As Part of the Most Recent Collective Bargaining Agreement with State

question 86

Essay

As part of the most recent collective bargaining agreement with state employees, a state government must offer dental insurance at "reasonable, nonprofit rates." The state plans to self-insure in place of using a private insurance company. Statistical evidence suggests that the average household currently spends $300 per year for corrective dental work and $80 for routine checkups. Administrative costs are expected to average $20 per family. The collective bargaining agreement dictates that the plan's coverages and rates be fixed for a period of three years. The auditor considers the choice of the plan to be extremely important. Consequently, the auditor has asked you to evaluate the three proposals listed below in terms of their propensity to result in adverse selection and/or moral hazard. Proposal 1 would charge a $400 premium with no deductible. Coverage is extended to preexisting conditions, but to cover the nondeductible clause, routine checkups are not covered. Proposal 2 charges a $200 premium with a $200 deductible. The plan does not cover preexisting conditions, but does cover routine office visits. Proposal 3 charges a $150 premium with a $150 deductible. This plan doesn't cover preexisting conditions or routine checkups. The collective bargaining agreement dictates that participation in the plan must be at the employee's option.

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Definitions:

Intrauterine Devices (IUDs)

Long-term, reversible contraceptives inserted into the uterus to prevent pregnancy, available in hormonal and non-hormonal forms.

Cervical Mucus

A fluid secreted by the cervix, undergoing changes in consistency and volume across the menstrual cycle, playing a key role in fertility.

Spermicidal Agent

A chemical product used to kill sperm, thereby reducing the likelihood of pregnancy.

Diaphragm

A barrier method of contraception, consisting of a dome-shaped cup made of silicone or latex that fits inside the vagina to cover the cervix and prevent sperm from entering.