Most people looking for the best group health insurance for their employees are choosing cover for somebody else. You sign the scheme; your staff are the ones who ring the insurer with a referral letter in their hand. Every setting you pick — who may join, whether families can come too, how existing conditions are treated, how much a member pays before the insurer does — lands on them rather than on you.
What you are really settling is the specification, before it goes out for quotes. Having two or three versions of it priced side by side shows what each staff-friendly choice adds to the bill, and a broker with FCA authorisation can set that comparison out at no charge, from the staff details you enter in the form on this page. The insurer wording quoted below comes from personal and family policies, so what follows is a way of deciding, not a verdict on any insurer’s group scheme. If you are the employee, wondering what your own work cover gives you, the pages on private health insurance through work and on judging a scheme you have been given are written for you.
What an employee actually gets when the scheme is used
A company scheme gives each member a route to private diagnosis and treatment, for the conditions its underwriting basis lets in, at hospitals the scheme reaches and within the limits it was bought with (the product’s basics have a page of their own). The NHS stays where it was: for the GP, for emergencies and usually for long-term conditions that need managing rather than curing. Staff meet the scheme as a sequence of steps, sketched in outline, not from any insurer’s own process, each governed by something you chose.
| What the employee does | The choice of yours that decides how it goes |
|---|---|
| Rings the insurer with a referral | Whether the condition is covered at all: the underwriting basis, and anything they had before joining |
| Sees a consultant, has tests or a scan | The out-patient cover; where it is capped or removed, this is the point at which they start paying |
| Is told where treatment can happen | The hospital list, and whether it reaches where they live as well as where the office is |
| Has the treatment | The excess, and who meets it |
| Needs physiotherapy, or help with their mental health | Whether therapies and mental health cover were included, and at what limit |
| Leaves the job | Whether anyone asked how the cover can continue in their own name |
Most of the levers that bring a premium down sit in the middle rows, which is also where a cheaper scheme is felt first: the insurer pays less because the member pays more, travels further, or waits for the NHS after all. What each lever takes out of a claim, in the insurers’ own wording, is on what company health insurance costs. Searches for Vitality or WPA employee benefits may be after wellbeing extras such as helplines or rewards for staying active; what those are worth varies with the insurer and the scheme, so value them apart from the cover that pays for treatment.
Four choices you make on your employees’ behalf
Each moves the price, which is why budget usually settles them; each also decides who the scheme helps.
Who is eligible
A scheme is normally written for a defined group. Everyone employed is easiest to explain; a tier — managers upwards, or staff past a qualifying period — usually costs less but creates two kinds of employee, and whoever sits just under the line will notice. Decide part-time staff, fixed-term contracts and new starters on probation on purpose, and check the insurer will write your rule.
Partners and children
Families can usually be inside the cover the firm pays for, available at the employee’s own cost, or not offered. The middle route often gives staff the most for what it costs the business. On our understanding of the general position, which is not tax advice, a family member’s premium paid by the employer adds to the employee’s taxable benefit, while a contribution the employee makes from net pay reduces it; the tax page carries the detail. Compare the scheme’s price with a family policy bought separately before assuming it is the better home.
How existing conditions are treated
This matters most to the people on the list and is hardest to see on a quote. The four routes — full medical underwriting, a moratorium, continuing medical exclusions carried from earlier cover, and medical history disregarded — each have a description, quoted from insurers, on the pre-existing conditions page. Under a moratorium or full underwriting, a colleague with a bad knee or past anxiety may find that condition excluded. Disregarding history is, in general terms, found on company schemes rather than offered to individuals, and, going by its name, the basis that excludes nothing a member already has; whether an insurer offers it for your headcount, and what it adds to the price, is something a broker can answer during the free call-back.
The excess, and whose pocket it comes from
Raising the excess tends to lower the premium, and on the individual wordings that say who is paid, Bupa’s and Freedom’s, both quoted on how an excess works, the member pays it to whoever treated them. On a modest salary it can be enough to stop someone claiming. Whether the firm can meet the excess instead depends on the scheme, so ask; if it cannot, set the level by what your lowest-paid member could pay without hesitating.
What makes a scheme good for employees, not merely cheap
A cheap scheme and a good one can carry the same insurer’s name; the difference is not in the per-head figure.
| Where to look | Specified on price alone | Specified with the staff in mind |
|---|---|---|
| Out-patient cover | Capped low or taken out, so diagnosis is the member’s bill | Enough to get from referral to a diagnosis without paying |
| Existing conditions | Whichever basis prices lowest | The most generous basis offered at your size, priced and then decided |
| Hospital list | The shortest list with a hospital near the office | Checked against where people live, home-based staff included |
| Excess | Whatever level met the budget | A level the lowest-paid member would pay without a second thought |
| Mental health | Left off, or kept to a token limit | Included, with the limit read before signing |
| Families | Not offered | Offered, even at the employee’s own cost |
The right-hand column tends to cost more; how much depends on your staff and the insurer. But a scheme specified from the right and trimmed where the budget insists differs from one built on the left and defended afterwards. So have both versions priced together: a broker can run the staff list you send via the form on this page through several insurers on each, and the cost of generosity is visible before you commit. The hospital row has its own method on checking a hospital list.
Telling staff about the scheme, and about each renewal
Cover employees do not understand goes unused. People searching for a health insurance renewal letter to employees want a template; rather than one, which would depend on your scheme’s terms, here is what it should cover:
- What has changed: any move in the excess, hospital list, out-patient cover or benefits since last year.
- Who is covered: how to add or remove a partner or child before the new year, and who pays.
- The tax: that, as we understand it, the cover is normally a taxable benefit for them though no invoice reaches them; the question below says more.
- How to claim: the claims number, whether a GP must refer them before they call, and where their membership number is printed.
Renewal is also the time to revisit the four choices above, because the people on the list are not all the ones who were there when you made them; what moves a renewal price is covered elsewhere.
Questions to settle with a broker for the people on the list
- If someone is already waiting for treatment when the scheme starts, what happens to them on each basis you can offer?
- Can staff add family through payroll, and are those family members underwritten on the same basis?
- Do the hospital lists quoted reach the towns our people live in, not just our office postcode?
- When someone leaves, can they carry on in their own name, and would conditions that arose while on the scheme stay covered?
What employers and employees ask about workplace cover
What is group health insurance for employees?
One private medical insurance policy an employer buys, covering each eligible employee as a member rather than a policyholder. The structure is set out on group health insurance schemes.
Is group health insurance taxable to the employee?
Generally yes, as far as we understand it: an employer-paid premium normally counts as a benefit in kind, taxed as the employee’s income. The tax page linked above has the detail.
How do I provide health insurance for my employees, and is there a minimum number?
Settle the four choices above, then have one specification priced by more than one insurer, directly or through a broker. Each insurer sets its own minimum group size; very small firms face extra hurdles, set out on the small-business page.
Can contractors, or “1099 employees”, join a company scheme?
A 1099 is an American tax form for independent contractors; here it depends on the scheme’s eligibility rule and the insurer’s, and a scheme written for employees will not usually reach someone who invoices the firm; see private health insurance for contractors.
Can part-time employees be included?
Yes, if the eligibility rule includes them and the insurer will write it. Leaving part-time staff out of a benefit full-time colleagues receive can raise employment-law questions, so take advice before writing that rule.
Do Vitality, WPA and Aviva provide cover for employees?
Their individual and family policies say nothing either way about their group business, which is a separate question. A member’s terms are in their scheme’s handbook; a buyer can ask a broker which insurers would quote.
Does this page cover NHS staff, government employees or schemes abroad?
US federal employees, Australian public servants and government employees in Jharkhand are under other countries’ rules; nothing here applies to them. NHS staff in the UK thinking about cover of their own have a page on private health insurance for NHS staff.
Once eligibility, families, the basis and the excess are settled, the specification is ready to price. The form on this page passes it to a broker with FCA authorisation, who can set out, insurer by insurer, what the generous version costs beside the lean one.