Capital baseado em risco no mercado de saúde suplementar do Brasil: análise de impacto se adotado o modelo praticado no mercado de seguros

• Ano de defesa: 2013
• Autor(a) principal: Silva, Adriana Barbosa Sousa
• Orientador(a): Famá, Rubens
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica de São Paulo
• Programa de Pós-Graduação: Programa de Estudos Pós-Graduados em Ciências Contábeis e Atuariais
• Departamento: Ciências Cont. Atuariais
• País: BR
• Palavras-chave em Português: Capital baseado em risco; Solvência; Operadoras de saúde; Saúde suplementar
• Palavras-chave em Inglês: Risk-based capital; Solvency; Health plans companies; Supplementary healthcare
• Área do conhecimento CNPq: CNPQ::CIENCIAS SOCIAIS APLICADAS::ADMINISTRACAO::CIENCIAS CONTABEIS
• Link de acesso: https://tede2.pucsp.br/handle/handle/1561

This paper has the main purpose to determine quantitatively the impact of framing of Health-plan Companies, in regards to sufficiency of solvency margin, if adopted the model of a risk-based capital used in the Insurance Market. We have conducted an exploratory study, based on secondary data available on the ANS - Agência Nacional de Saúde Suplementar (NSA- National Supplemental Health Agency). From a sample of 578 health operators modalities of Medical Group and Medical Cooperatives there were calculated solvency margin requirements of the relevant legislation operators supplemental health and solvency margin requirements for capital model based on current risk of the Brazilian Insurance Market. We performed a descriptive statistical result, segmented by the size of the operator. The results pointed to the need for solvency margin of 5% of the sample, i.e., 30 carriers that were framed in the solvency margin requirements by the legislation applied to health plans companies would no longer be framed if used the model risk-based capital, considering underwriting risk. This impact is higher among carriers of the Medical Group small group, where 15 operators, representing 10% of the mode and size, would no longer be framed. In addition to quantitatively assess the impact of the model adopted in the insurance market, which is more sophisticated and in line with the global trend of risk-based capital, this study sought to raise issues related to risk-based capital and solvency in the supplemental health operators