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The Jade Health Plan used a profitability index (PI) to rank the following capital proposals:
Proposal PI
A 0.45
B 1.05
This information indicates that, of these two projects, Jade would most likely select:
With regard to the financial statements prepared by health plans, it can correctly be stated that
The medical loss ratio (MLR) for the Peacock health plan is 80%. Peacock's expense ratio is 16%.
Peacock's MLR and its expense ratio indicate that Peacock
The amount of risk for health plan products is dependent on the degree of influence and the relationships that the health plan maintains with its providers. Consider the following types of managed care structures:
Preferred provider organization (PPO)
Group model HMO
Staff model health maintenance organization (HMO)
Traditional health insurance
Of these health plan products, the one that would most likely expose a health plan to the highest risk is the:
The Essential Health Plan markets a product for which it assumed total expenses to equal 92% of premiums. Actual data relating to this product indicate that expenses equal 89% of premiums. This information indicates that the expense margin for this product has:
