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Economic Issues Simulation Paper

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Economic Issues Simulation Paper
Health maintenance organizations (HMO) are organizations that provide or organize health insurance, self-funded health care benefits plans, individuals, and other entities for the United States as a liaison with health providers or hospitals on a prepaid basis. In this simulation a virtual organization Castor Collins Health Plans presented three HMO options to two organizations. I will review one of the company’s demographics, discuss the HMO choices, explain the differences in the choices presented, and why I chose the plan I chose. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options, this is way today you are given more than one option for health care.
Company: Constructit
Constructit consist of a 1000 employees (550 men and 450 women) ranging from ages 26 through 42 and 60 percent of them are married. Constructit has to consider in the number of employees that would covers their spouses or children for insurance coverage. Thirty-two of the workers are physical active and 25 percent are moderately physically active. There are 170 men and 210 women approximately 38 percent with no health issues. Ten percent of men and 8 percent of the women are heavy smokers. Obesity rate is also a problem with 39 percent being obese causing a heavy absenteeism for reason of high blood pressure, diabetes, heart issues, and hyperlipidemia. Knowing the demographics of Constructit, Castor is now charged with coming up with a plan that is profitable for Castor, but meets Constructit needs. There were two plans that were offered Castor Enhanced and Castor Standard.

Insurance plan detailed
Castor Standard and Enhanced are individual health plans. Castor standard does not cover preexisting medical conditions

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