Over the past ten years, Simplyhealth has been on a path of growth and diversification. By joining with companies that share common values, it has been building a strong organisation for the future.

The Denplan business will find a strong and strategic home within Simplyhealth, because both businesses share a strong focus on customer service. This is based on a fundamental belief in helping people access high quality healthcare and a culture and ethos that promotes staff engagement.

Simplyhealth's Intentions

As a self reliant business, Denplan will work alongside the Simplyhealth business and has no plans to integrate it unless over time is able to establish better or more efficient working practices. The Denplan brand is trusted and respected in the dental market for its continued drive to delivering top class services to dentists and their patients.

Axa will continue to underwrite the insurance elements of the Denplan products for a transitional period but this insurance business formed part of the acquisition and will ultimately be underwritten by Simplyhealth.

One of the major differences with this plan is that it covers a PMI excess payment of £200 on the Level 1 option (£1 per week) and will pay the provider direct. So clients who have PMI cover and are looking to reduce the premiums by including an excess now have the facility to claim the cost of the excess back from Medicash.

The main features are:

• 100% receipt claims
• Immediate cover on all benefits
• All pre-existing conditions covered
• ALL PMI excesses paid direct to the provider
• Children covered at adult rates for PMI benefit
• Children are covered FREE up to the age of 24 if in full time education
• No GP referral on any of the therapies
• Best Doctors service included - unique to Medicash
• Full personal accident cover included

£1 per week, £52 per year will buy your staff the following benefits

Therapies - £150

Alternative therapies - £75

Chiropody - £20

Health screening - £100

Prescriptions & inoculations - £20

Routine Dental Care - private £55 NHS £55

Dental accident & injury - £200

Optical - £55

Personal accident cover - £5,000

For further information please contact us on 01384-456-345 or email sales@healthwisegroup.co.uk

I am writing to update you on our discussions with BMI about treating Bupa members from 1 January 2012.
At the end of last year, we decided to remove 37 BMI hospitals from our recognised hospital lists from 1 January 2012 because our contract with BMI was due to expire and we had been unable to arrive at a mutually agreeable arrangement for treating Bupa members from that date.

I am pleased to let you know that we have now reached an agreement with BMI which is in the long term interest of Bupa members. We have agreed a number of improvements to the way Bupa and BMI will work together in the future which we believe will improve the quality, effectiveness and efficiency of care delivered to Bupa members.

As a result of this agreement, with immediate effect the vast majority of BMI hospitals are now included on Bupa's recognised hospital lists (Extended Choice, Partnership and Participating Hospital Networks). BMI Gisburne Park Hospital, BMI Lancaster Hospital and BMI Castle Consulting Suite, remain out of network.

We have now reinstated pre-authorisation with immediate effect for new in-patient, day-case and out-patient treatment for our members at the 34 BMI hospitals which are recognised once again.

We regret any inconvenience that members and consultants have experienced in recent weeks. Throughout the negotiations, including the out-of-contract period, both organisations remained fully committed to maintaining continuity of patient care.

We believe that the new arrangements provide a good basis to address the affordability of private healthcare while maintaining current standards of high quality care for Bupa members.

Apparently BUPA have been in discussion with BMI for some time about the arrangements for Bupa members however from 1 January 2012 they have decided to remove 12 hospitals/facilities from its recognised hospital lists as they do not believe they represent good value for its members. These are:

• BMI Castle Consulting Centre
• BMI Coombe Wing
• BMI Edgbaston Hospital
• BMI Foscote Hospital
• BMI Gisburne Park Hospital
• BMI Lancaster Hospital
• BMI Meriden Hospital
• BMI Oxford Clinic
• BMI Runnymede Hospital
• BMI Sefton Hospital
• BMI Syon Clinic

There are three exceptions where BUPA will continue to fund treatment at these 12 hospitals/facilities after 1 January 2012:

1. cataract operations and related out-patient consultations, as its cataract network agreement remains in place with BMI until 15 April 2012
2. MRI scans, as its MRI network agreement remains in place with BMI until 31 October 2014
3. Oncology treatment where Bupa consultants do not have practising privileges at another private hospital and where its member has already had chemotherapy at the hospital between 1 January 2011 and 31 December 2011 or has been referred for follow-up treatment by another consultant at the hospital and initial treatment has taken place before 31 December 2011.

We have posed a number of questions to BUPA regarding the implementation and as soon as we have any additional information we will let clients know.

The new Mosaic offering is available to groups who wish to insure more than 250 staff, previously if a company wanted to cover 250 staff the cost would have been £13,000 per year, the option would cost just £9,750.00 per year.

Cash Plans are a great way of improving staff morale, improving health and wellbeing of staff as well as showing that you care about them. For further information please contact us on 01384-456-345 or email sales@healthwisegroup.co.uk.

Bupa’s aim is to enable people to lead longer, healthier, happier lives through offering choice and providing access to the best healthcare.

We are pleased to announce that we’ve made a further improvement to the way we manage cancer cover for our members - NHS cancer cash payment offers members the choice to have their cancer treatment on the NHS instead of making a claim for cancer treatment under their Bupa cover.

Our new cancer cash payment enables members to claim £100 for every day they choose to have their radiotherapy, chemotherapy or surgery for cancer provided by the NHS - treatment that could otherwise have been received privately and covered under their Bupa policy.

The introduction of NHS cancer cash payment follows the creation of a specialist Oncology Support Team which was launched in 2010. The specialist team is available to all members who are diagnosed with cancer, and can discuss all the choices that are available to them including the option to have chemotherapy at home when clinically appropriate.

We are constantly looking at ways to further develop our cancer cover for the benefit of our members. We believe members going through cancer treatment should be given as much choice as possible, the introduction of NHS cancer cash payment is another way of offering this.

If you have any further queries, please contact us on 01384-456-345

Background

According to BUPA there is published medical evidence which shows that there is a lack of patient benefit from knee arthroscopy for certain conditions, such as chronic knee pain due to osteoarthritis.

As with many medical conditions, people with the same conditions and symptoms sometimes receive different treatments based on the preference of the treating doctor rather than good clinical evidence or the patient’s own preferences. This is known as unwarranted variation and has been widely documented in medical practice.

One of Bupa’s key priorities is to address unwarranted variation so that our customers do not have unnecessary surgery or pay for ineffective treatment through their premiums.

BUPA review of knee arthroscopy amongst its customers found that it is more than double the rate of NHS patients. While BUPA fully expect there to be some variation for clinical reasons, they have also found that some surgeons are three times more likely to perform a knee arthroscopy on BUPA customers than others and clearly, they need to understand the reasons for this.

Medical review process

BUPA want to work with doctors to review all knee arthroscopies performed on Bupa customers so that they can understand the clinical rationale for them and ensure its members are receiving the most appropriate treatment.

As a result, all knee arthroscopies performed on Bupa customers from 23 May 2011 must go through the new medical review process to confirm eligibility for funding.

In most cases, BUPA will confirm funding the next working day. Where a knee arthroscopy appears to fall outside published evidence-based guidelines, BUPA will seek a second opinion from one of its expert clinical advisers, who are independent UK-based consultant knee specialists, to ensure that it is medically necessary and therefore covered by Bupa as eligible treatment.

BUPA have written to its recognised orthopaedic consultants advising them that all knee arthroscopies need to be medically reviewed before treatment starts. BUPA will also let its customers know about the medical review process for knee arthroscopy when they call to pre-authorise treatment.

BUPA believe this is a good example of them helping its customers obtain the best treatment, ensuring they receive high standards of care and that their healthcare spend has a positive impact on their health.

Should you have any concerns regarding this article please contact our offices on 01384-456-345

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Following further additions to the Healthwise team, it has entered the Group Risk market to support clients on Group Life, Income Protection & Death in service as well as other Business Protection products.

Paul Swanson Commercial Director of Healthwise commented that clients are frequently asking us to look at these areas of insurance which lead us to recruit Bob Catchpole, who has over 22 years experience in this sector.

We look forward to talking to new and existing clients over the coming months.

In order to provide clients with even greater flexibility and choice, BUPA are launching a rolling moratorium underwriting option on Bupa Select (community rated) for new and renewing business from 1 October 2010.

This new underwriting option will give clients greater choice and a simpler joining process, plus the added benefit of health insurance from the market leader.

> Contact Healthwise

Bob Catchpole has been appointed New Business Manager at Healthwise Limited, the private medical insurance, Group Risk and specialist advisory firm based in the West Midlands.

Catchpole began his career in the general insurance industry and has over 20 years experience working for insurers in an external capacity. For the last 22 years he has operated in the healthcare market.

He was employed by the insurer Guardian Health for 11 years before making the transition from the insurer market to that of independent consultant in 1998.