Private Healthcare Organization Employee Benefits

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Part I
Company Profile:

San Antonio Endovascular and Heart Institute is an advanced cardiovascular practice located in San Antonio, Texas which supports approximately 2450 cardiology patients and roughly 3000 peripheral vascular patients. The company is lead by a staff of 4 of the United States' leading cardiologists, 2 of which are advanced practitioners in interventional endovascular medicine, and as an organization boast multiple research publications, developed several innovative medical devices and hold 15 U.S. patents for various cardiovascular catheters and surgical techniques. The company currently has two locations to enable them to support the large geographic area of San Antonio and is planning a third location within the next 2 years.

The company has 4 primary focuses to their operation plan; the physician office focus, the diagnostic testing focus, the research focus and the interventional focus. Within the physician office focus, the Institute sees just fewer than 22000 patients per year. Patients are routinely referred to the institute by their primary physicians in order to provide a higher level of specialty care for some of their more advanced disease state patients. Since San Antonio has a large Hispanic population, cultural diseases such as diabetes and morbid obesity are on the rise and present challenges for the local physicians as to the proper medical disposition of these patients. San Antonio Endovascular and Heart Institute provides advanced care and treatment options for this patient demographic helping patients to manage their disease state and possibly reverse some of the damage already caused by it.

The diagnostic capabilities of San Antonio Endovascular and Heart Institute consist of state-of the-art nuclear cardiology testing, advanced echocardiography and ultrasonic vascular scanning as well as standard EKG and extended period cardiac monitoring known as Holter and Event Monitoring. The technologist's that perform these exams have all completed the requirements for national registration and are considered to be among the top technologists in their field. Both the Nuclear Cardiology and the Echo/Vascular labs are nationally accredited by the Intersocietal Commission for the Accreditation of Nuclear Medicine (ICANL) and the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) respectively displaying their commitment to superior quality and outcomes.

The research focus is driven by the physician's drive to advance the science of cardiovascular and endovascular medicine. The institute has participated in over 50 of the nation's premier research studies in the field of cardiology and to date, 25 endovascular research protocols have been completed by the institute, with another 7 still in enrolling new patients. Each study is followed by an in depth report submitted for publication to all the major medical journals of which 63 have been accepted and included in the curriculum of the annual gathering of endovascular physicians in Washington, D.C, known as the Transcatheter Cardiovascular Therapeutics Conference (TCT).

The final focus, intervention, is the company's most influential focus. This part of the business is what drives the success of the company. Outcomes of the San Antonio Endovascular and Heart Institute cardiovascular lab are in the 98th percentile nation-wide. This means that only 2% of all facilities performing interventional cardiac and endovascular care have a higher rating. This is significant because the 2 % that have higher ratings are healthcare systems such as Mayo, Cedar-Sinai, and M.D. Anderson. Comparatively speaking, this is a David and Goliath story of epic proportions. San Antonio Endovascular and Heart Institute provides care on a level just below the largest healthcare systems in the world and does so with only 24 employees. They have developed a system not frequently seen in the U.S. but is popular in the American Heart branch hospitals located in Poland. The system is driven by efficiency and quality of service from the initial scheduling of a patient right down to the final discharge 4 hours after the intervention has been performed.

Company Benefits Plan:

Although San Antonio Endovascular and Heart Institute has been an established healthcare organization since November 2003, the employee benefit plan has not grown at the rate the rest of the business has. Initially, the firm offered no benefits of any kind. This was due to revenue being pushed back into the company to facilitate growth and equipment purchases. In 2005, the first benefits were offered to the employees. It was a healthcare plan offered by Blue Cross / Blue Shield of Texas and was a basic 80/20 plan with a $20.00 co-pay requirement and a $1000.00 deductible. Although this was the only benefit offered, the company paid 100% of the premiums to offset the employee's obligation.

The second benefit offered came in the form of a 401K plan through American Funds. This plan was offered to all employees with a maximum contribution rate of $15000 or up to 50% of an employee's salary and an employer match of funds as follows:

First 3% - 100% matched at 3%
Next 1% - increased the employer match to 3.5%
Next 1% employee contribution - increased the employer match to 4 %

Employees could place 15% of their annual salary into the plan but 4% was the maximum employer match they would receive.

That is the complete summary of the current benefits plan for San Antonio Endovascular and Heart Institute. As the company grew from a single physician, $2.1 million revenue per year entity to the $53 million revenue per year entity it is today, a more comprehensive employee benefit plan needs to be defined and implemented. There are several more options available to San Antonio Endovascular and Heart Institute employees that the once financially struggling company can now afford to offer their employees such as dental care, vision care, short and long term disability, life insurance, accidental death and dismemberment insurance, dependent care and legal assistance. The following sections will discuss some of the options in an effort to design a comprehensive employee benefits plan for today's San Antonio Endovascular and Heart Institute.

Part II
Statement of Issue
As stated in the text above, San Antonio Endovascular and Heart Institute began its original operations without offering any form of employee benefits. As time passed and the necessary resources were made available, a modest offering was put in place and funded by the company. It originally consisted of a standard 80/20 medical plan with a $1000/individual deductible and $20 co-pay. This was followed by an employee 401K plan which initially required at least 75% employee participation and offered a maximum 4% employer match to a 5% employee contribution and a maximum limit of $15000 or 50% of an employee's salary.

This plan was sufficient when the company originally began operation and only employed 9, hard-working and dedicated individuals. At that time, the company barely made a profit due to its high overhead and loan repayment schedule, however; now the company generates over $53 million per year in revenues and is basically debt free. The company has ...