Group plans and expense coverage

Group plans and expense coverage

Bachelor of Business Studies (BBS) — Fourth Year

Subject: Insurance and Risk Management (FIN 254)

Unit 5: Health Insurance

Academic Year: 2083/84

Topic Objectives

After studying this topic, students should be able to:

• Explain the scope and key elements of group plans and expense coverage.
• Apply the relevant financial concepts or calculations and explain their assumptions, risks and analytical limits.

Curriculum Scope

• Group medical expense insurance
• Traditional indemnity plans
• Managed care plans
• Consumer-driven health plan
• Expense insurance, Group medical expense contractual provisions

Detailed Microsyllabus

1. Group medical plans

   1. Group expense insurance.
   2. Traditional indemnity and managed-care approaches.
   3. Consumer-driven plans.

2. Contractual provisions

   1. Expense coverage and conditions.
   2. Compare source-prescribed forms by jurisdiction.
   3. Avoid assuming every international plan is available in Nepal.

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Curriculum reference: Tribhuvan University, Faculty of Management, revised four-year BBS curriculum, PDF pages 92–96.

Source note: The curriculum scope above is retained from the existing TU syllabus breakdown. The numbered study subtopics are editorial elaborations for teaching and study, rather than a separately issued TU syllabus. Unit or component allocations apply at their stated level; no separate topic hours or marks are assigned here. Examples involving current laws, rates, institutional products or Nepalese status must identify the relevant period and official materials; no changing numerical or legal requirements are invented here.