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Helping you answer those common questions about Private Medical Insurance


Delivering Value for Your People

Private medical insurance (PMI) is a healthcare insurance product often offered as part of an employee benefits package.

PMI helps your people access medical services more quickly and book appointments with specialists for their unique health conditions and issues. It can even support your wider efforts in maintaining a healthy workplace by helping to reduce absenteeism and increase productivity.

However, many questions can arise from PMI, and employers may not be sure how to answer them. Working with the right partner can help you answer those common questions about PMI and help you discover the true value of a policy. With added context, you can assess the benefits it can have not only your people but also for your business.

Boosting Your Wider Benefits Offering with PMI Data

If you have a PMI plan that provides you with management information around claims, this data can be analysed and used to create a longer-term healthcare strategy. You will be able to identify trends that can assist you in focusing your benefit-related communications.

If your employee headcount is below a certain size, management information data from PMI providers is typically difficult to access or simply not available, so what do you do in these circumstances? When analysing the increases associated with PMI plans, there are reasonable assumptions that can be drawn from the percentage increase. If you see an increase above 15%, it is a reasonable assumption that there is a high claim spend. Identifying the types of claims may not be possible, which is why it is important to understand what other benefits offer for a workforce to offset potential claims.

Here are a few examples of how this would work in practice. If there is a high spend on physiotherapy costs, then a health cash plan could provide employees with a set amount of cash per policy year that they can use for physiotherapy, removing the cost from the PMI plan. If your data suggests that mental health is an a large expense for your workplace, you might be able to better communicate your EAP services to lower spending in this area. If no data is available, you can still look into the reasons behind absences to better understand whether there is a potential claim on the horizon.

How Private Medical Insurers Are Adapting Solutions to the Current Market

Every healthcare provider has made digital solutions available for their members, and this ranges from virtual GPs to at-home well-being services. In the UK, healthcare providers do not specifically provide coverage for COVID-19-related symptoms as they feel the NHS are the best placed to manage the virus, but many have made adjustments to their offerings. One example is Vitality, which now offers a COVID-19 cashback benefit of up to £500 per day for those hospitalised due to coronavirus infection. Another example is WPA, which enhanced their products to include remote GPs, well-being and counselling, resilience boost vlogs, webinars, live chat and expanded functionality of the WPA Health app.

Wellness is a focus for all healthcare providers at present, but they all have different approaches to the subject. Vitality launched a “Workplace Wellbeing Calendar” that provides short sessions around mental well-being and high-intensity interval training sessions (HIIT sessions), among other topics. The calendar was aimed at both Vitality members and non-Vitality members and has proven to be popular.

Every healthcare provider we interact with has made an adaptation so that members of their healthcare plans can continue to use them. In facing life’s challenges, access to these services and materials can be a great help to your people.

Understanding How NHS Works with a Private Medical Insurance Policy

It is a popular misconception that PMI replaces the NHS. This is simply not the case. The NHS are quite often the starting point for claims on a PMI policy. Often, the claims journey is as follows:

  1. Member visits their NHS GP.
  2. Their GP investigates their symptoms.
  3. GP recommends seeing a specialist consultant for their specific circumstances.
  4. The patient then gets in touch with their PMI provider to discuss how they can assist.

So, with this in mind, what are the real benefits to an employee of joining a PMI plan? The NHS waiting times to specialist consultants vary by condition and can be quite lengthy, so PMI plans complement the NHS by offering the choice to see a specialist consultant more quickly. This has two effects: the anxiety associated with an employee’s specific condition is reduced as they will be able to discuss their condition and get the treatment required quicker, and it could reduce potential absenteeism associated with their condition.

PMI is designed to help with acute conditions or short term conditions that can be cured with treatment. Therefore, emergency treatment and chronic conditions will usually be managed by the NHS.

Looking at Wellness Solutions Private Medical Insurers Provide

Wellness solutions can be categorised under two headings:

  1. Physical well-being
  2. Emotional well-being

Providers typically partner with gyms or wellness services such as HeadSpace to provide their members with a discount on their services to encourage awareness around physical activity and mindfulness.

There are articles, webinars, vlogs and more readily available for people who would like guidance around emotional and physical well-being. The content and the approach vary by provider. For example, Vitality have a well-being programme wrapped around their core healthcare offering that encourages their members to live healthier lives and provides rewards for doing so.

Examining the Most Claimed Conditions on Private Medical Insurance

Historically, cancer and musculoskeletal conditions were the two highest claims points. In recent years, we have also seen a rise in mental health claims.

This data can help you tailor your wider employee benefits offering to support your people. It is, again, important to review the PMI data you have for your business as this will help you to design your wider well-being strategy specifically for your team. It is also worth asking what benefits you could offer to assist with diagnosis or prevention of these conditions.

Mental health care is becoming a highly desirable benefit. Understanding the conditions your people care most about can help you to ensure you are targeting your well-being efforts to have the most impact. It could be worth speaking to your PMI or EAP providers, as many of them have well-being products you can attach to your current policies that could prove to be more cost-effective than going elsewhere.

These highly claimed conditions highlight the importance of providing proactive support or raising awareness around the support available for these conditions. It is important to consider the resources available to your people from the entire benefits package as PMI is a largely reactive benefit. Reviewing the added value services available to an organisation is an effective method of promoting proactive support. This is where enhancing your benefits communications could be really valuable.

Putting It All Together

Understanding the full scope and possible impact of your benefits offering involves knowing the insurance and benefits market intimately. NFP has a team of experts who specialize in workforce empowerment and benefits packages. Our deep knowledge of the insurance industry and strong relationships with key benefits providers allow us to deliver a comprehensive solution for your people.

Let’s work together to ensure your workforce is engaged, healthy and empowered.
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