...Constructit Insurance Selection Economics: The Financing of Health Care HCS 440 December 27, 2013 Constructit Insurance Selection Companies that are considering offering insurance to employees must make some decisions on plans, costs to both the business and the employee, and services provided. The insurance company offering the insurance looks at the level of coverage they are willing to provide for the services they will cover and to make a profit. This becomes a delicate balance of offering quality insurance coverage while making a profit. Castor Collins is evaluating the best selection based on the coverage requested by the separate companies and the amount the companies are willing to pay per employee. This student will analyze the data put together through the simulation assignment as the Vice President of Strategy and Financial Planning at Castor Collins with the information gained about both companies and advice from other professionals at Castor Collins regarding the chosen business, employee demographics, health concerns, premiums, and plan selection. Company Selection Approaching Castor Collins for insurance are Constructit and E-Editors. Both companies are seeking insurance plans for their employees, but both companies have different amounts the employees are able to pay towards an insurance plan. Constructit has 1,000 employees and are willing to pay $4,000 per employee towards a maximum annual premium. E-Editors have 1,600 employees and are willing...
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...health plan is a health maintenance program (HMO) that was found in 1999. The company provides health insurance coverage through a system that involves a network of physicians and hospitals. Castor Collins Heath Plan uses the capitation model to fund its large distributed group of physicians and health care organizations. Currently, Castor Collins provides health care coverage to 100,000 subscribers and would like to increase their enrollees. It is the responsibility of the Vice President along with his most trusted advisers, Helen Feuerman, Chief Financial Officer, Jonathan Wilkes, Chief Medical Officer, and Adam Hunter, Executive Vice President, Planning and Development, to reach out to new clients; two in particular, E-Editors and Constructit. E-Editors Castor Collins has a major company that is looking for health insurance coverage for their employees. The company E-Editors employs 1,600 individuals, 760 males and 840 females. The employee’s ages range from 35-54. Most of the employees with E-Editors are married so they will need to provide an affordable health care plan for their families. Looking at the kind of work involved for most of the employee’s, Castor Collins found that many of the individuals have a sedentary position. In fact, ninety-five percent of the employees at E-Editors have a position that requires long hours of sitting in front of a computer; the remaining five percent of the employees have positions that require activity Castor Collins had done a thorough...
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...companies have a set rate their employees are able to pay for premiums since both groups will have to pay for his or her own insurance (Axia College, 2006). The first company is Constructit that consist of 1,000 people and E-Editors that consist of 1,600 people. It is up to my team to come up with a plan the meets Constructit $4,000 max on premium and E-editors max of $4,500 premium(Axia College, 2006). Our task is to keep revenue maximized and risk to a minimum by choosing one of our three plans, which are Castor Standard, Castor Enhanced and our customized plan called Castor Enhanced Minor to suit Constructit the company I have chosen. Demographics of Constructit Constructit consist of 550 men between the ages of 26 to 45 and 450 women between the ages of 26 to 42. At Constructit 32% of the workforce’s duties involve excessive physical activities. This can cause some health risk with these employees. Whereas 25% of the workforce’s duties involve modest physical activities and the remaining 43% of the workforce’s duties involve inactive activities (Axia College, 2006). With the modest activity there is always a chance an injury could happen. The inactive employees mainly desk employee are not immune from injury either. Married employees consist of 60% of the workforce. The employees at Constructit are not all in perfect health. Out of 1000 employees 170 men and 210 women 38% of the workforce has no major health problems. With almost 10% of the...
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...health plan is a health maintenance program (HMO) that was found in 1999. The company provides health insurance coverage through a system that involves a network of physicians and hospitals. Castor Collins Heath Plan uses the capitation model to fund its large distributed group of physicians and health care organizations. Currently, Castor Collins provides health care coverage to 100,000 subscribers and would like to increase their enrollees. It is the responsibility of the Vice President along with his most trusted advisers, Helen Feuerman, Chief Financial Officer, Jonathan Wilkes, Chief Medical Officer, and Adam Hunter, Executive Vice President, Planning and Development, to reach out to new clients; two in particular, E-Editors and Constructit. E-Editors Castor Collins has a major company that is looking for health insurance coverage for their employees. The company E-Editors employs 1,600 individuals, 760 males and 840 females. The employee’s ages range from 35-54. Most of the employees with E-Editors are married so they will need to provide an affordable health care plan for their families. Looking at the kind of work involved for most of the employee’s, Castor Collins found that many of the individuals have a sedentary position. In fact, ninety-five percent of the employees at E-Editors have a position that requires long hours of sitting in front of a computer; the remaining five percent of the employees have positions that require activity Castor Collins had done a thorough...
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...differences in the choices presented, and why I chose the plan I chose. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options, this is way today you are given more than one option for health care. Company: Constructit Constructit consist of a 1000 employees (550 men and 450 women) ranging from ages 26 through 42 and 60 percent of them are married. Constructit has to consider in the number of employees that would covers their spouses or children for insurance coverage. Thirty-two of the workers are physical active and 25 percent are moderately physically active. There are 170 men and 210 women approximately 38 percent with no health issues. Ten percent of men and 8 percent of the women are heavy smokers. Obesity rate is also a problem with 39 percent being obese causing a heavy absenteeism for reason of high blood pressure, diabetes, heart issues, and hyperlipidemia. Knowing the demographics of Constructit, Castor is now charged with coming up with a plan that is profitable for Castor, but meets Constructit needs. There were two plans that were offered Castor Enhanced and Castor Standard. Insurance plan detailed Castor Standard and Enhanced are individual health plans. Castor standard does not cover preexisting medical conditions...
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...Economic Issues Simulation Paper/ Constructit Ruby Medders HCS/440 March 16, 2015 Lori Geddes Economic Issues Simulation Paper/ Constructit The research was done on determining which insurance policy would be better for a striving company. My decision was to research Constructit; I will give you my reasons behind choosing this company, benefits that will help the employees of this company and why I think this was the better choice for this company. (Getzen, 2013) Profile The companies name is Constructit, it employees 1000 people. The demographics for this company is ages 26-45 years old, there are 406 people between the ages of 26-30, 314 people between the ages of 31-35, and 82 people between the ages of 41-45. The total count for this company is 550 men and 450 women and 60% of the people are married. The physical condition of the people who work for Constructit shows that 32 % of the employees are involved in great physical activity, 25% is involved in a moderate physical activity, and the rest of the employees which is 43% are involved in sedentary activities. The health risk of the employee has been rated moderately high for health risk in this group. The good part of the research showed that 35% of the group has no major health risk, although 18% of the people who work for this company are smokers. (Getzen, 2013) According to report some of the major causes of work absenteeism at Constructit are injuries, respiratory system diseases, digestive disorders...
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...Angel Gross I am the vice president strategy and financial planning for Castor Collins Health Plan. My job description consists of on a daily basis is interacting with new patients and formulating health plans that will suit their needs also including pricing plans and setting insurance premiums. The HMO provides health insurance and health care services to enrollees through it statewide network of physicians and hospitals. Castor Collins currently has 100,000 enrollees throughout the state and is looking to increase this number. The first group constructit consist of a 1,000 people while the E-editors, comprises 1,600 people neither group has employer insurance this means that people comprising both groups will pay for they own insurance the people at constructit are willing to pay the maximum annual premium of $4,000 per person, while the people at E-editors are willing to pay a maximum annual premium of $4,500 per person. Constructit comprises 500 men and 450 women with the age group of 26 to 42 about 60 percent of the group id married. The members of E-editors comprise 760 men and 840 women in all the ages of 35 to 54 with the highest percentage of 61 percent being between 45-54 years of age. The majority of E-editors employees are listed as married. The work at E-editors is largely sedentary work sitting in front of computers all day, according to their profile 95 percent of all the employees at E-editor have been doing this type of work for an average of 10 years. This leaves...
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...Jonathan Wilkes is not only the strategic planner for the medical aspect, but also the chief advisor for health care services. He also handles clinical services and management of utilization. He joined the Castor team in 2002. Helen has been there since Castor was founded. Her obligations are financial operations, which includes budgeting, underwriting, actuarial, forecasting, accounting, financial planning, risk management, and financial analysis. She is certified for both chartered life underwriter and public accountant. In January 2006, Mr. Hunter and I had a meeting with two groups of people. Constructit, which consists of one those and people, and the other group E-Editors, this group consists of one thousand six hundred people. Both do not have insurance coverage for their employees. This means that individuals of both parties have to pay their own insurance. As for the Constructit group, they are willing to pay a premium of four thousand for each person. The E-Editors group will pay up to four thousand five hundred for each person. Castor Collins has two available plans that could fit both of these groups. The first is Castor Standard and the other...
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...hospitals. Castor Collins offers several different insurance plans that would be beneficial to the employees of Constructit. The insurance plans offered vary according to services provided, cost of annual premium to employees, and utilization of services. Castor Collins has the ability to tailor an insurance plan that meets the health needs of Constructit employees at an affordable price while still brining in revenue for Castor Collins. Profile of Constructit and E-Editors Constructit is seeking a group health insurance plan and has 1,000 employees that is willing to pay a maximum of $4,000 in annual premiums. Of the 1,000 employees, 550 are men, 450 are women, and 60% of them are married. Their ages range from 26 to 42; 40% are 26-30, 31% are 31-35, 20% are 36-40, and 8% are 41-45. With a large percentage of younger employees, 38% reported having no major health risks. Reasons for absenteeism at Constructit include injuries, respiratory system diseases, digestive disorders, migraines, and allergic conditions. Some of the respiratory system diseases are attributed to the 10% of men and 8% of women who are smokers. Additionally, 43% of employees consider themselves as doing sedentary activities while 25% and 32% consider themselves as doing moderate and very moderate physical activities, respectively. One major health risk to consider is that 39% of Constructit employees are obese; 198 men and 192 women. Obesity related health risks such as high blood pressure, diabetes, cardiovascular...
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...why each plan could be selected and reason for my decision. Castor Collin health plan was founded in 1990 in Pantone, and offer Health Maintenance to organization. Castor Collin provide health insurance and health maintenance to enrollees through it statewide network of physician and hospital. Castor Collin currently has 10,000 enrollees throughout the Unites State and is looking forward to increasing this number. Two company are trying to find coverage for they employees and looking to see what Castor Collin has to offer them. The two company are E-editor and Constructit that are currently seeking coverage. Constructit consist of 1,000 employee and E-editor have 1,600 employee. Both of these company have provided the maximum amount they are willing to pay, the demographics, and health risk factor of their employee. E-editor are willingly to pay an annually maximum amount of $4,500 per employee, and Constructit is willing to pay $4,000 per employee annually. As a representative of Castor insurance the job is to minimize risk for the company while maximizing they profit. There are two plan that are convenient for the group, and a third one is available also but quite different from the other two. Castor Standard plan and Castor Enhanced covered the pre-existing condition that the employee might have. The castor enhance minor is the third plan, and different from...
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...why each plan could be selected and reason for my decision. Castor Collin health plan was founded in 1990 in Pantone, and offer Health Maintenance to organization. Castor Collin provide health insurance and health maintenance to enrollees through it statewide network of physician and hospital. Castor Collin currently has 10,000 enrollees throughout the Unites State and is looking forward to increasing this number. Two company are trying to find coverage for they employees and looking to see what Castor Collin has to offer them. The two company are E-editor and Constructit that are currently seeking coverage. Constructit consist of 1,000 employee and E-editor have 1,600 employee. Both of these company have provided the maximum amount they are willing to pay, the demographics, and health risk factor of their employee. E-editor are willingly to pay an annually maximum amount of $4,500 per employee, and Constructit is willing to pay $4,000 per employee annually. As a representative of Castor insurance the job is to minimize risk for the company while maximizing they profit. There are two plan that are convenient for the group, and a third one is available also but quite different from the other two. Castor Standard plan and Castor Enhanced covered the pre-existing condition that the employee might have. The castor enhance minor is the third plan,...
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...Economic Issues Simulation HCS 440 May 30, 2011 Professor Humberto Munoz Constructit is a business organization that currently does not offer employer paid health insurance. Constructit is compromised of 1,000 people and they are willing to pay up to $4,000 per person for their annual premium. The organization consists of 550 men and 450 women ranging in age of 26 to 45 years old. Fifty-seven percent of the workers range from high activity to moderate activity level while the remaining forty-three percent are mainly in a sitting position most of times. One factor to consider when determining which type of insurance to offer the group is the amount of health risk factors that affect all the employees. Thirty-eight percent of the employees have been deemed to have no major risk factors at all; however, almost eighteen percent of the workers are smokers and thirteen and a half percent of them suffer from some form of respiratory disease or illness. One of the biggest risk factors affecting the entire group of people is obesity. Obesity affects thirty-nine percent of these workers which in turn, increases the risk for obesity related diseases and illnesses. These diseases include but not limited to heart disease, hypertension, hyperlipidemia, and diabetes. This will increase the utilization of many healthcare services including prescription drugs, diagnostic services, and outpatient office visits (University of Phoenix, 2010). Castor Collins is a regional...
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...providers. Currently the company has 100,000 enrollees and is currently looking to increase this number. However, to increase enrollment numbers it will take the dedication of the chief vice president of strategy and financial planning to interact with new clients as well as formulate a health plan. The chief vice president along with colleagues Helen Feuerman (Chief Financial Officer), Jonathan Wilkes, MD (Chief Medical Officer) ,and Adam Hunter (Executive vice President of planning and development) are implementing plans that includes setting insurance premiums and price plans “which” will suite the need of the clients. The first phase of implementing plans will consist of the two companies, which are Constructit and E-Editors. Demographics of the people Constructit and E-editors are companies currently looking for insurance coverage for their employees and are willing to pay...
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...will suit their employees and not break the bank close attention to detail must be paid to the company’s overall state of health. An in-depth analysis is conducted and health conditions are looked at with much scrutiny. Although it appears to be much to go through for health insurance coverage, it is an absolute necessity. “Insurers have to determine a premium price based on risk factors balanced over the entire group, using general information on members of the group, such as age or gender” (National Conference of State Legislatures, 2013). Castor Collins Health Plans has taken on the task of deciding on offering coverage to one of two businesses. The businesses are Constructit Construction and E-Editor. Both company profiles were carefully reviewed before a decision was made regarding whether Constructit or E-Editors would be more suitable for health insurance coverage under Castor Collins Health Plan. In making the decisions the following information was taken into consideration basic demographics of the employees, the health care risk factors or potential areas of...
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...Economic Issues Simulation Paper HCS/440 University of Phoenix Individuals are encouraged to get insured, which serves as their proactive assurance of the possible risks that they may face in the future. By getting insurance, the person is able to minimize these risks. For instance, one may opt to buy insurance in order to have a fall back in case of a large loss or casualty, thus they can still be secure of a regular premium. Quite ironically, insurance has been one of the profit avenues of some companies. Profit can be gained in the insurance business because gaining the premium from the probability of a certain loss will still have a higher possibility of the same event to reoccur. Castor Collins Health Plans The main idea of insurance is letting the consumers or buyers give up a part of their money on a regular basis as their way of preparing for probable risks or losses. The clients of Castor Collins can choose between two plans of the company. The Standard plan will not cover the previous conditions, while the Castor Enhanced Plans can be used to cover up for the prior conditions of the client. Recently though, with the new Chief Financial Officer of the company, Helen Feuerman, the insurance company has come up with a better strategy that can provide them with greater profits. This is called the Castor Enhanced Minor. This new program basically eliminated all the company services that have a high level of utilization from their clients. With...
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