Insurance companies agree to pay medical costs to customers who pay into their health insurance program. One such insurance company offers health insurance to customers aged over 50, without any medical examination, it their family also buys the company's health insurance. Although the cost to the company of offering this insurance to customers above 60 is potentially high, the company still feels confident it will make a profit from this health insurance program. Which of the following assumptions is the company basing its expectations for good results on? The insurance payments made by young customers, who are less likely to make insurance claims, outweighs the costs of medical treatments that have to be paid to customers aged over 60 Families with more older members have a slightly higher average age than families with fewer older members. O Younger customers are likely to submit medical claims which are substantially lower than medical claims submitted by customers over 60 Many insurance companies have followed this company's example and have started offering similar insurance programs

Insurance companies agree to pay medical costs to customers who pay into their health insurance program. One such insurance company offers health insurance to customers aged over 50, without any medical examination, it their family also buys the company's health insurance. Although the cost to the company of offering this insurance to customers above 60 is potentially high, the company still feels confident it will make a profit from this health insurance program. Which of the following assumptions is the company basing its expectations for good results on? The insurance payments made by young customers, who are less likely to make insurance claims, outweighs the costs of medical treatments that have to be paid to customers aged over 60 Families with more older members have a slightly higher average age than families with fewer older members. O Younger customers are likely to submit medical claims which are substantially lower than medical claims submitted by customers over 60 Many insurance companies have followed this company's example and have started offering similar insurance programs

Essentials of Business Analytics (MindTap Course List)

2nd Edition

ISBN:9781305627734

Author:Jeffrey D. Camm, James J. Cochran, Michael J. Fry, Jeffrey W. Ohlmann, David R. Anderson

Publisher:Jeffrey D. Camm, James J. Cochran, Michael J. Fry, Jeffrey W. Ohlmann, David R. Anderson

Chapter5: Probability: An Introduction To Modeling Uncertainty

Section: Chapter Questions

Problem 17P: The probability distribution for damage claims paid by the Newton Automobile Insurance Company on...

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if the company is self-insured and the insurance plan says that it does not cover health routine and check up, does that mean that the company is still paying for that amount or not? for example: Plan A would charge a $350 premium with no deductible. Coverage is extended to pre-existing conditions, but to cover the non-deductible clause, health screening and routine check-ups are not covered. In this case, is the company only paying $350 or $350 PLUS the health screening?
An important distinction in health insurance is between the list price (PL) and out-of-pocket price (PP) of a medical good or service. The list price is the official price that the provider charges the insurance company, while the out-of-pocket price is the price that the insurance customer faces. Sometimes, the out-of-pocket price depends on the list price. Now assume the consumer is part of a partial insurance plan with a coinsurance provision. Her insurance pays 50% of all medical expenses. Consider again the relationship between PL and PP and plot a coinsurance plan demand curve in PL - Q space. Label this curve D3. Finally, assume the consumer is part of a partial insurance plan with a copayment provision. Her insurance pays all expenses above and beyond her copayment of $25 for each unit of Q. Consider again the relationship between PL and PP and plot a copayment-plan demand curve in PL - Q space. Label this curve D4.
Which is Idemenity Plan and which is Managed Care Plan? Insureds create contract with an insurer who does not provide health care services The higher the deductible, the lower the premium Insured receive health care services from a designated group of providers May not even involve an insurance company No annual deduction is incurred, but a small co-payment may be required I most value the freedom of choice and am willing to pay for it. Cost is my most important consideration. I’d rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider.
In the context of the health insurance and the life insurance, choose the sentence that IS NOT CORRECT: * The deductible in a health insurance is an amount of money the insured must pay before benefits become payable by the insurance company. When we buy a health insurance, we should make sure that we have enough insurance (the opportunity cost of not being adequately insured can be extremely high), but without wasting money by overinsuring Group Health Insurance (most of them being employer sponsored) represents a small percentage (around 5%) of all health insurance issued by health and life insurance companies. In a life insurance, a person purchases a policy by paying a premium and the insurance company promises to pay a sum of money at the time of the policyholder’s death to the designated beneficiary.
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K and L BuCross BlueShield of Illinois announced two new low-cost, cost-sharing Medicare supplement plans for Illinois seniors, Plans K and L These plans aim to help individuals seeking assistance with the portion of doctor and hospital bills that Medicare does not cover, Business Wire, Inc. reports. Plans Kand Lare options for seniors seeking lower premiums for their uoplemental insurance. They provide coverage comparable to other Medicare clement products but have lower monthly premiums in exchangr for higher cost-sharing by the member. Members with Plan K pay half of the cost-sharing for covered services (such as the fist day deductible for hospital care). Members with Plan L pay 25 percent for these wrvices. Once members reach an out-of-pocket limit (54.000 for Plan K and $2.000 ke Plan L). 100 percent of their Medicare copayments and coinsurances are covered for the rest of the calendar year. - Yolanda Younes-Garcia of Decatur, IL, has decided to purchase BCBS Plan K. She has a…
The risk of patients not paying their account balances resulting in bad debt expense is a reality today. This risk is greater as employers increase out-of-pocket maximums, deductibles, and co-pays as part of their medical insurance plans. Research and discuss some best practices healthcare organizations are using today to improve their patient liability or balance due collection process.
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With regards to group life insurance, which of the following statements are true? 1. An individual employee does not typically have the freedom to select a specific amount of insurance coverage, but rather the amount of coverage is typically a fixed dollar amount, or a variable amount in relationship to the employee's annual income.2. There is typically a change in the premium rate each year.3. Group insurance is normally a permanent type of insurance policy that provides long-term insurance protection for a significant number of Canadians.4. An employee who participates in a group life insurance plan normally has the opportunity to designate a beneficiary.5. Group life insurance plans typically do not apply age restrictions for participation in the plan.
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Q.Which of the following statement(s) regarding employer health insurance is (are) TRUE? (check all that apply) A. The (Affordable Care ACt) ACA does not force employers to offer health insurance to their employees. B. An employer with 100 employees is subject to a tax penalty if it offers health insurance, but at least one employee buys a policy from an Exchange and receives a tax credit. C. An employer with 75 employees is eligible to a tax credit if it pays at least 50% of the premiums D. An employer with 25 employees will not be subject to tax penalties if it does not offer health insurance to its employees. E.EAn employer with 20 employees is eligible for a partial tax credit if it offers health insurance to its employees (subject to a maximum for the average annual wages).
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