Private medical insurance for employers

An employee-benefits broker can help you compare group private medical insurance and the service needed to administer it. Ask who will review underwriting and continuity of treatment before any change, and who will help with insurer questions during the year.

This guide is published by Alltoogether, a UK employee-benefits broker. See how our service works and how to choose a broker.

Use this comparison sheet for every quote. Require a policy reference beside each answer.

Do not treat an unanswered cell as included. Ask for confirmation. Keep the same questions when comparing the existing policy with a proposed replacement.

Full medical underwriting uses disclosed medical history to establish terms. A moratorium excludes certain prior conditions subject to its stated time and eligibility rules. Continued underwriting can preserve aspects of a previous arrangement when switching, subject to acceptance. Medical history disregarded removes medical-history exclusions where offered; the policy's other limits still matter. These are different ways of arranging cover, not interchangeable labels. [S02]

Ask which basis applies to existing members, new joiners and dependants. Ask whether any individual exclusions remain. Keep written confirmation of the accepted transfer terms before cancelling the old policy.

For example, imagine an employee already having investigations when renewal arrives. The question is not simply whether the new insurer accepts the company. Ask who will pay for the next consultation, the tests already authorised and any treatment subsequently recommended. That example is a discussion prompt, not a prediction of a claim decision.

PMI is generally built around treatment of acute conditions. Long-term monitoring and management of chronic conditions need particular attention. Some policies make specific provision for ongoing cancer or mental health care; ask about those terms separately. Ask the insurer how its terms distinguish treatment intended to resolve a condition from continuing management, and how that distinction affects the cover being quoted. [S03]

Do not translate this into a promise that everything newly diagnosed is covered. The treatment must also meet the scheme's underwriting, benefit and authorisation requirements. Keep NHS care in the employee explanation and use NHS emergency services for emergencies. [S01, S03]

Before launch, write down who can join, when cover starts and who tells the insurer. Include probation, family cover, changes in working hours, overseas assignments and leaving employment in the administration questions.

For family cover, show separately who is eligible and who pays. An employee paying for an upgrade also needs to know how to change or end it. For leavers, obtain the exact cover end date and any continuation option directly from the provider.

Use a reconciliation between HR's eligible-member list and the insurer's membership confirmation. Investigate differences before announcing cover to a person whose membership has not been confirmed.

Compare the employer premium, employee contributions, excesses and any costs outside cover separately. Ask the broker to explain the premium difference against the same membership and benefits, with any changed assumptions identified. A cheaper total with reduced cover is a different purchase.

Employer-provided medical insurance is normally a taxable benefit. Reporting may be through payroll or P11D, depending on the arrangement; Class 1A National Insurance reporting remains a separate employer responsibility. Employee reimbursement and employee-arranged treatment can have different treatment. Ask payroll to confirm the scheme's handling before launch. [S04, S05]

Tell employees what they may contribute and how the taxable benefit will be communicated. Do not describe employer-funded cover as having no cost to the employee.

Check whether the scheme includes services such as virtual GP access or other health support, and whether each service is included or an optional purchase. Confirm its own eligibility and access instructions. An appointment through an added service does not by itself establish that subsequent treatment is insured. [S01]

Keep a dated support list beside the insurance summary. For each service record the provider, who can use it, the access link, any referral requirement and where current limits are published. Check whether it is a contractual insurance benefit or a separate service that may change. Link to the provider's current terms rather than copying a session count into an announcement.

Take the current schedule, membership totals, renewal quote, proposed alternatives and any questions about ongoing treatment. Use a secure channel for personal medical information; the employer comparison need not reproduce individual histories.

Ask for a written account of changed benefits, underwriting, provider access and employee payments. Establish what must happen before the renewal date and who owns each action. Keep the employee announcement until the terms and dates are confirmed.

The renewal health check gives a dated timeline for those actions, counted back from your renewal date.

Read group income protection for insured income during absence, health cash plans for contributions towards everyday health expenses and group dental insurance for dental cover.