Running Head: ASSESSMENT PAPER 1

Health Risk Assessment

Institutional Affiliation

Student Name

Course

Date
ASSESSMENT PAPER 2

MEMO

TO: C.E.O of the company

FROM: Risk Assessment Office

SUBJECT: Health Risk Assessment

Purpose and Frequency

A Health Risk Assessment is an implementation used to gather health information; it

involves biometric testing to evaluate an individual's health status, risks, and habits (Tarafdar,

2019). Wellness providers and employers use the data to understand the health risk to determine

employer-sponsored programs, including insurance purposes. Insurance companies depend on

this data for individual risk determination when providing a cover for an organization's employee

Khan et al.,2016). The H.R.A. is an essential document for any organization. It plays a vital role

in assessing risk; it can also be used during the Medical Annual Wellness Visit to determine

issues associated with an individual's health well-being. (Tarafdar, 2019).

As a reputable Insurance Company, incorporating Health Risk Assessment for every

individual who needs a cover with us will play a vital role in determining the type of cover to

provide (Fernandes,Ferreira,2020). Our clients; Individuals, S.M.E.s, and Corporate businesses,

need to be sensitized on filling H.R.A. to assess the health risk. Health insurance covers an

individual for one year, and so it is essential to evaluate the persons interested in our covers

yearly. It will help get actual individual data to describe a health policy concerning cost and

coverage limits. (Khan et al.,2016)

The entire process involves questionnaires that require answers from applicants who are

legible for the insurance covers. Our clientele base, which includes companies who sign up their

employees for medical covers, needs to ensure they allow us to do Health risk individual
ASSESSMENT PAPER 3

assessment (Khan et al., 2016). As per the Saudi Arabia Insurance Regulatory Authority's

policies, an individual must provide correct information, which will protect not only the

insurance companies but also the insured who will enjoy the cover as per the limit determined by

the H.R.A. (Fernandes,Ferreira,2020)

Health Risk Assessment Questions

The Health Assessment procedure involves questionnaires that are supposed to be

answered by an individual. The questions will help get precise data for ease of insurance

quotation. The questions include;

Demographic Characters-This is based on an individual's age and gender; age is used to

calculate the premium amount. The gender information also helps the insurance company to

understand their client. (Khan et al.,2016)

Lifestyle behaviours –Lifestyle behaviour generally refers to an individual's habits. It determines

the exercise routine of a person, eating habits if a person uses alcohol and tobacco. The lifestyle

describes the health risks that an individual might be exposed to, especially alcohol or tobacco

use (Fernandes and Ferreira, 2020). Likewise, a person who uses tobacco risks cancer-related

diseases and uses alcohol who risks liver cirrhosis.

Emotional and Physical Health –These questions will help our insurance company understand

its health status to be insured. Emotional health questions related to their mood, life events, and

stress management. Physical health involves the weight of the person, blood pressure, and

cholesterol levels in their body. The questions also provide information regarding an individual's

family health history since some diseases are hereditary, for example, diabetes. (Khan et

al.,2016)
ASSESSMENT PAPER 4

Current and Previous Health conditions- This information will provide the insurance company

with the history of an individual's health conditions, including previous conditions, how they

were treated and where they were treated. If a person has an existing situation, the insurance

company will determine if the policy clauses cover that type of health condition. (Thokala et

al,2016)

Impact of H.R.A. on risk and premium cost

H.R.A. is a crucial determinant in the evaluation of insurance premiums. The questions in

H.R.A. that give information about an individual's health history assist the insurance assessors do

determine the calculation of premiums (Fernandes,Ferreira,2020). Health history that includes

persons with chronic illness is unfortunate because the premium amounts will be high since huge

claims arise from their frequent visits to hospitals. Besides, the charges for treating these diseases

are generally high; hence it will be necessary for the company to establish if they will include

these diseases in their policy covers. (Tarafdar, Sinha,2019)

Demographic characters like the age of an individual help the insurance company

determine the age brackets for policy covers. A policy cannot cover some age brackets; people

above the age of 65 are not eligible for medical cover (Knaul et al,2015). Emotional and physical

health factors also let the insurer get the medical history of an individual to determine the cover's

premium amount.

The HRA Determines the risk that the insurer is willing to cover for an individual; family

medical history issues provide information on possible health risks. A person from a family with

diabetic history has a higher chance of inheriting the disease since it is hereditary. As insurance

providers, we will base our health policy cover on such an individual with precise information on

the risks involved. We can, therefore, make decisions whether to cover or not cover such cases
ASSESSMENT PAPER 5

concerning the risks associated. If the company decides to cover such instances per the Health

Risk Assessment, we can increase the individuals' premium amounts. (Khan et al.,2016)

Negative Implications of H.R.A. on people with chronic illness

Individuals with the chronic disease usually get negative implications based on their

Health Risk Assessment reports. The insurer can decide to entirely not cover them or charge high

premium amounts on their medical insurance policy covers (Thokala et al,2016). Chronic

diseases include cancer which is very expensive to treat. Many of the persons living with cancer

cannot afford the expense of treatment, and they cannot afford to pay for the premiums that can

cover the entire treatment package (Knaul et al., 2015). The treatment stages include

chemotherapy which is usually very expensive; to enjoy a medical cover with a chemotherapy

package; they would have to dig deeper in their pockets. The employers, on the other side, do not

provide medical covers that include policies with chronic disease packages. All these

explanations give a clear view of how individuals with existing chronic diseases are suffering

from insurance covers. (Thokala et al,2016)

Best Practices

Our Insurance Company needs to be aware of the best practices involving the Health Risk

Assessment procedures. An individual's health information is a piece of sensitive information,

and such should not be shared with unauthorized individuals. Confidentiality of information is

critical and a number one best practice for a suitable H.R.A. procedure (Thokal et al., 2016). It is

upon the insurer to ensure that the information gathered from H.R.A. for insurance purposes

should remain confidential and be used specifically for health medical cover purposes only. The

officers in charge of collecting the H.R.A. data need to be sensitized about the importance of a

client's confidentiality in regards to the information provided (Knaul et al,2015). Communication

ASSESSMENT PAPER 6

is another best practice; the client needs to be educated about the information they will be

provided to the insurer. Further information on how health information can affect their covers

should be sensitized to the client before the assessment day. (Fernandes,Ferreira,2020)

ASSESSMENT PAPER 7

References

Fernandes, H. E., & Ferreira, F. A. (2020). Health insurance risk assessment using cognitive

mapping and multiple‐criteria decision analysis. International Transactions in

Operational Research.

Khan, T. M., Emeka, P., Suleiman, A. K., Alnutafy, F. S., & Aljadhey, H. (2016).

Pharmaceutical pricing policies and procedures in Saudi Arabia: a narrative

review. Therapeutic Innovation & regulatory science, 50(2), 236-240.

Knaul, F. M., Bhadelia, A., Atun, R., & Frenk, J. (2015). Achieving adequate universal health

coverage and diagonal approaches to care for chronic illnesses. Health Affairs, 34(9),

1514-1522.

Tarafdar, A., & Sinha, A. (2019). Health risk assessment and source study of PAHs from

roadside soil dust of a heavy mining area in India. Archives of environmental &

occupational health, 74(5), 252-262.

Thokala, P., Devlin, N., Marsh, K., Baltussen, R., Boysen, M., Kalo, Z. ... & Ijzerman, M.

(2016). Multiple criteria decision analysis for health care decision making—an

introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value

in health, 19(1), 1-13.