When is it worth investing in comprehensive health cover?

A group health insurance policy covers your entire workforce, giving them access to private medical treatment as long as the policy covers it. You can choose your preferred insurance company and policy, then tailor your health insurance policy to suit your needs and budget. Your employees can only access private treatment via the policy if you choose to include it.

You can pay the premium via your business to cover every employee as part of their employee benefits package or make it a voluntary scheme where employees pay the premium if they want to join. The premiums for group health insurance are typically lower than those on a personal health insurance policy, making it more affordable than individual coverage.

A comprehensive health insurance policy covers a wide variety of treatments and services. Generally speaking, your employees can access private medical care for almost any illness or injury as long as it isn't excluded from coverage. We'll explain more about exclusions later.

Private medical insurance starts with a basic policy, and you can add optional extras to create more comprehensive health insurance. Many insurers also offer packaged private medical insurance with levels of coverage up to and including a comprehensive health insurance policy, meaning you can choose the level that meets your needs.

Comprehensive health insurance can also include various business services depending on the number of people you employ. For example, corporate health insurance typically includes services designed to reflect the demands of managing a large workforce.

As the name suggests, a comprehensive health insurance policy covers most medical expenses and various treatment types. Comprehensive health insurance is more expensive than a basic policy because the broader range of treatments makes it more likely your employees will claim. For example, basic policies always include in-patient treatment but limit out-patient coverage simply because you're less likely to spend a night in hospital than you are to need out-patient care.

A basic plan covers cancer treatment and provides access to around 8-10 counselling sessions to provide employees with mental health support. Most policies also include limited out-patient coverage, usually diagnostic tests or minor surgical procedures, depending on your chosen insurance company.

Your employees can also access support services such as 24/7 virtual GP services, telephone helplines and self-help resources. Most insurers have a member rewards scheme offering perks and discounts which can help your employees save money.

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As we've mentioned, you can build a comprehensive health insurance policy by expanding a basic policy with additional benefits and treatments. Your chosen insurance company may also have a comprehensive health insurance plan that includes every available treatment type. Providers vary in the coverage they provide, so always check the small print. Some comprehensive health insurance offers unlimited treatment sessions, while others have financial limits. You can save money and make the best use of your budget by prioritising treatments and services your employees will likely use and removing any they won't.

You'll typically find the following optional extras on a comprehensive health insurance plan:

Additional out-patient treatment

Out-patient treatment includes various treatments, tests and procedures. A basic health insurance policy typically includes limited coverage, such as a consultant appointment and tests or scans, typically up to a specified financial limit. Alternatively, your policy may include minor surgical procedures. A comprehensive health insurance plan provides more extensive coverage, meaning it covers all out-patient treatment.

Some insurers include physiotherapy in their out-patient coverage, while others don't, so always check the small print. Your chosen insurance company might cover physiotherapy after surgery but not as a standalone treatment. Alternatively, you might need to buy separate coverage for physio and other therapies.

Physical and alternative therapies

As mentioned, some insurers include physical therapies in their out-patient coverage, while others don't. A comprehensive health insurance plan will usually include out-patient and therapy coverage. Separate coverage often provides access to more treatments, such as podiatry, osteopathy, and chiropractic treatment. Some providers also include alternative therapies like acupuncture, reiki, or homoeopathy.

A comprehensive health insurance plan can also include complementary treatments for specific illnesses. For example, if an employee needs cancer treatment, a comprehensive policy can often provide support services, including nutrition.

Additional treatment sessions

Private health insurance often includes limits on how much your insurance company will pay for each type of treatment or a limit on the number of treatment sessions your employees can have. A comprehensive health insurance plan can provide unlimited treatment, which is the most expensive option. Alternatively, you can tailor the limits in each treatment category to suit your needs and budget. For example, your employees might engage in physically demanding work and be at increased risk of musculoskeletal problems or injuries. Increasing the availability of physiotherapy can help to protect them.

Investing in comprehensive health insurance means your team can access treatment quickly and continue it for as long as they need to. Otherwise, they may face a situation where their private treatment ends, and they must either self-fund or wait for NHS care.

An extended hospital list

When you invest in private health insurance, your policy will include a standard hospital list stating which private hospitals and treatment centres it covers. The list typically includes private hospitals, and your policy may also cover treatment if your local NHS hospital has a private patient unit. This can be ideal if your employee has already seen an NHS consultant, as they can continue their care with the same doctor while avoiding NHS waiting lists.

If your business and employees are based in London or another major city, your nearest private hospital may not appear on your insurance company's standard hospital list. Instead, you may want to pay an additional premium for the extended list, which includes hospitals with higher treatment costs. Extended lists aren't included, even on comprehensive policies. It's worth the cost if it lets your employees access care more easily; otherwise, you'll likely lose the benefits of paying for health insurance.

Dental and optical care

Strict rules determine who qualifies for free dental check-ups and eye tests. Unless your employees qualify, they're likely paying for private dental and optical care. Comprehensive health insurance can include dental and optical care, helping your employees save money on their routine medical expenses.

Dental coverage typically includes routine check-ups, hygienist appointments, and x-rays. Depending on your chosen policy, it can also pay for emergency treatment and other treatments such as crowns, bridges, and fillings.

Optical cover includes routine eye tests. Your business is legally required to provide eye tests to workers using display screens, and your health insurance can help reduce the cost of providing these tests. Coverage usually also covers glasses and contact lenses for employees needing them for the first time or if their prescription has changed since their last test.

Extended mental health coverage

Basic health insurance usually includes 8-10 CBT or counselling sessions, which your team can usually access without a GP referral. These sessions may be sufficient for short-term mental health support but don't provide long-term treatment.

Comprehensive health insurance provides extensive coverage for mental health issues, with additional counselling or CBT. Additional mental health coverage also provides access to in-patient, day-patient, and out-patient mental health services and treatment with a consultant psychiatrist and multi-disciplinary mental health teams if needed.

Additional business services

Most insurance providers offer additional services to their business customers to help them manage their workforce and effectively administer their health insurance benefits. Insurers tailor these services to businesses of different sizes, with policies tailored to small businesses and larger corporations based on the number of employees.

Many insurance providers include access to employee assistance programs and occupational health services as standard, with some providing a suite of additional services to their corporate customers. These can include crisis support and change management. Some services aren't available as standard to let you tailor your policy. For example, many insurance providers offer private vaccinations. You can pay for a nurse to come to your workplace for a half or full day to deliver vaccinations on-site. Alternatively, you can buy vouchers so employees can book an appointment at their chosen location.

Offering health insurance as part of your employee benefits package has many advantages. Providing more extensive coverage with a comprehensive health insurance plan increases these benefits, enabling your employees to access treatment when needed and avoid spending time on an NHS waiting list. Here are a few ways comprehensive private health insurance can benefit your business.

Reduced absenteeism

Private health insurance lets your team access treatment quickly, whether they need to speak with a GP, see a consultant for diagnostic tests or have surgery. If their illness or injury affects their ability to work, prompt treatment means they'll spend less time away. In some cases, it can also improve their chances of making a full recovery.

A shorter absence from work benefits your employees, as time spent out of routine can negatively impact mental health. Depending on your sick pay policy, a lengthy absence can also impact their financial security. If you have a small team, an absent employee can cause stress in their colleagues, who must absorb the additional workload.

A basic health insurance policy covers in-patient care and cancer treatment and provides some mental health support. However, it doesn't offer extensive out-patient coverage, meaning treatment for many debilitating conditions may not be available. Comprehensive health insurance avoids this by ensuring they can get treatment for most health issues.

Increased employee engagement and retention

Private health insurance is highly valued by employees, meaning it can help your business attract new talent. Offering health insurance as an employee benefit shows your team that you value their well-being, which is also great for staff retention. Business health insurance can provide insights into your employees' health and well-being and support for creating a health improvement strategy and wellness initiatives. Research suggests that companies with health strategies typically improve their employees' health and have a more productive workforce, which is great news for business growth.

While your business will benefit from a basic health insurance policy, a comprehensive health insurance plan offers greater advantages. Awareness of the importance of mental well-being is increasing, and job seekers look for employers who provide mental health support to employees. Comprehensive health insurance offers more extensive treatment alongside the counselling or mental health helplines available with a basic plan.

Tax benefits

Private health insurance premiums are an allowable expense for corporation tax, meaning you can deduct the cost of your health insurance policy and reduce your tax bill. Comprehensive health insurance costs more than a basic plan, meaning the premiums are higher. Potentially, the more you spend, the more you can save on tax. However, financial decisions are rarely that simple, and you should always speak to your financial advisers, accounts and legal representatives before setting a budget for your health insurance.

You must also consider the impact on your employees' tax affairs. HMRC classes health insurance as a benefit in kind. Your employees pay additional income tax on the value of the benefit, which is equivalent to the health insurance premium per person.

While a comprehensive health insurance plan provides extensive coverage that lets your staff access treatment for most health issues, it doesn't cover everything. In the UK, health insurance supplements NHS care but doesn't replace it entirely. Every health insurance policy has standard exclusions that apply to every customer, while other exclusions vary depending on an employee's medical history.

Standard exclusions

Standard policy exclusions apply to every health insurance plan and vary between insurers. Some insurance companies include coverage for conditions other insurers exclude. For example, most health insurance excludes addiction treatment, but BUPA treats it as a mental health condition and includes it in its coverage. Other insurers have a long list of exclusions but offer more generous comprehensive coverage elsewhere. A broker can help you compare policies and ensure your coverage fits with your priorities.

Most health insurance plans have the following standard exclusions:

• Intensive care
• Emergency care
• Straightforward pregnancy and birth
• Cosmetic surgery and weight loss treatment
• Treatment for allergies
• Treatment for behavioural or developmental conditions such as autism or ADHD
• Menopause treatment

It's worth remembering that even where standard exclusions apply, many insurers provide access to support or self-help resources. For example, AXA and Vitality give their health insurance customers access to the Peppy app, which supports fertility, pregnancy and menopause.

Chronic illnesses

Private medical insurance excludes chronic illnesses under its list of standard exclusions. Health coverage only funds treatment for acute conditions that treatment can cure, even if the treatment may not ultimately succeed. Conversely, chronic conditions can't be cured, but a doctor can monitor and manage the symptoms with ongoing treatment. Care for a chronic illness is typically best delivered by an NHS GP or consultant.

Some examples of chronic health issues include asthma, high blood pressure, diabetes or coronary artery disease. In some cases, medical insurance can cover treatment for a flare-up of symptoms related to a chronic illness, for example, if an employee needs surgery.

Pre-existing conditions

As we mentioned, some medical insurance exclusions vary depending on an employee's medical history. All insurers exclude pre-existing medical conditions from coverage. A pre-existing condition is any illness an employee sought medical advice or treatment for during the five years before they joined the policy. For example, say an employee saw a consultant for steroid injections in their knee before you employed them. Their medical insurance wouldn't cover further injections, physiotherapy or a knee replacement if they needed one a few months later.

However, insurers can remove exclusions if an employee stays symptom-free for the first two years of coverage. This period can vary depending on the type of care needed, with some insurers having different exclusions for cancer treatment.

Investing in comprehensive health insurance has many benefits for your business and employees. It's a good idea to seek professional advice from a broker to help you make an informed decision. At Globacare, we help our clients choose health insurance coverage that suits their needs and budget. Contact us for tailored advice on the right policy for your business.