Health insurance is a product that helps to minimize the financial impact of a consumer's medical costs by transferring some of the risk to the insurance provider. Yet, despite the importance of this product, many consumers still have anxiety when trying to select a health insurance plan and use the coverage. This course is designed to help consumers to understand the basic concepts and terminology that they need to know.
Why Is Health Coverage Needed and Who Provides It?
Explains why health insurance coverage is so important and the main sources of health coverage in the United States, including employer-sponsored group health plans and government programs.
Keys to Understanding Health Coverage
Identifies the definitions of basic health coverage terms, including who and what is covered under a plan, as well as types of plan costs. Also learn about communication tools used to explain coverage, such as the ACA required summary of benefits and coverage (SBC) or a summary plan description (SPD).
Legal and Legislative Considerations
Reviews the compliance requirements set forth under COBRA, ERISA, and the HIPAA Privacy and Security Rules. Also discusses subrogation.
Health Coverage Models
Describes the goal of managed care and how to differentiate between various plan approaches, including a preferred provider organization (PPO), health maintenance organization (HMO) and point-of-service (POS) plan. Also explains how consumer-driven health plans (CDHPs), health reimbursement arrangements (HRAs) and health savings accounts (HSAs) work.
Other Types of Coverage
Outlines other types of ancillary benefits including carved-in and carved-out prescription drug plans, dental plans, vision plans, behavioral health plans and alternative health care.