System in health insurance for establishing premiums so that an insurance company’s premium varies by not more than a fixed amount from other premiums for individuals in the same premium class within a certain geographical region.

Advance evaluation of a health care facility’s financial data by a government or private agency to determine the reasonableness of the hospital fees and assess a possible increase in the fees.

1. System used to contain health care costs in which the government sets payment fees for all insurance payers for categories of medical services. 2. In the Medicare program, to determine and establish the cost of medical professional services provided to a patient by using historical cost data reported by providers.

If a specific account’s actual experience at the close of an insurance contract period results in excess funds, these can be applied toward the account’s rate for the next year, which helps offset the rate increase.

1. Determining the value of risk of an individual or organization. 2. Establishing a year’s cost of a specific unit of insurance.
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Any procedure used to compute the premium rate which a particular insured or class of Insureds is charged for a given coverage.

Rate applied to risks of similar characteristics or a specific class of risk. For group life insurance the three rating classes for group premiums are (1) manually rated premiums, (2) experience-rated premiums, and (3) blended premiums. See also blended rates, experience rating, and manual rate .

Insurance handbook that includes suggested ratings and background information for each impairment shown.

Time during which a set of health insurance rates is guaranteed.