1. The ABC’s of Managed Care Ryan O. Catignani Corporate Underwriter Coventry Health Care
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4. The History of Managed Care Cheaper, More Restrictive More Expensive, Less Restrictive Staff Model Gatekeeper Direct Access Open Access HMO POS PPO Indemnity (Fee-For-Service)
14. Age/Sex Rates Composite Rates **Demographic shifts can positively/negatively affect a group’s rates** Each age, sex, and contract type bucket has its own age/sex factor applied and therefore a different premium for each bucket. The total group age/sex factor is then a weighted average of the individual employees’ age/sex factor. Group billing rates that apply to all subscribers within a specified contract type, regardless of their age or sex. **Different age/sex thresholds exist across different carriers (if at all)**
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