Economic_Issue_Simulation_Paper

Economic Issue Simulation Paper Introduction The Economic Issues Simulation Paper is regarding Castor Health Plans. Castor health plan was founded in Pantome state in the year of 1999 as a regional HMO. The focus of (HMOs) Health Maintenance Organizations is to offer health care insurance and services through a nationwide system of physicians and hospitals to their enrollees. This system is completed by means of a capitation model to pay a huge group of health providers. Even though Castor has thousands of enrollees they are looking to increase the amount. As a representative for Castor it is my duty to reduce the risk factors and capitalize on profit for the company. Additional responsibilities as a representative include interacting with new consumers, price planning, setting insurance premiums and setting health plans that work for the consumer. The job of making economic and financial decisions is never easy. Making these types of decisions is hard because the choice has to be one that will make profits and grow the company. Castor will have to choose between two companies to help cover their health plans. E-editor and Constructit are the two companies that have been placed in front of their health plan company. The simulation review has two plans to choose from and a customized plan that has disadvantages and advantages that include adding and removing services to consumers that have pre-existing conditions. Castor standard is top insurance plans that cover all accidents but it does not cover any pre-existing conditions and the cost can go up to $2,428 annually. The second plan is Castor enhanced that does cover pre-existing conditions and it runs up to $3,556 annually. The final plan is Castor enhanced minor and it also covers pre-existing conditions and the consumer can exclude coverage such as substance treatment, mental health and obesity. This plan can run about the same as the Castor enhance plan. Company One When looking at Constructit Company it has roughly around 1,000 employees. The Constructit Company consists of 450 women and 550 men and their ages range from 26years of age to 42 years of age. Company statics show that 32% of the employees are physically active, 25% are moderately active and 43% is sedentary. This company employee rate is high due to digestive disorders, on-the-job injuries, migraines, respiratory illnesses and other major illnesses. There is a high obesity rate within the group and the percentage is about 39%. As a spokesperson of Castor we notice that the high obesity related disease has a high risk for other illnesses. Company Two There are about 1600 employees within the company E-Editors and their employees age ranges from 35 to 54. The jobs for this company mostly require sitting in front of the computer. About 95% of the employees have previously worked with other companies doing the same type of job. Since these employees have worked for companies similar to E-editors they have a higher risk for stressed related injuries. Castor Company notices that this can affect their employee’s health causing obesity, diabetes, and even hypertension. The company notices that this heightens the chance for more employees with pre-existing conditions. Premiums When talking about premiums the Castor Company will should see what would aid their company growth, and not harm it. Comparing the two companies’ one company having more employees than the other meaning they would pay a higher premium. The negative aspect is more employers have a higher rate of employees that have pre-existing conditions. This problem hurt the company because the companies end up spending more money to cover the cost. Risks versus profits As a representative within the Castor Company believes it would be wise if they make available health coverage for the Costructit Company. Castor chose to go with this company for an array of reasons. One main reason is because their employees were more physically active and they were also younger than those at the other company. Constructit are at a lower risk and has a much lower utilization. Representatives at Castor noticed that this company have a high obesity rate and most of the employees health is good and do not have habits that would harm them. The best health insurance plan that Castor offer is the Castor Standard Plan. This plan carries a premium of $2,428 which saves Constructit around $572 a person. When looking at the company’s profit margin research showed that it was low, some representatives in the company believe it would be best to increase the premiums in order to get a larger profit, but employees with pre-existing conditions would be covered. Although Castor would be profit it would not be profiting as much as we would like. Castor declined health coverage to E-editors because of economics. This company shows that a lot of their employees are prone to have many pre-existing conditions and are high risk at different health problems, which only leads to the company having to pay more money for services that are rendered to the employee. Representatives of Castor have to formulate a plan that would benefit employees at E-editors and also protect the company from high risk payouts. Conclusion In conclusion, when dealing with any type of organization or business finding the best health insurance company there is a lot one should take into consideration.All businesses want the best for their employees, but yet they need to view all that is offered to them. It will not cost them a lot of out of the pocket money because they are helping the employees pay for any health care services that they needed. Castor had to choose between two companies that needed health care insurance. When deciding what company to choose the choice was not easy, due to all the evidence that was provided the best choice for Castor to cover is Constuctit but could cover E-editors at a higher rate. References University of Phoenix. (2011) Understanding economic issues for HMOs [Computer Software]. Retrieved from University of Phoenix, Simulation, HCS/440-Economics: The Financing of Health Care website