Economic Issues Simulation Paper Research Paper

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Introduction

Employees are the most valuable asset of each and every organization. The wellbeing of the employees has a direct relationship with their level of productivity. Employees who have managed to achieve all the elements of wellness are more productive (Wilkinson, 2005). There are five elements of wellness namely, physical wellness, career wellness, social wellness, community wellness and financial wellness. Every employee needs to achieve all the elements of wellness.

Physical wellness is the most challenging to achieve since it relates to the health of the employee. The challenge is attributed to the costs involved in treating the sick employee or preventing the occurrence of diseases among employees (Wilkinson, 2005). Besides, the employers or organizations suffer huge losses on a daily basis in the form of lost productivity when their employees fall sick (Wilkinson, 2005).

Thus managing the cost of preventing diseases and treating sick employees has become a major concern to employers and the government. Health insurance plans have been used as one of the most effective strategies for controlling expenses associated with treating and preventing diseases. This paper analyzes Construct IT in terms of the health insurance needs of its employees.

Company Profile

Construct IT is an industry-led consultancy organization in the construction industry (Construct IT, 2010). The organization was founded in 1994 in the UK to provide consultancy services to various stakeholders in the construction industry. Construct IT is a non-profit organization that facilitates networking in the industry by collaborating with representatives from various organizations and professionals in the construction industry (Construct IT, 2010).

The organization aims at improving the industry’s performance by encouraging innovative application of IT as well as research and development. The organization’s main activities includes promoting research, facilitating networking, value and benefits study, benchmarking best practice and managing projects.

The members of the organization are representatives from various firms in the construction industry. Representatives from various Universities and higher learning institutions are also members. However, the members are not employees of the organization. This means that their physical wellness is the responsibility of the companies that employ them.

Construct IT is run by a team of 15 employees. Out of the 15 employees, 13 are members of the management board (Construct IT, 2010). The remaining two serve in the positions of administrative support and webmaster. The staffs are employed on contracts that are renewable. 8 of the employees are male while the remaining 5 are female.

The employees fall in the age bracket of between 30 to 55 years with an annual income of at least $ 60,000. The employees are stationed in different parts of UK and Europe. They travel regularly in order to meet the clients and member of the organization (Construct IT, 2010). The staff members of the organization have specialized skills in various fields. All employees have at least a University degree in their areas of specialization (Construct IT, 2010).

The health risk factors for the organization include inactivity and excess weight. This is attributed to the fact that the employees are mainly engaged in in-door activities that discourage body exercise (Construct IT, 2010). Besides, they have limited time to visit physical fitness clubs in order to exercise their bodies.

The other health risk factor relates to behaviors such as smoking, consumption of alcohol and eating junk foodstuffs. Consequently, the employees are at risk of suffering from diseases such as cancer, high blood pressure and even obesity (Rodin, Blewett, & Davern, 2009). The company intends to manage the health issues through a health insurance plan. This will cost the company $78,000 annually.

Types of Health Insurance Plans

There are three health insurance plans that the organization can use to achieve its objective of reducing cost of healthcare and improving the physical wellness of its employees. The first plan is referred to as free-for-service health plan. In this case, the insurer pays for the cost of treatment when the insured employee visits a health provider for treatment (Rodin, Blewett, & Davern, 2009). The insurer pays part of the treatment fee while the insured pays the rest through their employer. Thus the employer pays monthly premiums to the insurer (Stvens, 2003).

The insured is compensated for the treatment fee upon filling a claims form. This plan gives the employees a chance to choose their preferred doctors and hospitals. The plan costs at least $ 500 per employee annually (Davern, Quinn, & Kenney, 2009). The free-for-service plan can be considered by the company due to the fact that it covers most illnesses. Besides, most of the organization’s employees are stationed outside the country. Thus they will need to obtain health services from different healthcare providers without restrictions.

The second plan is referred to as health maintenance organization plan (Stvens, 2003). It is a prepaid plan in which the users pay a monthly premium to the insurance company (Morrisey, 2007). The plan provides comprehensive cover to the employee and their families. The covered services include surgery, emergency care, hospital stay and doctor’s visits.

The plan would cost the organization at least $ 550 per employee annually (Davern, Quinn, & Kenney, 2009). This plan can be considered by the organization for two reasons. First, it covers the employees and their family members hence eliminating the anxiety that develops among employees when their family members fall sick. Second, it is efficient since claim forms are not needed to process payment. Finally, it covers most illnesses including regular health screening by a doctor.

The last plan is referred to as preferred provider organization health plan. This plan combines the features of for-free-service health plan and health maintenance organization plan (Davidson, Brown, & Kincheloe, 2007). In this case the insured are treated by a particular doctor at a particular hospital.

However, they can also visit other hospitals at a higher cost. The claim forms are not needed in this case since credit cards are used to process payment. The plan would cost the organization at least $ 500 per employee annually (Davern, Quinn, & Kenney, 2009). This plan can be considered by the organization due to the fact that it is convenient and also provides comprehensive cover.

Form the above analysis of the organization’s profile and the various health insurance plans, the preferred provider organization plan will be the best for the organization. Unlike, free-for-service plan it is more efficient since the claim forms are not needed to process claims (Davern, Quinn, & Kenney, 2009).

It also covers more healthcare services as compared to free-for-service plan. This plan is also better than the health maintenance organization plan since it allows the users to access health services from health providers outside the plan. Besides, it also covers preventive care which is not included in health maintenance organization plan.

Given the Gallup’s strategy of consumer-driven healthcare, the preferred provider organization health plan should be modified as follows. The plan should include programs that train or encourage the staff to be more responsible for their health. The high cost of providing health services should be emphasized in such programs.

To achieve this objective, the plan should use part of the premium to promote behavior change and better lifestyles among the employees. This will reduce cases of illnesses among the employees. Thus there will be savings as the employer and employees spend little on healthcare.

Conclusion

Physical wellness influences the performance of employees in every organization (Wilkinson, 2005). Therefore most organizations are focusing on strategies that can allow their employees to access medical services at reduced costs. Health insurance is one of the strategies used by organizations to access medical services at reduced costs.

It is for this reason that Construct IT intends to purchase a health insurance cover for its employees. A part from offering health insurance, organizations should encourage their staff to be responsible for their health. This will reduce chances of falling sick thus reducing spending on health services.

References

Construct IT. (2010). About us. Web.

Davern, M., Quinn, B., & Kenney, G. (2009). The American community servey and health insurance coverage estimates. Health Serrvices Research, vol. 44 (2) , 593-605.

Davidson, G., Brown, E., & Kincheloe, E. (2007). Accuracy of self-reported health insurance coverage among medicaid enrolees. Inquiry, vol. 45 (4) , 438-560.

Morrisey, A. (2007). Health insurance. New York: Health Administration Press.

Rodin, H., Blewett, L., & Davern, M. (2009). Employement and health insurance coverage for rural Latino population. Journal of Community Health, vol. 30 (1) , 181-195.

Stvens, W. (2003). Health insurance: current issues and background. New York: Nova Science Publishers.

Wilkinson, N. (2005). Managerial economics. Cambridge: Cambrige University Press.

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