State and explain the three specific ethical finance issuesregarding this situation Trigon Blue Cross/Blue Shield (Copayments)When most people are told they owe a coinsurance payment on amedical bill, they simply grimace and write a check; not GeraldHaeckel, a retiree from Richmond, Virginia. He wanted proof that hewas not paying more than the 20 percent portion that his healthinsurance policy required. When his insurer, Trigon Blue Cross/BlueShield, balked, the retiree besieged state and federal officialswith demands for an investigation. Gerald’s problem with theinsurer-provider negotiated discounts began when he became confusedby a bill sent by Trigon Blue Cross/Blue Shield. The bill was forGerald’s wife’s lumpectomy, which is an outpatient surgery toremove a tiny breast tumor. Trigon’s benefits- explanation formstated that the surgery had cost $950, that Trigon paid 80 percent,or $760, and that Gerald owed a 20 percent copayment of $190. Butthen Gerald received a list of charges from the surgery centerindicating that Trigon’s share of the bill had been more thanhalved to $374 because of a “contractual adjustment.” Geraldassumed that a mistake was made in the surgery center’s statementbecause if it were correct his $190 copayment would exceed a thirdof actual cost, instead of the 20 percent called for in hisinsurance policy. Ultimately, Gerald’s scrutiny of the $950 surgerybill led to a surprising discovery. Although insurance companiesfrequently complain about being duped by fraudulent policyholdersand providers, Trigon and dozens of other health insurers andmanaged care companies stand accused of a scheme to siphon offmillions of dollars from their policyholders. How does the allegedscheme work? For surgery priced at $1,000, the typical plan mightcall for the insurer to pay 80 percent, or $800, which leaves thepatient with a $200 copayment. But if the insurer has negotiated a50 percent discount from the provider and does not pass any of italong to its policyholders, the patient’s $200 copayment becomes 40percent of the $500 actual bill, and the insurer’s portion drops toonly $300. Trigon’s responses to Gerald’s queries stirred up morequestions than they answered. Norwood H. Davis, Trigon’s CEO,assured Gerald that he did indeed owe the $190, and added that thedetails of any Trigon’s provider discounts were “proprietary.” Inanother letter, Norwood made a distinction between Trigon actuallypaying its $760 share of the bill and “discharging” it. Norwoodadded that although Trigon might try to persuade a provider toaccept less than its $760 portion of the bill, a policyholder, suchas Gerald, was free to try to persuade the provider to acceptsomething less than the required $190 copayment. Gerald, who bythat point was incensed, replied “suggesting that an individualpolicyholder negotiate with a provider for price concessionsborders on the insulting!” and he threatened to take the matter upwith state regulators. At a time when consumers are expected totake more responsibility for their own healthcare, undiscloseddiscounts raise questions about the accuracy and honesty ofinformation provided by the insurers and employers. Indeed,providers often are contractually prohibited from disclosingdiscounts. The insurance industry argues that hiding discounts isnot widespread. The Chicago-based Blue Cross/Shield Associationnotes that no court has ruled for plaintiffs in a discounts-relatedcase. It adds that none of its affiliates that settled such casesadmitted to wrongdoing. Furthermore, Blue Cross/Shield executivesargue that the discounts benefit policyholders by reducingpremiums. In some situations, they add, employers who share in thesavings ask that discounts not be disclosed to their own employees.“We’re not lining our pockets with anything because there isnothing to line our pockets with,” said Joel Gimpel, a BlueCross/Shield Association attorney.