Comment on whether or not you see any issues with a company\'s benefit policies
ID: 462172 • Letter: C
Question
Comment on whether or not you see any issues with a company's benefit policies below:
The administrator of a group health insurance plan reports the following:
1) A new employee signed up for health insurance last month. He was treated for prostate cancer two years ago, so we told him that we would not cover any costs related to this condition for his first two years on the job.
2) We are charging employees who have family histories of serious health problems more for their premiums. It’s only fair that potentially heavy users of medical care pay more for their health insurance.
3) Due to the high costs associated with child birth, we will require that employees pay an extra $200 deductible before any child birth expenses are covered.
Explanation / Answer
All these decisions are not fair
The first One.
Its mentioned that , he was treated for prostrtate cancer two years before. Normally in a health insurance programme, pre existing diseases are not covered. But when an employee joins in your firm, he also subject to the benefits of health insurance, provided he was under the surveilance of health insurance in previous year. Hence company should take a health insurance programme that includes the coverage for pre existing diseases.
The second One
This is the worst policy among the three. A person with family history of serious health problems should not be charged more. The premium charging should be based on the number of persons in the company and their age. The age slab used are (18-44) and (45-65) and 65 and above. In order to manage unnecessary usage of health insurance, there are two options Co -Pay, and deductible where patient has to a fixed sum say $30 for any treatment or 20% upto $100 for the treatment received.
3) Charging this also unfair. The question is to give maternity benfit or not. Legally the firm is to give maternity benefit for the first two children in some countries and in some countries it's three. For the maternity benefit our company has to pay an extra premium to insurance company but charging deductible from patients at hospital is not fair. It should be same for the other kind of treatments.