HCS 440 Economic Issues Simulation

**ESSAY EXCERPT***

Castor Collins is a Health Maintenance Organization that will provide companies like ConstructIt premium health insurance plans for their employees. It has a statewide network that

has a large group of physicians and hospitals to provide services to the company's employees. ConstructIt has two plans from which it can choose from, with another customized plan that is an extension of one of the plans. The main health insurance plans available are Castor Standard, which does not cover preexisting conditions and Castor Enhanced that does cover preexisting conditions. The third plan is Castor Enhanced Minor, which is customized to add additional coverage for certain health risk factors. The chosen company is ConstructIt because although the risks are greater for providing a plan to this company, Castor Standard was the best plan to choose to serve them.

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Prepare a 1050- to 1400 paper in which you present a profile of the chosen company including the demographics of the employees, the health care risk factors (potential areas of high utilization), and the premiums the company is willing to pay. As a representative of Castor insurance, your job is to maximize profit and minimize risk for the company. Based on your analysis of potential utilization, give at least two reasons why each plan could be selected. Then state which plan you would select to sell to your chosen company? What are the reasons for this decision? Why did you not select the other plans offered?