Scenario: It is time to renew the annual health insurance policy for employee coverage in the medical practice where you serve as administrator. The plan for the past three years has been a Blue Cross Indemnity Plan, a plan with great benefits that the employees like. The practice covers 80% of the premium regardless of whether it is for employee only, employee and spouse, or family.

The practice also offers: A Prescription plan which covers brand name/first-generation medications, dental plan through Delta Dental (nominal cost), and vision plan through VSP (nominal cost)Currently 60 employees including the doctors are covered. Of these, 30 have family coverage, 20 employee/spouse, and 10 single coverage. For the past three years, the premium costs to the practice have gone up by 12%, 13.5%, and 15%. While the doctors want to continue to provide health insurance coverage for their employees, they have clearly stated that they cannot afford another double-digit increase this year. You have meetings lined up with sales reps from Blue Cross, Aetna, United, and Cigna.

Questions

1.) What will be your strategy and approach to providing the most comprehensive coverage possible, while maintaining a single-digit increase this year?.

2.)Discuss the various types of plans available, and what you might do to restructure the plan, benefits, and out of pockets costs (premium responsibility, co-pays, deductibles, co-insurance ) for the employees?

3.)Address health insurance, pharmacy, dental, and vision options