Lots of businesses and industries have legal obligations to pay money for various things at various times, they don't treat that as pass through...it's revenue and expenses. Money is fungible.
In health insurance specifically, profitability is somewhat regulated and this gets at the accounting issue here. Insurance companies should maintain a medical loss ratio of 80-85% meaning that fraction of the premiums should be paid to providers. The remaining 15-20% is split between administrative costs and profit. Most of the article's forensic arguments around this are weak and circular and represent a misunderstanding of the accounting itself.
Insurance money goes from the insured, into the insurance company's bank account, and IF the insured customers need services, it's then paid to service providers. If not, it sits in the insurance company's bank account as profit
Considering insurance premiums that are later paid as insurance claims as not being revenue is absolutely bonkers and there's a reason that's now how the accounting actually works
“This measure, while a standard accounting metric, obscures the strong financial performance of financial intermediaries such as health insurance companies, whose revenues are mostly pass-through payments between insured individuals and their health service providers. […]”
It seems to me that this document is almost entirely an argument for changing the accounting rules because of this distortion.
If they are, then what do we call it when my medical expenses surpass my premiums? Negative passthrough? Contra passthrough?
What do we call it when I pay premiums for a year, never use a dime of it, and then cancel my insurance? I don't get that money back, nor does it get passed through to medical providers.
Do life insurance companies consider my premiums to be a passthrough to my eventual benefit payment or do they count them as revenue?