The voluntary health insurance system in Ireland operates on the basis of community rating, whereby everyone pays the same price for the same product, and is supported by a Risk Equalisation Scheme which aims to keep health insurance more affordable for older and less healthy citizens.
The Risk Equalisation Scheme works by spreading the cost of insuring older and sicker people across the market, through the imposition of a stamp duty levy on every health insurance contract issued. These levies are paid into a fund, out of which risk equalisation credits are paid to insurers in order to reduce some of the additional costs they incur when insuring older, less healthy members.
Recommendations are made each year by the independent Health Insurance Authority regarding the appropriate level for risk equalisation credits. The risk equalisation scheme is self-funding and exchequer neutral, neither a cost nor a benefit to the State.