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   Leave granted to parents of young children for child care (usually several months or years). [ILO,694]

    Partial unemployment benefits, also called reduced working hour compensation, are paid for employees who are working in enterprises that due to specified (economic, cyclical, seasonal) conditions shortened working hours. The loss of income (of the hours worked less) is partialy compensated (50-70%) by either the unemployment scheme, the state budget or both.

   Leave granted to new fathers as an equivalent to maternity leave in order to allow the new father to spend time with his newborn baby after birth (usually several days or weeks). [ILO,694]

   An individual who utilizes health services: medical consultations, medicines, laboratory tests, surgical operations, deliveries, etc. [ILO-STEP, 144]

    The ratio of total annual expenditure of a scheme to the annual sum of insurable earnings underlying the scheme. It reflects the contribution rate to be charged annually if a scheme were financed on a pure annual assessment (PAYG)basis. [ILO,ISSA,630]

   A periodic benefit that replaces earned income. In many cases, this term is used to refer to long-term periodic benefits. [ILO,694]
See: long-term benefits

   Beneficiary of a pension. [ILO,694]
See: pension

   The share of the cost of a covered health service that is not borne by a health micro-insurance scheme and is always expressed as a percentage. The percentage co-payment helps moderate the consumption of health care and reduces the scheme's expenses. It is an effective means of combating moral hazard, but, when too high, may have the effect of limiting the accessibility of health care. [ILO-STEP, 144]

    Attempt to measure the performance of the administration , benefit delivery or financial performance of a social transfer scheme or system in quantitative terms, either in absolute terms or by comparison to defined benchmarks. [ILO, ISSA,630].

   Benefits that are provided during a given time period, recurring at regular intervals (generally on a weekly, monthly or quarterly basis, e.g. old age pensions) and whose main "raison d'être" is to provide income replacement by restoring, up to a reasonable level, income which is lost by reason of inability to work. In contrast, other cash benefits are generally paid at irregular intervals or once for each occurrence (e.g. funeral grant), whose primary aim is that of providing cash assistance and not of providing income replacement. [ILO,694]

   The level of income defining the borderline between the groups of "poor" and "non-poor" in a society. If a person/household has less than this amount at his/its disposal, the person/household is defined as being poor. There are different (absolute, relative and subjective) approches in estimating the poverty line. [ILO, ISSA,630]

   A fixed sum paid periodically by a member of a health micro-insurance scheme in order to benefit from the services provided by the scheme and to enable his or her dependents to benefit from them. The amount of the premium paid by a family may depend upon the number of persons protected, their characteristics (age, sex, place of residence, occupation) and the level of their family income. Premiums constitute the chief financial resource of the scheme and must enable it to cover its costs. These include expenditures related to the coverage of health expenses, operating costs, accumulation of financial reserves, etc.
The premium paid by a member is equal to the sum of the premiums calculated for each health service. The individual premium corresponding to a given health service is itself the sum of several elements, including the adjusted pure premium, the safety loading, the unit operating costs and the unit surplus. [ILO-STEP, 144]

   Synonym: collection of premiums

[ILO-STEP, 144]

   Synonym: registry of premium collection (Philippines)

   Synonym: member's premium sheet (Philippines)

    A set of mechanisms enabling individuals to pay for future health services at a time when they have sufficient resources available.

See: health savings [ILO-STEP, 144]

   Determined by or in virtue of national legislation. [ILO,694]

   The number of cases of a given disease as compared to all cases of disease and expressed as a percentage.
Example: If 15 per cent of the cases of disease registered by a health facility correspond to cases of malaria, then the prevalence rate of malaria is 15 per cent. [ILO-STEP, 144]

   A health development strategy based on improving the quality of health services at the first level of the health pyramid, extending health services (from curative treatment to prevention and promotion) and encouraging the public to participate in the management and cost of health services. [ILO-STEP, 144]

   A control mechanism applied prior to the receipt of health services by patients who are members of a health micro-insurance scheme. Before receiving care, patients must ask health providers to complete a request for prior agreement, which specifies the type of care and its cost. Patients must then submit this request to the health micro-insurance scheme, which considers the case and issues either an agreement or a refusal to provide coverage. This procedure enables schemes to exercise a degree of control over the services provided and the fees charged by health care providers, inasmuch as schemes reserve the right to refuse requests. The prior agreement is generally used for costly but non-urgent services, such as the provision of eyeglasses or planned surgical operations. [ILO-STEP, 144]

   Context: needs of the target population

   Employees of businesses owned by private investors as opposed to governments. This includes informal sector employees. [ILO,694]

   The odds that an individual in a given population will fall ill at least once in the course of a year (probability of falling ill) or of using a particular health service at least once in the course of a year (probability of utilizing a service). The probability of an occurrence is always greater than or equal to zero and less than or equal to one. The closer the probability of an event is to zero, the more rare the event (illness, utilization of a health service). Conversely, when the probability of an occurrence approaches one, that occurrence is commonplace. A probability of one corresponds to a certain occurrence. [ILO-STEP, 144]

   A rule or a set of rules followed in order to conduct all or part of a process. There are different types of procedures, including management and monitoring procedures.
Example of a management procedure: Prior to accepting an application for membership, it is important to verify that the applicant, that is, the future member, has not already been terminated by the health micro-insurance scheme in the past. [ILO-STEP, 144]

   Person who will be entitled to receive social security benefits once a risk/contingency or need materializes. Current beneficiaries are a subgroup of protected persons. [ILO,694]
See also: affiliated persons

   Regulated social security savings scheme that usually pays out a lump sum benefit rather than a periodic benefit. [ILO,694]

   Employee in national government, local government, government-owned or controlled corporation or government monetary institution. [ILO,694]

   The estimated average health expenses covered by a health micro-insurance scheme that correspond to each individual. The pure premium is used as an input in determining the insurance premium.
The pure premium may be calculated by applying the following general formula: Pure premium (health service) = Probability of using the service × Average quantity covered × Average unit cost. It may also be calculated by applying the specific formula: Pure premium (health service) = Frequency of utilization of the service × Average unit cost. [ILO-STEP, 144]