Ashworth College Individual versus Group Health Insurance Paper
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Activity 1: Overview of Managed Care (100 points)
Respond to the prompts below in no more than two pages total. Separate and identify your responses to Part A, B, C, and D.
The below scenario is only to provide you with an example of asetting to frame the activity questions. The details of this scenarioare not essential to answering the activity questions.
Blue Cross Blue Shield Association (BCBSA) consists of 36 independentand locally-operated health insurance companies. Blue Cross was createdin 1929 to provide pre-paid hospital care, and Blue Shield wasestablished approximately a decade later to provide reimbursement forphysician services. These separate entities merged in 1982 to form theBCBSA we know today. Its comprised of: publicly traded companies, suchas Anthem; multi-state private companies, such as the Health CareService Corporation and Highmark; and single-state or regionalcompanies. BCBSA also operates health plans outside of the UnitedStates. The BCBSA has experience offering health insurance coverageoptions of all kinds, including individual and group health insurance,and also administers government entitlement programs, such as Medicareand Medicaid. Its health plans have come in many different forms,including health maintenance organizations (HMOs), preferred providerorganizations (PPOs), point-of-service (POS), and consumer-directedhealth plans (CDHPs), among others. A CDHP is a special form of ahigh-deductible health plan coupled with a health savings account (HSA)to help individuals manage health care expenditures. BCBSA continues togrow and currently provides insurance coverage to nearly one out ofevery three Americans.
- Describe the difference between individual and group health insurance. (25 points)
- Describe the difference between Medicare and Medicaid, including who can qualify for coverage under each program. (25 points)
- Describe the difference between an HMO, PPO, POS, and CDHP. (25 points)
- Describe an HSA, including how it can be used to manage personal health care expenditures. (25 points)
