Business Health Insurance
Protecting your company's most important asset...
What does Company
Private Health Insurance pays for healthcare treatment in private medical facilities. The scope of the cover provided varies considerably depending on the options you select.
Most plans will cover inpatient treatment in full which means that your employees would be covered for treatment, testing and consultations where a hospital bed is required either overnight or just for the day.
In order to be covered for initial consultations and diagnostic testing where a hospital bed is not required then some level of outpatient cover will need to be selected. This is recommended to avoid NHS outpatient waiting lists.
How does Business Medical Insurance work?
The level of cover and type of treatment required will determine the exact process but the main variation depends on whether the policy includes outpatient cover.
No Outpatient Cover
With Outpatient Cover
Naturally, holding a policy with no outpatient cover does run the risk of an employee having to go through the NHS outpatient waiting list for testing and initial consultations.
Although the level of outpatient cover makes a sizable difference to the premiums it does ensure that the initial consultations and testing can be done privately.
Tip: It is very common for organisations to include at least some level of outpatient cover as it allows the speediest access to diagnosis and treatment.
It is common for plans to cover therapies up to the outpatient limit with GP referred therapies being an additional option with some providers.
Tip: Some organisations place an excess on the policy (such as £100) which the employee would have to pay themselves to discourage frivolous claims.
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The Fact Find:
Are you a looking to implement a company health insurance plan for your employess? There is always so much to consider whether it is setting up a scheme for the first time or reviewing an existing business health insurance plan.
This guide lays out some of the key points to consider such as the cost, who you wish to cover and how much cover you wish to provide.
First and foremost you should have a budget in mind, with a budget set you can get an idea of the level of health cover that is available.
Whether it is a basic business health plan covering treatment where a stay in hospital is required or a more comprehensive company plan which in addition covers outpatient treatment such as diagnostic tests and consultations.
Basic health cover
A basic private medical plan will provide employees with cover to receive treatment privately should they need a stay in hospital either as an inpatient or daypatient. With such cover any outpatient treatment such as diagnostic tests and consultations where a stay in hospital is not required would still have to take place via the NHS.
Mid range medical cover like a basic plan will provide cover for inpatient treatment in full, in addition the company health plan will provide a level of outpatient treatment for diagnostic tests and consultations.
The level of outpatient treatment often has a monetary cap of around £1,000 per policy year.
A comprehensive medical scheme will provide employees with both full inpatient and full outpatient cover, there is no monetary cap set on the outpatient treatment.
In addition comprehensive health cover often has a level of cover for alternative medicines such as osteopathy and a level of both inpatient and outpatient psychiatric treatment.
Other variable to consider can also depend on the size of the scheme you wish to set-up including how the business health insurance plan is priced and medically underwritten.
There are three ways in which a company health insurance scheme can be underwritten depending on the number of employees on the plan.
Full Medical Underwiting (FMU)
A business medical insurance plan which is fully medically underwritten means each and every member of the scheme will have to declare their medical history.
As a new employee/group member joins the scheme they will have to fill out an application form which includes a section to provide details of any medical conditions, these conditions will then be excluded from the cover. These option is available on all sizes of scheme given the nature of the underwriting.
The option removes some of the administration encountered with a fully medically underwritten scheme. Moratorium underwriting simply means that a condition will be excluded from the policy coverage should you have suffered from the condition in the past 5 years.
The moratorium underwriting allows for pre-existing conditions to be covered should you have not suffered from the condition during your first two years on the business health plan. Again similar to FMU schemes this option is available no matter how many individuals are on the plan.
Medical History Disregarded
The final option is only available for larger groups, often there has to be a minimum of at least 20 scheme members.
As this option states any medical history is disregarded and all individuals are covered on the plan for existing acute conditions.
An excess is the proportion of a claim that has to be met by the insured. Should an employee need to claim on the policy they would need to pay the excess towards the treatment. An excess can often range from as little as £50 up to £500.
The higher the excess the greater the discount on the premiums as the greater a proportion of the cost lies with the insured party.
Often treated as an additional extra on a business health insurance policy the alternative medicines option covers treatment such as physiotherapy, osteopathy and homeopathy.
The level of treatment is often capped at a monetary limit of say £1,000 per policy year and will often add 5-10% to the business health insurance premiums.
Psychiatric cover is sometimes provided on as a standard by the insurer but in many cases it is an option that must be selected. This option covers both inpatient and outpatient therapies such as Cognitive Behavioural Therapy. Selecting this option will again add roughly an additional 7% to the cost of the cover.
This guide will give you a brief overview of the type of decisions you will need to make when considering a business medical insurance plan.
In addition you will need to consider the type of plan that best fits your employees, some health policies now offer a more proactive approach towards the members health by rewarding them for healthy living and exercise. Other plans are suited for organisations with an older workforce.
Whatever you choose we are here to help, whether it is advising you on the most suitable product or the ongoing administration we are here to make your group insurance policies simple and affordable.
10/01/2015 N Tanner
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