The Health Insurance Market Contributors to Costs and External Factors.

The Health Insurance Market Overview Statistic Annual decrease in members from 2008 Decreased by 245,000 Market prescribed benefits per insured person between 2008 and 2012. Increased by 12.6% p.a. Market treatment days per insured person between 2008 and 2012. Increased by 45% Public Hospitals 35% of claims Private Hospitals 40% of claims Consultants 25% of claims

Public Health System Cost Drivers The cost of a private room in a public hospital has doubled since 2005. The cost of a semi-private room in a public hospital has risen by more than 137% in the same time period. Increase in cost of “multi occupancy” beds to insured patients: from €80 to €813 per night!

Health Insurance Levy The health insurance levy has increased by 150% since it was introduced in 2009. The levy is not serving this purpose of community rating but rather, is undermining the entire market that it is supposed to protect. When the levy is increased, three out of four insurers have no choice but to increase their prices to meet this cost. The levy, while designed to be neutral, will inevitably and invariably lead to price increases across the market. Since inception, over 300,000 mostly younger members have been forced out of the market.

Potential Cost Drivers Overall we expect a continued upward pressure on health insurance premiums Medical Inflation Cost Drivers – expected to be small over coming years Aging in the market – will drive up cost of claims (further impacted by fallout of younger members which we expect to continue) Tax Relief at Source – potential for further reductions at next budget (impacts net premium paid) Change to public hospital bed designation will drive up payments to public hospitals Expect that Health Insurance Levy will continue to increase Potential reductions in fees paid to private medical consultants Ongoing negotiation with private hospitals to deliver greater efficiencies may result in some reductions MFTP policy of Government may change the model for public hospitals – though we do not expect costs to reduce