Question

1. Discuss the differences between individual coverage and group coverage, fully insured plans and self-funded plans, and single and family coverage.
2. Summary the main requirements for the PPACA, do you think the government should require everyone have health insurance? Explain your answer.
3. Summarize the three broad health-care plan design alternatives.
4. Describe the principles of fee-for-service plans and managed care plans. What are the similarities and differences?
5. Briefly describe the consumer-driven approach and explain the role that spending accounts or arrangements play in this approach.   

Answer 1

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EXPLANATION:

Class coverage is an insurance plan extended as part of a benefit package to its employees, and an insurance plan paid by individuals for themselves by their own income or savings. The employer engages the insurance carrier for fully-insured plans to negotiate insurance terms based on the coverage and benefits number. The employer covers the insurance plan The insurance company is also at risk. The organization, by comparison, acts as its own insurer in self-financed ventures and pays for its employees' medical claims.Single insurance protects only the employee, while family insurance includes all the family members, not just the employee.

The employer pays the insurance premium for a community plan, which is normally based on the scope and value. the premium is based on The insurer will obtain a better rate or premium depending on the amount of insured. Person coverage may be more costly in this way. Nonetheless, coverage of a company is typically discontinued when the employee is dismissed or fired, and as such, reporting shortages may be exacerbated by job losses. The insured shall be given insurance coverage and personal protection, provided the insured pays the premiums.

The insurer will decide the costs of the policy through the insurance provider for fully covered policies based on the rate they agreed. Based on terms, it can be billed every year or every two years. The insurance company bears all costs and becomes easier to handle compensation for employees. Fully insured plans can be more costly than self-funded plans, though, and the company needs to discuss the terms during the renewal each year. The financial responsibility rests with the employer for self-funded schemes and performs administrative roles for the management of medical claims that are routine.Single policy is an insurance scheme covering only the employee and not the family members. Many employers may have family members, but workers must pay the fee. Nonetheless, managers are hired to recruit more talent or retain workers as a bonus to workers.