Your Business Medical Insurance Options
There are a range of options for employers to choose from that can improve the cover of the policy and adjust the cost.
Level of cover
Choose the level of cover for your employees, including the level of outpatient treatment. While outpatient cover can add to the cost of your policy, it can be a valuable benefit as it can reduce the time it takes for employees to get a diagnosis for their medical issues.
To prevent the cost of your policy going up too much, you can limit the amount of outpatient cover. With limited cover, insurers will limit employees’ outpatient treatments to a set amount per year, often £1,000.
Six week NHS wait
This option will reduce your employees’ cover, but it will also have a significant impact on the cost of premiums. With this added to your policy, insurers will only pay out for a claim if the NHS wait time for the procedure is longer than six weeks. If it is shorter than six weeks, then employees use the NHS for treatment instead.
By adding an excess you can reduce the cost of the policy, an excess can range from £100 to £1,000. With this option, an amount will be set for employees to contribute either per year or per claim to cover a fraction of the cost of the treatment that they receive from the policy.
Number of employees covered
The number of employees that you enrol in your company health Insurance scheme will affect the cost of the policy and the options available to you.
Most insurers will ask for a minimum of at least 5 employees to qualify for group cover and MHD underwriting will only be available if you have more than 20 people on the scheme. You could introduce different ‘levels’ of cover, with more comprehensive cover reserved for those higher up in the business.
Small business health insurance tends to be more expensive than larger company private health insurance schemes as there are economies of scale in covering more individuals under a single group.
Additional Policy Options
Most insurers will have various optional benefits to add to your cover from dental and travel insurance to alternative therapies. These can all impact on your premiums and where the limits can vary with each insurer it is difficult to compare them like for like.
Psychiatric cover is one of the most coveted options in terms of a business private medical insurance policy, but it can also be the most expensive. With psychiatric cover, employees will be able to claim for a set amount of psychiatric treatments or therapy sessions per year.
This is a great optional benefit to consider. Mental health issues are one of the most common concerns for employers today and every year the UK loses £70 billion as a result of mental health issues.
Dental and optical cover
Most group policies will cover operations and emergency procedures, most policies have an additional option to add cover for routine dental and optical treatments as well.
With this cover, employees will be able to claim for a certain amount of dental/optical checkups per year and have some of their other costs covered, including the cost of eyewear or retainers.
Cover for family members
Some employers extend coverage to family members which can either be set-up to be paid for by the company or the employee. This cover can be beneficial as it may reduce the amount of time employees are absent while they are looking after ill family members.
What’s Not Covered by Business Health Insurance
Pre-existing Medical Conditions
Pre-existing conditions are not always covered under a company health insurance policy however this will largely depend on how your group policy is underwritten.
Depending on the options you choose for your policy, pre-existing acute conditions will either be completely excluded, temporarily excluded, or covered regardless.
Chronic conditions are not typically covered by any health insurance policy. Chronic medical conditions are health issues that are long-term and cannot be reversed by treatment.
Asthma and diabetes, for example, are chronic conditions for which treatment will not be covered by an insurance policy. However, most insurers will cover consultations leading up to the diagnosis or acute flare-ups of certain conditions.
If an employee has an episode of inflammation as a result of arthritis, your insurer may cover the treatment of the flareup.
In addition to chronic conditions, most insurers have their own standard exclusions that you will not be allowed to claim for. Some of the most common ones that you will come across include:
- Emergency care
- Kidney dialysis
- Fertility treatment
- Standard pregnancy and childbirth (may be covered for complications)
- Treatment or rehabilitation for alcoholism/substance abuse
- Cosmetic and plastic surgeries that are not medically necessary.