hcr230checkpointwk1day3 - can be changed by the employer...

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Checkpoint Comparing Cost Control Strategies Angela Sanford August 31, 2011 HCR/230 The cost control strategies employers use for health plans are important benefit to employees as well as employers. It helps reduce health plan cost for employees and offers federal tax advantages for the employers. The health plans that are employer-sponsored is an insurance offered to employees that are not covered by entitlement programs. Employees have access to this insurance through their employers but they are covered with a policy by another organization. They pay their premiums through work but the money is sent to the insurance company. Many employers save money by choosing a self-funded health plan. This works by them not paying premiums to the insurance carrier or a managed care organizations. Riders or options may be purchased by employees to add additional coverage such as vision and/or dental services. Other services riders cover that basic coverage does not is services such as chiropractic, massage therapy, dietetic counseling, vitamins, and minerals.These plans
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Unformatted text preview: can be changed by the employer during negotiations that will allow the employer to create lower the price of coverage for their employees. Most employees have an enrollment period where the employee chooses a set of benefits during the benefit period. Most group health plans have specific rules in order to be eligible to enroll and drop coverage. These rules are based on employment status and conditions on enrolling dependents. The employer decides on which provider networks their employees will choose from. Many of them provide their own provider and others are allowed to choose their provider. Many of the employers are regulated by state laws when it comes to self-funded health plans. Third party administrators are hired do deal with the self-funded plans. The administrator has an administrative assistant who is hired only to perform tasks such as subscriber enrollment and claims processing. These plans are controlled by ERISA law instead of by state law....
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This note was uploaded on 09/19/2011 for the course HEALTH ADM HCR 230 taught by Professor Heathercsanky during the Spring '10 term at University of Phoenix.

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