Flexible cover to suit your business
You can choose other Cover Options for your plan. This means you can create a plan to suit your employees and your budget. All benefits are per insured member, per plan year, unless stated otherwise. Treatment must take place at a hospital eligible under your plan.
Cover OptionsYou can tailor your plan to suit your employees' lifestyles by selecting the level of cover you need.
Out-patient Cover pays for costs such as consultant appointments and physiotherapy, and diagnostic tests like MRI scans, blood tests and x-rays
The costs we cover depend on what you add to your plan:
- Out-patient cover with a limit. We can pay for diagnostic tests, consultant appointments and out-of-network physiotherapy up to a set limit.
A limit of £500, £750, £1,000, £1,250 or £1,500 can be chosen.
- Full Out-patient Cover. We pay for all the out-patient treatment, consultant fees and diagnostic tests needed.
We pay for these scans, as long as your employees have been referred by a consultant.
MRI, CT and PET scans will be paid in full, and not treated as part of the employees' Out-patient Cover limit.
Cover for a physiotherapist within our network
Treatment will be covered in full, and will not form part of the Out-patient Cover limit.
Cover for a physiotherapist outside of our network
Treatment will continue to be deducted from your employees Out-patient Cover limit and will be limited to £35 per session.
Out-patient diagnostics will be covered in full. Consultant appointments and out-of-network physiotherapy will continue to be covered up to the limit you’ve chosen for your employees.
Optical, Dental and Hearing Cover
- Eye tests, new prescription glasses or contact lenses – We’ll cover 100% of the bill, up to £500 each plan year when your employee uses Vision Express. If your employee chooses another provider, they can claim back 80% of the bill, up to £300 each plan year
- Routine dental appointments – We’ll cover 100% of the bill, up to £100 each plan year
- Dental treatment – Such as fillings, crowns, or implants. We’ll cover 80% of the costs, up to £400 each plan year
- Dental accidents – If your employee has an accident and needs treatment for broken or damaged teeth, we’ll cover 100% of the bill, up to £2,500 per claim. We'll pay for up to two claims each plan year
- Hearing tests and new or replacement hearing aids – We’ll cover 80% of the bill, up to £300 each plan year. They can claim back for the cost of a replacement hearing aid every five years. But they can claim in any plan year if their audiologist recommends a different type of hearing aid.
Mental Health Cover
We pay for up to 28 days of in-patient or day-patient treatment, and up to £1,500 for out-patient consultations (e.g. with a psychologist). Talking Therapy arranged through our network is covered in full, and won’t be deducted from your out-patient limit. All in-patient mental health claims are managed by our team of experienced case managers.
28 days in-patient or day-patient treatment
A separate £1,500 out-patient treatment limit
Full cover for in-network Talking Therapies
Emergency Overseas Cover
Whether your employees are on holiday or on a business trip, our Emergency Overseas Cover means they’ll get emergency medical treatment if they need it.
|For trips planned to last up to 120 days||Amount|
|Medical cover if taken ill overseas, including accommodation costs and travel expenses for one person to remain behind with the sick or injured member*
Repatriation or evacuation expenses* and transfer of body or ashes back to the UK
|Up to £10million|
|Cost of burial or cremation outside the UK||Up to £2,500|
Worldwide Travel Cover
|Overseas medical expenses|
Medical cover if taken ill overseas, including accommodation costs and travel expenses for one person to remain behind with the sick or injured member*
Transfer of body or ashes back to the UK
Up to £10 million
|Cost of burial or cremation outside the UK||Up to £2,500|
|Other travel expenses|
|Loss or damage to personal belongings*||Up to £3,000|
|Loss of personal money*||Up to £1,000|
|Loss of or damage to business machines*||Up to £1,000|
|Delayed departure||Up to £250|
|Missed departure*||Up to £1,000|
|Cancelling the trip or cutting it short*||Up to £10,000|
|Personal accident||Up to £50,000|
|Personal liability||Up to £2 million|
|Loss of passport*||Up to £250|
|Delayed baggage*||Up to £600|
|Legal expenses||Up to £25,000|
|Replacement employee travelling costs*||Up to £1,000|
|Travel vaccinations and medication||Up to £100 per plan year in total|
|Winter Sports Cover (cover is limited to 21 days in total each plan year)|
|Loss or damage to ski or snowboarding equipment*||Up to £500 per plan year|
|Loss of ski pass*||Up to £500 per plan year|
|Piste closure(£30 a day)*||Up to £500 per plan year|
|Loss of use of hired skis and ski pass due to illness or injury*||Up to £500 per plan year|
Unless we state otherwise, the benefits are for each insured member on your plan, per trip. Separate terms, conditions and exclusions apply to our Worldwide Travel Cover – please speak to your adviser to find out more.
Employee Assistance Programme
At some point, everyone faces emotional problems such as relationship or money worries, stress, and bereavement. If your employees have problems like these and are finding it hard to cope, an Employee Assistance Programme can help.
With the programme, your employees get:
- Debt counselling, legal and financial advice through our 24-hour helpline
- Up to six confidential, face-to-face counselling sessions per year
Our Employee Assistance Programme is provided by Health Assured.Unlimited access to a confidential telephone advice service, 24 hours a day, 365 days a year
Additional BenefitsChoose whether you want to give your employees a Personal Health Fund or add dental or travel cover
Personal Health Fund (PHF)
|Optical Treatment||Includes fees for sight tests, fitting, spectacle repairs, prescription swimming or diving goggles. They can also claim for glasses, lenses, spectacle frames, contact lenses, and prescription sunglasses.|
|Dentistry Claims||Check ups and treatment at a UK dentist, including fillings, crowns and bridges, plus hygienist fees.|
|Health Screens||They can claim back the costs of a health screen with our screening partner.|
|Chronic Prescriptions||If they have a chronic condition, they can use their PHF to cover the cost of a prescription prepayment certificate (PPC), which will cover the cost of NHS prescriptions for 3 or 12 months. This is the only healthcare expense they need us to authorise for payment from the PHF beforehand.|
|Private GP appointments||They can use their PHF to pay for a face-to-face appointment with a private GP.|
|Medical aids and devices||Your employees will be able to claim back 50% of the costs of a range of medical aids and devices including hearing aids, blood pressure monitors and TENS machines.|
|£100 towards a fitness device||They can use £100 of their fund to pay for a device which can be used to record Vitality points. Maximum of one claim of up to £100 per adult every three plan years. This excludes Apple Watch and smartphones.|
|Vitality status||Personal Health Fund|
|Start off at Bronze||£75|
|Reach Silver||Add £50|
|Reach Gold||Add another £50|
|Reach Platinum||Add another £50|
(Any unused balance will be rolled over to the following plan year. A maximum Personal Health Fund balance of £1,000 per adult member will apply)
Control PremiumsPremiums can be reduced with a range of excess levels and a choice of where your employees are treated.
Choose where your employees can get treatment
We offer your employees access to the best possible medical care and when they need treatment we ensure it’s at a hospital which offers clean and comfortable surroundings. There are two options as to where they may be treated and you can choose which options suit you and your employees best.
If you choose Consultant Select you will be offered a choice of high quality consultants to treat your condition at a private hospital in your area. Or you can choose which hospitals your employees can use from our Hospital Lists:
- London Care.
The higher contribution your employees pay, the lower we can make your premiums. You can choose this maximum contribution to be £0, £100, £250, £500 or £1,000
Once you’ve chosen an excess, you choose whether your employees pay once per plan year or each time they make a claim.
Vitality status-linked excess
For Business Healthcare plans with five or more employees you can link your employees' excess to their Vitality status. As they improve their Vitality status, we reduce the amount of excess they need to pay without changing your premiums.
The excess levels do not apply when making claims for NHS Hospital Cash Benefit, Childbirth Cash Benefit, Weight loss and Corrective Surgeries or costs relating to Vitality GP.
This excess would also not be applied to claims made under the Optical, Dental and Hearing Cover option, and also the Worldwide Travel Cover and Emergency Overseas Cover options, where a different excess or co-payment may apply.
When we’re working out whether we can cover your employees, what we can cover them for and how much their cover will cost, we go through a process called underwriting.
There are four different kinds of underwriting that you can choose from. Which one’s right for your business depends on whether you’ve already got a company plan with someone else, how much information you want us to ask your employees for, and how large your business is.
- Full Medical Underwriting
If you’re happy for us to ask your employees about their medical history, you can choose Full Medical Underwriting. We might need to exclude some pre-existing conditions from their cover, but we always tell them upfront exactly what they’re covered for.
- Moratorium Underwriting
If you don’t want us to ask your employees’ medical history, we tell them whether they’re covered at the time they make the claim. Your employees won't initially be covered for any condition that they have had within the five years prior to the start of their cover.
- Continued Personal Medical Exclusions Underwriting
If you’ve already got a company health insurance plan with another provider, you could choose Continued Personal Medical Exclusions Underwriting which means we will apply the same personal medical exclusions as your current insurer.
- Medical History Disregarded Underwriting
If you’ve already got a company health insurance plan with another provider and all members are currently insured on a Medical History Disregarded basis, or your company is currently uninsured but you wish to ensure 20 or more employees, you could choose Medical History Disregarded Underwriting.
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