Ms. Mariam, 60-year-old woman, is looking for information on health insurance. She is a US citizen and Baltimore city resident but was originally from Guatemala. She taught high school Spanish for 30 years and also ran a cooking club for high school students. She retired from her position in July 1, 2019. She has been unemployed for the last 3 months. She has no pre-existing health conditions. Her prior salary was $52,000 and she received health insurance benefits. She made the decision to leave teaching because she was frustrated by the bureaucracy and ready to transition to part-time employment.

She currently has two employment options: 1) part-time nanny for three children or 2) teacher in a daycare center. Both positions are part time: 4 hours a day. As she has not reached the age of 62, she is not eligible for social security benefits. The nanny position pays $20/hr, which comes out to $400/week. She believes, if she accepts this position, she will have to choose and finance a health insurance plan from the Maryland Health Connection insurance plans.

The daycare position pays $12 hr, which comes out to $240/week. The daycare position offers group health insurance as benefit. It is BlueCross Blue Shield PPO. Her contribution would be $97.00 per month.

Please prepare a one-page report for Ms. Mariam recommending your advice on which position she should accept. Include calculations for annual income and health insurance expenses. You need to take into consideration both the monthly insurance premium as well as the annual deductible. Please provide calculated expense if she only requires a yearly physical and monthly visit if she develops hypertension soon after acquiring insurance vs if she develops breast cancer after enrolling in a new insurance plan. (FYI internal medicine clinic visit cost: $90, Breast cancer surgery cost $30,000 plus weekly clinic visits ($120) for 6 months). If she selects her own insurance though the exchange, she will need to select a plan.

Please provide three different plan recommendations with justifications.
In addition to the one-page report, create a spreadsheet that shows income, insurance plan name, and plan expenses (monthly plus annual deductible).