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Adjustment of the supplementary health insurance premium

In view of the strong growth in healthcare system expenses, the company anticipates it will have to make use of precautionary provisions in May

The trend of growth in total expenses for supplementary payments for medical services and medicines under compulsory health insurance (OZZ), which are co-financed from the voluntary supplementary health insurance (PDZZ), continues. Growth is driven by medical inflation and the elevated volume of most health services, also as a result of emergency legislation to provide and pay for additional services to ensure the stability of the healthcare system. All of this has had a significant impact on the increase in the liabilities of Triglav, Zdravstvena zavarovalnica (TZZ) under the voluntary supplementary health insurance (PDZZ). Due to the said circumstances, the company will set a monthly PDZZ premium of EUR 45.52 as of 1 June 2023 onwards, which the calculations made by professional services show to be necessary to ensure the fulfilment of the company's obligations from the concluded insurance contracts. Due to the entry into force of the Decree of the Government of the Republic of Slovenia on the setting of the maximum price of the supplementary health insurance premium (Official Gazette of the Republic of Slovenia No. 44/2023, dated 14 April 2023), which sets the maximum permissible price of the PDZZ premium at EUR 35.67, the company will, during the period and provided the decree remains in force, charge the insured the premium in the amount stipulated by the decree.

High growth of total expenditure within the healthcare system
In the second half of 2022 and the first quarter of 2023, TZZ detected the continuation of the high growth of total expenditures within the healthcare system. At the same time, there is a constant increase in the amount of expenses for supplementary payments for medicines and medical services, by way of which the insured co-finance (through the PDZZ) the difference up to the total value of medical services of the public healthcare system not fully covered by the OZZ. According to the data of the Health Insurance Institute of Slovenia (ZZZS), expenditures for healthcare services increased by more than 30% in the period from 2019 to the end of 2022, while expenditure on medicines increased by over 36% in the same period. The growth of these expenditures is set to continue even in 2023, whereby health insurance companies have no direct influence on these expenditures, and the result of increased spending is the increase in expenditures for supplementary payments, which are financed by the PDZZ for the insured. From August 2022 onwards, TZZ allocates more funds per month to pay the costs of supplementary payments to an individual than it receives from that individual's insurance premium.

Surplus funds created during the epidemic have been fully exhausted
During the epidemic, there were excess funds from the PDZZ as a result of restrictive measures and a smaller volume of health services provided in the public health system, which is co-financed by health insurance companies. This type of surplus was used by the insurance companies providing PDZZ as part of the emergency act determining the measures to ensure the stable functioning of the healthcare system (ZNUZZSZS) to cover the increased expenses of the last quarter of 2022 and the initial months of this year. The TZZ is expected to fully exhaust these reserved funds of EUR 22 million in May 2023 and use them to finance healthcare services for the insured.

Ensuring uninterrupted and ongoing fulfilment of the company's obligations to the insured
TZZ estimates that the trend of growth of total expenses in the healthcare system will continue in the future as increased expenses from the OZZ managed by the ZZZS also entail an increase in expenses from the PDZZ. In order to ensure the uninterrupted ongoing fulfilment of the company's obligations, to maintain the stability of operations and, consequently, the stability of the healthcare system as a whole, the company is setting the monthly premium at EUR 45.52 as of 1 June 2023 onwards. The premium change is 28% and is necessary to ensure the fulfilment of the company's obligations under concluded insurance contracts. Due to the entry into force of the Decree of the Government of the Republic of Slovenia on the setting of the maximum price of the supplementary health insurance premium (Official Gazette of the Republic of Slovenia No. 44/2023, dated 14.04.23), which sets the maximum permissible price of the PDZZ premium at EUR 35.67, the company will, during the period and provided the decree remains in force, charge the insured the premium in the amount stipulated by the decree.


 
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