Healthcare Policy & Law - Insurance Plans
Added on 2020-03-02
6 Pages1360 Words95 Views
Public and Global Health
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Running head: HEALTHCARE POLICY AND LAW1Healthcare Insurance PlanStudent’s NameCourseProfessor’s NameInstitutionDate
HELATHCARE POLICY AND LAW 2Healthcare services may be expensive especially during unplanned medical situations.For this reason, there are several healthcare insurance plans provided by private insurers andgovernment-run such as Affordable Care Act (ACA). Purchasing the right healthcare plan for anindividual, family or business may be complicated. However, with the proper guidance, one mayresearch and examine the best plan that suits them depending on their medical requirements, age,federal laws, insurance regulations, lifestyle, and financial status. Most organizations purchaseMedicare insurance plans for their employees ensuring that they are subscribed to an insuranceplan protecting them from medical care financial costs during sickness or accidents (O'Connor,2016). For this assignment, considering the small size of the organization, I would use the Point-of-Service (POS) plan to purchase health insurance for the company. In essence, the POS plan isa health insurance plan designed to cater people willing to pay less. The organization orindividual contracts with an insurer who ensures the individual beneficiaries or the employeesget benefits which include healthcare services from providers, doctors, and hospitals within theplan’s network. Besides, the primary care doctor may refer the beneficiary to specialists,hospital, or providers’ in-the-network at no additional cost. Also, under the plan, the beneficiarymay visit any specialist, hospital or provider out-of- the- network at an additional cost("Insurance Glossary," 2017). Considering the cost analysis of the small organization, the POSplan is an apt plan since it offers extensive healthcare services at lower costs compared to otherplans. The extent to which the employee lifestyle choices and health economics factor into thePOS plan is that the plan offers a range of benefits to the employees and is less costly to theorganization. To start with, under the plan the employees have more freedom to choose theirprimary care doctor, hospital, and providers compared to other plans such as the HMO (Health
HELATHCARE POLICY AND LAW 3Maintenance Organization) plan ("Type of plan and provider network," 2017).The plan offerspocket-friendly monthly premiums, and only a small amount of a deductible fee is applied beforethe plan covers care beyond preventive services. Since the lifestyle choices differ among theemployees, the plan is appropriate in ensuring every employee chooses a primary care based onthe lifestyle choices and what one can afford. For the employees to receive ultimate benefitsfrom the plan, it is important to factor in various requirements. The company has to design astrategic program specifying the initiatives to promote healthy living styles. Additionally, theprogram will specify the organizational policies that promote safety and wellness of theemployee through medical check-ups, healthy eating, increased body exercise, and healthybehaviors (Sloan & Hsieh, 2017). Accordingly, factoring the health economics and employeelifestyle choices in selecting the POS plan will ensure the employees enjoy some benefits atlower costs while improving healthy lifestyle choices which is attributed to workplaceproductivity. The Affordable Care Act (ACA) recognizes the mandate of small business organizations-with fifty or less full-time-equivalent workers-to provide their staff with comprehensivehealthcare insurance through government healthcare insurance marketplace plans. Furthermore,the ACA is cautious about the welfare of the employees by stipulating that when choosing theinsurance plan, the employer should consider the premiums and deductible fees to be paid by theemployees by ensuring they are affordable to all employees (Blumenthal & Collins, 2014). TheACA states that any small business organization that neglects to provide affordable healthcareinsurance is liable to a penalty of $2,000 for each uninsured employee within the organizationwhere more than half of the staff are insured. Additionally, the organization is subject tocontributing 60% to the individual insurance coverage of every employee (Shaw et al., 2014).
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