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QUIZ 2

HSA 312 – 01: MAY 11, 2020

MANAGED CARE AND HEALTH INSURANCE

2000 – 2010: CHANGES IN EMPLOYER-BASED HEALTH INSURANCE AND THEIR IMPACT ON INSURANCE COVERGE FOR U.S. CITIZENS

THE AFFORDABLE CARE ACT OF 2010 – FIXING THE HEALTH INSURANCE COVERAGE PROBLEMS THAT AROSE 2000 - 2010

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NOTE: THESE QUESTIONS ADDRESS KEY POINTS ABOUT U.S. HEALTH INSURANCE FROM 2000 – 2010. ANSWERS SHOULD BE BRIEF AND TO THE POINT. JUST ANSWER THE SPECIFIC QUESTION.

QUESTIONS TO BE ANSWERED ARE IN GREEN.

READINGS 1. AND 2. PROVIDE BACKGROUND TO HELP YOU. THEY MAY NOT DIRECTLY RELATE

TO THE QUESTIONS BELOW.

QUESTION 1: EMPLOYERS AND INSURERS MOVE MOST EMPLOYEES TO INSURANCE COVERAGE THROUGH PREFERRED PROVIDER ORGANIZATIONS (PPOs):

USING ATTACHED READINGS 3.A. AND 3.B. ANSWER THE FOLLOWING:

Why did Employers and Insurers move the majority of workers who were enrolled in traditional health insurance plans (HMOs, Point of Service, Preferred Provider Organizations) into PPOs in the early 2000’s? Briefly describe TWO (2) reasons.

QUESTION 2: INCREASING NUMBERS OF LARGE EMPLOYERS MOVE FROM TRADITIONAL INSURANCE TO SELF - INSURANCE?

USING READINGS 1, 3.B. AND 4., ATTACHED, ANSWER THE FOLLOWING:

PART A: What does it mean when an Employer Self-Insures?

PART B: Why did an increasing number of large Employers (with over 2000 employees) move away from traditional insurance and become Self-Insured after the Managed Care Backlash? Briefly describe TWO (2) reasons.

QUESTION 3: THE GROWTH OF CONSUMER-DIRECTED HEALTH PLANS/A NEW PHILOSOPHY OF EMPLOYEE RESPONSIBILITY.

USING ATTACHED READINGS 5.A. AND 5.B.

PART A: What are the key components of a Federally approved Consumer Directed Health Plan (CDHP)? READING 5.A., ESPECIALLY THE FIRST PAGE, FIRST TWO PARAGRAPHS.

PART B: Which types of Plan Enrollees may be discouraged from receiving needed personal health care services if they are enrolled in a CDHP? READING 5.B.

QUESTION 4: CONDITIONS PROMPTING THE PASSAGE OF THE AFFORDABLE CARE ACT OF 2010.

USING READING 3.B., AND 6.A. (SLIDES 3 – 7), ANSWER THE FOLLOWING:

PART A: What happened to health insurance coverage for Individuals (the unemployed and self-employed) between 2000 and 2010? Was this related to Preexisting Conditions?

PART B: By 2009, on any given day, what percentage of the U.S. population had no health insurance coverage from any source?

QUESTION 5: THE AFFORDABLE CARE ACT OF 2010 – WHOM DOES IT HELP AND HOW?

USING READING 6.B.(SLIDES 7 AND 8) AND READING 7., ANSWER THE FOLLOWING:

PART A: In 3 – 5 sentences: What are the Affordable Care Marketplaces and what is their purpose?

PART B: Which two (2) groups of U.S. citizens, who traditionally do not have access to reasonably priced and comprehensive health insurance, are meant to benefit from the Marketplaces?