Group insurance underwriting logic and analysis of sub-health risk factors: from employment stability and participation rate to lifestyle interventions

3. Underwriting of Group Life Insurance and Health Insurance Group insurance is one of the main sources of business for life insurance companies, and the vast majority of it applies to employees in companies or groups. Because it is conducive to protecting the normal life of employees, improving relationships, thus alleviating many conflicts, improving efficiency, and having tax support from government social welfare policies, group insurance is widely welcomed in society and has become one of the employee welfare plans for many companies and groups to attract talent. Because of the fundamental difference between group insurance and individual insurance, the underwriting of group insurance is independent of the underwriting system of individual insurance. Individual insurance mainly focuses on individuals. Group insurance mainly focuses on the group, rather than a particular individual in the group. Therefore, the underwriting of group insurance first assesses the risk of the group as a whole. Based on this, the underwriting process of group insurance is also different from that of individual insurance. The differences are mainly reflected in the following aspects: (1) Selection of the group. The selection of the group is mainly considered from the following points: First, whether there is an existing group with a certain period of continuity. The group must be an existing and long-term group, not a temporary or near-dissolution group. Its members must also have relatively high stability and be able to perform their work normally. Second, a minimum number of people. A basic principle of insurance is scale operation. It must reach a certain scale to generate income and maintain normal operation. Third, uniform insurance coverage. Fourth, uniform insured amount. Fifth, uniform time. (2) Scope of personnel. It is mainly manifested in: first, a minimum number of people; second, the proportion of the number of insured to the total number of people in the group. Under the conditions of scale effect, there is generally no maximum limit on the number of insured as long as it is within the business scope and underwriting capacity of the insurance company. (3) Formulate a claims plan. Group insurance is sometimes insured by all members and sometimes only by some members. But in either case, the basic principle is to allow age or gender to determine whether to underwrite and the premium. Therefore, in order to make up for the defect of possible adverse selection, a claims plan must be formulated. (4) Group insurance underwriting factors. First, the nature of the group. The nature of the group is the nature of the industry or the nature of the work that the group is engaged in. Different group characteristics determine the degree to which work affects mortality and physical health. Generally speaking, some occupations that are considered high-risk and therefore uninsurable under individual insurance should not be considered high-risk or uninsurable under group insurance. Second, the level of group participation. For group insurance, insurance companies generally have strict limits on the number of participants and their proportion in the total group. This is mainly to prevent adverse selection, as people with poor health tend to have a more urgent need for insurance than those with good health. Third, the age and gender of group members. When assessing the average mortality rate of a group, the gender ratio and age structure are still factors that must be considered. A reasonable distribution of age and gender helps to reduce the loss ratio. Fourth, the group's development prospects. If the group has good development prospects, firstly, the personnel turnover is relatively stable, and the relationship between members and the group is close; secondly, to enter such a group, there is already competition in terms of physical condition and other aspects, and those who remain have relatively better conditions, thus reducing the overall risk. Fifth, the premium payment method. In premium-sharing payment methods, the individual's premium payment ratio should not be less than 25%, and the number of participants should not be less than 75% of the total number of people in the group. Otherwise, adverse selection must be considered.

Section 4 Application of the Sub-health Concept in Personal Insurance Personal insurance is insurance that takes the human body and lifespan as its insured object. It uses the human body and lifespan as its carrier, manifesting in various situations such as the loss of life, defects and loss of bodily functions, the occurrence of medical and nursing expenses, and a reduction in economic income for family expenditures. Sub-health, as a health condition that may develop into disease, has both objective and subjective environmental influences in its occurrence and development. Sub-health is a disease risk factor in personal insurance. I. Sub-health as a Disease Risk Factor in Personal Insurance Sub-health is influenced by social factors, lifestyle, psychological factors, environmental pollution, and mental work stress. Regarding lifestyle, the effects of drinking alcohol versus not drinking, smoking versus not smoking, and high versus low salt intake on physical condition vary. Taking smoking as an example, when a cigarette is lit, the combustion of the cigarette produces more than 4,000 chemical substances, including carcinogens such as benzo[a]pyrene, nitrosamines, carbon monoxide, nicotine, cyanide, and aromatic hydrocarbons. Smoking has a significant impact on the respiratory tract, blood, heart, stomach, lungs, kidneys, and skin, leading to functional decline and even qualitative changes. Smokers have a 50% higher probability of developing oral, laryngeal, esophageal, stomach, and bladder cancers than non-smokers, a 4 times higher probability of developing coronary heart disease, and an 8-12 times higher incidence of lung cancer. Increased work pressure and a faster pace of life cause mental fatigue, leading to emotional disorders, thought disorder, panic, anxiety, and other mental health problems. If these problems are not addressed promptly, they can affect health in mild cases and even endanger life in severe cases. The above analysis clearly demonstrates the significant impact of various disease risk factors in personal insurance on disease occurrence. From a medical perspective, some disease risk factors exist independently, while others are interdependent and interact with each other. For example, hypertension and hypertension disease: hypertension is merely a symptom; it is not considered hypertension disease until it damages other organs such as the heart, brain, and kidneys. Hypertension disease, on the other hand, is caused by elevated blood pressure, resulting in a series of other symptoms, typically affecting the heart, brain, and kidneys. This type of hypertension is called essential hypertension.