Question

Ronald Roth started his new job as controller with Aerosystems today. Carole, the employee benefits clerk, gave Ronald a packet that contains information on the company’s health insurance options. Aerosystems offers its employees the choice between a private insurance company plan (Blue Cross/Blue Shield), an HMO, and a PPO. Ronald needs to review the packet and make a decision on which health care program fits his needs. The following is an overview of that information.

1. a) The monthly premium cost to Ronald for the Blue Cross/Blue Shield plan will be $46.42. For all doctor office visits, prescriptions, and major medical charges, Ronald will be responsible for 20 percent and the insurance company will cover 80 percent of covered charges. The annual deductible is $580.

2. b) The HMO is provided to employees free of charge. The copayment for doctors’ office visits and major medical charges is $20. Prescription copayments are $10. The HMO pays 100 percent after Ronald’s copayment. There is no annual deductible.

3. c) The POS requires that the employee pay $28.55 per month to supplement the cost of the program with the company’s payment. If Ron uses health care providers within the plan, he pays the copayments as described above for the HMO with no annual deductible. He can also choose to use a health care provider out of the network and pay 20 percent of all charges after he pays a $580 deductible. The POS will pay for 80 percent of those covered visits.

Ronald decided to review his medical bills from the previous year to see what costs he had incurred and to help him evaluate his choices. He visited his general physician four times during the year at a cost of $145 for each visit. He also spent $69 and $93 on two prescriptions during the year. Assume Ron visited a physician outside of the network plan but had his prescriptions filled at a network-approved pharmacy.

If Ronald selects the POS plan, what will his annual medical costs be? (Round your answer to 2 decimal places.)

Answer 1

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Answer -

Following will Ron pay under each plan,

1) BCBS -

Yearly Premium - $557.04 (46.42*12)

Mnthly premium - 46.42 $

insurance compnay will cover 80 percent.

2) HMO -

Doctor Visit Copay - 4*10 = $40

Prescription Copay - 2*5 = $10

HMO pays 100 percent after Ronald’s copayment.

3) POS -

employee pay = $28.55

Deductible - $500

insurance ocverage after deduction

numberof visits = 4

cost per visit = $ 145 * 4 = $580

amount spent towards prescription is $69 and $93 . total amount paid will be sum total of annual charges, annual dedution & 20% odf the amount available for insurance coverage.

total expenses = (no of visits * cost per visit ) + amount spent on prescription

= ($ 145 * 4) + ($69 +$93)

= $580 + 162 = $742

total amounyunder insurance coverage = exense - deductions = $ 742 - $ 580 = $162

calculated under formula - total amount under * 20% insurance coverage = 162*20% = 32.4

annual premium - montly premium * 12 = (46.42*12) = $557.04

total cost paid = amount paid in addtition to insurance coverage + annual remium + annual dedcutioin = $32.4 + $557.04 +$580 = $1,169.44