Economic_Issues_Simulation_Paper

Economic Issues Simulation Paper The simulation presents two companies that wish to receive health insurance from Castor Collins Health Plans. The two companies are ConstructIt and E-Editors. One company is willing to pay more than the other one. At ConstructIt the 1,000 employees are willing to pay up to $4,000 whereas the 1,600 E-Editors employees are willing to pay $4,500. Castor Collins Health Plans have to do an analysis of why each plan could be chosen. They also have to select, which company to sell to any why that company was chosen. Castor Collins Health Plans also has to consider why the other plans were not chosen for the selected group. Selected Group In this simulation the chosen company is ConstructIt group. At ConstructIt there are 550 males and 450 females. Of the female population 308 are age 35 and under, 142 of those female employees are 35 and older. Of the male population 412 men are 35 and under, 138 of those male employees are 35 and older. So 720 employees are 35 and under while there are 280 employees over the age of 35. At ConstructIt 32% of the employees do exercise regularly while the remaining 43% do sedentary activity. Thirty-eight percent of this group have been checked and was told they had no major health risks. Eighteen percent of the men and women, combined, are smokers. Obesity statistics are 39% of women and men combined, which raises disease such as diabetes. With any company there is always a risk with employees who had preexisting conditions. Types of Plans With Castor Collins Health Plans there are three different types of plans. The first plan is Castor Standard. This plan does not support preexisting conditions but does cover many other conditions that the other two plans also cover. This plan also covers many inpatient and outpatient services with a very low premium. Some of the coverage's are inpatient hospital services, emergencies, substance abuse treatment, male and female sterilization, and obesity treatment. Outpatient services include some of the following: office visits, hearing screening, immunizations, allergy testing with treatment, x-rays, and physical therapy. Even though this plan covers many services there are two more plans that may suit ConstructIt better. Castor Enhanced is the second plan offered by Castor Collins Health Plans. This plan also covers everything that Castor Standard does, but it also covers preexisting conditions. This plan also costs more than Castor Standards because of the risk associated with preexisting conditions. Castor Enhanced Minor is the third plan offered by Castor Collins Health Plans. This plan has the same services as the previous two plans. However, this plan is customizable so it more affordable for the employees or maybe the employees may not need certain services. The ConstructIt employees are only willing to pay a maximum of $4,000 as an annual premium. With Castor Enhanced Minor the premium is over ConstructIt employees maximum and the employees do have previous health conditions. So Castor Enhanced is not the correct plan for ConstructIt employees. Castor Standard is also not the correct choice because it does not cover preexisting conditions. Castor Enhanced Minor is also expensive but is customizable for the employees. Selected Plan When selecting a plan for, ConstructIt I had to keep in mind the utilization, risk factors, and demographics. Once the factors are analyzed Castor Collins Health Plans can make a choice in which plan is best. In this scenario Castor Enhanced Minor is the best choice for ConstructIt employees. Castor Enhanced Minor offers everything the other two offers, but it is more affordable with preexisting conditions. The maximum ConstructIt employees will pay is $4,000, but this plan will charge the employees $3,943 annually. This will save the company money by paying a lower premium but also provide them coverage the other two plans offered. With Castor Enhanced Minor I opted to take out obesity coverage because many employees are obese, but it is something not medically important. Many employees can solve obesity problems without the help of doctors. Choosing Castor Enhanced Minor was the best choice for ConstructIt. It will cover any preexisting conditions, which is important to many people but not all. Even providing it to the whole group will benefit everyone and it makes the employees of ConstructIt with preexisting condition happy. With this plan there was one part of the coverage left out, Obesity, because it was not an important treatment and it dropped the premium down considerably. This made the plan much more affordable for the company dropping it down below the maximum they would pay. This is good for the company because it keeps them in budget and it also lets Castor Collins Health Plans make a profit of $3.94 million. The age groups for ConstructIt range from 26 to 45 this puts a risk of possessing a preexisting condition. So because there are preexisting conditions Castor Standard was thrown out because it does not cover those preexisting conditions. However, Castor Enhanced did cover the preexisting conditions it did not offer customization of the plan making the premium higher and out of range of ConstructIts budget. So Castor Enhanced was not chosen because of no customization and having a higher premium. Choosing Castor Enhanced Minor was for two reasons it offered preexisting conditions coverage and customization making it more affordable for ConstructIt. This was also chosen because only one service was left out if more than one service was left out than this plan may not have been the correct choice. Each of these plan are good health plans and each offers something the next plan did not such as ,customization and covering preexisting conditions. The purpose of the simulation was to see the difference in coverage and choose the correct coverage for ConstructIt. The age difference is quite large within ConstructIt knowing that it was good to chose a plan that would cover preexisting conditions. Meaning only two plans could be right but one plan had a high premium and one was customizable with a lower premium after customizing it. Conclusion Health care is important to many people and employers. Having good health means that the employees will be able to attend work making the employers profit. Castor Collins Health Plans made a plan that benefited ConstructIt by coming in within the companies budget. The plan also covered a variety of services, which includes preexisting conditions. This covered the age range having preexisting coverage and also allowed customization that would suit each person's individual needs. Choosing this plan gave the employees coverage they may need and saved ConstructIt money. It also allowed a profit for Castor Collins Health Plans.