...Chapter 9 health and disability insurance |CHAPTER OVERVIEW | Planning a health insurance program needs careful study because the protection should be shaped to the needs of the individual or the family. However, the task is simplified for many families because a foundation for their coverage is already provided by group health insurance at work. We begin the chapter by recognizing the importance of health insurance in financial planning and define health insurance. Then we analyze the benefits and limitations of the various types of health insurance coverage. Private and governmental sources of health insurance and health care are presented next, with a complete coverage of health maintenance organizations (HMOs). Then, we discuss the importance of disability insurance in financial planning and identify its resources. Finally, we explore why the costs of health insurance and health care have been increasing and what is being done to curtail them. |LEARNING OBJECTIVES |CHAPTER SUMMARY | After studying this chapter, students will be able to: |Obj. 1 |Recognize the importance of health |Health insurance is protection that provides payments of benefits for a covered sickness | | |insurance in financial planning. |or injury. Health insurance should be a part of your overall insurance program to | |...
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...Family Life Assurance Company is a fortune 500 company that was started by three brothers in 1955. The company is known for pioneering the supplemental insurance industry and was also the first insurance industry to offer a cancer policy. These major accomplishments all came about due to the Amos brother’s personal life experience with their father, whom after having worked several years and retired from a well-established company that offered great benefits, was still unable to pay his bills, after being diagnosed with cancer. As is the case with most families that have someone battling cancer, the surmounting cost of cancer treatment can put a severe strain on the family and cause the family to seek other means of covering health costs such as: savings accounts, loans, employers or friends. This ordeal propelled the brothers into wanting to help others and therefore, started their own health and life insurance company which is better known today as AFLAC. At the end of the first full year of operation, the company 6,426 policies and just over $388,00 in total assets (NATC,13). Since the 1950’s the company has seen significant growth due to it’s continued dedication to providing products that are needed and service that is unsurpassed. In 1964, Paul Amos introduced “cluster selling,” a virtually new concept in insurance marketing.”(NATC, 13) By the mid sixties the company was selling insurance in 11 states and covered 37 states by the 1970s. The company continued to grow...
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...Health Care Reform in the US Introduction Health care reform is a general term that is used for analyzing and discussing major health care changes and provisions. Most health care reforms are typically served with the responsibility of broadening the population so that they can receive adequate health care coverage through private or public insurance companies. Also they improve quality of existing health care system and decrease the cost (Weiner & Robert, 2009). The health care reform legislation act of 2009 is a bill that was enacted in USA to direct the health care insurance providers to draft and develop regulations in implementing a comprehensive policy aimed at providing effective and cheap insurance cover to all American citizens. Though beneficial to the public, since the bill was signed into law the implementation of the act has faced numerous economic, social and political challenges. In addition, the political climate is such that real challenges appear to be emerging, including legal challenges at the state level (Farber & Blustein, 2007). Finally, polls are showing that voters are not yet on board. In fact, some voters are unaware that a health care reform bill had been passed. Therefore this paper Identifies and describes the major challenges to health care reform implementation and gives an analysis of how these challenges can be resolved. Reasons and Recommendations for Health Care Reforms There is minimal question regarding the need to restructure the America's...
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...achieved a lot in terms of health improvement. But still India is way behind many fast developing countries such as China, Vietnam and Sri Lanka in health indicators (Satia et al 1999). In case of government funded health care system, the quality and access of services has always remained major concern. A very rapidly growing private health market has developed in India. This private sector bridges most of the gaps between what government offers and what people need. However, with proliferation of various health care technologies and general price rise, the cost of care has also become very expensive and unaffordable to large segment of population. The government and people have started exploring various health financing options to manage problems arising out of growing set of complexities of private sector growth, increasing cost of care and changing epidemiological pattern of diseases. The new economic policy and liberalization process followed by the Government of India since 1991 paved the way for privatization of insurance sector in the country. Health insurance, which remained highly underdeveloped and a less significant segment of the product portfolios of the nationalized insurance companies in India, is now poised for a fundamental change in its approach and management. The Insurance Regulatory and Development Authority (IRDA) Bill, recently passed in the Indian Parliament, is important beginning of changes having significant implications for the health sector. The privatization...
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... HEALTH INSURANCE Mrs.S.Gnana Sugirtham, Lecturer, Department of Commerce, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore – 641 043. Email ID:sugistephen@gmail.com. Introduction Over the last 50 years India has achieved a lot in terms of health improvement. But still India is way behind many fast developing countries such as China, Vietnam and Sri Lanka in health indicators (Satia et al 1999). In case of government funded health care system, the quality and access of services has always remained major concern. A very rapidly growing private health market has developed in India. This private sector bridges most of the gaps between what government offers and what people need. However, with proliferation of various health care technologies and general price rise, the cost of care has also become very expensive and unaffordable to large segment of population. The government and people have started exploring various health financing options to manage problems arising out of growing set of complexities of private sector growth, increasing cost of care and changing epidemiological pattern of diseases. The new economic policy and liberalization process followed by the Government of India since 1991 paved the way for privatization of insurance sector in the country. Health insurance, which remained highly underdeveloped and a less significant segment of the product portfolios of the nationalized insurance companies in India, is now...
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...EXECUTIVE SUMMARY: Company Description Affordable Health Insurance is a company offering comprehensive medical, dental and life insurance online. In today’s world where Internet, social media and web surfing has become so globalised the company offers a service online which is easy to access, does not consume much time, offers comparable rates at no cost to the consumer. Having health insurance is important for several reasons. Uninsured people receive less medical care and less timely care, they have worse health outcomes, and lack of insurance is a fiscal burden for them and their families. Moreover, the benefits of coverage outweigh the costs for added services. Mission statement: “QUALITY YOU CAN COUNT ON” The company’s mission is to provide quality, compassionate, and professional health care that is affordable, easily accessible and without discrimination to all. The company is dedicated to building a long term relationship with customers through quality service and support. Service viability in an online Environment Affordable Health Insurance is a company offering comprehensive medical, dental and life insurance online. In today’s world where Internet, social media and web surfing has become so globalised the company offers a service online which is easy to access, does not consume much time, offers comparable rates at no cost to the consumer. The products include medical, dental and Life insurance giving the consumer affordable and a vast variety of...
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...Health Care Economics Issues HMO Simulation Name University of Phoenix Economics: The Financing of Health Care HCS440 instructor date Health Care Economics Issues HMO Simulation Castor Collins is a health insurance company that offers health maintenance organization (HMO) to organizations. This health insurance company was founded in 1999 in Pantome. Two organizations are trying to seek coverage for their employees and have chosen to see what Castor Collins has to offer them. The two companies are Constructit and E-editor that are seeking policies for their employees. Each one of these companies has provided the demographics, health risks and maximum premiums they are willing to pay. The insurance company has three different plans they have to offer for these two companies .Castor Collins will review the company’s information and decided which plan is best for which company to see if they will be able to meet the companies’ needs. Castor Collins will also make sure their financial liability will not be too high. The three insurance plans Castor Collins has to offer is castor standard, castor enhanced, and castor enhanced minor. The castor plan and the castor enhanced plan offer the same type of services with little price different. The biggest difference between these two plans is the castor standard plan does not cover pre-existing conditions and the castor enhanced plan does cover pre-existing conditions. The castor enhanced minor plan is different from...
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...08/25/2014 When it comes to choosing a health care coverage it is always difficult to do. One has to look for the right coverage that suits you. The fact that health care insurance companies are nothing like any regular businesses. The health care reform law has made it very complicated for people to choose plans provided by their employers. Apart from looking into premiums, copayments, deductibles and so on, we need to consider provisions in the law that has been established and can have a great impact in your coverage in the near future. When choosing a plan there are different things to look into like: * Size and the cost * Factors in your favorite doctors * Make adjustments to your current plan or consider switching * Don’t get lured by those new freebies * Decide which plans suits your needs In the case of Castor Collins Health Plans they were a regional HMO founded in 1999 in the state of Pantome. As an insurance company they always looking for a way of expanding by increasing the number of people they served. Speaking of them at the beginning they have about 100,000 enrollees through the state and still looking for an increase. As a representative in this company my main objective is to maximize profit and minimize the company from risk. In the event I have these two companies in need of health insurance it is a good time for me to get the company to its goal. All these companies have their own good part. E. Editors are with the...
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...SYSTEM REFORM Course Project T. Wise DeVry HSM 534 Health Service Finance February 23, 2013 Week 7 Professor Alison Williams Background The United States, being the most diverse society in the world, has a long and unsuccessful history of attempts at healthcare reform. We spend almost $2 trillion dollars per year on healthcare, yet not all American people have medical coverage (Barton, 2007). A huge percent of the population have to rely on outside sources, such as benefit health care from an employer or from government programs, such as Medicare and Medicaid. As compared to other nations, our society has people that are more overweight, live under more stress, and are less in physical activity. Additionally, our healthcare system underperforms compared to with other nations in critical areas such as, access, quality and efficiency (Davis). How did our system get this way? Why are we paying so much while other nations not so much? A history of major events - The U.S. healthcare system is trying to evolve with modern times; however, as time goes on, our current situation becomes more apparent: * In the 1950s, the price of hospital care was growing; however, more attention was diverted to the war in Korea. Many legislative proposals were made, but none could not be agreed on. * In the 1960s, hospital care expenses doubled, and despite over 700 insurance companies selling health insurance, a large percentage of the population could not afford...
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...Trends, Benefits, and Impact of Consumer Health Insurance T Burke Health Care Delivery in the U.S./HCS235 July 17, 2010 Trends, Benefits, and Impact of Consumer Health Insurance Healthcare Insurance, better known as health insurance, like that of other forms of insurance has been around for a very long time, dating back to the first ever proposal in 1694 by Hugh the elder Chamberlen from the Peter Chanberlen family (Wikipedia). What is health insurance? Defined by a website entitled Ask.com health insurance is; “insurance against expenses through illness of the insured” (Ask.com, nd). Health insurance was originally established to provide accident insurance and operated like some of the disability insurance of modern times we have today. Today consumer health insurance programs have evolved into a comprehensive collection of coverage from accident to emergency room care and from the simplest minor scrape to the most difficult surgery. For one to have a better understanding of how the consumer health insurance works and has evolved from the past 75 years, one should be more familiar with some of the historical trends consumers have dealt with over the years, the type of benefits that are available, provider networks, some of the impacts benefits have on the healthcare delivery system, resource management and the overall health status of individuals and society. As a consumer of health insurance it is important to first have an understanding of...
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...organization must develop a product, determine the price customers are willing to pay, identify what place is most convenient for customers to purchase the product or access the service, and finally, promote the product to customers to let them know it is available. Product, price, place, and promotion are referred to as the four Ps of marketing strategy.3 It is these four controllable variables that a firm uses to define its marketing strategy. The mix of these four controllable variables that a business uses to pursue a desired level of sales is referred to as the marketing mix. The definitions of the four major elements of marketing as discussed below provide the focus of this book. Product Product represents goods, services, or ideas offered by a firm. In this text, the term “product” also will be used interchangeably with health care services and ideas. In health care, the nature of the product has changed dramatically. Thirty years ago, one could define the product simply as a medical procedure or as an orthotic device to correct a physical disability. In today’s climate, the discussion of...
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...The company he currently works for as an independent business owner is Motor Club of America. This company is rivaled with AAA coverage, and their goal is to give people the most reliable and substantial protection while driving. The company also offer’s cash rewards to those that bring in referrals. Nick claims the highest reward he can ever have is when he has made people financially independent and protected so they can go on living the life they have always desired. The ethical issues involving MCA are the fact that there advertising must be consistent with what they offer. There is an imperative for Nick to identify the company’s company plan and make sure that their insurance packages have required coverage. In Motor Club of America the insurance coverage is legally bound to protect those when on the road. Meaning to take advantage of the insurance one must be having a problem with their vehicle and no other property, personal injury outside the vehicle, and legal troubles such as being arrested. They offer a written contract agreement that is paid for on a monthly basis. A major perk to the company is that even clients can make money by referring friends to purchase subscriptions. One referral alone can end up paying someone’s monthly fees, and any additional leads to personal revenue. Nick said he has had people get a ticket and use MCA plan to get a lawyer and fight the ticket and that was fine. However, people have tried to use MCA for an insurance policy...
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...and Affordable Care Act on March 23, 2010. This is also widely known as “Obama care” and is the new Medicaid. This comprehensive health reform law has brought about significant changes in the health system. I am specifically focusing on three of the main components of the law, delivery system improvements, health insurance coverage and cost containment. Though many may disagree with the “right” solution when it comes to Obama care, it is commonly agreed that there is a fundamental problem with the current healthcare system: nearly 50 million people in this nation are without insurance and those who are covered face high premiums with plans that do not cover the services they need. This current system is inefficient and therefore is poor quality and creates high cost. The ultimate goal of the legislation was to extend both private and public coverage to about 32 million people who were uninsured; to improve access to quality coverage for the uninsured; to improve how affordable coverage would be; and to ultimately reduce the overall growth in health care costs. Now for the pros and cons of this law, this was passed on June 29 2012. The pros of this law are that Patients with pre-existing conditions cannot be denied coverage by insurance companies, and companies can no longer drop someone once they get sick. This also means that if an insurance company denies someone coverage, that person can go to an external appeals process. “If the law is upheld, argued Verilli, “people with...
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...Running Head: U.S. HEALTHCARE SYSTEM REFORM HS543 Health Services Finance Summer Term 2012 Instructor: Mary Black Course Project Outline U.S. Healthcare System Reform Submitted By Project Outline This project will explore the current state or our healthcare and where it is predicted to cost us in the future. We will also examine the overall health programs and how the uninsured will affect the system entirely. Universal healthcare would alleviate the financial burden on some of the population and provide access to almost all of the country's population; however, this system will cost more. Funding the program will be discussed as well as the taxes and other funding that will help pay for the coverage. Likewise, how this will affect hospitals and healthcare providers. Topic: U.S Healthcare System Reform Outline I. Abstract II. Introduce the Issue (Background) A. An analysis of our current healthcare system 1. A history of major events 2. Impact to healthcare organizations III. Defining the problem A. Political disagreements B. The increase of expenses IV. Literature Review A. Is U.S. Healthcare deteriorating? B. Effects on the profitability of local hospitals V. Analyze the Problem A. Raising insurance premiums B. The uninsured VI. Possible Solutions A. French Healthcare system B. A public option VII. Implementation Plan A. Financing VIII. Justification A. Access of...
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...HEALTH Health is a human right, which has also been accepted in the constitution. Its accessibility and affordability has to be insured. While the well-to-do segment of the population both in rural & urban areas have acceptability and affordability to wards medical care, at the same time cannot be said about the people who belong to poor segment of the society. It is well known that more then 75% of the population utilizes private sectors for medical care unfortunately medical care becoming costlier day by day and it has become almost out of reach of the poor people. Today there is need for injection of substantial resources in the health sectors to ensure affordability of medical care to all. Health insurance is an important option, which needs to be considered by the policy makers and planners. HEALTH CARE SCENARIO Health care has always been a problem area for India, a nation with a large population and a larger percentage of this population living in urban slums and in rural area, below the poverty line. Before independence the health structure was in dismal condition i.e. high morbidity and high mortalities, and prevalence of infectious diseases. Since independence emphasis has been put on Primary Health Care and we have made considerable progress in improving the Health Status of the country. CG: Central Government PH: Primary Health MCH: Maternal and Child Health. • Access to health care service providers and availability of physicians is one part of the...
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