Human Resource Management; Challenges And Changes – Essay Example

The of the plan that I have for health coverage is a PPO plan offered through Highmark Blue Shield. This is the insurance that is offered by myemployer. It is a benefit that is free for me and would cost very little for any of my family members that would want to be listed as dependents on this insurance coverage. I have a $750 deductible for all services that are provided by in-network medical professionals. If I want to use a specialist outside of the network, my deductible is $1500. I also have a $25 co-pay for any visit I make to the doctors. The only thing that I do not pay a co-pay for is well mother and well baby checkups. After I meet my deductible, most procedures are covered at 100% of cost. It often gets confusing though, because a hospital stay may include many different providers. Some of these providers will try to bill me for 80% or 50% of the cost even though I have met my co-payment. It is always a hassle to sort out, but I have always been able to work with my insurance company to get it figured out. This plan does not have a limit on pre-existing conditions. From what my manual says, I could bring a spouse onto the plan with everything from a pregnancy to a mental illness and it would be covered. There are exclusions for things like cosmetic surgery or hair replacement procedures. There are also limitations on the number of visits for services such as drug and alcohol counseling, chiropractic care and physical therapy.
COBRA is one of the most common recourses people use to extend their health coverage if they lose it. COBRA is most often used by an employee that loses a job because the employer experiences a reduction in staff. This employee can buy health care coverage at a group rate from the former employer for up to a year. The problem with COBRA is that the group rate is usually much more expensive than what the employee typically pays. For example, I dont pay anything for my own coverage, but my COBRA payments would be about $980 each month. HIPAA is the second option employees have to keep coverage. This is intended to protect employees that switch jobs. It ensures that the new employer does not discriminate against the new employee based on preexisting conditions or the number of dependants the new employees has.
Sources
U.S. Department of Labor (2007). Frequently Asked Questions about COBRA Continuation Health Coverage. Retrieved on August 29, 2007 from http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html.
U.S. Department of Labor (2007). Frequently Asked Questions about Portability of Health Coverage and HIPAA. Retrieved on August 29, 2007 from http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html.