Types of private health insurance policy — group schemes

A group health insurance scheme is one private medical policy bought for several people at once — most often by an employer for its employees, sometimes by a partnership or an association for its members — with each person covered as a member of the scheme rather than as a policyholder in their own right. Almost everything else follows from that one structural difference: who chooses the cover, how medical history is handled, who gets the renewal notice, and what happens when you leave.

If you are deciding whether to set a scheme up, start here: group cover is quoted, not listed, so a conversation is how you find out what it would cost. Fill in the form on this page and an FCA-authorised broker can put the same scheme to several insurers and come back with what each says; there is no charge for asking. We hold no premium data, so any figure this page gave you for what a scheme costs per member would be invented. The tax side has its own page: private medical insurance and tax.

What counts as a group, and who can set a scheme up

In the UK a group scheme is a commercial arrangement, not a legal category. No statute obliges an employer to provide private medical cover, and nothing obliges anyone to hold it — the NHS is there whatever a scheme pays for. So the group health insurance requirements and eligibility rules people search for belong to insurers rather than to the law, and two kinds sit on top of each other.

• The insurer's rules about the group. How many members it will write a scheme for, whether they must share an employer, and whether a partnership, charity, club or trade association counts at all. We hold no group scheme wording, so this page cannot state any of it, and it varies enough between insurers to be worth asking twice.
• The scheme's own rules, written by whoever bought it. Which employees are in, whether directors are included, whether there is a waiting period after joining, and whether partners and children can be added. These are the buyer's choices, which is why two schemes from one insurer admit different people.

Small employers are a large share of the searches here, and the floor is the insurer's to set rather than ours to guess: some do write schemes for very small employers, and whether yours clears a given insurer's minimum has an answer we are not in a position to give. A sole trader with nobody to pool with needs an individual policy instead, and our page on private health insurance for contractors covers buying in your own name or through a limited company.

Group health plan, GHP, ERISA, plan sponsor: the American vocabulary

Much of what a search for group health plans returns is American, and the words do not transfer. In the United States "group health plan" is a defined legal category, "plan sponsor" is the employer within it, ERISA is the federal statute governing employee benefit plans, and "catastrophic" names a tier on the marketplace there. None of them describes a UK arrangement, where what you buy is group private medical insurance — company PMI — under an ordinary insurance contract. "Agency" is the same story: in the United States it is the normal way to buy, and the UK equivalent is a broker, which we unpack on our page about the health insurance agency search. Searches phrased as exam questions — which underwriting requirement applies under most group health insurance plans, and the like — come from American licensing question banks, and the requirement being tested has no UK equivalent: here the insurer decides what bases it offers and the buyer chooses from those.

What changes when cover is bought for a group

The product is recognisably the same: a scheme pays for private treatment of conditions arising after a member joins, at hospitals the insurer recognises, up to the limits the policy sets — see what private health insurance is. What differs is who holds the levers.

The underwriting row changes the experience of buying most. On an individual policy the insurer reads your history and prices and excludes accordingly; the routes are quoted in the insurers' own words on our page about pre-existing conditions, one of them called medical history disregarded, which in general terms is found more often on employer-paid schemes than offered to an individual. On a scheme the choice is made once, at scheme level, before any member fills anything in — which makes the basis a scheme is written on the most useful single thing a buyer or member can establish, and it cannot be read off the product's name.

The renewal row matters next: a scheme's renewal reflects what the group claimed in aggregate, so one member's year can move the figure for everybody — see why a renewal price goes up.

What the policy wording says

A limit we would rather state than disguise: every policy document this site holds is an individual or family wording, so nothing here establishes what any insurer's group product does. What those wordings are good for is the architecture a scheme is assembled from, and the words its benefit table will use.

The Exeter's product summary shows how much of a policy sits outside hospital treatment:

"Additional benefits Private ambulance, Home nursing, Parental accommodation, Hospice donation, NHS cash benefit. A No Claims Discount, where you'll earn discounts on your premiums if you stay healthy and don't claim"

— The Exeter, Health+ Insurance Product Information Document (October 2025), page 1, read 4 September 2026. An IPID is a regulatory summary, not the full policy wording, so each benefit's limits are in the policy document, which we have not quoted. This is an individual product, not a group scheme.

Two things there matter to someone comparing schemes. What a policy pays for runs well past an operation — an ambulance, nursing at home, a bed for a parent staying with a child, a payment where NHS treatment is used instead — and those are the lines on which two similar-looking benefit tables turn out to differ. And the no-claims discount is one insurer stating in writing, on one individual product, that the price responds to whether you claimed; the group analogue is a scheme's claims experience at renewal. We have not established whether a no-claims mechanism exists on a group scheme, so ask rather than expect.

Our other two clauses for this page are quoted in full elsewhere on the site, and they serve a scheme buyer better as a warning than as a quotation. Freedom Health Insurance's policyholder guide lists out-patient treatment, alternative therapies, mental health care and dental, optical and private GP fees as optional additions to its Elite product — then says plainly that a benefit described in the guide is not cover unless it also appears on the certificate. That is the sentence a scheme member should carry around: a brochure describes a product, the certificate or scheme schedule describes your cover, and where they differ the certificate is what pays. The Exeter's wording adds the point from the other side: core out-patient cover is narrower than most assume, with broader consultation and diagnostic cover sold as an addition. Both clauses and their sources are on our page about private health insurance limits.

So the useful request — whether you are weighing proposals or reading what you have been given — is the benefit table and the certificate wording, not the summary: which benefits are core, which are paid additions, what each is capped at. Gathering that from several insurers is quicker through a broker than through four brochures, and the form on this page takes minutes.

What makes a group scheme dearer or cheaper

We hold no premium data, so this names the dials and not a number. Anyone quoting a per-employee figure without having seen your group is guessing.

The mechanism insurers describe for group cover is that risk is priced across the group rather than person by person, and that on some bases a member is not individually underwritten on joining. That is a real difference in method, not a promise about the result: whether a scheme lands above or below what the same people would pay individually depends on who is in the group, the basis it is written on and the cover chosen. It can fall either way, so treat any claim that group cover is simply cheaper as something to test against two quotes.

Three of those dials work the same way on a scheme as on a personal policy, and we cover each in the insurers' own words: what an excess is, how benefit limits work and the hospital list a scheme is priced on. The question for every proposal is the same: which dial was turned down to reach this figure, and is that the trade we meant to make? A cheaper proposal is usually a different product, not a better price for the same one.

The disadvantages, and what a group scheme does not do

Searches for the disadvantages of group health insurance come from two directions: an employer weighing whether to start a scheme, and an employee working out what they have been given. Four things come up either way.

• You did not choose the cover. A scheme set up with a large excess or a reduced out-patient limit can leave a member paying more at the point of treatment than "healthcare provided" suggested. Read the benefit table when you join, not when you are referred.
• The cover is attached to the job. It normally ends when the employment does, and a policy bought afterwards is a new contract, underwritten afresh unless the insurer offers to continue your cover on its existing terms. Ask before your last day.
• It is a taxable benefit. Where the employer pays, HMRC generally treats the premium as part of the employee's pay and taxes them on it, while the employer usually gets relief on the cost as a business expense. Group private medical insurance taxation, including P11D reporting and salary sacrifice, is on our page about health insurance and tax.
• It is medical insurance and nothing else. Not income protection, critical illness cover or group life insurance, and it pays you nothing for being unable to work. Nor is it "all inclusive": every UK wording we have read has exclusions and limits. And it does not remove the NHS, still where emergencies go — see private treatment and the NHS.

Against that, the reasons employers give are recruitment and retention, speed of access for staff waiting on a referral, and one arrangement covering everybody. Whether those are worth the premium is a judgement about your business.

If you are a member rather than the buyer

Most people reading a page like this are not the buyer: they have been told there is a scheme, or suspect there is, and want to know what it means for them.

• Whether you are on one. The signs are a membership certificate or card in your name, an entry for medical insurance on your payslip or P11D, and a members' handbook naming an insurer. HR or payroll can settle it.
• Your membership number is not any other number. It is issued by the insurer and printed on the certificate or card — not your NHS number, and not your National Insurance number. There is no national health insurance number in the UK, because there is no national health insurance scheme to have one: the NHS is funded through taxation rather than premiums.
• Adding a partner or children. Many schemes allow it and ask the member to pay, so compare dependants on the scheme against a separate family policy — remembering that adding them may increase the taxable benefit.
• If you also hold your own policy. A scheme at work and a personal policy do not give you two claims for one treatment, and the rules deciding which pays are worth knowing in advance — see claiming on two policies.

Common questions

Is group health insurance cheaper than an individual policy?

We cannot tell you, and nobody honestly can without quoting your group. The pricing method is genuinely different — risk across the members rather than person by person, and on some bases no individual underwriting — but the result depends on who is in the group and what cover was chosen, and can fall either way. Have the same cover quoted both ways before accepting that one is cheaper.

How many people do you need for a group scheme?

The minimum is each insurer's to set, and we hold no group wording that states one, so we will not put a number on it. Some insurers do write schemes for very small employers, so ask it early, and of more than one.

Can I get group health insurance as an individual?

Not on your own, because the cover is built around a group with something in common, usually an employer. If you are self-employed or a company of one, what is open to you is an individual or family policy with its own underwriting, which a broker can price in the same conversation.

Does a group scheme cover pre-existing conditions?

Sometimes, and it turns on the basis the scheme was written on rather than on its being a group scheme. A basis that disregards medical history treats existing conditions differently from full underwriting or a moratorium, either of which can exclude them like any other policy. Our page on pre-existing conditions quotes the insurers' words; for your scheme, ask which basis applies, in writing.

Can group health insurance be ported to another insurer?

"Porting" is not the usual UK word; the nearest arrangement here is switching with your existing underwriting carried over, which insurers call continued personal medical exclusions or switch terms. Whether it is open to you when a scheme ends or you leave a job is the receiving insurer's decision rather than an entitlement, so ask before the cover lapses — our page on renewal explains what it does to your terms.

Which insurers offer group private medical insurance in the UK?

The documents this site holds come from Bupa, AXA Health, Aviva, WPA, The Exeter, Freedom Health Insurance and Saga, and all are individual or family wordings — so we cannot say which of them writes group business or on what terms, and our not holding a group wording is not evidence that an insurer has none. A broker can say who writes schemes of your size. A search for a private healthcare group in the UK usually returns a hospital operator, not an insurer.

Can I find a local health insurance adviser for an individual policy?

You can, but a local one is not necessary: private medical cover is a national product, the same policies are sold throughout the UK, and most of this happens by phone and email. What matters more than proximity is that the firm is authorised, which you can check on the Financial Conduct Authority's register. This site is not an adviser and does not search the whole market; it introduces readers to one authorised broker.

Can a scheme cover employees who live or work abroad?

That is a different product rather than an extension of a UK scheme: cover for people living outside the UK is written as international private medical insurance and priced on the region of cover — see international health insurance and expat cover. The same applies to the medical insurance exchange and study-abroad programmes require of participants, which the programme sets.

Is there private health insurance for people on a low income?

Private medical insurance in the UK has no low-income tier and no means-tested version; it is priced on risk and on the cover chosen, and NHS care is free at the point of use whether or not anyone is insured. If cost is the obstacle, the dials above are the ones to turn.

Is this page about Group Health Plan Inc, Axis Bank, Medi Assist or USAA?

No — those searches arrive here by accident. As far as we can tell, Group Health Plan, Inc. and USAA are American organisations, while Axis Bank and Medi Assist are an Indian bank and an Indian claims administrator, each distributing or administering group cover under rules unconnected to UK insurance. "Group Health Plan" also appears to be an achievement in the video game Overwatch. None of it applies here.

If you want figures rather than mechanisms, the next step is to have your own group priced. Fill in the form on this page and an FCA-authorised broker will take the number of members, who is to be covered and what you want included, and come back with what several insurers say, with the benefit tables behind each figure.