Case Study : The La Fontaine Dealership

1169 WordsFeb 29, 20165 Pages
Perhaps the business is considered medium-sized because there are over 100 employees. Although technically speaking the federal government recognizes a large business over 100 employees. Regardless, the company can afford to offer two different forms of health insurance. The current perspective client for the medium-size business is the La Fontaine dealership, which offers a variety of vehicles from Ford to Toyota. LaFontaine dealership currently employs 250 people. The first perspective plan that the company could offer the employees is a Preferred Provider Organization (PPO) from Blue Cross Blue Shield of Michigan. The projected costs for the employer to have this insurance per month are $36,000. The employer will pass on 30% of the costs to each employee, thus, each employee would pay $108 every month or $54 on their biweekly paycheck. Overall, it equals to just $1296 for the year, which still falls below the $2000 maximum allowed from the ACA. Blue Cross Blue Shield of Michigan PPO is constructed in such a way that the ACA considers it a Silver plan because it covers 80% of the healthcare costs with just 20% of the cost being placed on the enrollee. The resource-based relative value scale (RBRVS) will pay the physicians in this plan in a fee-for-service system. If the enrollee stays with and preferred provider network, then the services will be covered at 80% with the patient only paying a 20% coinsurance provided that they have met their deductible of $1500 or $3000

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