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FIN 355 Milestone Two Case Study

Part A

Health Insurance

John’s company recently changed their health insurance offering. Jenny’s dental office does not
offer any health insurance options. John and Jenny can choose between the following two
health offerings:

Option 1 Option 2

Annual Deductible

• $1,500 if you cover yourself
only
• $3,000 if you cover yourself
plus one or more dependents

• $2,500 if you cover yourself
only
• $5,000 if you cover yourself
plus one or more dependents

Medical Coinsurance

• 10% of all covered in-
network services other than
certain preventive care
• 30% up to MRC of all
covered out-of-network
services other than certain
preventive care

• 10% of all covered in-
network services other than
certain preventive care
• 30% up to MRC of all
covered out-of-network
services other than certain
preventive care

Prescription Coinsurance

• 15% of the cost of the
generic (tier 1) drug up to
the per-prescription
maximum ($25 pharmacy,
$63 home delivery)
• 30% of the cost of the
preferred brand name (tier
2) drug up to the per-
prescription maximum
($100 pharmacy, $250 home
delivery)
• 50% of the cost of the non-
preferred brand name (tier
3) drug up to the per-
prescription maximum ($150
pharmacy, $375 home
delivery)

• 15% of the cost of the
generic (tier 1) drug up to
the per-prescription
maximum ($25 pharmacy,
$63 home delivery)
• 30% of the cost of the
preferred brand name (tier
2) drug up to the per-
prescription maximum
($100 pharmacy, $250 home
delivery)
• 50% of the cost of the non-
preferred brand name (tier
3) drug up to the per-
prescription maximum ($150
pharmacy, $375 home
delivery)

Annual Out-of-Pocket
Maximum
total amount of deductible
plus coinsurance
for covered in- and out-of-
network
medical and prescription
drug expenses
you may pay in a calendar
year

• $3,000 if you cover yourself
only
• $6,000 if you cover yourself
plus one or more dependents

• $4,500 if you cover yourself
only
• $9,000 if you cover yourself
plus one or more dependents

Cost $750/month $280/month

Long-Term Disability Insurance

Both spouses have group disability insurance from their employers.

John: Benefits equal 50% of salary subject to a maximum of $2,500 per month.

Coverage benefits are limited to 5 years. John’s employer pays for this
coverage.

Jenny: Benefits equal to 50% of salary subject to a maximum of $2,000 per month.
Jenny pays a premium for this, and she has a choice to pay with pre-tax
dollars or after-tax dollars. She currently has the premiums paid with pre-tax
dollars.

Additional Client Notes

Clients John and Jenny have a nice-size savings account with around $40,000 and a 401K

through John’s work that has a balance of $265,000. Jenny does not have a retirement account.

Part B

John and Jenny also want your help in answering questions about Social Security, Medicare,

Medicaid, and long-term care insurance. Below is information they have provided for your

analysis.

Demographics

Family Members Age Occupation Health

Jenny 54 Office manager Treated for mild depression.
5’4″, 135 pounds. No other health issues.

John 56 Sales manager Treated for high cholesterol.
6’1″, 186 pounds. No other health issues.

Emily (Child) 30 Married, lives in
another state far
away

No health issues

Tiffany (Child) 28 Single, attending
a graduate
program in
England

No health issues

Incomes

Income for the past three years and projected current year income for each spouse is shown
below in Table 1:

Table 1

Family Income

Year John Jenny

2013 $64,000 $0

2014 $67,000 $0

2015 $71,000 $47,000

2016 $74,000 $50,000

Table 1: Income for the past three years and projected current year income for each spouse

Current Assets/Information

Home valued at $550,000 is almost paid for. Six years remaining with a balance of $100,000.

John has a 401K with an approximate value of $480,000.

Jenny has a Roth IRA with an approximate value of $25,000.

Joint savings of roughly $50,000.

Both cars are paid for and in reasonable shape. John and Jenny expect to replace at least one
car in the next 5 years.

John has worked full-time as a sales manager for more than 30 years. Jenny has worked as an
office manager for the last 2 years and did not work previously. Jenny is uncertain about her

future with her current company and may not work much longer. She plans to work on some
home improvements around the house should she stop working and is hoping to spend more
time with some of her hobbies that she has missed over the years.

John’s expected Social Security benefits are as follows:

Age 62: $1,780/month
Age 66 (full retirement): $2,456
Age 70: $2,914

  • FIN 355 Milestone Two Guidelines and Rubric
  • Overview: For Milestone Two, you will submit a draft of the health, disability, and long-term care insurance, and social security, Medicare, and Medicaid sections
    of the insurance plan. There are two parts of Milestone Two. In the first part of Milestone Two (Part A), you meet with your clients John and Jenny Smith to
    discuss questions they have about health insurance and disability insurance. They want your help in evaluating both their insurance needs and the insurance
    coverage they already have. The Smiths have also decided they would like to start planning for retirement and would like some information on long-term care
    insurance. Review the case notes and background of your clients, and address the assigned critical elements regarding health, disability, and long-term care
    insurance.

    In the second part of Milestone Two (Part B), 20 years have passed, and John and Jenny now have some new questions, concerns, and needs regarding Social
    Security, Medicaid, and Medicare. Review the case notes and background of your clients, and address the assigned critical elements regarding Social Security,
    Medicare, and Medicaid.

    Prompt: Review the case notes and background of your clients, and address the assigned critical elements regarding health, disability, and long-term care
    insurance.

    Specifically, the following critical elements must be addressed:

    IV. Health, Disability, and Long-Term Care Insurance (Part A): In this section, you will evaluate the clients’ current health, disability, and long-term care
    insurance coverage and make appropriate recommendations for their needs. To effectively address the critical elements in this section, you must use the
    client information in the first scenario.

    A. Analyze potential health insurance options for the clients, and recommend a health insurance option that best meets the clients’ needs.
    Support your

    recommendation with relevant client information.

    B. Discuss the ability of the clients’ disability insurance to meet their coverage needs, making recommendations where appropriate. Support your
    response with relevant client information.

    C. Analyze the clients’ health information and determine at what age the clients should purchase long-term care insurance. Support your
    determination with relevant client information.

    V. Social Security, Medicare, and Medicaid (Part B): In this section, you will analyze the eligibility requirements for and benefits of Social Security,
    Medicare, and Medicaid and make recommendations to the clients about the age at which they should retire to maximize their retirement benefits. To
    effectively address the critical elements in this section, you must use the client information in the second scenario.

    A. Summarize common eligibility requirements for Social Security, and explain how the clients can maximize their Social Security benefits.
    B. Differentiate between Medicare and Medicaid, and explain how and why the clients will or will not benefit from the programs. Support your

    explanation with relevant client information.
    C. Recommend a retirement age for each client that will allow them to take full advantage of all retirement benefits. Support your

    recommendation with relevant client information.

    http://snhu-media.snhu.edu/files/course_repository/undergraduate/fin/fin355/fin355_milestone_two_case_study

    Part A Rubric
    Guidelines for Submission: Your draft should adhere to the following formatting requirements: 3–4 pages, double-spaced, using 12-point Times New Roman
    font, one-inch margins, and APA format.

    Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
    Health, Disability, and

    Long-Term Care Insurance:
    Potential Health Insurance

    Options

    Analyzes potential health
    insurance options for the
    clients, recommending a health
    insurance option that best meet
    the clients’ needs, and supports
    recommendation with relevant
    client information

    Analyzes potential health
    insurance options for the
    clients, recommending a health
    insurance option to the clients,
    but analysis is cursory or
    contains inaccuracies, or
    recommended insurance option
    is not appropriate, or
    supporting client information is
    irrelevant or nonexistent

    Does not analyze potential
    health insurance options for the
    clients, recommending a health
    insurance option to the clients

    30

    Health, Disability, and
    Long-Term Care Insurance:

    Disability Insurance

    Discusses the ability of the
    clients’ disability insurance to
    meet their coverage needs,
    making recommendations
    where appropriate, and
    supports response with relevant
    client information

    Discusses the ability of the
    clients’ disability insurance to
    meet their coverage needs,
    making recommendations
    where appropriate, but
    response is cursory or illogical
    or contains inaccuracies, or
    supporting client information is
    irrelevant or nonexistent

    Does not discuss the ability of
    the clients’ disability insurance to
    meet their coverage needs,
    making recommendations where
    appropriate

    30

    Health, Disability, and
    Long-Term Care Insurance:
    Long-Term Care Insurance

    Analyzes the clients’ health
    information, determining at
    what age the clients should
    purchase long-term care
    insurance, and supports
    determination with relevant
    client information

    Analyzes the clients’ health
    information, determining at
    what age the clients should
    purchase long-term care
    insurance, but response is
    cursory or illogical or contains
    inaccuracies, or supporting
    client information is irrelevant
    or nonexistent

    Does not analyze the clients’
    health information, determining
    at what age the clients should
    purchase long-term care
    insurance

    30

    Articulation of Response Submission has no major errors
    related to citations, grammar,
    spelling, syntax, or organization

    Submission has major errors
    related to citations, grammar,
    spelling, syntax, or organization
    that negatively impact
    readability and articulation of
    main ideas

    Submission has critical errors
    related to citations, grammar,
    spelling, syntax, or organization
    that prevent understanding of
    ideas

    10

    Total 100%

    Part B Rubric
    Guidelines for Submission: Your draft should adhere to the following formatting requirements: 3–4 pages, double-spaced, using 12-point Times New Roman
    font, one-inch margins, and APA format.

    Critical Elements Proficient (100%) Needs Improvement (75%) Not Evident (0%) Value
    Social Security, Medicare,
    and Medicaid: Common
    Eligibility Requirements

    Summarizes common eligibility
    requirements for Social Security
    and explains how the clients can
    maximize their Social Security
    benefits

    Summarizes common eligibility
    requirements for Social Security
    and explains how the clients can
    maximize their Social Security
    benefits, but response is cursory
    or illogical or contains
    inaccuracies

    Does not summarize common
    eligibility requirements for Social
    Security and explain how the
    clients can maximize their Social
    Security benefits

    30

    Social Security, Medicare,
    and Medicaid: Medicare

    and Medicaid

    Differentiates between
    Medicare and Medicaid,
    explaining how and why the
    clients will or will not benefit
    from the programs, and
    supports explanation with
    relevant client information

    Differentiates between
    Medicare and Medicaid,
    explaining how and why the
    clients will or will not benefit
    from the programs, but
    response is cursory or illogical
    or contains inaccuracies, or
    supporting client information is
    irrelevant or nonexistent

    Does not differentiate between
    Medicare and Medicaid,
    explaining how and why the
    clients will or will not benefit
    from the programs

    30

    Social Security, Medicare,
    and Medicaid: Retirement

    Age

    Recommends a retirement age
    for each client that will allow
    them to take full advantage of
    all retirement benefits, and
    supports recommendation with
    relevant client information

    Recommends a retirement age
    for each client that will allow
    them to take advantage of
    retirement benefits, but
    recommendation is illogical or
    does not allow clients to take
    full advantage of all benefits, or
    supporting client information is
    irrelevant or nonexistent

    Does not recommend a
    retirement age for each client
    that will allow them to take
    advantage of retirement benefits

    30

    Articulation of Response Submission has no major errors
    related to citations, grammar,
    spelling, syntax, or organization

    Submission has major errors
    related to citations, grammar,
    spelling, syntax, or organization
    that negatively impact
    readability and articulation of
    main ideas

    Submission has critical errors
    related to citations, grammar,
    spelling, syntax, or organization
    that prevent understanding of
    ideas

    10
    Total 100%

      FIN 355 Milestone Two Guidelines and Rubric
      Part A Rubric
      Part B Rubric

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