Question: Can you help me solving these 2 questions: The 45 year-old The Beans and Salsa Company (BSC) is a VA based producer of humus, dips

Can you help me solving these 2 questions:

The 45 year-old The Beans and Salsa Company (BSC) is a VA based producer of humus, dips and chips products. Due to their great success, they operate in 9 locations around the U.S. The BSC employs 31,300 full time employees in the US. It is a publicly traded successful corporation with strong brand name. The fiscal year of the company is July 1 to June 30 (July 1, 2020 June 30, 2021 is fiscal year 2020).

So far, the BSCs employees had 15 babies born in fiscal year 2020. The CFO had open heart surgery and 11 employees had various expensive surgeries. All the babies were healthy except the pre-mature baby who stayed in the hospital for 6 months and had 2 surgeries to save his life. The human resources department asked the employee benefits consultant Zenadu Benefits Consulting to help the company with the health care benefits and potentially by self-insuring them. [This material is explained in chapters 20, 22 and 23].

The Beans and Salsa Company (BSC) uses Kaiser Permanente in CA and Washington D.C. as well as Anthem BCBS for the two choices of health plans offered to the employees and their families:

Overall the 3 plans are as follows: 1. One PPO plan without HSA with the lowest possible deductible, and 2. A second PPO plan with HSA with medium deductible, and 3. An HMO Staff model of Kaiser Permanente.

The employer provides $800 each month to each employee. The rest is paid by the employee using a premium conversion plan (payroll deductions before taxes).

The plans are as follows from Anthem BCBS:

  • PPO without HSA with minimal deductible (with co-pays and co-insurance) is available in all locations (Total premiums asked by the insurer for employee only [without spouse and children] is $970 per month)
  • PPO with HSA with medium deductible is available in all locations (Total premiums asked by the insurer for employee only [without spouse and children] is $710 per month).
  • The Kaiser Permanente HMO staff model is available only in Northern VA and CA (Total premiums asked by the insurer for employee only [without spouse and children] is $820 per month)

Question

What do you think are the logical and acceptable co-insurance percentages for the PPO without HAS and the PPO with HSA?

Group of answer choices

A-With HSA it is 20/80 and without HSA, the co-insurance is 70/30

B-With HSA it is 20/80 and without HSA, the co-insurance is 70/40

C-With HSA and without HSA, the co-insurance is 80/20

D-With HSA it is 20/80 and without HSA, the co-insurance is 60/40

The 45 year-old The Beans and Salsa Company (BSC) is a VA based producer of humus, dips and chips products. Due to their great success, they operate in 9 locations around the U.S. The BSC employs 31,300 full time employees in the US. It is a publicly traded successful corporation with strong brand name. The fiscal year of the company is July 1 to June 30 (July 1, 2020 June 30, 2021 is fiscal year 2020).

So far, the BSCs employees had 15 babies born in fiscal year 2020. The CFO had open heart surgery and 11 employees had various expensive surgeries. All the babies were healthy except the pre-mature baby who stayed in the hospital for 6 months and had 2 surgeries to save his life. The human resources department asked the employee benefits consultant Zenadu Benefits Consulting to help the company with the health care benefits and potentially by self-insuring them. [This material is explained in chapters 20, 22 and 23].

The Beans and Salsa Company (BSC) uses Kaiser Permanente in CA and Washington D.C. as well as Anthem BCBS for the two choices of health plans offered to the employees and their families:

Overall the 3 plans are as follows: 1. One PPO plan without HSA with the lowest possible deductible, and 2. A second PPO plan with HSA with medium deductible, and 3. An HMO Staff model of Kaiser Permanente.

The employer provides $800 each month to each employee. The rest is paid by the employee using a premium conversion plan (payroll deductions before taxes).

The plans are as follows from Anthem BCBS:

  • PPO without HSA with minimal deductible (with co-pays and co-insurance) is available in all locations (Total premiums asked by the insurer for employee only [without spouse and children] is $970 per month)
  • PPO with HSA with medium deductible is available in all locations (Total premiums asked by the insurer for employee only [without spouse and children] is $710 per month).
  • The Kaiser Permanente HMO staff model is available only in Northern VA and CA (Total premiums asked by the insurer for employee only [without spouse and children] is $820 per month)

Question

What do you think are the logical and acceptable maximum annual out of pocket expenses for the PPO and the PPO with HSA?

Group of answer choices

A- With HSA, it is as high as $10,000 and without HSA it is $3,000 - $6,000

B- With HSA, it is as high as $3,000 and without HAA it is $3,000 - $6,000

C- With HSA, it is as high as $7,000 and without HSA it is $8,000

D- With HSA, it is as high as $7,000 and without HSA it is $3,000 - $6,000

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