plans. Greater engagement of enrollees and advocates with quality of care and patient experience information for Medicare Advantage plan selection is recommended.

China's Green Finance Premium Anomalies Based on Factor Models

Abstract The positive externalities of green producers usually reduce the company's earnings. Whether the markets give sufficient premium is important. Sampling the data of listed companies from May 2005 to April 2017 in Shanghai and Shenzhen A-share main-board markets, we construct 12 portfolios based on market factor RMRF, scale factor SMB, book-to-market factor HML and green factor GF. Results show: 1) SMB premium is significant positive, while HML is negative; 2) For green concept stocks, HML has a significant positive impact; 3) Portfolio with non-green concept stocks has a higher return; 4) GF has a significant negative risk premium on China’s green concept stocks, and the premium level will decrease as the book-to-market ratio increases. The interpretation of the above premium anomalies improves national environmental protection policies which is of great significance for the formation of a sound environmental protection industry. Keywords: Factor Model; Green Finance; Premium Anomalies; Excess Return; Environmental Protection.

Vertical Housing Price Gradient and Ground Floor Premium in Taipei City

This study aims to examine the influence of the floor level on housing prices based on the vertical dimensions of the building. A two stage least squares regression (2SLS) and two stage quantile regression (2SQR) are utilized to analyze the urban regions in Taipei City by using data obtained from the online actual price registry of real estate transactions from August 2012 to April 2020. After considering the spatial autocorrelation, the following conclusions are reached. First, in addition to the ground floor, the floor level premium is 0.55% for residential buildings with an elevator, and the premium increases when the housing price quantile increases. However, for walk-up apartments, there is a floor level discount of -4.21%, and the price discount increases when the quantile for the housing price increases. Secondly, when compared to the other floors, the ground floor premium is 9.61% for residential buildings with an elevator, which is a little higher than walk-up apartments for which the ground floor premium is 8.54%. The results reveal that the influence of the type of residential building and the total number of floors on the ground floor premium is not as high as expected. Finally, regardless of whether the residential buildings have an elevator or are walk-up apartments, the ground floor premium increases when the housing price quantile increases. The ground floor premiums for residential buildings with an elevator range from 7.30% to 11.85%. They are a little higher than those for walk-up apartments which range from 6.25% to 9.69%.

Implementasi Metode Perhitungan Aktuaria Program Dana Pensiun Menggunakan Flask

The pension fund program is a program that seeks future planning by providing pension benefits to participants. The vital thing that becomes a concern in the pension fund program is the actuarial cost method. There are two categories for actuarial cost methods, which are Accrued Benefit-Cost Method and Projected Benefit-Cost Method. The normal contribution characteristic of the Projected Benefit-Cost Method is more stable than the Accrued Benefit-Cost Method, so it is better to use it from the participants’ perspective. This study discusses the use of the Projected Benefit-Cost Method by calculating normal contributions and actuarial liabilities from the methods included in it, which are Attained Age Normal, Entry Age Normal, and Individual Level Premium. Based on the calculation results, the Entry Age Normal and Individual Level Premium methods have a smaller final value of normal contribution payments and have a larger actuarial liability than the Attained Age Normal. Thus, of the three methods included in the Projected Benefit-Cost Method, the Entry Age Normal and Individual Level Premium methods are better used from the perspective of participants. For the calculation of pension funding using the Attained Age Normal, Entry Age Normal, and Individual Level Premium methods to be widely implemented by the public, this study created an application website using flask, which can be accessed at https://perhitunganaktuariadapen.herokuapp.com/.

Estimation of Life Insurance Asset Value From Household Survey

The omission of the asset value of life insurance policies in computing household assets would underestimate household wealth and therefore bias measures of wealth inequality. We propose a method to estimate the cash value of household life insurance assets by combining the Lee-Carter model, which forecasts mortality risk, and the concept of the net level premium reserve in actuarial science. This method is readily applicable using household survey data.