Health insurance is insurance against loss by illness bodily injury.
Health care is  the treatment of illness or injuries.
Wellness is good physical & mental health obtained by a healthy diet, physical activity and a healthy lifestyle.

WELLNESS AS COST CONTAINMENT
  • 83%: Don’t have a good die
  • 65%: Are overweight obes
  • 70%: Of all cusses of death are lifestyle and related and preventable

HEALTH INSURANCE MARKET
  • Individual Plan
  • Group Plan
  •  Medicare
  • Medicaid
  • Worker Comp
  • Auto
  • Personal Liability
Health Insurance
  • Premium: - the monthly cost of the policy  
  • Copay: - flat amount charge for health care service
  • Coinsurance: -Percentage charged for health care service
  • Deductible: - initial payment due to health care provider before insurance pay,
  • OUT OF POCKET MAX: -the most member payout of pocket does not include premium

HEALTH INSURANCE
  • Network: the providers that have contracted with the insurance company 
  • HMO: Health Maintenance Organization – a product that dose not have an out -of-network benefit
  • Emergency coverage: - most plan allow for emergency coverage notwithstanding network

INDIVIDUAL COVERAGE
  • Insurance companies
  • No premium subsidy available
  • Health care ger in PA
  • Coverage thought insurance companies
  • Premium subsidies
  • Other cost sharing covered
  • Copays deductibles, coinsurance
  • Out of -pocket max

GROUP PLAN
  • Strategic planning considerations

BENEFIT STRUCTURE
  • Petevmine if existing benefit plan wellness goals & objectives identify screens &tests not covered
  • Evaluate the potential cost and benefits of preventive service

ALNALYZE EMPLOYEE ATTITTUDES
  • Interest in participating in specific programs barriers participation in participation programs

PERFORM A HEALTH RISK ASSESSMENT
  • Health risk and habits of employees and other beneficiaries
  • Readiness to change unhealthy life style habits