Purchasing Health Insurance for your Organization that has Fifty Full-time Employees

The provision of insurance by an organization is one of the best ways of attracting and retaining top talent. Although the provision of insurance has become more than a necessity for many organizations, it is important that an organization finds the best insurance policies that meet their budgets. In addition, there is need for the organization to put into consideration the requirements of the law as provided for in the Affordable Care Act (ACA). The Affordable Care Act requires that all organizations with at least fifty full-time employees must provide insurance cover (Mason, 2015, pp. 186). Also, the insurance cover must provide full coverage to the employees’ children who are aged 26 and less, though it is not a must that it covers the spouses of the employees.

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The Affordable Care Act has provided a marketplace or exchanges, where individuals and organizations can purchase insurance plans that meet the requirements of the law. Presently, there are a number of insurance in the market place that the payers can choose to purchase. In regards with my organization, the plan that I would use to purchase health insurance for my organization employees is the Health Maintenance Organizations (HMOs). According to (Riegelman, 2010) the HMOs is an employment-based insurance plan that charges the patients a monthly fee for coverage of a comprehensive package of services. This insurance plan is suitable for a small organization similar to the one under the study, whose employees numbers at least 50. The use of HMOs can help to meet the organization financial costs, employee lifestyle choices as well as helping in meeting the goals of the Affordable Care Act.

The choice of HMOs plan would support the employee financial capabilities, their health care preferences and lead to a reduction in healthcare costs. The HMO plan has been touted as supporting preventive services and thus serves better in keeping people healthy. According to (Riegelman, 2010) the HMOs charges patients a monthly fee that is designed to cover a comprehensive number of services. The HMOs plan shifts the utilization risks to from the payer to the provider (Roussel, Swansburg & Swansburg, 2006). In addition, owing to market competitions, the consumers are drawn to less costly services when they have only one choice of plan. Since the plan also lays major focus on preventive services, it helps in reducing the number of hospital admissions, thus leading to a reduction in the insurance costs by 10-40% (pp. 297).

Moreover, HMOs offers the flexibility that can match employee lifestyle choices and the costs of their healthcare needs. The insurance plan allows the employees to enjoy the opportunity of choosing their primary care physicians. In case an employee feels the scope of coverage under the HMOs does not meet their needs, they can decide to increase the levels of coverage out of their own pockets. The HMOs possess lower healthcare costs compared to other insurance plans in the market, making them affordable to the organization. According to (Riegelman, 2010), the HMO classic charges just $50 and $300 for a family, with no yearly deductibles. This rate is affordable for any employee, more so if the organization decides to subsidize on the monthly insurance subscriptions.

            The Affordable Care Act (ACA) outlines healthcare reforms that are geared towards achieving a number of goals. According to (Vu, White, Kelley, Hopper & Liu, 2016) the ACA have the triple goals of improving the health of the population, the patient quality of care and satisfaction and a reduction in healthcare costs. These goals have had the implication on the choice of HMOs as the best insurance option for the organization, since the HMOs is geared towards improving the health of employees by providing a number of services at affordable costs. In addition, the HMOs offer services in preventive care, which aims at maintaining the health of the population and at the same time reducing costs related to patients’ admissions.

            The idea to purchase insurance cover for the employees by an organization rather than through government provision offers some benefits and disadvantages. One of the advantages of purchasing insurance cover for employees is that it acts as strategy for attracting and retaining employees. When an organization pays all or subsidizes the insurance plans for its employees, it is able to retain present and attract more employees as employees feel their healthcare needs are taken care by the organization. More importantly, when the chosen insurance plan offers flexibility such as that of HMOs, employees have freedom of enjoying diverse services (Mason, 2015). This improves their satisfaction and desire to work for the organization in the long-term.

            The other advantage of purchasing insurance plans for organization employees is the economic benefits it brings to the employees. An organization can buy insurance cover for its employees and thus enabling them to enjoy healthcare services of their providers without making any extra payments. This can lead to increased satisfaction and reduced employee turnover. This is particularly true for less mobile employees, for example, mothers with children would prefer to work for employers who provide benefits.            

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Although the purchase of insurance cover for organization employees offers some advantages, it has its own demerits. Providing employee benefits like insurance plans can be expensive for small organizations, who have to incur higher administration and pay for higher prices owing to small purchasing power. In addition, providing insurance plans to employees exposes the organization to risks such as legal suits in case of mistakes and possible concerns regarding legal compliance.

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