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Posted on Aug 17, 2024

5. Please generate the gross premium of each plan Inpatient, Outpatient, Dental and the total premium to be paid for the following benefit (see the

5. Please generate the gross premium of each plan Inpatient, Outpatient, Dental and the total premium to be paid for the following benefit (see the excel spreadsheet), if company has the acquisition cost of 15%, general operating expenses of 10% and target profit of 10%. image text in transcribed

AA AB Surgery Minor Anaesth Complex Anaesth. Minor Medical Implant 0.03327 1 2 3 4 5 6 7 8 9 10 11 12 13 Room & Board 500,000 0.06653 0.03975 0.03511 0.03677 0.03908 0.03994 0.04793 0.05921 0.06029 0.06419 0.12363 0.15092 0.22411 ICU 1,000,000 0.00233 0.00278 0.00246 0.00257 0.00274 0.00280 0.00336 0.00414 0.00422 0.00450 0.00865 0.01056 0.00784 Physician Specialist Miscellanous 210,000 5,000,000 0.06653 0.06653 0.03975 0.03975 0.03975 0.03511 0.03511 0.03511 0.03677 0.03677 0.03677 0 0.03908 0.03908 0.03908 0.03994 0.03994 0.03994 0.04793 0.04793 0.05921 0.05921 0.05921 0.06029 0.06029 0.06419 0.06419 0.06419 0.12363 0.12363 0.12363 0.15092 0.15092 0.15092 0.22411 0.22411 0.22411 1 INCIDENCE RATES: IP Inner Limit 2 Entry-age 3 - 14 Sex: M 4 15-19 5 20-25 6 26-30 7 31 - 35 8 36 -40 9 41 - 45 10 46 - 50 11 51 - 55 12 56 - 60 13 61 - 64 14 65-69 15 70 - 16 17 - 14 Sex: F 18 15 - 19 19 20-25 20 26-30 21 31 - 35 22 36 -40 23 41 - 45 24 46 - 50 25 51 - 55 26 56 - 60 27 61 - 64 28 65-69 29 70 - 30 Surgery Complex 25,000,000 0.00000 0.00000 0.00000 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.00000 Surgery Surgery Major Intermediate 6,250,000 0.00000 0.01774 0.00000 0.02120 0.01872 0.01872 0.01961 0.01961 0.02084 0.02084 0.02130 0.02130 0.02556 0.02556 0.02211 0.02211 0.02251 0.02251 0.02396 0.02396 0.06593 0.06593 0.08049 0.08049 0.05976 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 Anaesth. Anaesth. Major Intermediate 2,500,000 0.00000 0.01774 0.00000 0.02120 0.01872 0.01872 0.01961 0.01961 0.02084 0.02084 0.02130 0.02556 0.02211 0.02211 0.02251 0.02251 0.02396 0.02396 0.06593 0.06593 0.08049 0.08049 0.00000 0.05976 0.00000 0.00000 0.00000 0.01961 0 0.02084 0.02130 0.02556 0 0.02211 0.02251 0.02396 0.06593 0 0.08049 0.00000 0.02130 0.02556 Operating Operating Operating Operating complex Major Intermediate Minor Emergency 2,500,000 #*****# 3,000,000 0.00000 0.00000 0.01774 0.01774 0.13306 0.00000 0.00000 0.02120 0.02120 0.07950 0.00000 0.01872 0.01872 0.01872 0.07022 0.01961 0.01961 0.01961 0.01961 0.07354 0.02084 0.02084 0.02084 0.02084 0.07816 0.02130 0.02130 0.02130 0.02130 0.07988 0.02556 0.02556 0.02556 0.02556 0.09586 0.02211 0.02211 0.02211 0.02211 0.11843 0.02251 0.02251 0.02251 0.02251 0.12059 0.02396 0.02396 0.02396 0.02396 0.12838 0.06593 0.06593 0.06593 0.06593 0.24726 0.08049 0.08049 0.08049 0.08049 0.30184 0.00000 0.00000 0.05976 0.05976 0.44822 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 Dental Ambulance 2,000,000 0.01663 0.01500 0.00994 0.01500 0.00878 0.01500 0.00919 0.01500 0.00977 0.01500 0.00999 0.01500 0.01198 0.01500 0.01481 0.01500 0.01508 0.01500 0.01605 0.01500 0.03091 0.01500 0.03773 0.01500 0.05603 0.01500 0.04793 Pre/Post Hospital 310,000 0.08427 0.06095 0.05383 0.05638 0.05992 0.06124 0.07349 0.08132 0.08280 0.08815 0.18956 0.23141 0.28387 Private Nurse 210,000 0.00000 0.00199 0.00176 0.00184 0.00195 0.00200 0.00240 0.00324 0.01968 0.02497 0.00618 0.00755 0.01121 Funeral Hemodialisis ######## 10,000,000 0.00138 0.02218 0.00138 0.02650 0.00149 0.02340 0.00149 0.02451 0.00159 0.02605 0.00268 0.02663 0.00419 0.03195 0.00699 0.02763 0.01105 0.02813 0.01630 0.02995 0.02215 0.08241 0.03359 0.10061 0.05928 0.07470 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 0.06029 0.00000 0.02151 0.05527 0.05717 0.0150 0.0150 0.0150 0.0150 0.0150 0.0150 14 15 16 17 18 19 20 21 22 23 24 25 28 0.04302 0.05527 0.05717 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.00151 0.00387 0.00400 0.00418 0.00459 0.00467 0.00553 0.00592 0.00563 0.00562 0.00613 0.00732 0.00548 0.04302 0.05527 0.05717 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.04302 0.05527 0.05717 0.05974 0.06563 0 0.06670 0 0.07905 0.08459 0.08039 0.08024 0 0.08756 0.10461 0.15648 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.00000 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.0292 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02999 0.03269 0.03905 0.02921 0.00000 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.08604 0.11054 0.11434 0.11948 0.13126 0.13340 0.15810 0.16918 0.16078 0.16048 0.17512 0.20922 0.31296 0.01076 0.01382 0.01429 0.01494 0.01641 0.01668 0.01976 0.02115 0.02010 0.02006 0.02189 0.02615 0.03912 0.0150 0.05105 0.07590 0.07851 0.08204 0.09013 0.09160 0.10856 0.11617 0.11040 0.11019 0.12025 0.14366 0.18569 0.00000 0.00276 0.00286 0.00299 0.00328 0.00334 0.00395 0.00423 0.00402 0.00401 0.00438 0.00523 0.00782 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00138 0.00138 0.00138 0.00149 0.00149 0.00191 0.00294 0.00472 0.00804 0.01313 0.01749 0.02631 0.04440 0.01004 0.02579 0.02668 0.02788 0.03063 0.03113 0.03689 0.03948 0.03751 0.03744 0.04086 0.04881 0.03651 0.0150 0.0150 0.0150 0.0150 0.0150 0.0150 0.02921 Medical Room & Board Surgery Complex Surgery Major Surgery Intermediate Surgery Minor Anaesth Complex Anaesth. Anaesth Major Intermediate Anaesth Minor Operating complex Operating Operating Operating Major Intermediate Minor Emergency Pre/Post Hospital Private Nurse ICU Physician Specialist Miscellanous Dental Ambulance Implant Funeral Hemodialisis 31 NUMBER OF UNITS: (LOS, Avg. Days, Freq.) 32 Entry-age 33 - 14 Sex: M 1 34 15-19 2 35 20 - 25 3 36 26 - 30 4 37 31 - 35 5 38 36 -40 6 39 41 - 45 7 40 46 - 50 8 41 51 - 55 42 56-60 10 43 61 - 64 11 44 65-69 12 45 70 - 13 46 47 - 14 Sex: F 14 48 15 - 19 15 49 20-25 16 50 26 - 30 17 5.40 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 3.80 3.78 2.87 2.87 2.94 4.06 4.83 4.83 4.83 6.00 7.10 7.80 11.60 5.40 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 0.00 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 9mHQRUDE 4.50 3.70 3.70 3.90 3.20 2.60 2.60 2.70 4.50 3.70 3.70 3.90 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 0.00 3.70 3.70 3.90 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test no 5 E F G V W AA AB D Room & Board 6.90 8.60 10.10 11.10 16.50 ICU 4.83 6.00 7.10 7.80 11.60 Physician Specialist Miscellanous 6.90 1.00 1.00 8.60 1.00 1.00 10.10 1.00 1.00 11.10 1.00 1.00 16.50 1.00 1.00 J Surgery Major 0.13 0.13 0.13 0.13 0.00 Surgery Complex 0.07 0.07 0.07 0.07 0.00 Surgery Intermediate 0.17 0.17 0.17 0.17 0.30 Surgery Minor 0.63 0.63 0.63 0.63 0.70 M Anaesth Complex 0.07 0.07 0.07 0.07 0.00 N Anaesth Anaesth Major Intermediate 0.13 0.17 0.13 0.17 0.13 0.17 0.13 0.17 0.00 0.30 10 11 12 13 Anaesth. Minor 0.63 0.63 0.63 0.63 0.70 R S T Operating Operating Operating Operating complex Major Intermediate Minor Emergency 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.00 0.00 0.30 0.70 1.00 Dental Ambulance 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Y Private Nurse 6.90 8.60 10.10 11.10 16.50 Pre/Post Hospital 1.00000 1.00000 1.00000 1.00000 1.00000 Z Medical Implant 1.00 1.00 1.00 1.00 1.00 Funeral Hemodialisis 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1 INCIDENCE RATES: IP Inner Limit 41 51 - 55 42 56-60 43 61 - 64 44 65-69 45 70 - 46 47 - 14 Sex: F 48 15 - 19 49 20-25 50 26 - 30 51 31 - 35 52 36 - 40 53 41 - 45 54 46 - 50 55 51 - 55 56 56 - 60 57 61 - 64 58 65-69 59 70 - 60 9gH28 MBER&Bu88888 14 15 16 17 18 19 20 21 22 23 24 25 26 4.50 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 12.50 26.80 3.20 2.60 2.60 2.70 3.30 4.60 4.60 4.50 5.80 6.70 8.40 8.80 18.80 4.50 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 0.00 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 12.50 26.80 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 12.50 26.80 Room & Board Surgery Complex Surgery Major Surgery Intermediate Surgery Minor Anaesth Complex Anaesth Minor Anaesth. Anaesth Major Intermediate Operating Operating Operating Operating complex Major Intermediate Minor Emergency Pre/Post Hospital ICU Medical Implant Physician Specialist Miscellanous Dental Ambulance Funeral Hemodialisis 1 2 61 UTILIZATION: 62 Entry-age 63 - 14 Sex: M 64 15-19 65 20-25 66 26 - 30 67 31 - 35 68 36 - 40 69 41 - 45 70 46 - 50 71 51 - 55 72 56 - 60 73 61 - 64 74 65-69 75 70 - 76 77 - 14 Sex: F 78 15 - 19 79 20-25 80 26 - 30 81 31 - 35 82 36 -40 83 41 - 45 84 46 - 50 85 51 - 55 86 56 - 60 87 61 - 64 88 65 - 69 89 70 - 5 6 7 8 9 10 11 12 13 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 37.50% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 37.50% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 50.00% 100.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% Private Nurse 40,000 0.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 50.000% 75.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 14 15 16 17 18 19 20 21 22 23 24 25 26 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 37.50% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 37.50% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 50.00% 100.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 50.000% 75.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 80.00% 0.00% Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test no 5 + A B 11 E D Room & Board F G H 1 Surgery Physician Specialist Miscellanous Complex Physician +drug Drugs Laboratory Physiotherapy J Surgery Major Surgery Intermediate L Surger Mind ICU Physician Specialist Admin 1 INCIDENCE RATES: IP Inner Limit 92 INCIDENCE RATES : Out Patient 93 Entry-age 94 - 14 Sex: M/F 95 15-19 96 20 - 25 97 26 - 30 98 31 - 35 99 36 -40 100 41 - 45 101 46-50 102 51 - 55 103 56 - 60 104 61 - 64 105 65-69 106 70 - 107 1.97200 2.46500 2.55000 2.72000 2.89000 3.06000 3.40000 3.82500 4.25000 4.67500 5.10000 5.52500 5.95000 0.34800 0.43500 0.45000 0.48000 0.51000 0.54000 0.60000 0.67500 0.75000 0.82500 0.90000 0.97500 1.05000 0.99 1.23 1.28 1.36 1.45 1.53 1.70 1.91 2.13 2.34 2.55 2.76 2.98 2.32000 2.90000 3.00000 3.20000 3.40000 3.60000 4.00000 4.50000 5.00000 5.50000 6.00000 6.50000 7.00000 0.58000 0.72500 0.75000 0.80000 0.85000 0.90000 1.00000 1.12500 1.25000 1.37500 1.50000 1.62500 1.75000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 2.95 3.68 3.80 4.05 4.30 4.55 5.05 5.68 6.30 6.93 7.55 8.18 8.80 Physician +drug Physician Specialist Drugs Laboratory Physiotherapy Admin 108 NUMBER OF UNITS: Out Patient 109 Entry-age 110 - 14 Sex: M/F 111 15 - 19 112 20-25 113 26 - 30 114 31 - 35 115 36 - 40 116 41 - 45 117 46 - 50 118 51 - 55 119 56 - 60 120 61 - 64 121 65 - 69 122 70 - 123 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Physician Specialist Physician +drug Drugs Laboratory Physiotherapy Admin 124 UTILISATION : Out Patient 125 Entry-age 126 - 14 Sex: M/F 127 15 - 19 128 20-25 129 26 - 30 130 31 - 35 131 36 - 40 132 41 - 45 133 46-50 134 51 - 55 135 56 - 60 136 61 - 64 137 65 - 69 138 70 - 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 2.50% 5.00% 50.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% test no 2 test no 3 Data for test no 4 test no 5 Multiple Choice Answer Test no 1 data for test no 5 Basic 1.000000 1.000000 1.000000 Basic +Gum 1.000000 1.000000 1.000000 Preventive 1.000000 1.000000 1.000000 Complex 1.000000 1.000000 1.000000 Protestic 1.000000 1.000000 1.000000 Rehabilitative 1.000000 1.000000 1.000000 69 20 DENTAL 1 NUMBER OF UNITS: Dental 2 Sex:M 3 Sex: F 14 Child 15 16 INCIDENCE RATES: Dental 27 Sex: M 8 Sex: F 19 Child 50 1 UTILISATION : Dental 52 Sex: M 53 Sex: F 4 Child 55 Basic 0.258250 0.324500 0.236250 Basic +Gum 0.050000 0.062500 0.045000 Preventive 0.200000 0.250000 0.180000 Complex 0.080000 0.100000 0.072000 Protestic 0.090000 0.112500 0.081000 Rehabilitative 0.120000 0.150000 0.108000 Basic 100.00% 100.00% 100.00% Basic +Gum 100.00% 100.00% 100.00% Preventive 100.00% 100.00% 100.00% Complex 100.00% 100.00% 100.00% Protestic 100.00% 100.00% 100.00% Rehabilitative 100.00% 100.00% 100.00% och B E N 0 0 6 1000 13 1 IN-PATIENT PLAN 1 Room & Board, per day Max. 90 days per Policy Year 500,000 3 2 Intensive Care Unit, per day Max. 15 days per Policy Year 1,000,000 4 3 In-hospital Physician's visits, per day Max. 90 days per Policy Year 210,000 5 4 In-hospital Specialist Consultations, per day Max. 90 days per Policy Year 1,000,000 5 Miscellaneous Hospital Suplies, per confinement 5,000,000 7 6 Surgery, per operation 8 a. Complex 9 b. Major 10 c. Intermediate 6,250,000 11 d. Minor 3,125,000 12 7 Anesthesia (40% of surgical limits), per operation a. Complex 14 b. Major 5,000,000 15 c. Intermediate 2,500,000 16 d. Minor 1,250,000 17 8 Operating Theater (40% of surgical limits), per operation 18 a. Complex 19 b. Major 5,000,000 20 c. Intermediate 2,500,000 21 d. Minor 1,250,000 22 9 Emergency Accidental Out-Patient Treatment, per policy year 3,000,000 23 10 Emergency Accidental Dental Treatment, per policy year 2,000,000 24 11 Pre & Post Hospitalization Treatment Max. 30 days per Policy Year 1,500,000 25 12 Ambulance Services, per confinement 310,000 26 13 Private Nurse, per day Max. 30 days per Policy Year 210,000 27 28 Overall Limit, per policy year Unlimited 29 30 14 Medical Equipment that implanted in the body, per policy year 31 15 Funeral Expenses 3,000,000 32 16 Hemodialys and Chemoterapy 33 34 35 36 OUT-PATIENT PLAN 1 37 1 Out-patient Physician's visit, per day 75,000 38 2 Out-patient Specialist Consultation, per day 225,000 Package ut nationt Physician's vicit+ Preccrintion Druce Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test AA AB Surgery Minor Anaesth Complex Anaesth. Minor Medical Implant 0.03327 1 2 3 4 5 6 7 8 9 10 11 12 13 Room & Board 500,000 0.06653 0.03975 0.03511 0.03677 0.03908 0.03994 0.04793 0.05921 0.06029 0.06419 0.12363 0.15092 0.22411 ICU 1,000,000 0.00233 0.00278 0.00246 0.00257 0.00274 0.00280 0.00336 0.00414 0.00422 0.00450 0.00865 0.01056 0.00784 Physician Specialist Miscellanous 210,000 5,000,000 0.06653 0.06653 0.03975 0.03975 0.03975 0.03511 0.03511 0.03511 0.03677 0.03677 0.03677 0 0.03908 0.03908 0.03908 0.03994 0.03994 0.03994 0.04793 0.04793 0.05921 0.05921 0.05921 0.06029 0.06029 0.06419 0.06419 0.06419 0.12363 0.12363 0.12363 0.15092 0.15092 0.15092 0.22411 0.22411 0.22411 1 INCIDENCE RATES: IP Inner Limit 2 Entry-age 3 - 14 Sex: M 4 15-19 5 20-25 6 26-30 7 31 - 35 8 36 -40 9 41 - 45 10 46 - 50 11 51 - 55 12 56 - 60 13 61 - 64 14 65-69 15 70 - 16 17 - 14 Sex: F 18 15 - 19 19 20-25 20 26-30 21 31 - 35 22 36 -40 23 41 - 45 24 46 - 50 25 51 - 55 26 56 - 60 27 61 - 64 28 65-69 29 70 - 30 Surgery Complex 25,000,000 0.00000 0.00000 0.00000 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.00000 Surgery Surgery Major Intermediate 6,250,000 0.00000 0.01774 0.00000 0.02120 0.01872 0.01872 0.01961 0.01961 0.02084 0.02084 0.02130 0.02130 0.02556 0.02556 0.02211 0.02211 0.02251 0.02251 0.02396 0.02396 0.06593 0.06593 0.08049 0.08049 0.05976 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 Anaesth. Anaesth. Major Intermediate 2,500,000 0.00000 0.01774 0.00000 0.02120 0.01872 0.01872 0.01961 0.01961 0.02084 0.02084 0.02130 0.02556 0.02211 0.02211 0.02251 0.02251 0.02396 0.02396 0.06593 0.06593 0.08049 0.08049 0.00000 0.05976 0.00000 0.00000 0.00000 0.01961 0 0.02084 0.02130 0.02556 0 0.02211 0.02251 0.02396 0.06593 0 0.08049 0.00000 0.02130 0.02556 Operating Operating Operating Operating complex Major Intermediate Minor Emergency 2,500,000 #*****# 3,000,000 0.00000 0.00000 0.01774 0.01774 0.13306 0.00000 0.00000 0.02120 0.02120 0.07950 0.00000 0.01872 0.01872 0.01872 0.07022 0.01961 0.01961 0.01961 0.01961 0.07354 0.02084 0.02084 0.02084 0.02084 0.07816 0.02130 0.02130 0.02130 0.02130 0.07988 0.02556 0.02556 0.02556 0.02556 0.09586 0.02211 0.02211 0.02211 0.02211 0.11843 0.02251 0.02251 0.02251 0.02251 0.12059 0.02396 0.02396 0.02396 0.02396 0.12838 0.06593 0.06593 0.06593 0.06593 0.24726 0.08049 0.08049 0.08049 0.08049 0.30184 0.00000 0.00000 0.05976 0.05976 0.44822 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 Dental Ambulance 2,000,000 0.01663 0.01500 0.00994 0.01500 0.00878 0.01500 0.00919 0.01500 0.00977 0.01500 0.00999 0.01500 0.01198 0.01500 0.01481 0.01500 0.01508 0.01500 0.01605 0.01500 0.03091 0.01500 0.03773 0.01500 0.05603 0.01500 0.04793 Pre/Post Hospital 310,000 0.08427 0.06095 0.05383 0.05638 0.05992 0.06124 0.07349 0.08132 0.08280 0.08815 0.18956 0.23141 0.28387 Private Nurse 210,000 0.00000 0.00199 0.00176 0.00184 0.00195 0.00200 0.00240 0.00324 0.01968 0.02497 0.00618 0.00755 0.01121 Funeral Hemodialisis ######## 10,000,000 0.00138 0.02218 0.00138 0.02650 0.00149 0.02340 0.00149 0.02451 0.00159 0.02605 0.00268 0.02663 0.00419 0.03195 0.00699 0.02763 0.01105 0.02813 0.01630 0.02995 0.02215 0.08241 0.03359 0.10061 0.05928 0.07470 0.01774 0.02120 0.01872 0.01961 0.02084 0.02130 0.02556 0.02211 0.02251 0.02396 0.06593 0.08049 0.05976 0.06029 0.00000 0.02151 0.05527 0.05717 0.0150 0.0150 0.0150 0.0150 0.0150 0.0150 14 15 16 17 18 19 20 21 22 23 24 25 28 0.04302 0.05527 0.05717 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.00151 0.00387 0.00400 0.00418 0.00459 0.00467 0.00553 0.00592 0.00563 0.00562 0.00613 0.00732 0.00548 0.04302 0.05527 0.05717 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.04302 0.05527 0.05717 0.05974 0.06563 0 0.06670 0 0.07905 0.08459 0.08039 0.08024 0 0.08756 0.10461 0.15648 0.05974 0.06563 0.06670 0.07905 0.08459 0.08039 0.08024 0.08756 0.10461 0.15648 0.00000 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.0292 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02999 0.03269 0.03905 0.02921 0.00000 0.00000 0.00000 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00000 0.00000 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.00000 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.08604 0.11054 0.11434 0.11948 0.13126 0.13340 0.15810 0.16918 0.16078 0.16048 0.17512 0.20922 0.31296 0.01076 0.01382 0.01429 0.01494 0.01641 0.01668 0.01976 0.02115 0.02010 0.02006 0.02189 0.02615 0.03912 0.0150 0.05105 0.07590 0.07851 0.08204 0.09013 0.09160 0.10856 0.11617 0.11040 0.11019 0.12025 0.14366 0.18569 0.00000 0.00276 0.00286 0.00299 0.00328 0.00334 0.00395 0.00423 0.00402 0.00401 0.00438 0.00523 0.00782 0.00803 0.02063 0.02134 0.02230 0.02450 0.02490 0.02951 0.03158 0.03001 0.02995 0.03269 0.03905 0.02921 0.00138 0.00138 0.00138 0.00149 0.00149 0.00191 0.00294 0.00472 0.00804 0.01313 0.01749 0.02631 0.04440 0.01004 0.02579 0.02668 0.02788 0.03063 0.03113 0.03689 0.03948 0.03751 0.03744 0.04086 0.04881 0.03651 0.0150 0.0150 0.0150 0.0150 0.0150 0.0150 0.02921 Medical Room & Board Surgery Complex Surgery Major Surgery Intermediate Surgery Minor Anaesth Complex Anaesth. Anaesth Major Intermediate Anaesth Minor Operating complex Operating Operating Operating Major Intermediate Minor Emergency Pre/Post Hospital Private Nurse ICU Physician Specialist Miscellanous Dental Ambulance Implant Funeral Hemodialisis 31 NUMBER OF UNITS: (LOS, Avg. Days, Freq.) 32 Entry-age 33 - 14 Sex: M 1 34 15-19 2 35 20 - 25 3 36 26 - 30 4 37 31 - 35 5 38 36 -40 6 39 41 - 45 7 40 46 - 50 8 41 51 - 55 42 56-60 10 43 61 - 64 11 44 65-69 12 45 70 - 13 46 47 - 14 Sex: F 14 48 15 - 19 15 49 20-25 16 50 26 - 30 17 5.40 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 3.80 3.78 2.87 2.87 2.94 4.06 4.83 4.83 4.83 6.00 7.10 7.80 11.60 5.40 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 0.00 0.00 0.00 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.00 0.00 0.05 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.13 0.00 0.30 0.30 0.25 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.30 0.70 0.70 0.70 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.63 0.70 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 0.00 5.40 4.10 4.10 4.20 5.80 6.90 6.90 6.90 8.60 10.10 11.10 16.50 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 9mHQRUDE 4.50 3.70 3.70 3.90 3.20 2.60 2.60 2.70 4.50 3.70 3.70 3.90 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 0.00 0.00 0.00 0.03 0.00 0.00 0.05 0.07 0.30 0.30 0.25 0.23 0.70 0.70 0.70 0.67 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 0.00 3.70 3.70 3.90 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test no 5 E F G V W AA AB D Room & Board 6.90 8.60 10.10 11.10 16.50 ICU 4.83 6.00 7.10 7.80 11.60 Physician Specialist Miscellanous 6.90 1.00 1.00 8.60 1.00 1.00 10.10 1.00 1.00 11.10 1.00 1.00 16.50 1.00 1.00 J Surgery Major 0.13 0.13 0.13 0.13 0.00 Surgery Complex 0.07 0.07 0.07 0.07 0.00 Surgery Intermediate 0.17 0.17 0.17 0.17 0.30 Surgery Minor 0.63 0.63 0.63 0.63 0.70 M Anaesth Complex 0.07 0.07 0.07 0.07 0.00 N Anaesth Anaesth Major Intermediate 0.13 0.17 0.13 0.17 0.13 0.17 0.13 0.17 0.00 0.30 10 11 12 13 Anaesth. Minor 0.63 0.63 0.63 0.63 0.70 R S T Operating Operating Operating Operating complex Major Intermediate Minor Emergency 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.07 0.13 0.17 0.63 1.00 0.00 0.00 0.30 0.70 1.00 Dental Ambulance 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Y Private Nurse 6.90 8.60 10.10 11.10 16.50 Pre/Post Hospital 1.00000 1.00000 1.00000 1.00000 1.00000 Z Medical Implant 1.00 1.00 1.00 1.00 1.00 Funeral Hemodialisis 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1 INCIDENCE RATES: IP Inner Limit 41 51 - 55 42 56-60 43 61 - 64 44 65-69 45 70 - 46 47 - 14 Sex: F 48 15 - 19 49 20-25 50 26 - 30 51 31 - 35 52 36 - 40 53 41 - 45 54 46 - 50 55 51 - 55 56 56 - 60 57 61 - 64 58 65-69 59 70 - 60 9gH28 MBER&Bu88888 14 15 16 17 18 19 20 21 22 23 24 25 26 4.50 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 12.50 26.80 3.20 2.60 2.60 2.70 3.30 4.60 4.60 4.50 5.80 6.70 8.40 8.80 18.80 4.50 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 0.00 0.00 0.00 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.03 0.00 0.00 0.00 0.05 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.07 0.00 0.30 0.30 0.25 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.30 0.70 0.70 0.70 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.70 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 1.00000 0.00 3.70 3.70 3.90 4.70 6.50 6.50 6.40 8.30 9.50 12.00 12.50 26.80 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 12.50 26.80 Room & Board Surgery Complex Surgery Major Surgery Intermediate Surgery Minor Anaesth Complex Anaesth Minor Anaesth. Anaesth Major Intermediate Operating Operating Operating Operating complex Major Intermediate Minor Emergency Pre/Post Hospital ICU Medical Implant Physician Specialist Miscellanous Dental Ambulance Funeral Hemodialisis 1 2 61 UTILIZATION: 62 Entry-age 63 - 14 Sex: M 64 15-19 65 20-25 66 26 - 30 67 31 - 35 68 36 - 40 69 41 - 45 70 46 - 50 71 51 - 55 72 56 - 60 73 61 - 64 74 65-69 75 70 - 76 77 - 14 Sex: F 78 15 - 19 79 20-25 80 26 - 30 81 31 - 35 82 36 -40 83 41 - 45 84 46 - 50 85 51 - 55 86 56 - 60 87 61 - 64 88 65 - 69 89 70 - 5 6 7 8 9 10 11 12 13 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 37.50% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 37.50% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 50.00% 100.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% Private Nurse 40,000 0.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 50.000% 75.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 14 15 16 17 18 19 20 21 22 23 24 25 26 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 50.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 55.00% 37.50% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 75.00% 37.50% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 0.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 0.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 80.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 10.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 20.00% 50.00% 100.00% 75.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 0.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 50.000% 75.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 100.000% 80.00% 0.00% Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test no 5 + A B 11 E D Room & Board F G H 1 Surgery Physician Specialist Miscellanous Complex Physician +drug Drugs Laboratory Physiotherapy J Surgery Major Surgery Intermediate L Surger Mind ICU Physician Specialist Admin 1 INCIDENCE RATES: IP Inner Limit 92 INCIDENCE RATES : Out Patient 93 Entry-age 94 - 14 Sex: M/F 95 15-19 96 20 - 25 97 26 - 30 98 31 - 35 99 36 -40 100 41 - 45 101 46-50 102 51 - 55 103 56 - 60 104 61 - 64 105 65-69 106 70 - 107 1.97200 2.46500 2.55000 2.72000 2.89000 3.06000 3.40000 3.82500 4.25000 4.67500 5.10000 5.52500 5.95000 0.34800 0.43500 0.45000 0.48000 0.51000 0.54000 0.60000 0.67500 0.75000 0.82500 0.90000 0.97500 1.05000 0.99 1.23 1.28 1.36 1.45 1.53 1.70 1.91 2.13 2.34 2.55 2.76 2.98 2.32000 2.90000 3.00000 3.20000 3.40000 3.60000 4.00000 4.50000 5.00000 5.50000 6.00000 6.50000 7.00000 0.58000 0.72500 0.75000 0.80000 0.85000 0.90000 1.00000 1.12500 1.25000 1.37500 1.50000 1.62500 1.75000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 0.05000 2.95 3.68 3.80 4.05 4.30 4.55 5.05 5.68 6.30 6.93 7.55 8.18 8.80 Physician +drug Physician Specialist Drugs Laboratory Physiotherapy Admin 108 NUMBER OF UNITS: Out Patient 109 Entry-age 110 - 14 Sex: M/F 111 15 - 19 112 20-25 113 26 - 30 114 31 - 35 115 36 - 40 116 41 - 45 117 46 - 50 118 51 - 55 119 56 - 60 120 61 - 64 121 65 - 69 122 70 - 123 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Physician Specialist Physician +drug Drugs Laboratory Physiotherapy Admin 124 UTILISATION : Out Patient 125 Entry-age 126 - 14 Sex: M/F 127 15 - 19 128 20-25 129 26 - 30 130 31 - 35 131 36 - 40 132 41 - 45 133 46-50 134 51 - 55 135 56 - 60 136 61 - 64 137 65 - 69 138 70 - 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 2.50% 5.00% 50.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% 100.00% 100.00% 2.50% 10.00% 100.00% 100.00% test no 2 test no 3 Data for test no 4 test no 5 Multiple Choice Answer Test no 1 data for test no 5 Basic 1.000000 1.000000 1.000000 Basic +Gum 1.000000 1.000000 1.000000 Preventive 1.000000 1.000000 1.000000 Complex 1.000000 1.000000 1.000000 Protestic 1.000000 1.000000 1.000000 Rehabilitative 1.000000 1.000000 1.000000 69 20 DENTAL 1 NUMBER OF UNITS: Dental 2 Sex:M 3 Sex: F 14 Child 15 16 INCIDENCE RATES: Dental 27 Sex: M 8 Sex: F 19 Child 50 1 UTILISATION : Dental 52 Sex: M 53 Sex: F 4 Child 55 Basic 0.258250 0.324500 0.236250 Basic +Gum 0.050000 0.062500 0.045000 Preventive 0.200000 0.250000 0.180000 Complex 0.080000 0.100000 0.072000 Protestic 0.090000 0.112500 0.081000 Rehabilitative 0.120000 0.150000 0.108000 Basic 100.00% 100.00% 100.00% Basic +Gum 100.00% 100.00% 100.00% Preventive 100.00% 100.00% 100.00% Complex 100.00% 100.00% 100.00% Protestic 100.00% 100.00% 100.00% Rehabilitative 100.00% 100.00% 100.00% och B E N 0 0 6 1000 13 1 IN-PATIENT PLAN 1 Room & Board, per day Max. 90 days per Policy Year 500,000 3 2 Intensive Care Unit, per day Max. 15 days per Policy Year 1,000,000 4 3 In-hospital Physician's visits, per day Max. 90 days per Policy Year 210,000 5 4 In-hospital Specialist Consultations, per day Max. 90 days per Policy Year 1,000,000 5 Miscellaneous Hospital Suplies, per confinement 5,000,000 7 6 Surgery, per operation 8 a. Complex 9 b. Major 10 c. Intermediate 6,250,000 11 d. Minor 3,125,000 12 7 Anesthesia (40% of surgical limits), per operation a. Complex 14 b. Major 5,000,000 15 c. Intermediate 2,500,000 16 d. Minor 1,250,000 17 8 Operating Theater (40% of surgical limits), per operation 18 a. Complex 19 b. Major 5,000,000 20 c. Intermediate 2,500,000 21 d. Minor 1,250,000 22 9 Emergency Accidental Out-Patient Treatment, per policy year 3,000,000 23 10 Emergency Accidental Dental Treatment, per policy year 2,000,000 24 11 Pre & Post Hospitalization Treatment Max. 30 days per Policy Year 1,500,000 25 12 Ambulance Services, per confinement 310,000 26 13 Private Nurse, per day Max. 30 days per Policy Year 210,000 27 28 Overall Limit, per policy year Unlimited 29 30 14 Medical Equipment that implanted in the body, per policy year 31 15 Funeral Expenses 3,000,000 32 16 Hemodialys and Chemoterapy 33 34 35 36 OUT-PATIENT PLAN 1 37 1 Out-patient Physician's visit, per day 75,000 38 2 Out-patient Specialist Consultation, per day 225,000 Package ut nationt Physician's vicit+ Preccrintion Druce Multiple Choice Answer Test no 1 test no 2 test no 3 Data for test no 4 test no 5 data for test