Pakistan has made great strides in health coverage, offering valuable in-patient cover to some of the most vulnerable members of society through the Sehat Sahulat Program, an initiative of the federal government and the province of Khyber Pakhtunkhwa. In 2018, an independent actuarial study of the Program was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH with funding from the Federal Ministry for Economic Cooperation and Development. This report captures the key findings and recommendations of this study.