Private Medical Insurance (PMI)
AKA: Private Health Cover/ Private Health Insurance.
Provide comprehensive health insurance for healthy, happy workforces and reduced sickness absence.
£500-£2,000 p.a
Typical per member premium range.
What is PMI?
Covers the cost of private treatments via private facilities and consultants of the members choice.
Typically covers acute but not chronic conditions.
A 'private' alternative to NHS treatment.
The treatment provider would be paid directly by the insurer.
Why PMI for your employees?
Reduce sickness and absence periods.
Enhance recruitment and retention.
Save money - group cover is typically lower cost than individual.
Drive employee loyalty through provision of a highly valued employee benefit.
Maintain a healthier, happier, more secure workforce.
Be a better employer and fulfil your ‘Duty of Care’.
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Policy terms that you can choose
Here are the terms that you can choose when designing your group PMI scheme. Figures shown illustrate premium variance from an average group policy based upon cover choices.
Variable Description Premium Variance
Excess Amount of claim payable by member. -20% +30%
Hospital network scale Defining the number and location of treatment facilities available. -40% +80%
Outpatient Limit Limiting outpatient cover. -15% +20%
Mental health Increasing mental health cover provision. -25% +10%
Therapies Inclusion of physio, acupuncturists, homeopaths, osteo or chiro cover. -10% +15%
Extra cancer cover Increasing cancer cover, typically to provide more outpatient and home care treatment. -12% +10%
Six week waiting list Restriction of treatment to any condition untreatable by the NHS within 6 weeks. -20% +20%
Dental and optical Inclusion of dental and optical, routine and non-routine, cover. -20% +17.5%
Employee assistance plan (EAP) Telephone based stress counselling service. -1% +2%
Variable Premium Variance
Excess -20% +30% keyboard_arrow_down
Amount of claim payable by member.
Hospital network scale -40% +80% keyboard_arrow_down
Defining the number and location of treatment facilities available.
Outpatient Limit -15% +20% keyboard_arrow_down
Limiting outpatient cover.
Mental health -25% +10% keyboard_arrow_down
Increasing mental health cover provision.
Therapies -10% +15% keyboard_arrow_down
Inclusion of physio, acupuncturists, homeopaths, osteo or chiro cover.
Extra cancer cover -12% +10% keyboard_arrow_down
Increasing cancer cover, typically to provide more outpatient and home care treatment.
Six week waiting list -20% +20% keyboard_arrow_down
Restriction of treatment to any condition untreatable by the NHS within 6 weeks.
Dental and optical -20% +17.5% keyboard_arrow_down
Inclusion of dental and optical, routine and non-routine, cover.
Employee assistance plan (EAP) -1% +2% keyboard_arrow_down
Telephone based stress counselling service.
Policy terms set by insurer
Variables set by the insurer, but which you should understand.
Underwriting basis
The terms upon which the insurer requires medical history disclosure, typically four types
Variable Description Premium Variance
Full medical underwriting (FMU) Completion of a health questionnaire is required in order for insurer to confirm cover, any cover limits or premium loadings to be applied. -20% +30%
Continued personal medical exclusions (CPME) Continuing your exclusion terms from your previous PMI policy. No need for medical questionaire. -40% +80%
Moratorium (Mori) No cover for pre-existing conditions with symptoms or treatment within last five years, until you’re symptom or treatment free for two years. No need for medical questionnaire. -15% +20%
Medical history disregarded (MHD) Typically only available to schemes with >50 members. No personal medical exclusions for any pre-existing conditions. -25% +10%
Variable Premium Variance
Full medical underwriting (FMU) -20% +30% keyboard_arrow_down
Completion of a health questionnaire is required in order for insurer to confirm cover, any cover limits or premium loadings to be applied.
Continued personal medical exclusions (CPME) -40% +80% keyboard_arrow_down
Continuing your exclusion terms from your previous PMI policy. No need for medical questionaire.
Moratorium (Mori) -15% +20% keyboard_arrow_down
No cover for pre-existing conditions with symptoms or treatment within last five years, until you’re symptom or treatment free for two years. No need for medical questionnaire.
Medical history disregarded (MHD) -25% +10% keyboard_arrow_down
Typically only available to schemes with >50 members. No personal medical exclusions for any pre-existing conditions.
NHS Cash Benefit
When a member chooses to have treatment by the NHS for a condition which would have been covered by the policy.
Variable Description Premium Variance
NHS cash benefit A cash payment is made to the member. -1% +1%
Variable Premium Variance
NHS cash benefit -1% +1% keyboard_arrow_down
A cash payment is made to the member.
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Tax treatment
Typical tax treatment of these insurances, subject to your tax advisors and tax controller.
For employers
Corporation tax
PMI premiums do qualify for corporation tax relief as a business expense.
Insurance premium tax
Insurance Premium Tax is applied to PMI premiums. Quotes include IPT (currently at 12%).
For employees
P11d tax
Employer paid PMI is subject to P11d benefit in kind tax.
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