You are a healthcare consultant and Corporation Y (CY) approaches you for advice. Some months ago, CY engaged Eduardo, a healthcare consultant, and per Eduardo's advice, CY decided it will establish a self-funded ESI health plan. Due to personal reasons, Eduardo can no longer help CY, so CY approaches you to help it implement the self-funded ESI health plan. CY wants to offer adequate health coverage to its employees, but is also concerned about expenditures:

a. CY does not know anything about health insurance, and does not want to deal with all the paperwork, provider contracts, reimbursement to providers, etc.What would you recommend for CY to do?Why?

b. Would you recommend for CY's to set its plan as an HMO or a PPO? Why?

c. Should the health services covered under CY's health plan be comparable to those covered in federal marketplace (a.k.a. health insurance exchanges, Obamacare) plans, or should CY cover additional services? Why?

d. What can CY do to control expenditures?

Answer rating: 100% (QA)

a I would recommend that CY consider partnering with a thirdparty administrator TPA or hiring a benefits administrator to handle the administrative tasks associated with the selffunded ESI health plan ... View the full answer