Assignment
Introduction
One of our clients, an American Citizen, has been living abroad for nearly a decade. He is moving back to the U.S. next month. He needs us to recommend a health insurance plan for him. Even though the national enrollment period has passed, our client will be able to apply because of the relocation.
Client Statistics
Our client is a male non-tobacco user. He was born 01/15/1960. He is the only person in his household. If you must provide income during your investigation, use $100,000 per year. Use a zip code and county for an urban area in your state and an effective date of the first day of the month following your receipt of this task (or as close to that as possible) to get quotes. He has no insurance now.
Client Desires
Private plan
Our client would prefer to get a plan without using federal or state exchanges. You can investigate the exchanges. But the client prefers purchasing from the insurer. If all else fails, exchange plans will work.
Under NO circumstances will the client consider HMOs. He prefers PPOs but may consider POS plans.
Task Description
Assess the health insurance plans in your state. Select the three best plans according to company reliability, provider availability and plan options. Rank them according to your assessment and recommend the best.
• Assess reliability according to financial ratings (A.M. Best rating) and customer reviews.
Although A.M. Best will charge you for its ratings, insurers will provide it for free.
• Assess PPO networks by number of providers. List all PPOs offered.
• Assess a plan's value according to out-of-pocket expense (deductibles, copays and coinsurance) without regard for cost. Platinum Plans preferred.
Report
Record your findings in a MS Word file. List your three plans in order of preference starting with the best. Provide, in this order, plan name, network type, plan features (deductible, copays, coinsurance, maximum out-of-pocket), plan cost, billing options, company name, company address and company telephone number. List the advantages and disadvantages of each plan and explain your recommendation. We will verify all information, so please provide accurate data. Do not include web links in your report!
Email your report to your manager. Emails must be under 10 MB. Split anything larger into multiple emails.
Format your report according this sample report that was done for a different client in the state of Texas.
#1 CoreMed Platinum 1
Type
• PPO
Features
• Deductible: $950
• Office Visit Copay: none
• Rx Copay: none
• Coinsurance: none
Sample Report
• Maximum out-of-pocket: $950 (deductible)
Cost
• $413.18
Billing Options
• Monthly bank draft
• Quarterly credit card debit
Company Name
• Assurant Health
Company Address
• 501 West Michigan Milwaukee, WI 53203
Company Phone Number
• 800-553-7654
Reliability (1-10)
• 8
Network (1-10)
• 10
Plan Options (1-10)
• 7
Advantages
• Lowest out-of-pocket
• A.M. Best rating of A-