Week 5 Discussion 1 State Licensure Requirements

State Licensure Requirements

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In preparing for this discussion, read Chapter 24 of the course text. For your initial post, address the following in the discussion forum:

•              Compose the organization’s eligibility requirements for a Medicare Advantage Plan contract.,

•              Outline two pieces of vital information regarding Medicare Advantage Plans from the Kaiser Family Foundation’s Website.

Your initial post should be at least 300 words. Support your response with a minimum of two scholarly sources that were published in the last five years.

Guided Response: Compare the differences and similarities between your and your peer’s selected vital facts about Medicare Advantage Plans. Be sure to support your response by citing at least one scholarly source to validate your assertions. Respond to at least two of your classmates’ posts.

Carefully review the Discussion Forum Grading Rubric for the criteria that will be used to evaluate this Discussion Thread.

Why is accreditation important? What is the difference between rating and underwriting and how is it used? Identify and discuss any ethical issues that could arise in the underwriting process.

Even though laws has been enacted and regulatory changes have been made that affect insurance programs, the number of individuals without insurance remains high and the costs of insurance keep growing. Employer-sponsored health insurance provides insurance coverage to two-thirds of the population under 65 and nearly 80 percent of the uninsured live in a family where at least one adult is employed (Stanton, 2004). The goal of the employer-sponsored sales process should be to expand coverage to as many citizens of the country to reduce the economic burden associated with the uninsured. Underwriting involves collecting and analyzing data about applicants to determine the risk associated with the applicant (Kongstvedt, 2007). Once the risk is assessed, the policy is rated to determine the applicant’s premium. Since the risk is greater with individual policies, the underwriting is stricter than in group policies. As the access to data increases, one ethical issue that might arise in the underwriting process is price optimization. Price optimization involves using predictive analysis to determine which consumers are less likely to research oth