Price Variations Among Standardized Voluntary Health Insurance Plans: Evidence From Hong Kong
Author(s)
Chelsea Mok, BSc1, Yikun Zhang, MSc2, Xuechen Xiong, PhD2, Jianchao Quan, MD2.
1University of Hong Kong, Hong Kong, China, 2School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
1University of Hong Kong, Hong Kong, China, 2School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong.
OBJECTIVES: Health financing in Hong Kong is highly reliant on government funds (52%) and household out-of-pocket payments (31%). The Voluntary Health Insurance Scheme (VHIS) introduced in 2019 promotes risk pooling of voluntary contributions and consumer protection through Certified Plans offering standardized features, including guaranteed renewal and specified coverage. VHIS has grown steadily to 1.2million active policies by 2022, with over half of insured individuals age below 40. We analyzed variations in community-rated premium prices for VHIS Standard Plans and assessed factors associated with higher premiums.
METHODS: In 2024, there were 94 Certified Plans (31 Standard and 63 Flexi). We analyzed 7,184 annual premium rates from all 31 Standard Plans providers. We fitted generalized linear regression models to assess associations between age, sex, and smoking status with premiums. We also tested interactions between variables.
RESULTS: Premium prices ranged from US$130 to US$5,862 with wide variations between providers. Mean premiums for age groups 30-40, 40-50, 50-60, 60-70 and 70-80 were 1.6x, 2.3x, 3.2x, 5.0x and 7.7x higher than those age below 30. Premiums for males were 10% lower than females but showed age-dependent difference. For example, males had premiums 20% lower than females for age 30-50, but 10% higher for those age over 60. Smokers had 30% higher premiums than non-smokers consistently across all age groups.
CONCLUSIONS: Premium price differences were mainly driven by age and choice of provider. Gender variations differed by age group whereas the additional premium for smokers remained consistent across age groups. Quantifying these differences can help determine actuarial fairness and viability of community rating pricing for Standard Plans.
METHODS: In 2024, there were 94 Certified Plans (31 Standard and 63 Flexi). We analyzed 7,184 annual premium rates from all 31 Standard Plans providers. We fitted generalized linear regression models to assess associations between age, sex, and smoking status with premiums. We also tested interactions between variables.
RESULTS: Premium prices ranged from US$130 to US$5,862 with wide variations between providers. Mean premiums for age groups 30-40, 40-50, 50-60, 60-70 and 70-80 were 1.6x, 2.3x, 3.2x, 5.0x and 7.7x higher than those age below 30. Premiums for males were 10% lower than females but showed age-dependent difference. For example, males had premiums 20% lower than females for age 30-50, but 10% higher for those age over 60. Smokers had 30% higher premiums than non-smokers consistently across all age groups.
CONCLUSIONS: Premium price differences were mainly driven by age and choice of provider. Gender variations differed by age group whereas the additional premium for smokers remained consistent across age groups. Quantifying these differences can help determine actuarial fairness and viability of community rating pricing for Standard Plans.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD85
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas