HC 463 Third Party Reimbursement and Risk Management
U1T 2007 DL
William N. Goodwin
BBA-Accounting Texas A&M University-KingsvilleMBA-Texas A&M University- Corpus Christi
Park Campus Center-Corpus Christi-NAS
Textbooks can be purchased through the MBS bookstore
Textbooks can be purchased through the Parkville Bookstore
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Learning Outcomes: Core Learning Outcomes
Other Assessment Guidelines
All work must contain appropriate formatting, grammar, and spelling.
Completing a student opinion survey form located in the Distance Learning section of the Park University website in Week Eight of this class.
Locating a suitable Proctor with e-mail and Completing a Proctored Final Examination.
The final exam will be closed book and closed notes.
After reading the assignment, write a reflection piece that includes:
90 - 100
80 - 89
70 - 79
Quantity and timing of posts
First post by Wednesday. Posts 2-3 days/wk. Offers 2 original posts; responds to 2+ others
First post by Wednesday. Posts 2-3 days/wk. Offers 1 original post; responds to 2+ others
Initial post by Thursday. Typically participates 1-2x more during the week
Does not participate, or posts Friday or later. Typically posts 1-2x in a week
Promptness and initiative
Consistently responds to postings in less than 24 hours; demonstrates initiative
Responds to most postings within a 24 hour period; requires occasional prompting to post
Responds to most postings several days after initial discussion; limited initiative
Usually responds to few postings; rarely participates freely (if at all)
Delivery of post
Consistently uses correct grammar and punctuation, with rare misspellings
Few grammatical or spelling errors are noted in posts
Errors in spelling and grammar are present in several posts
Uses poor spelling and grammar in most posts; posts appear hastily written
Relevance of posts
Consistently posts topics related to discussion topic; cites additional references related to topic
Frequently posts topics that are related to discussion content; prompts further discussion of topic
Occasionally posts off topic; most posts are short in length and offer no further insight into the topic
Posts topics that do not relate to the discussion content; makes short or irrelevant remarks
Expression within the post
Expresses opinions and ideas in a clear and concise manner with obvious connection to topic
Opinions and ideas are stately clearly with occasional lack of connection to topic
Minimal connection to topic, shown by minimal expression of opinions or ideas
Does not express opinions or ideas clearly; no connection to topic
Weekly Questions and Essays
(Grade will reflect percentage of assigned points)
90 – 100%
80 – 89%
70 – 79%
60 – 69%
Main point is present and directly supported.
Main point is present and most points supported.
Main point is present but vague; No direct support of main point.
Main point is vague with little support or strays from thesis.
Lacks organizing idea.
Well written, fully elaborates points.
Well written, most points elaborated with clear and detailed information to support thesis; may contain minor factual errors.
Adequately written points; some points elaborated.
Awkward writing style, points are general, factual errors present, and may stray from main points.
Poor writing style with little or no specific details.
Good 0rganization with few statements out of place.
Organization is confusing to the reader. Organization lacks proper paragraph construction.
Little or no structure.
Rambles from topic to topic. Completely off topic.
No errors interfering with comprehension.
Possesses 1-3 critical errors interfering with comprehension.
Possesses 4-5 critical errors interfering with comprehension.
Possesses 6-7 critical errors interfering with comprehension.
Possesses 7 or more errors interfering with comprehension.
All final exams will be comprehensive and will be closed book and closed notes. If calculators are allowed, they will not be multifunctional electronic devices that include features such as: phones, cameras, instant messaging, pagers, and so forth. Electronic Computers will not be allowed on final exams unless an exception is made by the Associate Dean.
The Proctored final exam for online courses must be passed with a grade of 60% or higher in order to pass the course regardless of the overall average. The grade for students who pass the proctored final will be based on the overall average of homework and tests taken during the course. The proctored final exam must address only material which the student has been taught in class.
Classroom Rules of Conduct:
9. According to Park University guidelines, this course is divided into eight weeks with the first week beginning on the first day of the semester, a Monday, and ends midnight the following Sunday. Weeks Two through Eight also begin on Monday and end on the following Sunday. Assignments scheduled for completion during a class week should be completed by the end of the week assigned, ie.,1,2,3-8. Writing assignments and formal papers should be completed and successfully emailed so that they are in by the due date.
10. Students are expected to complete 5 hours per week of conferencing or other appropriate online activities, including sending/receiving E-mail and navigating and conducting research over the World Wide Web.
1. What is the difference between risk and chance of risk?. Give examples of each.
2. Loss prevention activities can be divided into two categories: loss prevention and loss reduction. How do these activities differ? Provide an example of each.
3. Explain the concept of adverse selection. How does this concept tend to influence the processes followed by insurance companies ?
4. Define the law of large numbers and why it is important to private insurers.
5. Explain the concept of preloss objectives and postloss objectives. Please give examples of each.
6. Describe the role that technology plays in formulating risk management programs.
7. Describe the risk management process in detail. Be sure to explain the technique of risk control and risk financing.
1. Explain the law of agency and how it affects the actions of insurance agents.
4. Why are other insurance provisions necessary in insurance contracts?
5. What are the three categories of torts?
6. What are the common defenses against negligence?
7. Explain in detail the fundamental legal principles that are reflected in insurance contracts. (Requires one page).
8. Discuss the required components of an insurance contract.
2. Describe the difference between preexisting condition clauses concerning individual and group health insurance coverage.
3. Explain the basic rules to follow when purchasing individual health insurance.
4. Describe the advantages of long-term care insurance. How long has this type policy been available?
6. Describe the advantages afforded an individual by disability insurance.
7. What are the major problems associated with the current health care system in the United States?
9. Please comment on your experience with individual health insurance, its cost, coverage, and any problems you have encountered in this area.
2. Describe the basic characteristics of cafeteria plans.
3. Describe the ways insurance companies use the coordination of benefits provision in their payments to providers of health care.
4. Describe how self-insured health plans are operated. Do employers save money with these type of plans?
6. What is a PPO? How do PPO's differ from EPO's? Give examples of each with your answer.
7. How are preexisting conditions provisions and coordination of benefits provisions often used in group health insurance plans?
8. What coverages are typically provided through group basic medical expense plans?
9. Discuss the basic underwriting principles used in group insurance.
Academic Honesty:Academic integrity is the foundation of the academic community. Because each student has the primary responsibility for being academically honest, students are advised to read and understand all sections of this policy relating to standards of conduct and academic life. Park University 2006-2007 Undergraduate Catalog Page 87-89
Plagiarism:Plagiarism involves the use of quotations without quotation marks, the use of quotations without indication of the source, the use of another's idea without acknowledging the source, the submission of a paper, laboratory report, project, or class assignment (any portion of such) prepared by another person, or incorrect paraphrasing. Park University 2006-2007 Undergraduate Catalog Page 87
Attendance Policy:Instructors are required to maintain attendance records and to report absences via the online attendance reporting system.
Park University 2006-2007 Undergraduate Catalog Page 89-90
Disability Guidelines:Park University is committed to meeting the needs of all students that meet the criteria for special assistance. These guidelines are designed to supply directions to students concerning the information necessary to accomplish this goal. It is Park University's policy to comply fully with federal and state law, including Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, regarding students with disabilities. In the case of any inconsistency between these guidelines and federal and/or state law, the provisions of the law will apply. Additional information concerning Park University's policies and procedures related to disability can be found on the Park University web page: http://www.park.edu/disability .
Last Updated:5/17/2007 10:53:24 AM