American College of Surgeons, 63

American Medical Association

opposition to group health plans by, 70

opposition to social insurance proposals by, 59-60, 63, 65

American Risk and Insurance Association, 41 n.6

Americans with Disabilities Act of 1990, 117-118, 148, 316-317

application to risk selection, 185-187

confidentiality provisions of, 246

legal uncertainties in, 186

medical records management in, 17

medical underwriting in, 182

B

Benefit, definition of, 43, 335

Benefit design, 114-115

basic benefits, 19-20, 193, 249, 258

cost management in, 74-75

cost sharing in, 74, 103-106

diversity in, 10, 122-126, 237-238, 242

employee assistance programs in, 118-119

employee concerns about, 136-137, 145-149

ERISA on, 84, 302

evolution of, 101-102

flexible, 119, 218, 337

in health maintenance organizations, 102

health promotion programs in, 116-119

influence on risk selection of, 171-172, 173-174

innovation in, 10, 71-72, 238-239, 242

insurable events in, 44-45, 338

Medicare, 78-79

mental health care in, 104-106

planning, in case study, 130-133, 137-139

regulating, 19-20, 193-194, 249, 258

risk selection affecting, 184-185

in sample request for proposal, 156-158, 162-165

in social insurance, 41-42, 56-57

state-mandated, 101, 249, 298

in workers' compensation programs, 115-116

Biased risk selection, see Risk selection

Blue Cross plans

costs of, 219

HMO sponsorship by, 126

origins of, 66-69, 71-72, 295

Blue Shield plans

HMO sponsorship by, 126

in Medicare program, 78-79

origins of, 54 n.3, 68-69, 295

Bureau of the Census, Current Population Survey, 88, 93, 96

C

Cafeteria plan, 335

California, 37, 108, 250

Canada, 22, 32, 33, 110, 151, 252

Capital expenditures, regulation of, 208-209

Capitation, 335

Carve-outs, for retirees, 94-95 n.6

Case management, 335

Case study

contrasting cases, 142-145

employee advisory group in, 135-137

evaluating benefit plans in, 131-133

evaluating proposals in, 137-140

financial management in, 133

goal setting in, 130

implementing new benefit plan in, 140-142

legal issues in, 134

request for proposals in, 137, 155-166

small business concerns in, 143

Catastrophic expense protection, 335

Certificates of need, 209



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