Economics Issue Simulation Plan: Employee Health Insurance

The provision of health care insurance plans for employees is challenging for employers because it raises their costs and may potentially affect their business development. On the other hand, the provision of employees with health care insurance plans enhances the job satisfaction and may contribute to the improvement of the employee performance. In such a situation, companies should weigh carefully health insurance plans for their plans to choose the right one which matches interests of both, the company and employees. At this point, it is possible to refer to the case of Constructit and E-Editors Group among which the former is more preferable due to the younger age of employees and lower probability of health problems among its employees.Economics Issue Simulation Plan: Employee Health Insurance

The demographics of the employees in the two companies is quite different since Constructit employs younger professionals, whose age ranges from 26 to 45, while E-Editors employs older employees, whose age ranges from 35 to 54. In such a way, the age of employees in these companies reveals that Constructit is in a better position because younger employees are less likely to have health problems, while older ones, employed by E-Editors, have higher chances to develop health problems, including chronic ones which may be costly for the employer because they need long-lasting treatment and increase the level of absenteeism in the company.

Health care risk factors or potential areas of high utilization vary between companies but still risk factors are relatively low. At any rate, the Health Care risk factors Economics Issue Simulation Plan: Employee Health Insurance

Under the Castor Enhanced plan, the costs for inpatient services vary between the two groups but the cost does not carry a huge cost difference. Subsequently, the outpatient service for both groups under the Castor Enhanced plan does not carry much difference. The Constructit Group under the Castor Enhanced plan also presents lower annual earnings than the E-Editors under this plan. The risks for both groups are minimal and the revenue under this plan for E-Editors present increase that maximizes the costs. The cost under the Castor Enhanced Minor plan would provide a lower premium cost that will allow the companies to maximize the cost incurred for premiums. This plan minimizes risks by excluding certain services, such as substance abuse treatment, obesity treatment under inpatient services. Therefore, Castor Enhanced Plan is more costly for the company compared to Castor Enhanced Plan Minor.

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Premiums the company is willing to pay are relatively low because both companies are seeking for decreasing their health care costs and apparently prefer the Castor Enhanced Plan Minor which excludes some health care risks, such as substance abuse, for example. At the same time, such risks are associated with the personal responsibility of employees and have nothing to do with the job they do in either company. In other words, by choosing the Castor Enhanced Plan Minor the two companies manifest their readiness to pay high premiums for health problems employees may have but exclude risks of covering employees’ health care costs caused by the negligent attitude of employees to their health, for example, through substance abuse. At the same time, such risks are quite high because the deterioration of employees’ health occurs under the impact of such factors.

At the same time, both plans could be selected by either company. There are several reasons why each plan could be selected. In case of the Castor Enhanced Plan companies may select this plan because this will contribute to the consistent enhancement of their social responsibility that will increase the job satisfaction of employees and increase their loyalty to their company (Getzen & Moore, 2007). In addition, high costs of such plan still will lead to the improvement of the employee performance due to the better health care services they receive because, if employees know that their employer covers their health insurance, they are more concerned with their health, while, if they have no money to pay for health care services, they neglect minor health problems and those health problems which they cannot pay for that leads to the steady deterioration of their health. The deterioration of the employee health leads to the deterioration of their performance and companies will suffer from the overall deterioration of their organizational performance.Economics Issue Simulation Plan: Employee Health Insurance

As for the Castor Enhanced Plan Minor, this plan also has its advantages and reasons for the implementation. First, this plan excludes the responsibility of companies to cover health care costs associated with substance abuse treatment, obesity treatment under inpatient services. In such a way, the plan excludes risks associated with health problems that basically emerge from employees’ personal irresponsible attitude toward their health. Hence, the employer will not cover substance abuse treatment, for example, which is costly and, what is more important, which is not always effective because patients, who suffer from substance abuse, often slip to substance abuse, when the treatment is complete (Lasser, Himmelstein, & Woodlander, 2006). Another advantage of the Castor Enhanced Plan Minor is the full coverage of other health care problems. Therefore, if employees have serious health problems, they still may count on their employer and the full coverage of their health care costs under the plan. In this regard, the Castor Enhanced Plan Minor offers the same benefits as the Castor Enhanced Plan with a few exceptions.

This is why I would sell the Castor Enhanced Plan Minor to Constructit. There are several reasons for this decision. First, this plan does not cover substance abuse treatment, obesity treatment under inpatient services and is more cost-efficient compared to the Castor Enhanced Plan. Second, employees of Constructit are young that means that they are unlikely to have many health problems. Therefore, the implementation of this plan will not be really costly for the company. At the same time, the high coverage of health care costs will increase the certainty of employees in their future and increase their loyalty to the company because they will be certain that the employer will cover their health care costs and pay high premiums, if they have health problems and need treatment other than substance abuse treatment and obesity treatment under inpatient services. However, such exclusions are very important for the company because young employees may be more inclined to substance abuse since they do not often care about health as much as older employees, who become more aware of the high risk of health problems as they grow older. This is why the plan will protect the employer from unreasonable risks and coverage of health care costs triggered by employees’ negligent attitude to their health.Economics Issue Simulation Plan: Employee Health Insurance

In such a situation I decided against the Castor Enhanced Plan because it is too costly for the company and involves high premiums which are unreasonably high and cover health care costs which have nothing to do with the job performed by employees of companies but are rather triggered by employees themselves. Therefore, this plan is unworthy choosing from the economic perspective because of its high costs and too broad coverage of health care costs of employees.

Thus, the Castor Enhanced Plan Minor is the best choice for Constructit because the company has relatively low risks of covering high health care costs but still the plan secures the company from the coverage of unreasonable health care costs.

References:

Getzen, T. E., & Moore, J. (2007). Health Care Economics [University of Phoenix Custom Edition eBook]. Retrieved from University of Phoenix Ebook Collection, website.

Lasser, K. E., Himmelstein, D. U. & Woodlander, S. (2006). “Access to
Care, Health Status, and Health Disparities in the United States
and Canada: Results of a Cross-National Population-Based Survey.”
American Journal of Public Health 96 (7), 1300.Economics Issue Simulation Plan: Employee Health Insurance