FirstCal'e FirstCare Health Plans Gold Monthly Cost ak-\"U_m mm; Flrslcare Health Plans $271.26 HMO Deductible 0% Premium: 5271 26 Coinsurance 20% Subsidy: 50 00 Out at Pocket Maxrmum 55 3:70 ll, r e 1 r y. Deductibles and Cost Sharing In Network Out at Network Deductible (Individual) $0 $0 Deductible (Family) $0 $0 Coinsurance 20% $0 Out of Pocket Maximum (Individual) $6,350 $0 Out of Pocket Maximum (Family) $12,700 $0 Services In Network Out of Network Primary Care Visit $30 $0 Specialist Visit $50 $0 In Patient Hospital Services 20% $0 Emergency Room Services $250 $250 copay Mental / Behavioral Health $50 copay $0 Imaging (CT/PET Scans. MRIs) 20% coinsurance $0 Rehabilitative Speech Therapy $50 copay $0 Rehabilitative Occupational & Physical Therapy $50 copay $0 Preventative Care $0 $0 Laboratory Outpatient and Protessional Services $0 $0 Xray and Diagnostic Imaging $0 $0 Prescription Drugs In Network Out of Network Generic Rx $20 Preferred Brand Rx $50 Non Preferred Brand Rx $70 Specialty Drugs 20% Scenario: Stacy and Kyle Crawley have asked for your assistance putting together an insurance plan. They are both 28 years old and have a 3-year-old son and a 1-year-old daughter. They want to make sure they are taking the right steps financially. You will assist them and make recommendations for improving their situation at a meeting with them November 10th. Kyle is an engineer and earns $60,000 a year. Stacy is a pastry chef and earns $50,000 a year. Kyle's life expectancy is 90 years and Stacey's is 95. They plan on retiring when they are 67. They are saving 5% of their salary to their 401(k) plans and they get a 3% match. Currently, Kyle has $31,000 in his 401(k) and Stacy has $38,000 in her 401(k) plan. Health Insurance: here are three health insurance policies that they could choose from (see attached last 3 pages). 1. Help Kyle and Stacy determine which of the three plans to choose. They want to know which plan would be best if they estimate their medical costs at approximately $13,500 per year and which plan to use if they estimate their medical costs closer to $45,000 per year. Help the Crawley family determine how much of their risk they should transfer and how much they should retain (higher deductibles/co-insurance means they are retaining more risk). You will enter your data into canvas for submission and to check for accuracy. (Hint 1: Find out which one provides sufficient coverage at a reasonable cost.) Low Medical Expenses (~$13,500/year) High Medial Expenses (~$45,000/year) Estimated Medical Cost First Care irst Care Blue Choice First Care Blue Choice Bronze Gold Gold First Care Bronze Gold Gold Out of Pocket Expense: Annual Total Cost: Which plan should they choose? And Why? Life Insurance: In addition to their current situation, Kyle's grandfather was a professional golfer and is expected to give Kyle $2,000,000 in various assets (net of taxes) in 20 years. Kyle is concerned with the taxes associated with leaving assets behind to his kids. Kyle and Stacy aye and Stacy would like to make sure they have enough insurance to pa ay off their debts, pay for funeral expenses, replace the other's salary, and provide assets to allow for 1 year of grieving time. Mortgage: 41 months into a 30-year mortgage: Current balance is $284,685; 3.25% interest rate Car: 5 months into a 60-month loan for the truck: Current balance is $46,589; 1.9% interest rate Funeral Expenses: Unsure, they need your help researching it. They want a nice service with food, limos for family, lots of lowers, premium caskets, and nice head stones 2. What types of life insurance do you recommend for the Crawley's? 3. How much coverage do you recommend overall, for each client, and for each type of policy? a. Hint, you'll probably layer different coverages and policy types. 4. Justify your recommendations from the course materials, you must cite where in the materials you found your justifications. a. Do not simply google answers, use your book! Disability Insurance: 5. Based on this course what type of disability insurance should the Crawley's get? How much? Coverage for Kyle: a Short Term Long Term Insurance Amount(s): Coverage for Stacy: a Short Term D Long Term Insurance Amount(s): Justify your recommendationsBlueCross. Blue Choice Gold PPO 002 Monthly Cost BlueShield. Blue Cross Blue Shield of Texas $333.69 PPO Deductible $1,500 Premium: $333.69 Subsidy: $0.00 Coinsurance 20% Out of Pocket Maximum $3,500 More Details Find a Provider Cost Sharing In Network Out of Network Deductible (Individual) $1,500 $3,000 Deductible (Family) $4,500 $9,000 Coinsurance 20% 40% Out of Pocket Maximum (Individual) $3,500 $7,000 Out of Pocket Maximum (Family) $10,500 $21,000 Services In Network Out of Network Primary Care Visit $10 40% coinsurance Specialist Visit $60 40% coinsurance $200 Copay per Stay and In Patient Hospital Services 40% coinsurance 20% Coin $400 Copay and 20% 20% coinsurance after $400 Emergency Room Services Coinsurance a copay/visit Mental / Behavioral Health $10 copay 40% coinsurance Imaging (CT/PET Scans, MRIs) 20% coinsurance 40% coinsurance Rehabilitative Speech Therapy 20% coinsurance 40% coinsurance Rehabilitative Occupational & Physical 20% coinsurance 40% coinsurance Therapy Preventative Care $0 40% coinsurance Laboratory Outpatient and Professional 20% coinsurance 10% coinsurance Services X-ray and Diagnostic Imaging 20% coinsurance 40% coinsurance Prescription Drugs In Network Out of Network Generic RX No Charge Preferred Brand Rx $35 Non Preferred Brand Rx $75 Specialty Drugs $150FirstCare. FirstCare Health Plans Bronze Monthly Cost HEALTH PLANS Firstcare Health Plans $209.97 HMO Deductible $4,500 Premium: $209.97 Subsidy: $0.00 Coinsurance 30% Out of Pocket Maximum $6,350 More Details Find a Provider Deductibles and Cost Sharing In Network Out of Network Deductible (Individual) $4,500 $0 Deductible (Family) $10,000 Coinsurance 30% Out of Pocket Maximum (Individual) $6,350 $0 Out of Pocket Maximum (Family $12,700 Services In Network Out of Network Primary Care Visit $60 $0 Specialist Visit $70 Copay after deductible In Patient Hospital Services 30% Coinsurance after deductible $0 Emergency Room Services $300 Copay after deductible $300 copay Mental / Behavioral Health $70 copay $0 Imaging (CT/PET Scans, MRIs) 30% coinsurance $0 Rehabilitative Speech Therapy $70 copay $0 Rehabilitative Occupational & $70 copay $0 Physical Therapy Preventative Care $0 Laboratory Outpatient and $0 $0 Professional Services X-ray and Diagnostic Imaging 30% coinsurance $O Prescription Drugs In Network Out of Network Generic Rx $20 Copay after deductible Preferred Brand RX $50 Copay after deductible Non Preferred Brand RX $70 Copay after deductible Specialty Drugs 30% Coinsurance after deductible