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   It is a formal procedure whereby a state accepts the convention as a legally binding instrument and engages itself to make it part of its own domestic law, and to implement it as such.

   Context: needs of the target population

   See: affiliated persons

   Always considered as in-kind benefit. Furthermore, any cash payment which is not made directly to the protected person or to a dependant of a protected person is considered as in-kind benefit (e.g. payment to health care providers). [ILO.694]

   Benefit covering the actual cost of a good or service. Requires recipients to show evidence of expenditure (e.g. funeral costs, home care costs). [ILO,694]

   A mechanism through which an insurer obtains insurance from a third party (the reinsurer) for all or a part of the risks it has undertaken to cover, in exchange for the payment of a premium. The contract concluded between an insurer and a reinsurer is called a reinsurance contract and may be thought of as the insurer's insurance coverage, or second-degree insurance. Reinsurance allows for the diversification of risks and their redistribution over a broader base, thereby reducing the insurer's risk of bankruptcy. [ILO-STEP, 144]

   A period of 12 months for which data are reported. This could either be a calendar year or, where this is not possible, another period such as a fiscal year. [ILO,694]

   A group of persons belonging to a segment of the population that displays the same characteristics as the overall population: same proportion of men and women and the same proportion of young, elderly, actively employed and unemployed persons, etc. The size of the representative sample must conform to minimum requirements, which depend upon the size of the target population and its homogeneity. [ILO-STEP, 144]

   Own capital accumulated by the health micro-insurance scheme to meet future expenses, particularly those arising from unforeseen circumstances. The level of such funds is usually subject to regulatory provisions.
Synonym: reserves

    See: reserve fund

   Refers to the probability that an uncertain event will occur, and, by extension, to an uncertain event that, when it does occur, may have adverse financial consequences. This is why individuals seek insurance against the financial consequences of certain risks. Insurance cannot prevent risks from occurring, but it can reduce their financial impact. The main social risks are sickness, disability, old age, unemployment, death, etc. [ILO-STEP, 144]

   An approach that consists of taking certain precautionary measures and organizing oneself in order to deal with the future occurrence of a risk.
Example: Stocking food supplies in anticipation of a drought or a shortage, saving for a wedding, etc. [ILO-STEP, 144]

   A phenomenon according to which health providers adjust their prescriptions to correspond to patients' maximum level of coverage, without opposition from patients, given the fact that the latter know they are covered. Health providers may have a tendency to prescribe more medicines than necessary, lengthen hospital stays, systematically use diagnostic services, such as laboratory tests, X-rays, etc. [ILO-STEP, 144]

   The principle according to which the financial consequences of individual risks are not borne by each individual but by an entire group. Risk pooling refers to the sharing of risks, which is the basic premise underlying insurance mechanisms. [ILO-STEP, 144]

   The whole group of covered persons, whose individual levels of coverage and consumption of health services vary from one person to the next and represent costs for the scheme. Schemes must ensure that their risk portfolio is well-balanced, that is, that the presence of high risks (persons who consume more health services than the average) is compensated by low risks (persons who consume fewer health services than the average). [ILO-STEP, 144]

   A measure or a set of measures that consist of giving priority to persons who represent a low risk of illness and excluding those with a high risk of illness. Risk selection may be practiced by certain insurers, particularly when they are unable to set rates that reflect individual risks.
Example: When an insurer establishes an age limit on enrolment or when it excludes members who have reached a certain age, it is practising risk selection.
Within the context of a capitation system (see global payment) some providers may have a tendency to give priority, in terms of treatment, to patients who represent a low risk of illness, who they know will not consume excessive amounts of health care, and to discourage those who represent a high risk. Health micro-insurance schemes must, of course, see to it that such practices do not arise. [ILO-STEP, 144]