Health Insurance Trust

Large Corporate Health Insurance (covering 400 plus employees)

Offering Health Insurance to your employees demonstrates that you take your employees health very seriously and that you care. It not only provides access to prompt medical treatment, most importantly it will help you recruit and retain quality personnel and at the same time reducing absenteeism.

Who is Health Insurance for?

It is design is to protect the Health needs of Directors and Senior Management within a business, as well as employees.

When you include more than 400 employees on a Health Insurance the scheme design is tailored to meet your specific business requirements, i.e. bespoke to you. Typically premiums are a flat rate so that everyone under the age of 65 pays the same premium level.

Future premiums are based upon your own group’s claims spend, as a result the insurer provides regular claims reports showing the amounts claimed, conditions treated, hospitals utilised , age profile of claimants, employee or dependent claims. Due to Data Protection the claimant’s name is not included in these reports.

Insurance Premium Tax (IPT)

As the Government includes IPT at 12% on all Health Insurance Premiums this can add a significant cost to the premiums. By way of example, a premium of £500,000 would attract IPT at £53,571 so a significant cost to UK business.

As a result insurers have come up with Trust or partial Trust’s options which help reduce the IPT liability due to its Trust status. Essentially a Trust is a pot of money which you pay into and claims are paid from in line with the Trust agreement.

As the policy is not administered as an Insurance contract the claims fund (pot of money) is not liable for Insurance Premium Tax (IPT) which will reduce your overall premium. It not only reduce the premium you pay, it will also reduce the cost you declare on the employees behalf, thus reducing the employees P11d liability.

VAT is charged on the day to day administration charge levied by the insurer.

Why Large Group Health Insurance Trust) cover?

Health insurance policies are adaptable to meet both your business and financial needs, however in principle they include the following:

• More choice in terms of scheme design
• A clearer pricing mechanism
• Option to include a Specific Stop Loss to cover one-off expensive claims
• Reduced IPT contributions
• Reduced P11d liability
• Typical savings 4%

What happens when you join?

When you join a Health Insurance policy for the first time you will typically be offered one of three underwriting options.

These options are Full Medical Underwriting (FMU) or Moratorium (Mori) underwriting or Medical History Disregarded (MHD) or perhaps a combination of all options if required.

Full Medical Underwriting

A method of underwriting where the insurer requires details of previous medical history and current state of health from each applicant covered by the policy. This usually involves the completion of a health questionnaire as part of the application for cover.

From this, the insurer’s underwriter can then decide whether to:

• allow cover on standard terms with no personal exclusions applied;
• exclude cover for a specified medical condition and any associated medical conditions;
• exclude cover as above, but with the proviso that the insurer will review the decision at a stated time in the future.

Moratorium

Cover will typically not be provided for any medical conditions which you were aware of in the five years prior to joining the policy. However if after two years continued membership you have had no re-occurrence of the medical condition, sought no advice or medication then after two years the condition may be eligible for treatment.

With moratorium underwriting, you should be aware that claims will be assessed in accordance with the insurer’s standard policy terms and conditions at the point of claim, which will be based upon your GP records.

Medical History Disregarded (MHD)

As you are covering a large number of employees, insurers will allow you to commence cover without the need to declare your employees medical history. As such any known or on-going medical conditions will be covered from day one. By selecting MHD terms, your group’s claims experience will typically be higher than the other two underwriting options, which would affect the premiums you pay at future renewal dates.

How can we help?

As experts within this field of insurance our Consultants will take the time to understand your business requirements and then negotiate and source the best possible terms with the insurers for you. As your premiums are influenced by your own claims spend it is essential that you have someone who understands risk. Healthwise has built its own risk tools to work out how your scheme is priced; this includes:

• Taking into account the current years claims spend
• An average of the last two years claims spend
• An average of the last three years claims spend
• As well as the above three alternatives, accounting for any large unusual claims and membership changes
• Large claims for staff who are no longer covered

If you have Health Insurance cover

If you already have Health insurance cover then you have come to the right place as Healthwise are experts in reviewing existing insurance arrangement.  We have the in-house tools to understand your risk profile and determine whether you are gaining value for money.

Why is Healthwise different?

As well as having an in depth knowledge of the Health Insurance sector, we also have our own claims team on hand to support any problematic claims. Or if you simply require someone to take control of an urgent  claim our staff are experienced in sourcing treatment, pre-authorising cover with the insurer and booking appointments for our clients with consultants – a complete end to end service.

Simply call our offices and we will to help and guide you – with no obligation, no fee and no pushy sales staff.