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Group Health Insurance
What is Group Health Insurance?
Whether for a small firm or a large corporate scheme it is a product which can really pay dividends ensuring you minimise the days of absence an employee may have waiting for treatment in turn minimising the cost of sick days per employee.
According to research by the CIPD in 2009, employee absence is a significant or very significant cost to 80% of businesses with the survey revealing that on average sickness costs employers £692 per employee every year.
Causes of Absence
The main causes of short-term absence are minor illnesses such as colds and flu, stress and musculoskeletal conditions. The main causes of long-term absence are acute medical conditions, stress and mental health conditions and musculoskeletal conditions and back pain.
The main causes of short-term absence are minor illnesses such as colds and flu, stress and musculoskeletal conditions. The main causes of long-term absence are acute medical conditions, stress and mental health conditions and musculoskeletal conditions and back pain.
Most insurers offer products that will cover inpatient treatment where you have to stay in hospital overnight or longer and day-patient treatment where you'll need to spend some time recovering, but not overnight. More comprehensive cover will also cover outpatient treatment including pre and post-treatment appointments relating to your condition.
Experts say that early intervention to treat both mental health and musculoskeletal conditions is key to maximising the likelihood of an individual's safe and speedy return to being fit for work. Group health cover ensures that employees suffering with acute medical conditions can be diagnosed and receive treatment as quickly as possible.
Level of Private Medical Insurance Cover
There are a variety of options to choose from when deciding upon the right health insurance plan for your organisation, generally speaking cover can be defined as either basic, mid-range or comprehensive.
A very basic plan will cover inpatient treatment only, as you increase the level of cover on a plan so the level of outpatient cover increases.
Where a basic plan will limit cover to inpatient treatment a mid range plan will provide a level of outpatient cover which will be restricted by a monetary cap often set at £1,000 pounds.
The most comprehensive group private medical insurance will cover both inpatient and outpatient treatment in full. In addition many other benefits are provided including a level of overseas cover, home nursing and some even cover GP services.
As with anything it is a case of you get what you pay for. The more comprehensive the cover the more likely a claim will be made and thus the more expensive the monthly premiums.
There are a range of personal and cover factors which affect the cost of the premiums which we will discuss in more detail below, it is important to understand the the various options available so you can ensure affordable group health insurance rates.
Personal Factors Affecting Group Premiums
Age
Age is one of a number of personal factors, which affect the premiums of your company's medical insurance policy. We are all too familiar with aging and the growing aches and pains we suffer. Thus it should come as no surprise that the older the average age of your workforce the more expensive your group medical plan premiums due to the increased likelihood of claims.
Age is one of a number of personal factors, which affect the premiums of your company's medical insurance policy. We are all too familiar with aging and the growing aches and pains we suffer. Thus it should come as no surprise that the older the average age of your workforce the more expensive your group medical plan premiums due to the increased likelihood of claims.
Gender
Statistics have shown that although the average life span of females is longer, females tend to suffer more illnesses throughout their life time.
Statistics have shown that although the average life span of females is longer, females tend to suffer more illnesses throughout their life time.
Due to these statistics some insurers still price male and females slightly differently, as such if you have a high ratio of female employees your premiums are likely to be higher than a company with a higher proportion of male employees.
Location
The location of your workforce can affect your premiums with some areas tending to have higher claims ratios then others which has naturally led to insurers inflating premiums on these locations.
The location of your workforce can affect your premiums with some areas tending to have higher claims ratios then others which has naturally led to insurers inflating premiums on these locations.
Group Scheme Policy Options
There are a number of factors which effect your schemes premiums which cannot be controlled, such as employee demographic. However we do have at our disposal a range of other plan options which we can alter keep the premiums in check.
Level of outpatient cover
Group medical insurance is designed around inpatient cover as your increase the level of outpatient cover so you increase the premiums.
Group medical insurance is designed around inpatient cover as your increase the level of outpatient cover so you increase the premiums.
Outpatient treatment includes consultations and diagnostic tests and thus tends to be the area, which results in most claims.
Excess
An excess is the option to have employees pay a set amount per year or per claim towards any treatment they may receive.
An excess is the option to have employees pay a set amount per year or per claim towards any treatment they may receive.
By including an excess and having the employees pay for a proportion of the treatment reduces the risk of them making futile claims and thus the insurers reward you with cheaper group insurance premiums.
Psychiatric treatment
Psychiatric cover is an additional option that can be chosen on most plans, it can provide both inpatient and outpatient treatment for many forms of mental illness and behavioral disorders often covering up to 45 days of treatment per policy year.
Psychiatric cover is an additional option that can be chosen on most plans, it can provide both inpatient and outpatient treatment for many forms of mental illness and behavioral disorders often covering up to 45 days of treatment per policy year.
Alternative medicines
An option which provides cover for alternative treatments, these treatments include acupuncture. homeopathy and osteopathy. Some individuals swear by these complementary medicines others do not give them the time of day so it is important to weigh up whether you feel the added cost is deserved of the cover.
An option which provides cover for alternative treatments, these treatments include acupuncture. homeopathy and osteopathy. Some individuals swear by these complementary medicines others do not give them the time of day so it is important to weigh up whether you feel the added cost is deserved of the cover.
Six week wait option
If the NHS waiting time is longer than six weeks, your employees can access private treatment straight away. Although this limits the cover provided large savings can be made on your monthly premium.
If the NHS waiting time is longer than six weeks, your employees can access private treatment straight away. Although this limits the cover provided large savings can be made on your monthly premium.
Underwriting
Full Medical Underwriting
Employees provide their full medical history on application and insurers may exclude cover for pre-existing conditions but will tell the employee what is excluded before the policy commences.
Employees provide their full medical history on application and insurers may exclude cover for pre-existing conditions but will tell the employee what is excluded before the policy commences.
Switch or Continuing Personal Medical Exclusions
If you are looking to review an existing scheme you can often move to a new insurer on "switch/CPME" terms. The insurance company will continue to cover conditions that arose for any of the employees covered since the existing plan commenced.
If you are looking to review an existing scheme you can often move to a new insurer on "switch/CPME" terms. The insurance company will continue to cover conditions that arose for any of the employees covered since the existing plan commenced.
Medical History Disregarded
Such a plan removes a lot of the administration as there is no need for employees to declare their medical history. An MHD plan tends to require at least 20 employees and is going to incur higher premiums due to the additional risk the insurer is accepting.
Such a plan removes a lot of the administration as there is no need for employees to declare their medical history. An MHD plan tends to require at least 20 employees and is going to incur higher premiums due to the additional risk the insurer is accepting.
Require More Information
Should you require further information or guidance on implementing a new group scheme or reviewing existing arrangements then please do not hesitate to get in touch, we are here to help. Some of the most commonly asked questions can be found in our questions and answers section, if you cannot find what you are looking for then ask the question yourself and we will do our best to answer.
