Article révisé par les pairs
Résumé : This paper proposes a practical way for indexing level premiums inlifelong medical insurance contracts, in order to take into account observed medicalinflation. The indexing can be achieved by considering only premiums, withoutexplicit reference to reserves. This appears to be relevant in practice as reservingmechanisms may not be transparent to policyholders and as some mutual andshareholder insurers do not compute contract-specific reserves, managing the wholeportfolio in a collective way. Note that the similarity with the existing literature onlife insurance comes from the lifelong nature of the contracts considered in oursetting. However, in the case of health insurance covers the value of future benefitsis random. The present study originates from a proposal for indexing lifelongmedical insurance level premiums in Belgium. As an application, we study theimpact of various indexing mechanisms on a typical medical insurance portfolio onthe Belgian market.