Cost_Control_Strat._Hcr230

  Comparing cost control strategies There are a few cost control strategies that employer-sponsored plans can implement. To begin, the employers can offer just a certain number of products or services to their employees. Employees can buy options, called riders, to augment their health plan coverage. This is used for things like dental and vision care, or complementary health care such as acupuncture, massage, and dietetic counseling. Usually enrollment for employer-sponsored plans takes place annually. The enrollment is called “open enrollment.” It may also take place after a waiting period that the employer has specified; this is usually the case for new employees who join the company at any time other than open enrollment. During enrollment, employees select the set or plan of benefits for the next year. This type of plan has no third-party administrators. Different levels of premiums and deductibles are available from which to choose. Adequate coverage is available in both plans, but the self-funded plans generally have higher risks. In self-funded health plans, cost control strategies are created to save money. Employees do not have the ability to purchase riders under self-funded plans. Open enrollment does not take place, though a waiting period for enrollment does exist. Often, third party administrators will handle parts of the insurance’s management, like collecting premiums from people covered. Both types of plans are not portable from one job to the next. If an individual changes employers, insurance is lost after a certain number of days. However, other coverage options are available in cases such as these. In both plans, there are provider networks of HMO, PPO, and POS. Employer-sponsored plans sometimes allow the employee to choose his or her provider network, but this freedom can affect the plan’s cost. In self-funded plans, the cost depends upon the decisions the employer has made in purchasing the health plan. Comparing the different cost control strategies that employer-sponsored plans can provide can be elaborate. Employer-sponsored health plans are regulated by state laws. Employer-sponsored health plans buy medical insurance from insurance companies to given to their employees as benefits. The Human Resources department negotiates the health care benefits offered to the employees. Employees are offered basic benefits and riders. Riders are additional coverage’s purchased by the employees. These can be used for different coverage’s like dental and vision care. They can also be used for complementary healthcare such as acupuncture, massage, and some dietetic counseling.   Employers may eliminate certain coverage’s to reduce their costs. The enrollment periods happen once a year when employers choose a particular set of benefits for the upcoming benefit period. Sometimes these enrollments occur after a waiting period that the employer specifies. This is just for new hires, so that they can have the insurance coverage when they have waited the allotted time specified by their employer.   During the enrollment, employees decide on which plan or benefits they would like for the next year. There are different level of premiums and deductibles that are available. There is adequate coverage in both plans, but usually the self-funded plans have the higher risks that come with them. These types of plans have no third party administrators involved. In self-funded health plans, there are many cost control strategies put in place to help the company save money. With self-funded health plans, the employees do not have the ability to purchase riders. The do not have an open enrollment and they use third party administrators to handle parts of the insurance’s management. For example, third party administrators collect the premiums and they enroll through a waiting period.  Employer-sponsored Medical Insurance The human resource department of employees selects health care benefits along with the health care plan then offers them to the employees. Riders which is also called options and open enrollment periods are chosen by employees. Riders are added coverage, so if an employee needs vision or dental services, if their health care plan does not provide these services they can purchase the added coverage. Rider also has complementary health care that includes treatment, acupuncture, massage therapy and more. Employers may change coverage to reduce the price. The open enrollment periods usually once a year and is where the employee chooses a specific benefit plan. The employer gives helpful information to help the employees choose what plan will fit their family needs along with the best prices. Self-funded Health Plan Some employers save money by using the self-funded health plan where the employer covers the cost of employee’s medical benefits instead of buying insurance from other companies. These employers set aside funds that will pay for benefits and they may set up their own provider network or they may buy a vision package instead of insuring the benefit. The self-funded plan may use third party administrators who are contract to take care of the processing and paying claims, collecting premiums, and keeping the list of members up to date. Portability is regulations where employees can accumulate pension rights through an employer who participates in a health care plan that such as optional rider. Portability helps employees with health coverage in situations that change their job, some illnesses, and pregnancy. Creditable coverage is health insurance under a group to helps patients/employee who join a new health care plan. If a patient who had medical insurance that supplied specific coverage and it ended, the patient will give documentation it to the new health care plan.