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Employment and Health Benefits: A Connection at Risk
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