The Teachers Service Commission

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Table of Contents

History and Organizational Background
Organizational Goals
Plan Specifications
Claim Administration
References

The Teachers Service Commission (TSC) is seeking proposals from insurance companies that have the acumen to offer dental insurance coverage. The organization wishes to insure three thousand employees. This is mainly geared towards enhancing a greater productivity from the employees and also creating an incentive among them. It will also ensure massive health improvement that will, in turn, sensitize the community on the importance of proper pursuit of dental health. This has been a danger to humanity. It will also encourage the spirit of giving back to the community we serve.

History and Organizational Background

Teachers’ Service Commission is an organization with a large number of homogenous exposure units that comprises of preparatory, primary and secondary school teachers. The total number of teachers is fifteen thousand six hundred and thirty four. In the year two thousand and nine, the organization insured twelve thousand and ninety teachers from the primary and secondary school level. In this plan, we intend to insure three thousand. The three thousand constitute of the teacher in the preparatory level who had not registered with the organization by the year two thousand and nine.

Organizational Goals

The Teacher Service Commission as a pure replica of any other organization has noteworthy goals. The policy is a crucial undertaking of the organization and hence must be consistent with the organizational goals. This will ensure that we are focused and in line with the objectives. We protect and respect the mutual goals we have set.

The organization has an objective of inculcating the welfare of all its employees in a bid to motivate them and at the same time extend their opportunities to the communities it serves. It has also worked at collective responsibility in reduction of poverty by sharing economic burdens with the state. Since such health burdens befall the government they opt to take up apart of the risk. The organization also aims at creating an idealized influence to the community at a personal level towards fighting indifference to poor health and ignorance among the community members. It also works towards supporting inter-organizational relations by working closely with them, a factor that has been presented satisfactorily in this phenomenon. Lastly is to acknowledge the organization’s willingness to commit itself to something bigger than itself by giving back to the community of which the employees are a part.

Plan Specifications

TSC wants to cover the remaining number of teachers who have not had a chance for insuring. The coverage is for all employees working on a full time schedule and those who qualify to be depending on them. It is impossible to cancel enrollments that have already been made except in instances with changes in the status of the family. We intend to involve the employees to participate on either the HMO plan or the PPO plans according to their wishes (Dorsey, 1975).

Employees will receive diagnostic and preventive services, which will include the use of fluorides to strengthen their teeth, cleaning of teeth by specialists, oral check ups conducted on often basis. The employees will also receive tooth replacements, oral surgery, periodontal, general anesthesia and endodontic (Kongstvedt, 2001). These services will be available to the employee every time s/he requires. It is also vital to mention that minimal insurance restrictions are preferred because the dental problems require readily available services.

Claim Administration

When a covered employee is befallen by an unfavorable event that might cause dental disease or injuries, they should make a claim in pursuit of a payment for the loss incurred. In this case, a TSC employee should submit a standard legal form for the payment of a claim to the Benefit Office. According to the rules of the organization this should take place within ninety days to the payment date. These forms can also be taken from the personnel office in the headquarters. The compensation is done in reference to the date of submissions. Within these ninety days, some critical evaluation procedures are undertaken to determine whether or not to pay for the claims. The proof of payment by the company must be attached in the claim form. The payments are acceptable when they are in the form of a paid receipt, charge card receipt or a cancelled check. The dentist must have signed to show that the employee suffers a dental problem which needs compensation. For the case of dental injuries, the injury must have resulted from the employer’s workplace. If any of the above requirements has not been met, then the form must be returned to the employee for corrections. When the corrections are made, it is resubmitted to the claim office.

If the forms have the above stated requirements, the information should be evaluated, and the procedures carried out within two weeks time. After this, the compensation should be done through direct bank deposit for all employees who receive direct bank deposit and checks for all employees who receive payment through the checks. It is necessary to note that the insurance coverage will be geared towards returning the employee to their workplace healthy as they were before the loss, and should not make any profit from the existence of the policy.

References

Dorsey, J. (1975). The Health Maintenance Organisation Act of 1973 and Prepaid Ground Practice Plan. Cambridge, UK: Cambridge University Press.

Kongstvedt, P. (2001). The Managed Health Care Handbook. Tomorrow’s Teachers, CA: McCutchen Publishing Corporation.

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The Teachers Service Commission

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