Self Funded Inclusive Insurance + Group Wellness Programs
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Employer-based inclusive insurance with global stop loss policies and wellness programs is proposed as a solution to the lack of adequate healthcare access globally. This involves businesses providing self-funded health insurance to employees through an in-house insurer. Risk is managed through stop loss insurance policies at both the individual business and global levels to insure against extraordinary medical claims. Wellness programs aim to offset costs by encouraging healthy behaviors. Reinsurance provides a further safety net against losses exceeding other risk management measures.
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#2 What is voluntary insurance why do employees need it
Voluntary insurance provides additional coverage to employees to help pay medical and living expenses not covered by major medical insurance. It is not required but is completely optional for employees to enroll in. Many employees are interested in voluntary insurance because nearly half have less than $1,000 to pay out-of-pocket medical costs, and two-thirds would struggle with the costs of a serious injury or illness. Voluntary insurance can help employees pay deductibles, coinsurance, copays, and bills that continue after an illness or injury when someone cannot work. It benefits both employees and employers by providing financial protection for employees with no direct cost to companies.
Why supplemental-insurance-matters
This document discusses the importance and benefits of voluntary (supplemental) insurance for businesses and employees. It makes three key points:
1) Voluntary insurance helps protect employees from unexpected medical costs and makes them more satisfied. It is an important part of an employer's benefits package for attracting and retaining talent.
2) Many employees are unprepared to manage the rising costs and responsibilities of healthcare. Voluntary insurance can provide financial protection from out-of-pocket costs like deductibles and coinsurance.
3) Voluntary insurance benefits both employers and employees. It boosts employee satisfaction and loyalty while costing employers little to nothing. It also supports healthier employees and lower workers compensation claims.
Employer Sponsored Health Insurance
Every American is entitled and bound to avail Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA) - also known as Obamacare. While some opt for individual health insurance plans offered by private institutions, more than 60% opt for Employer-Sponsored Health Insurance. Employer-Sponsored Health Insurance makes your work easy because you don't have to go through multiple insurance plans available online. Employers, on an average pay 82% of your premium for a single insurance policy. For employers also this is a win-win situation because it results in employee retention, better health of employees thus more productivity. Employers use good health benefits as a great tool to recruit sought-after talent in the industry.
The slide deck talks about Employer-Sponsored Health Insurance, its comparison to individual health insurance and the win-win situation for employee and employer.
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Health insurance covers medical and surgical expenses for insured individuals. It can reimburse costs out-of-pocket or make direct payments to providers. It is important for individuals and families who cannot get insurance through employers due to rising healthcare costs. Government plans like Medicare provide health insurance for those over 65, while private long-term care insurance covers nursing home and home healthcare costs for those needing assistance with daily tasks. Additional types of insurance include dental, vision, and disability coverage.
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#2 What is voluntary insurance why do employees need it
Voluntary insurance provides additional coverage to employees to help pay medical and living expenses not covered by major medical insurance. It is not required but is completely optional for employees to enroll in. Many employees are interested in voluntary insurance because nearly half have less than $1,000 to pay out-of-pocket medical costs, and two-thirds would struggle with the costs of a serious injury or illness. Voluntary insurance can help employees pay deductibles, coinsurance, copays, and bills that continue after an illness or injury when someone cannot work. It benefits both employees and employers by providing financial protection for employees with no direct cost to companies.
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This document discusses the importance and benefits of voluntary (supplemental) insurance for businesses and employees. It makes three key points:
1) Voluntary insurance helps protect employees from unexpected medical costs and makes them more satisfied. It is an important part of an employer's benefits package for attracting and retaining talent.
2) Many employees are unprepared to manage the rising costs and responsibilities of healthcare. Voluntary insurance can provide financial protection from out-of-pocket costs like deductibles and coinsurance.
3) Voluntary insurance benefits both employers and employees. It boosts employee satisfaction and loyalty while costing employers little to nothing. It also supports healthier employees and lower workers compensation claims.
Employer Sponsored Health Insurance
Every American is entitled and bound to avail Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA) - also known as Obamacare. While some opt for individual health insurance plans offered by private institutions, more than 60% opt for Employer-Sponsored Health Insurance. Employer-Sponsored Health Insurance makes your work easy because you don't have to go through multiple insurance plans available online. Employers, on an average pay 82% of your premium for a single insurance policy. For employers also this is a win-win situation because it results in employee retention, better health of employees thus more productivity. Employers use good health benefits as a great tool to recruit sought-after talent in the industry.
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Health insurance covers medical and surgical expenses for insured individuals. It can reimburse costs out-of-pocket or make direct payments to providers. It is important for individuals and families who cannot get insurance through employers due to rising healthcare costs. Government plans like Medicare provide health insurance for those over 65, while private long-term care insurance covers nursing home and home healthcare costs for those needing assistance with daily tasks. Additional types of insurance include dental, vision, and disability coverage.
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The document defines health insurance as a contract between an insurance provider and an individual or organization that covers medical expenses. Key aspects of health insurance include premium payments, deductibles, copays, coverage limits, and what medical costs are covered. Rates are calculated based on personal health history and risks. Premiums can increase if claims are high or an individual's health status changes. Missed payments can cause a policy to lapse or be cancelled. The document also outlines some common types of health insurance plans and tax benefits.
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This document provides an overview of the major types of health insurance plans in the United States. It discusses employer-based group plans that cover over half of Americans, as well as self-paid private plans for individuals. It also outlines the government programs of Medicare for seniors and disabled, Medicaid for low-income individuals, and SCHIP for children. Other sources of coverage discussed include other government programs, private charities, and Health Savings Accounts. Around 8% of the population, or 26 million people, lacked health insurance in 2019.
Medical insurance
Medical insurance covers unforeseen medical expenses like illness, injury, or accidents. It protects individuals and families in the same way other types of insurance like auto or homeowner's insurance provide protection. Medical costs have risen sharply in recent years. Private health insurance companies offer a variety of medical insurance plans that vary in coverage, costs, benefits, and complexity making it important for consumers to understand the differences between plans. Government programs also provide some forms of medical insurance coverage for specific groups.
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Ch. 5 Paying for Health Care
Learning Objectives
After reading this chapter, you should be able to:
Distinguish the benefits and shortcomings of private sources of payment for the care of vulnerable persons.
Identify the benefits and shortcomings of public sources of payment for the care of vulnerable persons.
Recognize the most common public payer options, and understand their eligibility requirements.
Understand how health care is financed for people with no health insurance coverage.
Introduction
Photo of a large group of people protesting in front of a white government building. A woman at the front left of the photo carries a sign that says, "Responsible capitalism, healthcare for all." A man at the front right of the photo holds a sign that says, "Medical bankruptcy has a face."
Courtesy of Jodi Jacobson/iStockphoto
Costly new technologies and the free-market nature of the health care industry have raised the cost of health care.
The cost of health care is rising, in part because of expensive new technologies and procedures, and in part because of the market failure of the health care industry. It has been argued that deregulation of health insurers, combined with a free market health care industry, has changed health care from a service-based structure to a commodity, or a product available for purchase. America's health care delivery system is geared toward the multibillion dollar health insurance industry rather than individual payers, many of whom lack the financial ability to cover health care expenses out of pocket, from general emergency room care to a life-threatening illness. After all, few people have $10,000 in their budgets to cover the cost of an emergency room visit for a broken arm.
Americans purchase health insurance to cover medical bills, but health insurance is too expensive for many families to afford. In 2010, 64% of the American population had private health insurance for all or part of the year. That isn't a very large majority, considering that everybody needs medical attention at some point. In that same year, 31% of the population had government-run public health insurance, and 16.3% had no health insurance at all for all or part of the year (DeNavas-Walt, Proctor, & Smith, 2011). The question across America, from Congress to kitchen tables, is how to insure all, how to tackle rising health care costs, and how to decipher a fair and equitable payee process.
Critical Thinking
What do you think will be the impact if health care costs are not addressed? What future problems do you predict?
5.1 Private Payers
The private payer sector comprises programs that provide financial access to health care, which includes insurance companies, employer-run health coverage programs, and individuals who pay for health care out of pocket. Individuals who pay for all of their health care out of pocket are rare, as the cost of health care is prohibitive. Employer-run health coverage programs are types of i ...
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Could You Live on Half a Paycheck
- Group long-term disability insurance (GLTD) typically covers only 60% of income and has maximum monthly caps, leaving many people with significantly lower incomes if disabled. GLTD also excludes bonuses, commissions, and may not cover partial disabilities.
- Over 90% of disabilities are caused by illnesses rather than accidents, and can happen to anyone. However, most people assume they are young and healthy or covered by their employer so do not purchase individual disability insurance.
- Purchasing a supplemental individual disability income policy can fill in the gaps in coverage left by GLTD policies to better protect one's full income and lifestyle in the event of a disability. It can be designed to cover bonuses and partial disabilities
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This will work because so much of this is already in place and a lot of the rest would be quick and easy to implement. As in all areas, knowledge is power. Consumers can take control of your insurance portfolio by becoming educated about insurance. Better education and understanding will lead to positive results for consumers and for the insurance industry.
Why Roundstone? We are the solution.
This document discusses why the Mid-Market Med group captive program is a viable solution for mid-market employers given changes under the Affordable Care Act. The program offers comprehensive services, low collateral requirements, top-tier reinsurance, flexibility, and has achieved positive results including an 18% annual premium return and 99% client retention. The program allows mid-market employers to share risks and lower healthcare costs through a medical stop loss group captive.
Benefits of the Mediclaim Policy
By opting for the cashless mediclaim policy, the policy holder is able to reimburse cashless benefits on the medical expenses.
Importance of health insurance
Importance of Health Insurance: Incase you get sick or need any kind of medical attention. Can you afford to pay for a doctor’s visit without insurance? Depending on the type of doctor and practice it can cost from www.lifethenfinance.com 2 $95–$265 per visit. Insurance co-pays: $5–$50 per visit. Are you certain you won’t hurt yourself or catch some type of cold? Do you have allergies, wear contacts or need any other type of regular prescriptions? Can you afford those medications without insurance? On average prescription generic medications start around $50. Insurance co pays usually around $5–$20.
Self-Funding Overview
Should an Employer Be Self-Funded?
That is quite a question. In the past we cautioned that claims savings was not guaranteed by self-funding. And with a small difference in fixed fees vs. fully insured retention, there was not much incentive for smaller employers to take the risk, given that they were more susceptible to wide fluctuations in claims cost.
Review our research and analysis on self-funding to help determine if the program is the right fit for your business. Contact McGohan-Brabender to discuss self-funding in detail.
https://www.mcgohanbrabender.com/
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Chapter 18 Private and Government Healthcare Systems Pri
Chapter 18
Private and Government Healthcare Systems
Private and Government Healthcare Systems
In the United States, health insurance coverage is generally classified as either private (non-government) coverage or government-sponsored coverage.
Healthcare Coverage vs. Uninsured
The National Center for Health Statistics defines health insurance as public and private payers who cover medical expenditures incurred by a defined population in a variety of settings.
In the United States, the risk of becoming uninsured increases significantly for those earning low wages, the unemployed, and when employers are unable to provide insurance to workers.
Table 5-2 presents the trend of declining health insurance coverage.
Private Health Insurance
The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount.
Employment-Based Plans is coverage offered through one’s own employment or a relative’s employment.
It may be offered by an employer or by a union.
Private Health Insurance Continued
Direct-Purchase/Fee-For-Service Plans are the traditional type of healthcare policy.
The physician sets a price for each type of service delivered, and then the client or insurance company pays the fee.
This type of health insurance provides the most choices of doctors and hospitals.
Private Health Insurance Continued
The two kinds of fee-for-service coverage are basic and major medical.
Basic covers some hospital services and supplies, such as X-rays and prescribed medicine.
Major medical insurance covers the cost of long-term, high-cost illnesses or injuries plus whatever basic did not cover.
Private Health Insurance Continued
Group Contract Insurance—to make hospitals and physicians products and services affordable to ordinary people in the United States.
With unmanaged care (fee-for-service) payments, healthcare providers could increase the number of single services they deliver in order to increase profit.
Private Health Insurance Continued
Managed Care—manages the cost and delivery of healthcare services, the quality of that healthcare, and access to care.
Managed care influences how much healthcare clients can use.
Health Maintenance Organizations (HMOs) are prepaid health plans.
The goal of an HMO is to provide affordable, well-organized healthcare by allowing clients to prepay (capitation payment) on a regular monthly basis for all services provided.
Private Health Insurance Continued
Including physicians’ visits, hospital stays emergency care, surgery, laboratory (lab) tests, X-rays, and therapy for all members and their families.
There may be a small co-payment for each office visit, such as $15 for a doctor’s visit or $50 for hospital emergency room treatment.
Private Health Insurance Continued
Point-of-Service Plans (POS) offer enrollees the option of receiving services from participating or nonparticipating prov ...
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The document discusses various types of insurance, including life, general, health, and property insurance. It provides definitions and classifications of insurance, explains concepts like premiums and insurers, and gives examples of specific insurance policies and plans like health, home, and renter's insurance. Key details covered include classifications of insurance, definitions of terms, common policy elements and exclusions, health insurance initiatives and schemes in India, and importance of property and health insurance.
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Ch. 5 Paying for Health CareLearning ObjectivesAfter reading.docx
Ch. 5 Paying for Health Care
Learning Objectives
After reading this chapter, you should be able to:
Distinguish the benefits and shortcomings of private sources of payment for the care of vulnerable persons.
Identify the benefits and shortcomings of public sources of payment for the care of vulnerable persons.
Recognize the most common public payer options, and understand their eligibility requirements.
Understand how health care is financed for people with no health insurance coverage.
Introduction
Photo of a large group of people protesting in front of a white government building. A woman at the front left of the photo carries a sign that says, "Responsible capitalism, healthcare for all." A man at the front right of the photo holds a sign that says, "Medical bankruptcy has a face."
Courtesy of Jodi Jacobson/iStockphoto
Costly new technologies and the free-market nature of the health care industry have raised the cost of health care.
The cost of health care is rising, in part because of expensive new technologies and procedures, and in part because of the market failure of the health care industry. It has been argued that deregulation of health insurers, combined with a free market health care industry, has changed health care from a service-based structure to a commodity, or a product available for purchase. America's health care delivery system is geared toward the multibillion dollar health insurance industry rather than individual payers, many of whom lack the financial ability to cover health care expenses out of pocket, from general emergency room care to a life-threatening illness. After all, few people have $10,000 in their budgets to cover the cost of an emergency room visit for a broken arm.
Americans purchase health insurance to cover medical bills, but health insurance is too expensive for many families to afford. In 2010, 64% of the American population had private health insurance for all or part of the year. That isn't a very large majority, considering that everybody needs medical attention at some point. In that same year, 31% of the population had government-run public health insurance, and 16.3% had no health insurance at all for all or part of the year (DeNavas-Walt, Proctor, & Smith, 2011). The question across America, from Congress to kitchen tables, is how to insure all, how to tackle rising health care costs, and how to decipher a fair and equitable payee process.
Critical Thinking
What do you think will be the impact if health care costs are not addressed? What future problems do you predict?
5.1 Private Payers
The private payer sector comprises programs that provide financial access to health care, which includes insurance companies, employer-run health coverage programs, and individuals who pay for health care out of pocket. Individuals who pay for all of their health care out of pocket are rare, as the cost of health care is prohibitive. Employer-run health coverage programs are types of i ...
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Health insurance- insurance products-individual and family floater
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This document provides an overview of health insurance. It discusses why health insurance is needed given rising healthcare costs. It outlines the types of medical expenses that can be incurred and that most health insurance policies cover expenses related to hospitalization. There are two major types of health insurance plans - indemnity plans which reimburse expenses, and managed care plans which provide incentives to use selected healthcare providers. When determining an appropriate level of health insurance coverage, factors to consider include age, health history, income, financial obligations, profession, and the option of a floater policy that provides coverage for a family rather than individuals.
Could You Live on Half a Paycheck
- Group long-term disability insurance (GLTD) typically covers only 60% of income and has maximum monthly caps, leaving many people with significantly lower incomes if disabled. GLTD also excludes bonuses, commissions, and may not cover partial disabilities.
- Over 90% of disabilities are caused by illnesses rather than accidents, and can happen to anyone. However, most people assume they are young and healthy or covered by their employer so do not purchase individual disability insurance.
- Purchasing a supplemental individual disability income policy can fill in the gaps in coverage left by GLTD policies to better protect one's full income and lifestyle in the event of a disability. It can be designed to cover bonuses and partial disabilities
7 Health Insurance Questions, Answered
Here are 7 Health Insurance Questions, Answered: 1. What Is Health Insurance? 2. Why Do I Need Health Insurance? 3. What Are the Different Types of Health Insurance? 4. What Is a Premium, Deductible, and Copayment?
A health insurance roadmap
A health insurance roadmap takes a look at some simple solutions to the complex issues facing health insurance, medicare, medicaid, long term care insurance, and the high cost of health expenses in retirement.
This will work because so much of this is already in place and a lot of the rest would be quick and easy to implement. As in all areas, knowledge is power. Consumers can take control of your insurance portfolio by becoming educated about insurance. Better education and understanding will lead to positive results for consumers and for the insurance industry.
Why Roundstone? We are the solution.
This document discusses why the Mid-Market Med group captive program is a viable solution for mid-market employers given changes under the Affordable Care Act. The program offers comprehensive services, low collateral requirements, top-tier reinsurance, flexibility, and has achieved positive results including an 18% annual premium return and 99% client retention. The program allows mid-market employers to share risks and lower healthcare costs through a medical stop loss group captive.
Benefits of the Mediclaim Policy
By opting for the cashless mediclaim policy, the policy holder is able to reimburse cashless benefits on the medical expenses.
Importance of health insurance
Importance of Health Insurance: Incase you get sick or need any kind of medical attention. Can you afford to pay for a doctor’s visit without insurance? Depending on the type of doctor and practice it can cost from www.lifethenfinance.com 2 $95–$265 per visit. Insurance co-pays: $5–$50 per visit. Are you certain you won’t hurt yourself or catch some type of cold? Do you have allergies, wear contacts or need any other type of regular prescriptions? Can you afford those medications without insurance? On average prescription generic medications start around $50. Insurance co pays usually around $5–$20.
Self-Funding Overview
Should an Employer Be Self-Funded?
That is quite a question. In the past we cautioned that claims savings was not guaranteed by self-funding. And with a small difference in fixed fees vs. fully insured retention, there was not much incentive for smaller employers to take the risk, given that they were more susceptible to wide fluctuations in claims cost.
Review our research and analysis on self-funding to help determine if the program is the right fit for your business. Contact McGohan-Brabender to discuss self-funding in detail.
https://www.mcgohanbrabender.com/
Medicare Medical Health Insurance - A B C D
If you have been paying into social security during your working life, and possess met the minimum w...
REPORT ON HEALTH INSURANCE & CONSUMER
Report on Health insurance and consumer, it is an overview of what health insurance is all about, what are its scenario in India. It also explains about how the regulatory authority perform its function and hoe do they deal with the consumer, faulty transaction etc. We have done a survey of
Chapter 18 Private and Government Healthcare Systems Pri
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Private and Government Healthcare Systems
Private and Government Healthcare Systems
In the United States, health insurance coverage is generally classified as either private (non-government) coverage or government-sponsored coverage.
Healthcare Coverage vs. Uninsured
The National Center for Health Statistics defines health insurance as public and private payers who cover medical expenditures incurred by a defined population in a variety of settings.
In the United States, the risk of becoming uninsured increases significantly for those earning low wages, the unemployed, and when employers are unable to provide insurance to workers.
Table 5-2 presents the trend of declining health insurance coverage.
Private Health Insurance
The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount.
Employment-Based Plans is coverage offered through one’s own employment or a relative’s employment.
It may be offered by an employer or by a union.
Private Health Insurance Continued
Direct-Purchase/Fee-For-Service Plans are the traditional type of healthcare policy.
The physician sets a price for each type of service delivered, and then the client or insurance company pays the fee.
This type of health insurance provides the most choices of doctors and hospitals.
Private Health Insurance Continued
The two kinds of fee-for-service coverage are basic and major medical.
Basic covers some hospital services and supplies, such as X-rays and prescribed medicine.
Major medical insurance covers the cost of long-term, high-cost illnesses or injuries plus whatever basic did not cover.
Private Health Insurance Continued
Group Contract Insurance—to make hospitals and physicians products and services affordable to ordinary people in the United States.
With unmanaged care (fee-for-service) payments, healthcare providers could increase the number of single services they deliver in order to increase profit.
Private Health Insurance Continued
Managed Care—manages the cost and delivery of healthcare services, the quality of that healthcare, and access to care.
Managed care influences how much healthcare clients can use.
Health Maintenance Organizations (HMOs) are prepaid health plans.
The goal of an HMO is to provide affordable, well-organized healthcare by allowing clients to prepay (capitation payment) on a regular monthly basis for all services provided.
Private Health Insurance Continued
Including physicians’ visits, hospital stays emergency care, surgery, laboratory (lab) tests, X-rays, and therapy for all members and their families.
There may be a small co-payment for each office visit, such as $15 for a doctor’s visit or $50 for hospital emergency room treatment.
Private Health Insurance Continued
Point-of-Service Plans (POS) offer enrollees the option of receiving services from participating or nonparticipating prov ...
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Recipes & Perceptrons
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Top massage center in ajman chandrima Spa
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查询留服认证是国内鉴别留学生海外学历的唯一途径，但认证只是个体行为，不是所有留学生都操作，所以没有办理认证的留学生的学历在国内也是查询不到的，他们也仅仅只有一张文凭。所以这时候我们提供的和学校颁发的一模一样的毕业证成绩单，就有了使用价值。
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Hypotension and role of physiotherapy in it
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
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Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
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Self Funded Inclusive Insurance + Group Wellness Programs
- 1. SELF FUNDED INCLUSIVE INSURANCE + GROUP WELLNESS PROGRAMS A POSSIBLE SOLUTION TO THE GLOBAL ISSUE OF ADEQUATE ACCESS TO HEALTHCARE
- 2. The technical terminology for the proposed solution: Employer based inclusive insurance as self-funded insurance with global stop loss policies + wellness programs for staff
- 3. The Problem Close to 5 billion people lack adequate health insurance. -One problem with this issue is that some people do not trust government or large corporation insurers. Along with this, close to 1 billion people do not have proper identification.
- 4. The proposed solution for the global problem: -A business can have a essentially in- house health insurance company (Self-Funded). This is already being done in the United States. Those who are distrustful of government or private health insurance may have more trust in their local
- 5. In economically disadvantaged counties, workers lacking proper identification in the country where they work may be more willing to apply for proper identification because of the ability to gain employer based health insurance.
- 6. Risk: Although routine medical expenses may be readily afforded with a proper financial reserve for claims, extraordinary medical expenses can deplete the entire reserve fund.
- 8. This is managed by means of a private health insurance policy for these types of claims, called a stop loss insurance policy.
- 9. However; for small companies, the extraordinary health insurance claims can still be too much to manage. This brings why "global stop loss" is in the title of this solution…
- 10. What is envisioned is a diverse portfolio of businesses paying for what would be inclusive, microinsurance stop loss policies… essentially pooled risk.
- 12. To offset extraordinary medical expenses, wellness programs are envisioned for policy holders.
- 13. A key part of wellness programs is working with a portion of the employee population to encourage smoking and alcohol cessation.
- 14. REINSURANCE
- 15. Reinsurance is insurance for insurers. In the event of losses that exceed the stop loss policy despite the risk management being implemented, there is also the option of reinsurance