RCP Task 1.docx Health Plan for Seamus Company Western Governors University Introduct

RCP Task 1.docx    Health Plan for Seamus Company  Western Governors University  Introduction  Seamus Company has an opportunity to cut costs and more health aware culture by restructuring our health plan. By transitioning from a fee-for-service to a MCO model, we are able to reduce our health insurance plan costs as well as encouraging employees to become more staff to become more proactive about their health and behavior.   Sustainable Strategies   One strategy available is a Preferred Provider Organization or a, PPO plan. With this plan, employees are able to choose their preferred provider that is in a wide network in order to reap maximum benefit. Employees may elect to choose an out of network provider but will see an increase in out of pocket expenses. Employee also will not need a referral in order to seek specialized medical services if needed. Rates are negotiated and contracted for a lower costs providing employees with lower copays and deductibles. Health plans are also pre-tax deductible so employees will essentially receive the part of their income that pays for coverage, tax free.   The second available MCO option is a Health Management Organization, or HMO plan. With this plan, employees are instructed to designate a Primary Care Provider, PCP, who will deliver the initial or maintenance visits. In order for an employee to seek a more specialized service, the PCP will need to order the service. This structure of health care allows for a greater continuity of care and a more