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Estimation of Prospective Benefit Reserve Based on Gross Premium Valuation Method using Indonesian Mortality Table IV and De-Moivre Assumptions

According to regulations, life insurance companies must meet several requirements related to the company's financial health, one of which is a technical reserve. Technical or premium reserves are funds that the insurance companies must prepare. These funds will cover financial losses experienced by someone who applies for the claim. Thus, the author will use the Gross Premium Valuation (GPV) method in this research. Premium reserves can be determined using two approaches: retrospective and prospective reserves. In this research, the author will determine the prospective reserves with GPV for single decrement insurance and single life n-year continuous term life. The distribution of deaths used in determining the probability of death is the Indonesian life table IV and the de-Moivre assumption with parameter (ɷ=111). Different assumptions for the death probability distribution will result in different premium reserve values, so we can see a difference in premium reserves resulting from the two death probability distributions. This research uses data from male policyholders aged 40 years who followed continuous term life insurance for 20 years. Benefits will be paid right at the time of death, with a discrete method of premium payments made at the beginning of each year for 10 years.

Effect of Perceived Risk of Greenwashing on Consumers’ Willingness to Pay a Price Premium: An Empirical Study

Since China released the timetable of ‘dual carbon’, domestic enterprises have taken relevant measures to facilitate the development of a national green low-carbon economy. However, some of the enterprises have misled consumers by marketing communication of the so-called ‘green’, and this phenomenon of greenwashing should be addressed urgently. From the demand-side perspective, the correlation between perceived risk and willingness to pay a price premium is investigated in this study, and the moderating effect of green innovation identification and the mediating effect of consumers’ negative emotions are verified. As revealed by the empirical results: (1) Greenwashing perceived risk has a significant negative effect on premium payment intention. (2) Greenwashing perceived risk exerts a significant adverse effect on the willingness to pay a price premium on the basis of consumers’ negative emotions, in which consumers’ negative emotions have a partial mediating effect. (3) Green innovation identification is found to have a moderating effect, i.e., the higher the level of green innovation identification of consumers, the more the positive effect of greenwashing perceived risk on their negative emotions will be weakened. The conclusions of this study can help enterprises regulate their own behavior and elevate the market realization level of green premium.

Understanding inactive membership in voluntary contributory schemes: A case study of micro‐traders in Kenya

SummaryMotivationThe provision of health insurance is a public policy response to address the problem of catastrophic health expenditure, which leads to deprivation. Studies show a low uptake of health insurance among informal workers, but the focus has been on understanding enrolment behaviour. Little attention has been paid to understanding inactive membership among informal workers.PurposeThis article asks why informal workers in Kenya are abandoning health insurance schemes. It uses micro‐traders as a case study to understand inactive membership among voluntary contributors in Kenya's national health insurance scheme.Methods and approachBased on primary data combining qualitative and quantitative methods, the article compares inactive members with active and non‐members to identify factors contributing to inactive status.FindingsThis article contends that unmarried voluntary contributors who consider themselves to be healthy and are own‐account workers with low and irregular earnings are more likely to drop out of the scheme. The key drivers of “inactiveness” are the inability to commit to the payment of regular premiums, due to the irregularity of earnings, the change of employment status from formal to informal, and dissatisfaction with scheme services.Policy implicationsSince unmarried, “healthy,” voluntary contributors are more likely to drop out, this creates problems of adverse selection in cases where the scheme retains “unhealthy” members, who are more likely to claim benefits. When “healthy” members drop out, this may force the scheme to increase the level of premiums, since contributory schemes rely on members' contributions. An increase in premiums may trigger further dropouts, which is counterproductive in relation to the global agenda of increasing access to essential health care.

Does free health insurance improve health care use and labour market outcomes of the elderly in Ghana?

Affordable access to health care was a challenge for the elderly in Ghana until the introduction of the National Health Insurance Scheme in 2003, where the elderly were exempted from premium payments. The study employs household-level data from the Ghana Living Standard Survey to investigate whether exempting the elderly from health insurance premium payments affects healthcare utilisation and labour market outcomes of the elderly in Ghana. The study finds that having health insurance increases the elderly visits to a health facility and the probability of being treated by health professionals. For labour market outcomes, the results indicate that free health insurance increases both the number of hours worked and earnings of the elderly and the size of the increase in earnings in agriculture is slightly larger for females than with males.

The effect of input value chain financing on rice farmer’s efficiency in IFAD assisted value chain development Programme, Awka

To ensure the sustainability of the agricultural sector, some special arrangements should be made to increase farmers’ access to credit through input loans. This study on the effect of input value chain financing on rice farmer’s efficiency in the Value Chain Development Programme, Awka; specifically looks at the value chain financing options obtainable; its economic implication; its effect on food security, determinants of value chain financing effect on food security, and the efficiency of value chain financing on rice production sector. Data was collected from a cross-section of 200 farmers using a value chain financing arrangement. Descriptive statistics, multinomial logistic regression and data envelopment analysis were used for data analysis. The study revealed that 88.2% of the farmers received a certain percentage of input loan support, whereas, 78.2% received total input loan support. To the general economy of the nation, input value chain financing encourages early planting (87.1%), and enables the farmers to access production inputs (85.9%) which eventually springs forth food security in the country. Equally, the study found that value chain financing spurred 73.5% of the farmers to food security, while only 26.5% are food insecure. The food security index was 0.67 with a food security line of 38.3 USD for the farming household. We also discovered that a certain percentage of input loan support, guaranteeing farmers' financial loan applications and helping the farmers to pay for insurance premiums are the three determinants of relative food security. Whereas; certain percentage input loan, 100% input loan by value chain actors, and supports in payment of insurance premium are the four determinants of absolute food security in the study. The study, therefore, recommends that value chain financing should be adopted by stakeholders and policymakers to ensure the availability of credit to farmers.

Analisis Implementasi Strategi Pemasaran Asuransi Pendidikan Mitra Iqra Plus Dalam Kajian Asuransi Syariah


 Mitra Iqra Plus is one of the products owned by PT. Bumiputera Sharia Life Insurance, KPS Medan, which aims to help fund children's education. The purpose of this study was to determine the implementation of Mitra Iqra Plus' educational insurance marketing strategy in the study of sharia insurance at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, the application of sharia principles in the marketing implementation of Life Insurance products at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, and challenges in implementing sharia. marketing conducted by PT Asuransi Jiwa Syariah Bumiputera, KPS Medan. This type of research uses qualitative research. Data collection techniques in the form of interviews, observations, and documentation. The data analysis technique used is to reduce the data, present the data, then draw conclusions. The results show that PT Asuransi Jiwa Syariah Bumiputera, KPS Medan implements according to sharia marketing principles ranging from Wisdom (Strategy), Needs (Needs), Halal (Tayyibat), Welfare (Falah), Mutual Consent. The inhibiting factors in implementing the Mitra Iqra Plus educational insurance marketing strategy are the lack of public knowledge about sharia insurance, lack of public trust in sharia insurance, lack of agents and customers who are difficult to collect for premium payments. The challenge is the lack of technology development, the weak market share of PT. AJS Bumiputera due to lack of support from the government and the community.
 Keywords: Implementation of Sharia Marketing Strategy, Mitra Iqra Plus, Sharia Insurance.

A new robust insurance model considering the time of accident

The principle of maximum utility is generally adopted to design the optimal insurance contracts, which should consider the influence of different factors such as the probability of accident, premium, compensation, and so on. However, most literatures deal with these variables from a static perspective. This paper considers the accident probability and the value of insurance subject based on the time of accident, which is rarely involved in the previous studies and considers the utility function of the insurer and the policyholder from a dynamic perspective. Firstly, to make this model more universally applicable, we establish an insurance model that considers the time of the accident and different premium payment forms for policy-holders and insurers respectively. Next, we derive a robust premium insurance model based on min-max regret, in which the time of the accident can be assumed to be certain and uncertain respectively. Then, we conduct numerical experiments and analyze the utility of the policy-holders, demonstrating guarantee period and value of insurance subject are significant when insuring and derive the optimal coverage rate. These results also show that the insurance model that takes into account the time of accident performs better.

The GMWB guarantee embedded in Life Insurance Contracts: Fair Value Pricing Problem

Due to the complexity of the variable annuities products, we rely on numerical resolution to fairly price the guaranteed minimum withdrawal benefit (GMWB) rider. This policy, known as an embedded put option in the life insurance contracts, gives the contract owner the possibility to withdraw a fixed amount for a fixed period. We assume a single premium payment upfront. We use a Monte Carlo simulation to approximate the fair fees under specific assumptions related to the contract design and conception, the policyholder characteristics and lapse behavior, and different market parameters. More notably, our algorithm allows to perform a sensitivity analysis to seek the impact of different parameters on the value of the policy as recommended by the Solvency II regularities. We find that the GMWB fair fees are intensively sensitive and responsive to any sudden change in the contract inputs.

Analisis Implementasi Strategi Pemasaran Asuransi Pendidikan Mitra Iqra Plus Dalam Kajian Asuransi Syariah


 Mitra Iqra Plus is one of the products owned by PT. Bumiputera Sharia Life Insurance, KPS Medan, which aims to help fund children's education. The purpose of this study was to determine the implementation of Mitra Iqra Plus' educational insurance marketing strategy in the study of sharia insurance at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, the application of sharia principles in the implementation of marketing life insurance products at PT Asuransi Jiwa Syariah Bumiputera, KPS Medan, and challenges in implementing sharia. marketing conducted by PT Asuransi Jiwa Syariah Bumiputera, KPS Medan. This type of research uses qualitative research. Data collection techniques in the form of interviews, observations, and documentation. The data analysis technique used is to reduce the data, present the data, then draw conclusions. The results show that PT Asuransi Jiwa Syariah Bumiputera, KPS Medan implements according to sharia marketing principles starting from Wisdom (Strategy), Needs (Needs), Halal (Tayyibat), Welfare (Falah), Mutual Consent. The inhibiting factors in implementing the Mitra Iqra Plus educational insurance marketing strategy are the lack of public knowledge about sharia insurance, lack of public trust in sharia insurance, lack of agents and customers who are difficult to collect for premium payments. The challenge is the lack of technology development, the weak market share of PT. AJS Bumiputera due to lack of support from the government and the community.
 Keywords: Implementation of Sharia Marketing Strategy, Mitra Iqra Plus, Sharia Insurance.

Aplikasi Multi Platform Penerapan Algoritma Naive Bayes untuk Klasifikasi Keterlambatan Pembayaran Premi Asuransi

Human carelessness can be one of the main factors in accidents. Knowing this situation, the insurance company takes the role as well as the opportunity f rom the consumer s , to be the one who will bear the loss known as risk. The problem that often arises in insurance companies is the number of customers who are in arrears in paying premiums. In the procedures applicable to insurance, there is a grace period for payment of 30 days during which the customer/insured must pay a predetermined amount of premium and if the customer/insured does not pay the premium, the insurance policy will be canceled so that the insurance profit will be reduced and if it happens , it will be detrimental to the insurance. This research i s conducted by applying the Naive Bayes algorithm using insurance customer data. The result of this study is a classification system for late payment of insurance premiums that can classify the status of premium payments for insurance customers. The system test results show that the system can classify the premium payment status of insurance customers with an accuracy rate of 82.5%, then the resulting precision level is 94.83% and the resulting recall is 86.39%.

Introduction of the ombudsman institute in the insurance market of Ukraine

The insurance industry plays an important role in the economy, contributing to the intermediation and risk-bearing mechanism. At the same time, the insurance industry contributes to socio-economic growth due to accumulated long-term financial resources that can be directly used in the economy. The purpose of the article is to develop recommendations on the possibility of creating an insurance ombudsman institute in Ukraine based on international experience. The set goal determined the solution of the following tasks: to investigate the legal aspects of the activity of the financial ombudsman in different countries and provide their comparative characteristics; to determine the specifics of the implementation in Ukraine of the alternative dispute resolution mechanism on the insurance market; justify the benefits of activating the activity of the insurance ombudsman institute in Ukraine. In the process of carrying out a scientific search, such general scientific methods as: abstract-logical; monographic; comparative; graphic; dialectical method; comparative legal method; structural-functional method. The peculiarities of the functioning of the relevant alternative mechanisms for resolving insurance disputes in different countries, the mechanisms for dealing with customer complaints, and the resolution of disputes with the participation of a professional mediator were studied. It was determined that in world practice, two main models of financial ombudsmen are usually distinguished: British and German. It is substantiated that the introduction of the insurance ombudsman institute in Ukraine as an alternative platform for considering complaints will have advantages for all participants of the insurance market.It has been proven that the activities of such an institution can consider disputes related to settlement of claims, wrongful sale, payment of insurance premiums, legal registration of the policy, delay of settlements, failure to issue insurance documents, etc. Such an insurance ombudsman institution will be responsible for protecting the interests and handling policyholder complaints, and the main purpose of the ombudsman’s activities is to handle policyholder complaints outside the court system in a cost-effective and impartial manner

Pricing Total Return Swaps

Total return swap (TRS) involves a pricing dilemma: LIBOR discounting of its premium leg forces upfront payment of future funding premium, and yet replacing LIBOR with a firm’s own funding rate falls into the well-known FVA debate trap. We consider TRS hedge financing from a repo market perspective and apply postcrisis derivatives valuation with collateralization and funding to TRS. We find that the financing cost of the TRS hedge should be reflected on the security leg, and the funding premium can only be discounted in conjunction with the TRS as a whole, depending on margining schemes. An easy to implement, recursive tree model is developed to value TRS with repo-style margining or defaultable underlying, together with any value adjustments.

Проблемні аспекти соціального страхування в Україні щодо ризиків упродовж життя

Social insurance implements a mechanism to strike a balance between national work ethic and mandatory care for retirees and those who are unable to work through social programs that support total consumption spending. Most studies focus on compulsory state social insurance, therefore, it is relevant to study the social insurance system from the perspective of state and non-state insurance throughout life. The purpose of the study is to identify problematic aspects and to investigate the current mechanism of social and pension insurance against social risks. The scientific novelty consists in providing analytical support for identifying the features and problematic aspects of the functioning of social insurance in Ukraine, which, unlike the existing one, involves an analysis of the legal framework, statistical indicators in the context of the national institutional environment and the development of proposals to overcome problematic aspects in the field of social insurance throughout life. The research methodology is based on the following methods: analysis, synthesis, systematization and statistical analysis. The analysis of the study covers the period of the Covid-19 crisis and the pandemic era, which allows us to assess the potential of public administration in the event of unforeseen situations and economic downturns. Based on the results obtained, it is revealed that the main feature of state social insurance is the assistance earned by citizens through the payment of insurance premiums in the course of labor activity in exchange for the right to receive protection from social risks. At the same time, the assessment of the state costs part of the budgets of state insurance funds reveals shortcomings in the activities on non-fulfillment of planned indicators, failure to control the targeted use of funds from own reserves and lack of resource capacity. The analysis of social insurance with point of view а system of private pension provision on the main indicators of funds reveal a low development of investment processes, which requires the introduction of measures to spread public awareness of non-state pension insurance. The results of the study can be used by the Government to strengthen social insurance aimed at improving the quality of life of the population. In particular, pay more attention to the need to increase the financial awareness of citizens by providing them with financial information about retirement savings and options to increase their income levels at retirement age.

보험업종사자의 전직(경업)금지와 영업비밀보호에 관한 소고

As the 4th Industrial Revolution was applied to the entire industry, many changes occurred in the financial industry, including the insurance industry. These changes can be examined through ① insurance product development·improvement and risk management through big data analysis, ② rapid and accurate insurance rate calculation and underwriting of insurance contract using A·I, ③ the simplification of insurance conclusion, insurance premium payment, and insurance payment procedures using block chain technology, ④ effective marketing and efficient contract maintenance and management tasks through chatbot. The pace of change in the insurance industry is increasingly accelerating due to numerous practical changes in a short period of time and normative changes such as the revision of related laws of insurance industry. With the rapid change of the insurance industry, phenomena such as ① diversification of the people working in the insurance industry, ② activation of job change of the people engaged in the insurance industry, and ③ advancement of technology or information required or used in the insurance industry are occurring. If the people engaged in the insurance industry changes their jobs frequently, the possibility of leakage of information or technology related to the insurance industry or infringement of trade secrets may occur. Since this can cause fatal damage to the insurer, it will be necessary to prepare a plan to prevent the leakage of such information and technology and to protect trade secrets. In this paper, in order to protect the interests of insurers, the validity of the contract for prohibition of job transfer, which is a pre-emptive remedy, not an ex-post remedy according to the Act on the Prevention of Unfair Competition and Trade Secret Protection, the Monopoly Regulation and Fair Trade Act, etc. And we would like to examine the effectiveness of the contract for prohibition of job transfer and review its application to the people engaged in the insurance industry.

CUSTOMER RETENTION STRATEGIES AND PROFITABILITY AMONGST INSURANCE COMPANIES IN KENYA: A CASE OF LIBERTY LIFE ASSURANCE CO. LTD

This study sought to investigate the influence of customer retention on profitability of insurance companies in Kenya using Liberty Life Assurance Company Ltd as a proxy. The Specific objectives of the study were to examine the effect of product quality assess the effect of quality customer service, and to establish the influence of firms service/product pricing on profitability. The theories of Assimilation, Contrast, and Assimilation-Contrast guided this current study. Descriptive and correlational design were used on a target population of 2, 653 customers who have held life policies since 2010 with Liberty Life Assurance Co. The sample of the study consisted of 347 respondents. A questionnaire was used to collect primary data from customers while a structured interview schedule was used to collect qualitative data from 10 managers. Validity of instruments was ensured by consulting experts from Business Administration Department, Africa Nazarene University. Reliability of instruments was achieved through test-retest method on randomly selected 39 customers, whereby Cronbachs Alpha of 0.849 was calculated from the obtained data. Qualitative data was analyzed through thematic analysis while correlation and regression analysis were used to analyze the relationship between customer retention strategies and profitability in Liberty Life Ltd, Kenya. The study findings showed that 40.4% changes in profitability at Liberty Life Assurance is attributed to the customer retention strategies investigated by the study (R2 =0.4042). Findings also showed that product quality (β=0.428) quality of services (β=1.188) and product pricing (β=0.601) all are significant predictors {F (1, 338) =88.495, P<0.05} of profitability at Liberty Life. It is concluded that product quality, quality of services, and product pricing are critical customer retention strategies for enhancing firm profitability. The study therefore recommends insurance should adopt corporate social responsibility practices as well as flexibility mode of premium payment to improve and stabilize their customer base. Further research should be done on the influence of expanded benefits in insurance product packages on customer retention and profitability.

Factors affecting the social insurance compliance of enterprises in Vietnam

This article aims to determine the factors affecting the social insurance compliance of enterprises in Vietnam. Based on the economic and behavioral approach, hypotheses on the determinants of insurance compliance are proposed. A sample of 240 enterprises with data on paying insurance premiums for employees in Vietnam from 2016 to 2018 is collected to carry out this research. According to the Probit regression model results, the enterprises' decision to comply with social insurance is significantly positively impacted by the number of employees, the proportion of female employees, the age of the managers, inspectors, and unions. On the contrary, the gender of managers, and non-state enterprises have a negative and statistically significant influence on compliance with social insurance regulations. Besides, the results in Tobit regression models reveal the proportion of female employees, seniority of participation, inspections, unions, and auditors have a positive impact on the level of social insurance compliance of Vietnamese enterprises, while foreign and non-state enterprises have a negative effect on the contribution rate of these enterprises. Most of the previous studies focused on the decision to participate in social insurance without considering the actual payment ratio compared to the regulations, and empirical studies on this topic are still limited in Vietnam. This study can be an empirical basis for managers to minimize the debt of social insurance of enterprises, and increase the responsibility of employers for government regulations related to the protection of workers' rights.

Insuring against droughts: addressing issues of trust, transparency and liquidity in the demand for livestock index insurance

ABSTRACT Pastoralists in sub-Saharan Africa are particularly vulnerable to changing climatic conditions and heavily affected by an increasing frequency of severe droughts. To increase drought resilience, livestock index insurance constitutes a promising tool that is aligned to mitigate covariate risks. Uptake rates for these products are, however, relatively low. This article uses choice-experimental data collected in Northern Kenya to analyse preferences for hypothetical livestock index insurance contracts among pastoralists. Results show that pastoralists prefer lower strike levels as well as transparency in the form of regular radio announcements and text messages informing the policyholder about the location-specific index readings. Highly valued are trust enhancing features such as an index certification. We do not find any indication that the option to split the premium payment into two instalments as a way to relax potential liquidity constraints could lead to higher demand.

PRODUK UNIT LINK UNTUK JOINT LIFE MENGGUNAKAN PENDEKATAN STOKASTIK

The insurance program has developed quite rapidly and the products that are displayed are only very attractive from protection products to protection and investment products known as unit link insurance. In general, unit-linked insurance products are offered with a death benefit for one person or single life. This study discusses unit link insurance with death benefits for two people or living together using profit testing calculations with a stochastic approach. This study aims to calculate the company's expectations of death benefits, profits and profits from unit link insurance for joint life using a stochastic approach. In this study, the ages of the participants of this unit link insurance are 35, 45, and 55. Premium payments of Rp4.200,000.00 are made annually for 5 years and are covered until the age of 75 years. In the research, it is expected that the profit and death benefit using the stochastic approach are as follows: if the insured ages are 35, 45, and 55 years old, the company experiences a profit of Rp9,445,498,66, Rp5,975,926.42, and Rp2, respectively. 197,106.56 and the expected death benefit value is Rp. 33,167.00, Rp. 99,007.00 and Rp. 328.005.00, respectively.

Turnover in Zero-Premium Status Among Health Insurance Marketplace Plans Available to Low-Income Enrollees

Recent subsidy enhancements in Affordable Care Act (ACA) Marketplaces made many low-income enrolles (below 150% of the federal poverty level [FPL]) eligible for 2 free silver-tier plans. eligible for 2 free silver-tier plans. However, an unintended consequence of this structure is that the identity of which silver plans are free will often "turn over" between years, requiring that enrollees actively initiate premium payment (or lose coverage). The prevalence of this free-plan turnover is not known. To measure the prevalence of free-plan turnover in ACA Marketplaces and to estimate how many enrollees below 150% of FPL are likely to be affected. This observational cross-sectional study used data on plan offerings and premiums in 33 state ACA Marketplaces using HealthCare.gov in 2021 and 2022, along with estimates of county-level enrollee characteristics and plan selection patterns. The enrollment-weighted share of county markets affected by free-plan turnover was quantified, along with the association of turnover with enrollee and market characteristics. Estimates of the number of affected low-income enrollees were calculated using the data plus statistics reported in past research. Data were analyzed from November 21, 2021, to February 28, 2022. This study found that turnover of zero-premium plans was quite common, with 93% of HealthCare.gov counties (weighted by enrollment) experiencing at least 1 zero-premium plan in 2021 turning over to nonfree in 2022; 84% of counties experienced turnover of all $0 silver plans from 2021 to 2022. This turnover affected an estimated 1.36 million people with incomes below 150% of FPL. Turnover was more common in counties with a higher share of non-White enrollees, in Medicaid nonexpansion states, in counties with more carriers, and in counties with changes in the number of offered plans. The findings of this cross-sectional study suggest that owing to the prevalence of zero-premium plan turnover, many low-income ACA enrollees faced elevated risk of disenrollment at the start of 2022. Outreach to affected enrollees and other actions to encourage coverage retention and midyear reenrollment could help mitigate coverage losses.

Operational and structural factors influencing enrolment in community-based health insurance schemes: an observational study using 12 waves of nationwide panel data from Senegal.

Community-based health insurance (CBHI) has been implemented in many low- and middle-income countries to increase financial risk protection in populations without access to formal health insurance. While the design of such social programmes is fundamental to ensuring equitable access to care, little is known about the operational and structural factors influencing enrolment in CBHI schemes. In this study, we took advantage of newly established data monitoring requirements in Senegal to explore the association between the operational capacity and structure of CBHI schemes—also termed ‘mutual health organizations’ (MHO) in francophone countries—and their enrolment levels. The dataset comprised 12 waves of quarterly data over 2017–2019 and covered all 676 MHOs registered in the country. Primary analyses were conducted using dynamic panel data regression analysis. We found that higher operational capacity significantly predicted higher performance: enrolment was positively associated with the presence of a salaried manager at the MHO level (12% more total enrolees, 23% more poor members) and with stronger cooperation between MHOs and local health posts (for each additional contract signed, total enrolees and poor members increased by 7% and 5%, respectively). However, higher operational capacity was only modestly associated with higher sustainability proxied by the proportion of enrolees up to date with premium payment. We also found that structural factors were influential, with MHOs located within a health facility enrolling fewer poor members (−16%). Sensitivity analyses showed that these associations were robust. Our findings suggest that policies aimed at professionalizing and reinforcing the operational capacity of MHOs could accelerate the expansion of CBHI coverage, including in the most impoverished populations. However, they also suggest that increasing operational capacity alone may be insufficient to make CBHI schemes sustainable over time.