WHAT IS SENIOR CITIZEN HEALTH INSURANCE
Health insurance for senior citizens in India is offered by different insurance companies to
financially secure those who are aged 65 years and above. The medical insurance policies for
senior citizens are designed to cover all kinds of medical expenses that are incurred by the
policyholder. Gifting health insurance to your aged parents or senior citizens in the family is the
best way to care for their needs.
Health insurance is a kind of insurance that offers coverage against medical expenses such as
hospitalization and surgery. The insurance coverage is offered in two ways.
The insured pays the hospital bills; the insurance provider offers reimbursement to the insured.
The insured gets cashless treatment and the insurance provider pays the hospital The insurance
provider offers cashless treatment at network-listed hospitals.
SIGNIFICANCE OF THE STUDY
This dissertation presents review of health insurance situation in India - the opportunities it
provides, the challenges it faces and the concerns it raises. A discussion of the implications of
privatization of insurance on health sector from various perspectives and how it will shape the
character of our health care system is also attempted. The paper following areas:
Economic policy context
Health financing in India
Health insurance scenario in India
Health insurance for the poor
Consumer perspective on health insurance
Models of health insurance in other countries
Competitive analysis of health insurance sector in India
THE IMPLEMENTATION STRATEGY
1. Preparation of Plan of Action
2. Setting up of separate Bureau for Older Persons in Ministry of Social Justice and
Empowerment.
3. Setting up of Directorates of Older Persons in the States
4. Three Yearly Public Review of Implementation of policy.
5. Setting up of a National Council for Older Persons headed by Minister for Social Justice and
Empowerment (Representatives from Central Ministries, States, Non-Official members
representing NGOs, academic Bodies, Media and Experts and members).
6. Establishment of Autonomous National Association of Older Persons.
7. Encouraging the participation of local self Government
..
THE BENEFITS OF CHOOSING THE BEST HEALTH
INSURANCE PLAN FOR SENIOR CITIZENS ARE AS
FOLLOWS:
Enjoy higher sum insured benefit
Get tax benefit on health insurance premiums
Enjoy the free-look period on the policy
Day care costs which arise due to use of special equipment while treating procedures
such as dialysis and chemotherapy are covered
Avail health check-ups annually
Cashless hospitalization can be availed if patient admitted for more than 24 hours – This
comprises of doctor fees, medical bills, room charges, etc.
Option to renew policy available
Subject to the limit, ambulance expenses for transporting the policyholder shall be borne
Pre and Post hospitalization is covered depending on the number of days
Pre-existing diseases are covered subject to terms mentioned in the policy document
Quick and hassle-free claim settlement
HERE ARE A FEW FREQUENTLY COMMITTED ERRORS
WHILE SELECTING A MEDICAL INSURANCE PLAN AND
THE WAYS TO CORRECT THEM.
Mistake 1:- Focusing solely on the Insurance Premium and Deductible
Generally, people commit the error of selecting a plan based on its premium and deductible.
These factors lure several insurance buyers. Such buyers are disappointed at the time of claim
settlement as the coverage covers only a part of the expenses and the insured is supposed to bear
the remaining amount from his/her pocket.
Correction- At the time of buying an insurance plan, consider your ability to cover the
deductibles at the time of a health emergency. If you can’t do that, then go for a plan that comes
with lower deductibles.
Mistake 2:- Blindly buying your Friends or Colleagues’ Suggestion
Our medical condition and medical history differ from our friends’ and colleagues’. Insurance
expectations are so individualistic that your insurance plan might not fulfill the insurance
expectations of your friend.
Correction- Before selecting a plan suggested by a friend or an acquaintance, check whether it
fulfills your insurance expectations and medical needs. Compare it with other policies so that
know what is offered in the insurance market and what suits your needs.
Mistake 3:- Purchasing Health Insurance only for Tax Benefits
A large number of the people buy a health insurance plan just to avail the tax benefit. True, it
does offer tax benefits, but the primary objective while purchasing a medical insurance plan
should be the coverage of your health needs and financial protection against medical
emergencies.
Correction- By focusing solely on tax, you will end up purchasing a health plan that doesn’t
fulfill your health needs and will provide you with insufficient coverage.
Mistake 4:- Lying About Pre-existing Illnesses While Buying the Policy
Some insurance buyers falsify their health information while filling the proposal form. They
think that it will save them from high premiums, or it will help their cause in acceptance of their
proposal form.
Insurance providers check medical details thoroughly before giving a green signal. Also, some
insurance providers conduct a medical screening before approving a proposal. In that case, your
proposal is liable to get canceled.
Correction- It is important to disclose your medical information while filling out the proposal
form and select the plan that is right for you.
Mistake 5: Error- Co-payment and the Fine Print
Co-payment is a part of medical expenses that an insured has to bear by himself at the time of
claim settlement. Co-payment and its terms vary from insurance provider to insurance provider.
Correction- Carefully read the fine print of the policy document and pay attention to the
exclusions so that you don’t have any doubts.
LIST OF HEALTH INSURANCE COMPANIES SUCH AS:-
1. Apollo Munich Health Insurance Company Limited.
2. Star Health and Allied insurance Co Ltd.
3. Future Generali India Insurance Company Ltd.
4. SBI General Insurance Company Ltd.
5. HDFC ERGO General Insurance Co Ltd.
6. United India Insurance Co Ltd.
7. Reliance General Insurance Co Ltd.
8. The New India Assurance Co Ltd.
9. Bajaj Allianz General Insurance Co Ltd.
10. Life Insurance Corporation of India.
11. ICICI LOMBARD Insurance Company Ltd.
HOW TO SELECT THE BEST HEALTH INSURANCE PLAN
FOR PEOPLE ABOVE 60?
1. Buying health insurance for aging parents has to be done carefully as you would want
them to deserve the best. Keep the following points in mind while choosing medical
insurance for parents above 60 years:
2. Know the medical history: While buying a health policy for your senior citizen parents,
you need to know their medical history. But, sadly they too may be unaware of many
prevailing medical conditions that they suffer from. In such cases it would be difficult to
rely solely on their knowledge of their medical history. Before providing such
information to the insurance company, it is always better to cross-verify.
3. Compare and choose plan: There are many existing and new senior citizen medical
insurance plans available online in India. It is essential to compare between the different
schemes. Comparison between the various health insurance plans for senior citizens can
be done on factors such as coverage, price, riders/add-ons, inclusions, and exclusions.
4. Fill proposal form: While selecting the policy, fill in relevant and accurate information.
Incorrect information could cause problems and your insurer will reject the application.
5. Do a medical check-up: The insured would have to undergo a medical screening after
submitting the proposal form. The doctors on the panel of the insurance company would
verify the information related to the medical conditions of the policyholder. Depending
on the health of the insured, a few medical tests would be conducted by the doctor. Some
of the tests include lipid profile, blood routine, sugar, urine routine, kidney and liver
function, sonography, etc. Note: There are certain senior citizen medical insurance plans
that don’t require pre-policy medical screening tests.
For Example: Mayur lives with his wife who is a homemaker, 2 school-going kids and his
parents. He earns around 50,000 per month and is the only bread-earner of the family. Since his
parents are aged above 65, he decided to purchase a senior citizen medical insurance plan for
them. Sudden medical crisis could leave the whole family financially crippled. That was
something Mayur didn’t want.
So, after assessing his parents' medical history by going through all their earlier medical reports,
he browsed the web and searched health insurance plans for parents. Their pre-policy medical
check-up showed normal reports and the insurance company accepted the proposal form. The
policy that Mayur chose for his parents required him to pay just Rs. 6000 per month. This was
the best decision that Mayur took as it left him and his parents financially secure and happy.
HOW TO COMPARE SENIOR CITIZEN HEALTH INSURANCE
PLANS?
If you want to compare senior citizen medical insurance in India, you need to remember that the
type of policy a person wishes to avail depends primarily on:
Fixed income amount
Financial status
Number of dependents
Health of dependents
While doing a comparison on health insurance plans for senior citizens in India, consider the
following parameters:
AGE:-Age plays an important role when buying health insurance for senior citizens in
India. The decision to issue a policy depends on the age. Hence, one should buy at an
earlier age to increase chances of getting better coverage. When it comes to public sector
insurance companies, senior citizen health insurance plans offered by them are the ones
in the 60-80 age group.
A few insurers have no maximum entry age and allow entry even after 80. Always pick a medical
insurance policy that goes on for a longer period. The age limit for renewal varies from one
company to another so check the terms and conditions carefully before buying the policy.
NUMBER OF INSURED PERSON IN A POLICY:-The number of insured persons in
a policy depend on whether you want add your spouse to your plan, or you prefer buying
a separate senior citizen health insurance plan for them. This decision is purely based on
their medical conditions and your budget constraints.
PREMIUM:-Although premiums for senior citizen health insurance policies are higher,
they're totally worth it. At a stage in life when you should be unwinding and savoring the
retired years, the last thing you should be doing is raising funds to take care of your
medical expenses. A little bit of planning in your budget will easily sail you through the
retired phase.
COVERAGE OF SPECIFIC DISEASES:-It is important to get the best senior citizens
health insurance plan which covers many ailments including critical illnesses with
progressing
HOSPITAL NETWORK:-When you age, nothing beats the comfort of a nearby hospital
with cashless facility. Do enquire about the cashless tie-ups in the hospitals of your
choice before making the payment.
WAITING PERIOD
1. Waiting period: Mostly first 30 days from the policy issuance except for accidental
injuries/hospitalization.
2. Pre-existing Diseases: Most insurance companies have 2-4 years waiting period to cover any
pre-existing conditions. The lesser, the better. Illness Specific: Many illnesses are covered only
after a waiting period of around 2 years.
Deductibles and Co-Payments:-Many senior citizen health insurance policies in India come
with deductibles and co-payments. Therefore, check for the plans that have the lowest deductible
and the least co-payment clause. On an average, 10% co-payment is quite standard.
Inclusions and Exclusions:- Thoroughly check what your policy covers to avoid any surprises
during claims. Read the policy wordings carefully to understand the scope of coverage. Every
health insurance policy comes with certain exclusions, and Senior Citizens Health Insurance Plan
is no different. As mentioned earlier, refer the policy wordings for the details about what the plan
doesn't cover.
REASONS FOR CHANGE IN PREMIUM OF SENIOR CITIZEN
HEALTH PLAN
Sometimes, the insurance company may hike the premium of the senior citizen health plan if the
policyholder is found to consume alcohol, tobacco, or be involved in other activities that can
deteriorate their health conditions.
Best health insurance for senior citizen in India necessary because:
The medical costs are increasing more than the average inflation rate.
Seniors may have limited income or unstable income after their retirement
Seniors may be financially dependent on their heirs
They are easily prone to illnesses or accidents. There might be a sudden requirement of financial
help.
Their employer’s health insurance policy might be ceased to exist after retirement.
INDIAN SCENARIO
As per 2001 Census, total population of Senior Citizens (60+) was 7.7 crore, of
which population of males and females was 3.8 crore and 3.9 crore, respectively. The
share of people aged 60 years and above in the total population as per Census 2001 is
given below:
Population
(Fig. in crore)
Persons Males Females
All India 102.9 53.2 49.7
Senior Citizens 7.7 3.8 3.9
As % of total 7.5 7.1 7.8
INCOME TAX EXEMPTIONS
Tax exemptions is provided to the senior citizens by the Ministry of Finance. Some other
facilities provided by the Ministry are as under:
Income tax exemption for Senior Citizens of 60 years and above up to Rs. 2.50 lakh per
annum.
Income tax exemption for Senior Citizens of 80 years and above up to Rs. 5.0 lakh per
annum.
Deduction of Rs 20,000 under Section 80D is allowed to an individual who pays medical
insurance premium for his/ her parent or parents, who is a senior citizen.
An individual is eligible for a deduction of the amount spent or Rs 60,000, whichever is
less for medical treatment of a dependent senior citizen.
INSURANCE REGULATORY DEVELOPMENT AUTHORITY
(IRDA)
IRDA which is working under the Ministry of Finance has issued instructions on health
insurance for senior citizens to CEOs of all General Health Insurance Companies like:
allowing entry into health insurance scheme till 65 years of age,
transparency in the premium charged,
reasons to be recorded for denial of any proposals etc. on all health insurance products
catering to the needs of senior citizens. Likewise the insurance companies cannot deny
renewability without specific reasons.
to design their products in such a way that various options are available to policy holders
so that those who are unable to pay can go for reduced premium with reduced sum
assured.
PENSIONS PORTAL
A Pension Portal has been set up by the Department of Pensions, Government of India, to enable
senior citizens to get information regarding the status of their application, the amount of pension,
documents required, if any, etc. The Portal also provides for lodging of grievances. As per
recommendation of the Sixth Pay Commission, additional pension will be provided as per details
given below to older persons.
Age Groups % pension to be added
80+ 20
85+ 30
90+ 40
95+ 50
100+ 100
CASE STUDY
STAR HEALTH
Benefits of senior citizen health insurance plans offered by Star Health and Allied
Insurance:
Senior citizens aged 60 to 75 years can apply for the plan.
No-pre insurance medical test is required.
Insurance covers pre-existing diseases from 2nd year onwards.
Policy comes with a guaranteed lifetime renewability option.
Medical consultations can be availed as an outpatient in a network hospital.
The following features/terms are common to all plans on offer:
In-patient hospitalization/treatment which includes hospital expenses* incurred for a minimum
of 24 hrs. (unless otherwise mentioned).
Pre-hospitalization Expenses: Generally up to 30 days.
Post-hospitalization Expenses: Generally up to 60 days; usually met through a lump sum
payment @7% of the expenses or Rs.5,000, whichever is less.
Pre-existing diseases are included subject to prior coverage by a domestic insurer; usually for the
four years preceding policy inception (2 or 3 years where specified).
Floater Basis: Family includes the primary policyholder, husband/wife and children who are
dependent on the parent (generally subject to an age cap of 25 years); Sum assured is equally
apportioned among insured members.
Individual Basis: The sum assured is per person insured
Reinstatement of sum assured: Normally allowed after a specified number of claim-free years
*(Room, Nursing, Boarding, Surgery, Anaesthetist, Medical Practitioner, Consultation,
Specialists, Oxygen, OT charges, X-ray, Dialysis, Chemotherapy, Diagnostic Materials, Blood,
Medicine, Drugs etc. depending on the plan chosen. This is not a restrictive list)
Star Health and Allied Insurance Mediclaim Premium Calculator:
The online premium calculator available on the insurer’s website makes it easy for insurance
premium calculation of your chosen health insurance policy. Visit the official website of Star
Health Insurance and click on the chosen plan. For instance, if you have chosen a family
insurance plan, enter how many adults and children you want to insure under the scheme, enter
the sum insured amount, the date of birth of the eldest member of your family, your mobile
number and email ID. Click on Proceed To Buy. You will get an instant quote of the insurance
premium for the chosen policy.
Star Health and Allied Insurance Policy Document:
It is important to go through the policy document for inclusions and exclusions when buying an
insurance plan so as to avoid any hassle when making a claim. Star Health and Allied Insurance
application form, policy document, brochures, pre-authorisation form, and KYC form are
available on the insurer’s website. You can download the forms, fill it, and submit it at the
nearest Star Health Insurance branch office.
Star Health and Allied Insurance Customer ID:
A new health insurance scheme was launched by the Tamil Nadu state government in partnership
with the stand-alone health insurance company, Star Health and Allied Insurance to provide
health cover for government employees. The insurance company issued identity cards to the
employees and the beneficiaries covered under the new health insurance scheme through the
respective pay drawing officers within a period of 60 days from the date of commencement of
the scheme.
Star Health and Allied Insurance Network Hospitals:
Star Health and Allied Insurance has tie-ups with over 8,200 hospitals across the country where
policyholders with a Star Health Insurance policy can avail cashless hospitalisation as well as
reimbursement facility. It is one of the largest base of network hospitals in India. The insurer also
offers a hassle-free claim settlement process without the intervention of a Third-Party
Administrator (TPA).
To locate a network hospital near your home, select your state and city from the drop-down box
on the online Network Hospital Locator. You will get a list of network hospitals with contact
details instantly. Star Health also has tie-ups with Agreed Network Hospitals where the insured
members can avail cashless transactions and get package rates for identified procedures.
How to File a Claim with Star Health?
Cashless Claim: Visit a network hospital of the insurer to avail cashless treatment. Intimate the
insurer within 24 hours of unplanned hospitalisation and 48 hours prior to your planned
hospitalisation by calling the toll-free number of Star Health Insurance.
Display your Star Health ID at the network hospital help desk. The hospital will verify your
identity details and submit a duly-filled and signed pre-authorisation request form to the
insurance company.
Star Health will appoint a doctor to verify the pre-authorisation request and send an approval
letter to the hospital.
The hospital will proceed with the cashless treatment for the insured member.
If the cashless claim is denied, the insured member can get treated and file for a reimbursement
claim after discharge.
Reimbursement Claim: A field doctor will be assigned by Star Health to make hospitalisation
easier for the insured. All claim intimations have to be made within 24 hours of hospitalisation.
Reimbursement facility can be availed at network as well as non-network hospitals.
Settle all the hospital bills at the time of discharge and collect all the original documents such as
discharge summary, prescription, medical bills, hospital bills, pharmacy bills, etc.
Submit a reimbursement claim form along with the original medical documents at the nearest
Star Health branch office within 30 days of discharge.
Upon successful verification and approval, the claim amount will be sent to the insured.
Senior Citizen's Red Carpet:
Senior citizens are an oft-ignored segment of the health insurance industry given their limited
incomes and high susceptibility to age-related illnesses. Star Health has addressed this group's
protection needs through this Star senior citizen's red carpet plan which provides affordable and
adequate coverage along with attractive features
Entry Age 60 to 75 years
Renewals Guaranteed after 75 years
Sum assured Rs.1 lakh to Rs.10 lakhs
Premium charges Rs.4,450 to Rs.22,500 depending on sum
assured chosen
Discount 5% (based on meeting certain criteria)
Medical screening Not required.
Treatment Provided at any network hospital
Co-payment 50% for pre-existing disease claims; 30% for
other claims
Covers All types of pre-existing diseases effective
from first policy year or from the second year
if treatment was availed in the year preceding
inception,
ICU/Nurse/Specialist/Consultation/Surgeon
charges (as per limits), Cardiovascular
diseases/Cancer/Bone
breakage/Cerebrovascular accidents/Renal
Complications and other major surgeries, Post-
hospitalization expenses, Ambulance charges
SCOPE OF COVER
In the event of any claim/s becoming admissible under this section, the Company will pay to
the Insured person the amount of such expenses as would fall under different heads mentioned
below and as are reasonably and necessarily incurred hereof by or on behalf of such Insured
Person but not exceeding the Sum Insured in aggregate mentioned in the Schedule hereto.
HOSPITALISATION BENEFITS LIMITS
A) i)Room, Boarding expenses a i)Up to 1% of Sum Insured per day
provided by the ii)Up to 2% of Sum Insured per day
Hospital/Nursing Home Overall limit:25% of the S.I. per
(ii) If admitted in IC Unit illness/injury
B) Surgeon, Anaesthetist, Medical Up to 25% of Sum Insured per
Practitioner, Consultants, illness/ Injury
Specialists Fees, Nursing
Expenses
C) charges, Surgical appliances(any Up to 50% of Sum Insured per
disposable surgical consumables illness/ Injury
subject to upper limit of 7% of
Sum Insured), Medicines, drugs,
Diagnostic material & X-Ray,
Dialysis, Chemotherapy,
Radiotherapy, cost of pacemaker, artificial limbs,
Cost of stent &
Implants
HOW DOES THE AUTO-RECHARGE WORK?
If the sum insured is exhausted by an insured member in one claim in a policy year, then the
insurer will automatically recharge the base sum insured at the time of renewal. Auto-recharge
happens only once in a policy year.
KEY FEATURES OF SENIOR CITIZEN HEALTH INSURANCE:
Some of the most significant features of health insurance plans for senior citizens in India are as
stated below-
Hospitalization cover including medical bills and room charges
Cashless Hospitalisation
Day Care expenses which arise out of technological advancements
Ambulance Charges are covered
Pre-existing diseases are covered based on the insurance provider
No medical test required before availing medical insurance. This is based on insurance provider
Higher sum insured coverage
Pre-existing disease coverage
Faster and hassle-free settlement
WHY IS IT NECESSARY FOR ME TO DISCLOSE MY
CURRENT HEALTH STATUS CORRECTLY AND
ACCURATELY WHILE I BUY A HEALTH INSURANCE
POLICY?
It is important to disclose the medical condition such as a pre-existing disease or condition of the
insured member at the time of policy inception in order to avoid any hassle when making a claim
at a later date. Insurance companies have the right to terminate a policy or reject a claim on the
basis of the policyholder’s misrepresented or falsified data.
CLAIM SETTLEMENT RATIO
This has to be looked at before you buy any insurance policy. Claim settlement ratio (CSR)
indicates how many claims a company has settled against the number of claims received. Higher
the CSR, the greater are the chances of settlement of a claim. It is also a measure of the insurer’s
reputation. Among life insurers, LIC has the highest claim settlement ratio of 98.33%.
An indicator of the number of claims settled
Always look for a high ratio
“For other genres such as protection-cum-investment products, do look at other factors as well
like returns, guaranteed benefits, cost, tenure, portfolio, etc.,” says Narula. While all the ratios
are important, none should not be looked at in isolation. Along with these ratios, do consider all
the parameters such as quality of service, policy features, terms and conditions, etc, before
making a purchase decision
It means, out of every 100 claims received in a financial year, it has settled 98. “It is prudent to
cumulatively analyse the past few years’ claim settlement data to assess the trend for a particular
insurer,” suggest Narula. You must not ignore CSR especially before buying pure risk covers
such as term plans
HOSPITALIZATION COVERAGE:
Protects the insured for in patient hospitalization expenses for a minimum of 24 hrs. These
expenses include room rent, nursing and boarding charges, Surgeon, Anesthetist, Medical
Practitioner, Consultants, Specialist Fees, Cost of Medicines and Drugs up to the limits specified.
HOW TO FILE A HEALTH INSURANCE CLAIM:
Taking health insurance and paying premium is one story and filing for claim is another.
Claiming benefits can be quiet tricky at times so you have to be smart and careful while filing for
the claim. To file a Health Insurance claim with your Insurance Company one has to keep the
following things in mind.
Claim form duly filled and signed by the claimant.
Discharge Certificate from the hospital
All documents pertaining to the illness starting from the date it was first detected i.e. Doctor's
consultation reports/history
Bills, Receipts, Cash Memos from hospital supported by proper prescription.
Receipt and diagnostic test report supported by a note from the attending medical
practitioner/surgeon justifying such diagnostics.
Attending doctor’s certificate stating the nature of the operation performed, bill and receipt.
Attending consultant's / specialist's / anaesthetists’ bill and receipt, and certificate regarding
diagnosis.
Certificate from the attending medical practitioner / surgeon that the patient is fully cured.
Details of previous policies if the details are not already with TPA except in the case of accidents.
OBJECTIVE OF THE STUDY
To know about the risk covered in health insurance.
To protect in the event of unexpected loss, but due to reasons associated with health care costs.
To make health insurance important for many people.
To ensure quality services to the customers.
To provide the superior selling skills to market quality products and services that provides best
insurance value for consumers.
To provides direct payment or reimbursement for expenses associated with illness & injuries.
To protects you & your dependents against any financial constraints arising on account of a
medical emergency.
To cover the ever rising medical expenses. It is affordable & carries the assurance & freedom
from insecurities that threaten normally now & then.
To save you from buying a policy which might not be appropriate for you & can also be
expensive.
IMPORTANCE OF HEALTH INSURANCE
People buy health insurance for different reasons. The following are some of the reasons:-
Health insurance can protect you from the risk of uncertain bills for health care.
Without health insurance, you may not be able to afford expensive services.
Health insurance can pay for services that you use often.
Health insurance an help you to get better quality care as a member of a coordinated health plan
than you would get on your own.
With health insurance, you do not have to worry about the cost of care when you are sick.
The additional money provided by health insurance when you are sick may be more valuable to
you than money when you are well.
If you have more dependents than most people, then you may get more out of a family policy for
health insurance.
If you or your dependents than most health care needs than most people and you only pay an
average premium, then you get more from health insurance than most people.
You do not pay income tax on health insurance benefits so it is more valuable per dollar than the
same amount in taxable pay; and
Health insurance companies generally pay lower prices to Doctors and hospitals than you would
pay on your own..
WHY HEALTH INSURANCE FOR PARENTS?
The medical costs are increasing more than the average inflation rate.Parents may have limited
income or unstable income after their retirementParents may be financially dependent on their
heirsThey are easily prone to illnesses or accidents. There might be sudden requirement of
financial help.Their employer’s health insurance policy might be ceased to exist after retirement.
If you are living with dependent parents who are aged above 60 years then buy individual health
insurance plans instead of family floater plan. In family floater plans, the age of the oldest family
member is considered in determining the premium rates.