3 questions: 1 .Which level of goverment do you think should regulate the insura

Question

3 questions:

1.Which level of goverment do you think should regulate the insurance industry, the various states or the federal government? Explain in detail your reasoning. 2. Why do younger people prefer HMO's while older people prefer traditional insurance or PPO. Explain. 3.Prepare an insurance plan for a Day Care Center for preschool children. Make sure you identify each component of the plan. The property that you are using for the center is rented facility in downtown Chicago.Also,for a fee,you provide bus service to and from the center. 4.Explain what coverage's would be needed for a family of four living in a large metropolitan area.Both adult memebers are employed at a major firm in the areaand one child is 8 years old and the other is 3 years old.Assume they have a mortgage and each adult owns a vehcle.Both travel over 20 miles to and from work. Home is worth 275.000 and they have swimming pool.

Explanation / Answer

Ans1: SInce the time of civil war, the question who should regulate the insurance industry has been debated in

the united state.Insurance continues to be regulated by the states despite several challenges to their authority over the years. The states’ authority over insurance was supported in various courts' decisions until the Southeastern Underwriters case in 1944. In Southern Underwriters, the Supreme Court determined that the commerce clause of the Constitution applied to insurance and that insurance companies (and agents) were subject to federal antitrust law.

During that time, the majority of insurance companies.state over federal insurance regulation. However, today the bulk of insurance is written by national (and international) companies operating across state borders. Many of these insurers have come to view state regulation as an increasing drag on their efficiency and competitiveness.

Ans2: In HMO Plan, You can pick one primary care physician. All your health shall be cared by that physician.That means that you need a referral before you can see any other health care professional, except in an emergency. Visits to health care professionals outside of your network typically aren’t covered by your insurance.

For example, if you get a skin rash, you wouldn’t go straight to a dermatologist. You would first go to your primary care physician, who‘d examine you. If your primary care physician can’t help you, he or she will give you a referral to a trusted dermatologist in your network that will.

In case of PPO on the other side, PPO plans give you flexibility.You don’t need a primary care physician. You can go to any health care professional you want without a referral—inside or outside of your network. Staying inside your network means smaller copays and full coverage. If you choose to go outside your network, you'll have higher out-of-pocket costs, and not all services may be covered.

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