Community rating whereby all subscribers are charged the same premium for a particular plan, irrespective of risk factors such as age, gender or health status is a fundamental cornerstone of the Irish health insurance market. Risk equalisation is the standard transfer mechanism used to equalise risk and underpin community rating internationally. The Risk Equalisation Scheme in Ireland involves the collection of a community rating levy from insurers by the Revenue Commissioners. These levies are paid into a Risk Equalisation Fund operated by the Health Insurance Authority who redistributes the Fund back to the market through credits payable to insurers in respect of insured older lives (aged 60 and over) and utilisation of in-patient hospital services. This system ensures that all insured persons continue to pay the same net amount for a given health insurance product and helps to support affordable premiums for all.
The Risk Equalisation Scheme is self-funding, ie the cost of credits is met by the stamp duties raised. The total stamp duty levies raised under the Risk Equalisation Scheme on health insurance products written in 2013 was €413m, while an additional €173m was taken in under the ARTC Scheme in respect of policies taken out or renewed from 1 August to 31 December 2012 and paid to the Exchequer in February 2013. The total amount raised in 2014 was €582m.