RMI-3011 Lecture Notes - Lecture 12: Health Insurance Portability And Accountability Act, Capitation Fee, Health Insurance Mandate
21 Nov 2017
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Individual evidence of insurability is usually not required: experience rating is used. In the single plan approach, the employee who wants only term insurance pays only the mortality and expense charges. Individual producers conduct sales interviews with employees on site: a wide range of products are sold, including life insurance, ad&d insurance, and annuities, premiums are paid by payroll deduction. Traditional indemnity plans: under a traditional indemnity plan: If patients see providers who are in the network, they pay little or nothing out of pocket: deductibles and co-payments are higher if patients see providers outside. Individual mandate: guaranteed issue, affordable insurance exchanges, employer requirements/penalties, tax on high-value policies. Increase in employers offering of wellness benefits: use of health risk assessments, establishment of onsite health clinics. Cafeteria plans: a cafeteria plan allows employees to select those benefits that meet their specific needs.
