Jamie Lee bas had good maternity care so far, but they both felt a need to...
Fantastic news! We've Found the answer you've been seeking!
Question:
Transcribed Image Text:
Jamie Lee bas had good maternity care so far, but they both felt a need to review their health insurance policies with the poten- Jamie Lee and Ross, happy newlyweds with a new home and rwins on the way, are anxiousty awaiting their new bundles Joy, Ross was a linle nervous, and understandably s, jas he wondered ir evervihine would go smoothly with Jamie's pregane) Fortunately for them, they coordinated benefits from the medical insurance erout plan offfered by Ross's employmen graphics agency and Jamie Lee's own plan, although Ross's ptan would be their primary. His employer offers a Hicamy Savings Plan, but Ross previously had not realized the need to participale in this benefit. tial of extensive medical expenses just on the horizon. Would their sataries be enough to pay for the expenses that were not coverç or even the deductibles for out-of-network doctors? Current Medical Insurance Provisions Jamie Lee and Ross have a PPO, or Preferred Provider Orgunitation plan. In-Network Medical Care: Jamic Lee and Ross currently have a $15 conayment on regular preventive care doctor visits and a S30 copayment on specialists that are preferred providers or participating members from the PPO plan's list. Out-of-Network Medical Care: Jamie Lee and Ross have the choice of seeking medical care from the professional of their choice outside the PPO member list, but will incur a deductible of $500 per person/S1.000 per family, per year. After the deduct ible is met, there is a coinsurance of 80%/20%, whereas the insurance comupany would cover 80% of the allowable medical fees and the policylholders would be responsible for 20% of the allowable medical fees. Medical fees that are not allowed under the medical plan provisions would be 100% the policyholder's responsibility. Out-of-Pocket Limits: Their health insurance plan provides an out-of-pocket limit of S75.000 per year. Questions 1 Using the text as a guide, list some of the strategies that Ross and Jamie Lee can use to better prepare financially for the arrival of the twins. 2. How could Jamie Lee and Ross prepare for the birth of the twins with their existing PPO plan? 3. Jamie Lee and Ross learned that the hospital that they plan to use for the delivery is not a participating hospital. What will their financial responsibility be for the nonparticipating hospital expenses? 4 The doctor's office has estimated the hospital expense for Jamie Lee and the babies' delivery, without complications, to be approximately $18.000. Based on their health insurance policy, how much would Jamie Lee and Ross owe for this out-of- network hospital stay? 5. Surprise! The babies arrived five weeks carly and Jamic Lee and Ross are the proud parents of triplets! There are two boys and a girl, and as they were pre-term, they will neced to spend a few extra days in the hospital for observation. How will Ross and Jamie Lee make provisions for adding the babies to their health insurance policy now that they have arrived? Jamie Lee bas had good maternity care so far, but they both felt a need to review their health insurance policies with the poten- Jamie Lee and Ross, happy newlyweds with a new home and rwins on the way, are anxiousty awaiting their new bundles Joy, Ross was a linle nervous, and understandably s, jas he wondered ir evervihine would go smoothly with Jamie's pregane) Fortunately for them, they coordinated benefits from the medical insurance erout plan offfered by Ross's employmen graphics agency and Jamie Lee's own plan, although Ross's ptan would be their primary. His employer offers a Hicamy Savings Plan, but Ross previously had not realized the need to participale in this benefit. tial of extensive medical expenses just on the horizon. Would their sataries be enough to pay for the expenses that were not coverç or even the deductibles for out-of-network doctors? Current Medical Insurance Provisions Jamie Lee and Ross have a PPO, or Preferred Provider Orgunitation plan. In-Network Medical Care: Jamic Lee and Ross currently have a $15 conayment on regular preventive care doctor visits and a S30 copayment on specialists that are preferred providers or participating members from the PPO plan's list. Out-of-Network Medical Care: Jamie Lee and Ross have the choice of seeking medical care from the professional of their choice outside the PPO member list, but will incur a deductible of $500 per person/S1.000 per family, per year. After the deduct ible is met, there is a coinsurance of 80%/20%, whereas the insurance comupany would cover 80% of the allowable medical fees and the policylholders would be responsible for 20% of the allowable medical fees. Medical fees that are not allowed under the medical plan provisions would be 100% the policyholder's responsibility. Out-of-Pocket Limits: Their health insurance plan provides an out-of-pocket limit of S75.000 per year. Questions 1 Using the text as a guide, list some of the strategies that Ross and Jamie Lee can use to better prepare financially for the arrival of the twins. 2. How could Jamie Lee and Ross prepare for the birth of the twins with their existing PPO plan? 3. Jamie Lee and Ross learned that the hospital that they plan to use for the delivery is not a participating hospital. What will their financial responsibility be for the nonparticipating hospital expenses? 4 The doctor's office has estimated the hospital expense for Jamie Lee and the babies' delivery, without complications, to be approximately $18.000. Based on their health insurance policy, how much would Jamie Lee and Ross owe for this out-of- network hospital stay? 5. Surprise! The babies arrived five weeks carly and Jamic Lee and Ross are the proud parents of triplets! There are two boys and a girl, and as they were pre-term, they will neced to spend a few extra days in the hospital for observation. How will Ross and Jamie Lee make provisions for adding the babies to their health insurance policy now that they have arrived?
Expert Answer:
Answer rating: 100% (QA)
1 In the PPO plan Ross can take the out of network medical care for 10... View the full answer
Related Book For
Andersons Business Law and the Legal Environment
ISBN: 978-1133587583
22nd edition
Authors: David P. Twomey, Marianne M. Jennings
Posted Date:
Students also viewed these organizational behavior questions
-
Cepat Sdn. Bhd. (CSB) produces a liquid fertiliser for local farmers. The fertiliser is made in two consecutive production processes. The cost accountant has provided the following information for...
-
Jamie Lee and Ross need to evaluate their emergency fund of $21,000. Will their present emergency fund be sufficient to cover them should one of them lose their job? Show the equation for calculating...
-
1. As Jamie Lee and Ross review their assets, can you tell them which will be valuable to them for income as retirement approaches? 2. Jamie Lee and Ross estimate that they will have one million...
-
1. Insurance Act, RSBC 1996 c226 Read Parts 1 and 2 of this statute and describe any changes to the standard commonlaw rules for contracts that you notice. 2. KP Pacific Holdings Ltd. and Churchland...
-
How does securitization of risk increase capacity in the property and casualty insurance industry?
-
What role does professional research play within an accounting firm or department? Who primarily conducts the research?
-
Why can we say that the mean or the median figure is the choice of an indecisive person?
-
How can marketers exploit the characteristics of the Internet to improve the product element of the marketing mix?
-
Part a: Assume that the height of your cylinder is 6 inches. Consider A as a function of r, so we can write that as A (r) = 2x + 12 r. What is the domain of A (r)? In other words, for which values of...
-
The half-life for a link on Twitter is 2.8 hours. Write an exponential function T that gives the percentage of engagements remaining on a typical Twitter link after 1 hours. Estimate this percentage...
-
Not confidentAs a computer technician , you will work with circuit boards, and you will use Boolean algebra and logic gates to solve problems. In this discussion, you focus on the most typical type...
-
3. Consider a complete binary tree represented by an array [19, 14, 28, 15, 16, 7, 27, 15, 21, 21, 5, 2]. How many edges of this tree violate the max-heap property? In other words, for how many edges...
-
The Credit Officer at Real Bank has awarded a score to Joe Black based on information provided for each category considered for risk assessment relating to his application for a personal loan. The...
-
if a $25,000 non-wage didtribution was made to each shareholder in an S corp, how would the balance sheet be affected
-
Suppose that a company had a target of $4.000.000 of sales revenues and $1.000.000 of profits. However, due to macroeceonomic reasons, the company had only achieved half of the sales target and...
-
-Discuss employee engagement and behavior impact on the organization's performance and why this is important -Define employee engagement -Define the term behavior impact.
-
Informal Seating Company is currently selling 2,200 oversized bean bag chairs a month at a price of $75 per chair. The variable cost of each chair sold includes $35 to purchase the bean bag chairs...
-
The maximum pressure that can be developed for a certain fluid power cylinder is 15.0 MPa. Compute the required diameter for the piston if the cylinder must exert a force of 30 kN.
-
TLC was an Atlanta rhythm, blues, and hip-hop band that performed at clubs in 1991. The three-woman group signed a recording contract with LaFace Records. The groups first album that LaFace produced,...
-
The Eminem ad for Chrysler that ran during the Super Bowl in February 2011 was rated as one of the best ads for the game. In May 2011, Audi ran an ad at a German auto show that had the feel of the...
-
David Ungar holds a Dunkin Donuts franchise. The terms of his franchise agreement require him to use only those ingredients furnished by Dunkin Donuts. He is also required to buy it snap kins, cups,...
-
What is this project's discounted payback period? (10 points) a. 3.04 b. 3.24 c. 3.44 d. 3.64 Assume that the appropriate cost of capital for this project is 12 percent. Time 0 1 Cash Flow -$750 $400...
-
What is this project's IRR? a. 25.67% b. 27.19% c. 28.76% d. 29.86% Assume that the appropriate cost of capital for this project is 12 percent. 0 1 2 Time Cash Flow -$750 $400 $300 3 $200 4 $400
-
What is this project's Modified IRR (MIRR)? a. 18.78% b. 19.65% c. 20.14% d. 21.37% Assume that the appropriate cost of capital for this project is 12 percent. Time Cash Flow 0 1 -$750 $400 $300 2 3...
Study smarter with the SolutionInn App