PREMIUM CALCULATION OF TEN DISEASE CATEGORIES BASED ON BPJS KESEHATAN DATA IN 2015-2016

• Main Author: Kusumajiasni M, Annaztazza
• Format: Theses
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/65061
• Institution: Institut Teknologi Bandung

Health is one of the well-being elements that must be realized accordance with the ideals of the Indonesian nation as stated in the Preamble 1945 Constitution of the Republic Indonesia. Indonesia’s government’s efforts to advance well-being is establishing BPJS Kesehatan which serves almost all kind of diseases and treatments. BPJS Kesehatan since its operating has recorded a deficit due to under price premium. Sample data BPJS Kesehatan processing result for ten categories of diseases showed that premiums obtained from the whole diseases only suffices about 45.84% of the total cost of the claim incurred in 2015 and 2016. The survival function of disease is obtained by determining appropriate distribution based on the minimum value of absolute AIC (Akaike Information Criterion), BIC (Bayesian Information Criterion), and RMSE (Root Mean Square Error). The survival function generates morbidity tabel to calculate the actuarial present value (APV) of benefit, annuity, and expected premium as an end-product. Premium prediction for January to June 2017 was estimated using time series model. The calculation shows different results depending on disease categories and the age of participants.