In recent years the steady increase of the cost of public health services, much higher than the inflation rate, the continue variations in the number of subscribers and the population ageing led the Health funds, operating in Italy, to address financial sustainability issues.

Health funds experience an increasing necessity to develop adequate instruments to face those risks, by quantifying the exposure and identifying the criticalities of their own management model. They must appropriately arrange corrective actions to ensure their future financial sustainability. The main instrument for proper management and control of the economic-financial balance associated with these risks is the Technical-Actuarial Balance.

This instrument further to include revenues and expenditures, evolution in the assets of the fund under evaluation, also allows:

  • A reliable appraisal on the impacts of future law modifications in terms of revenues/expenditures to develop the best solution for mid-long term strategies,
  • A study on a gradual compliance with the new laws provisions,
  • An evaluation on the impact of the modification of single items contained in the health service tariff,
  • An evaluation on the impact of different financial instruments.

In addition, under the release of the DM October 27th, 2009, a registrar of the Health funds has been established by the Ministry of Health aiming at the implementation of a census survey and a control of the funds complementary to the SSN (National Health Service) in Italy. Enrolment to the registrar, and the following renewals, are necessary to obtain tax deduction on the contributions paid in by fund’s subscribers.

The recognition of the benefit will be granted only if at least 20% of the resources for health services to subscribers is bound to the offer of dental care assistance and special care for dependent people or people temporarily affected by accidents or illnesses.

Pursuant to article 51 of the TUIR (Income Tax Act), the health funds that intend to access the preferential tax regime are required by July 31st of every year to communicate to the Registrar the certification, undersigned by the legal representative, of the amount of the “constrained resources”.

This action requires the involvement of a third party for the verification and validation of the required parameters. To be more specific, some values included in the decree have typical actuarial requirements (premium provision, outstanding claim reserve, tax equalization reserve, ageing reserve etc.).

In this context, Managers & Partners offers its expertise and know-how on periodical actuarial evaluations for the preparation and release of the required certification and actuarial reports.