Essay on Evaluating Health Insurance Program: Taqueria Tsunami's Contribution Strategy

When evaluating an existing or new health insurance program, your organization's contribution strategy is a critical consideration. For instance, in the Taqueria Tsunami considers the amount of money their employees pitch in for insurance coverage and the percent of healthcare insurance paid by the restaurant. With the company-provided healthcare insurance, the Taqueria Tsunami contributes a minimum percentage of funds, and the employees settle the remaining amount. The payment is deducted from the employees' payroll. The average amount of money paid by the employees to cover for their healthcare insurance is 80 percent for family coverage and 76 percent for single coverage.

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Being a small business restaurant, Taqueria Tsunami grapples with the healthcare insurance contribution methods and tight budget. For this reason, the company utilizes alternative contributive strategies. For example, instead of purchasing company-provided healthcare insurance policies, the company offers a health reimbursement arrangement. It is an arrangement whereby the company provides allowances towards its employees' healthcare insurance premiums. These arrangements are beneficial because they help the company to set its contribution limit - an affordable alternative. Utilizing a compliant HRA, the company provides a tax-free health benefit without necessarily having to deal with participation requirements, costs, and the percentage associating with insurance provided by the company.

The Affordable Care Act and Patient Protection Act made it a mandatory requirement for insurers to spend 75% to 80% of their premium revenue on health insurance for their employees, and this is in alignment with the Taqueria Tsunami.

The most affordable insurance strategy at Taqueria Tsunami charges hourly employees about $15 a week, and this comes to $728.46 yearly. In return, the company receives $3,000 worth of annual insurance coverage. If an employee is injured in the workplace or come down with the flu, the company is eligible to cover them. However, the cost paid by the insuring company is and cannot be equal to the employees' premiums. If an employee is diagnosed with appendicitis or cancer, they cannot be insured.

The best insurance plan an employee can take costs $1,500 and with a capped benefit of $12,000. However, for the outpatient treatment (emergency room), the benefits stand at $14,000. Taqueria Tsunami also offers a limited-benefit plan - a premium that is an affordable alternative compared to expensive traditionally health insurance premiums, particularly costing as low as $50 to $140 a month. According to Taqueria Tsunami, 80 percent of its mini-med employees spend less than $4,000 in medical expenses annually. This means that 75 percent of the 20,000 participants are acceptable for a medical insurance policy. Across the United States, a healthcare applicant gets health insurance for $40 - $ 200 per month. By providing an individual reimbursement premium plan, Taqueria Tsunami allows its employees to buy real personal healthcare insurance on a pre-tax base. Additionally, the company offers its low-wage employees a choice for purchasing primary healthcare insurance, but only if they choose to. The company also saves up to 8.60% in FICA taxes on its employees' tax contributions to individual healthcare insurance.

Conclusion

In summing up, when evaluating the percent of healthcare insurance paid by Taqueria Tsunami, it can be seen that there is a difference between coverage for low-wage and high-wage employees. On average, the company contributes about 80 percent for family coverage and 70 percent for single coverage.