Health Care Reform for a Small Business
Title: Health Care Reform for a Small Business/ Rough Draft of Final Project
Ashley Wilson
Week3
| What is the top risk for Healthcare reform? | Risk Issues | Was the approach successful? |
| Regulatory Uncertainty | Yes | |
| How stakeholders will be affected with the recent change | Stakeholder education and audience reassurance remain priorities for community-based nonprofit hospitals struggling to cope with the operational consequences of the reform in a tough economy. | Yes |
| Agile approach | Dealing with low income to none and taxes. | Yes |
| Requirements | Have to have insurance by 2014. | Yes |
The risk Methodology connector applied is to identify members with the greatest chance of incurring high cost based on their life style indicators and omissions in care. The American Healthcare system is an interlocked network of patients, physicians, hospitals, employers, and insurers and other stakeholders. The Healthcare reform provides access of insurance to uninsured and individual with pre-existing conditions. One change can reshape the entire system. Stakeholder education and audience reassurance remain priorities for community-based nonprofit hospitals struggling to cope with the operational consequences of the reform in a tough economy .This also provides individuals access to coverage that does not impose any coverage exclusions. There is also now a penalty on taxes if you individuals font have healthcare insurance. There is a 2% of your yearly income or $325 per person for the year and $162.50 per child under the age of 18/ year 2015 fee. You will pay the fee in the federal income tax return. (www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/)I agree with the Healthcare reform as this brought down the cost of health care coverage. Health plans, including the grandfather plan (I have this plan.) must annually report on the share of premium dollars spent on medical care and provide rebates for medical loss ratios. Obama signed into law on March 23, 2010. (http://en.m.wikipedia.org)
Health Reform is used for creating changes for governmental policy that affects health care delivery in a given place. ((http://obamacarefacts.com/obamacare-small-business/)I work for Arkansas Blue Cross and Blue Shield and we are striving to make Health plans more affordable for new and existing members. There are 4 different plans being offered to help individuals afford insurance (HCR):1.Silver2.Bronze 3.Gold 4.Platinum.The purpose of the Metallic in which is a standard policy for members/ a policy that is affordable and gives more care to citizens. Consumers have a difficult time with choosing from so many plans and different policies. It is over whelming with choosing and comparing benefits coverage and out-of pockets as some plans may not explain to the member what type of policy they have. Some members feel that having insurance is too expensive and they would rather not have any. The Standard policy is defined that the services must be covered and make the out of pocket cost more transparent.
These benefits include Emergency service, laboratory service prescription drugs and vision just to name a few. The Standard plan insures small group can offer plans that will fit within four levels of coverage and off the exchange. Insures are not required to offer a health plan but if they see the product they must offer at least one silver plan and one gold. I have a gold plan as the deductible as myself has a 420 co-pay/$30 for specialty and an annual deductible $1000.HIPAA excepted benefit as traditional plans include ancillary products like critical illness, accident and cancer policies. In 2014 Insures are likely to offer a rich product designed for less income replacement. (http://Healthadvantage-hmo.com)
Metallic plans:
| Bronze | Silver | Gold | Platinum |
| Deductible:$2500 | Deductible $2000 | Deductible $1000 | Deductible $300 |
| Coinsurance 50% | Coinsurance 70% | Coinsurance 80% | Coinsurance 90% |
| Annual out of pocket $6500 | Annual out of pocket$5500 | Annual out of pocket $3000 | Annual out of pocket $2500 |
| Pcp co-pay n/a | Pcp co-pay $40 | Pcp copay $20 | Pcp co-pay $20 |
| Drug card n/a | Drug card $10-30-50 | Drug card-Same as silver | Drug card-Same as silver |
