Implicit Rate Subsidy – What is it?

Key Benefit Concepts Actuarial

Implicit Rate Subsidy, or “IRS” for short, is the difference between individuals’ actual incurred costs for medical coverage (i.e., incurred medical claims paid by the insurer, in the case of a fully-insured health plan) and the individuals’ total premiums charged for such coverage. In essence, premium rates are determined for a group medical plan based on the total expected medical …