Jelf Employee Benefits White Paper on Cancer

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1 Jelf Employee Benefits White Paper on Cancer Edition 1, September 2013 Wellbeing at Work

2 Cancer, covered. 250,000 people are diagnosed with cancer in England every year** Cancer Research UK states that more than one in three will develop the disease over their lifetime; a figure they predict will rise to 1 in 2 men and 44 out of 100 women by 2027* Cancer is a highly emotive topic and the hard facts surrounding it are staggering. Cancer Research UK states that more than one in three will develop the disease over their lifetime; a fi gure they predict will rise to 1 in 2 men and 44 out of 100 women by 2027*. Most of us are likely to be directly or indirectly affected by the disease over our lifetime. But, with the complexity and cost of treatment increasing, employers can fi nd themselves having to balance the emotional and fi nancial aspects, when considering the level of cancer cover they offer to employees. This paper discusses some of the key issues in covering your employees for cancer. It discusses the latest facts about cancer, the issues facing treatment of the disease, as well as a range of options available to ensure you have cancer covered. This includes: The hard facts about cancer the numbers affected and costs NHS shortfalls Issues with private medical insurance Pressures on employers The response from insurers Alternative cancer cover Medical expenses & group critical illness cover Benefi ts of alternatives NHS shortfalls Although cancer is one of the NHS s key focuses, the provision and availability of treatment is constantly coming under criticism. This is largely because, as the cost and variety of treatment increases, it has become much more diffi cult to balance its budget. A good example of this is the Cancer Drugs Fund, which was launched in April This 200m a year fund is designed to help cancer patients in England access drugs that are recommended by their consultant, but aren t authorised by the National Institute for Health and Care Excellence (NICE). Almost two-thirds of cancer treatments presented to NICE are not authorised but, because of the fund, around 30,000 people have been able to access some of these drugs (Daily Mail, 1 July 2013). It was due to be wound up in 2014 and replaced by a new value-based method of assessment however it has been announced that an extra 400m will see the fund extended to Reception to the news has been mixed, however, with some charities welcoming the extension but others warning that it is just a stop-gap.

3 Issues with private medical insurance Pressures on employers Against this backdrop, many employers believe it is important to give their employees the reassurance that, if they are diagnosed with cancer, they will be able to access treatment. But, insurers face the very same financial pressures as the NHS. Cancer Research statistics show that almost two-thirds of cancer occurs in the over-65s. Although medical insurance schemes are more shielded from the costs than the NHS, they are exposed to a broader range of treatments. Additionally, with the abolition of the Default Retirement Age, this protection will start to fade. This means that if an employee is diagnosed with cancer and receives treatment through medical insurance, the size of the claim can be substantial. According to fi gures from Bupa, the average cost of treating cancer was 30,000 in 2010, but with some of the drugs costing two or three times this amount, the overall cost can be much higher. For instance while a drug such as Glivec costs 21,000 a year, patients who suffer side effects may be offered drugs costing as much as 100,000. Just one or two of these claims can have a signifi cant effect on premiums on an experience rated scheme. For example, we have seen instances where, following a cancer claim, the renewal premium has increased by 40% plus. As examples, one of our clients made two claims for cancer, totalling around 33,000, and saw the premium increase by 40%. Another saw their premium rise by 147% after making two claims in the region of 50,000, one for cancer and the other for a heart condition. The response from insurers While there is a risk of a large claim putting pressure on premiums, the response from insurers has been mixed. For the larger players - Bupa, AXA PPP Healthcare, Aviva and PruHealth - there s been a move to make cancer cover as comprehensive as possible as part of private medical insurance plans. For example, under its cancer pledge, Aviva increased cover to include reimbursement in full for targeted drug therapies, bisphosphonates and bone scans, specialist nursing and rehabilitation, with policyholders also entitled to additional help with the cost of wigs and prostheses. While these insurers have taken a belt and braces approach, others have focused on the needs of employers, who would like a less open-ended and potentially more cost effective approach to covering cancer. Simplyhealth, for example, pays for recognised treatments and licensed drugs that aim to cure cancer or induce a remission. They also cover any necessary treatment for 12 months once a patient reaches remission, their cancer is stable or they need palliative care. Taking this more limited approach, it argues, will protect employers from the potential price rises associated with unlimited private medical insurance cover. The continued importance of cancer as an issue to employers and employees is demonstrated by insurers, who make a point of including cover even in their more basic products. For example WPA s NHS Top up includes optional mycancerdrugs cover and, despite its comprehensive approach, Bupa provides cover in its Foundations Treatment plan. 130,000 people die in England every year as a result of cancer** 18.3 bn - the annual cost of cancer to society**

4 Alternative cancer cover Medical expenses & group critical illness cover While private medical insurance is one way to provide fi nancial support to employees diagnosed with cancer, it is not the only option. A major medical expenses plan focusing on cancer, or a group critical illness insurance policy could provide fi nancial support, without putting pressure on claims experience. These operate in a slightly different way to medical insurance. Rather than pick up the cost of treatment, they provide a lump sum payment on diagnosis of certain types of cancer. As an example, although it is an individual product, AIG s Cancer Cover plan provides a lump sum payment of between 25,000 and 100,000 on diagnosis of cancer, depending on the level of cover selected. With group critical illness plans, the employer or employee selects the level of cover with 25,000 to 50,000, or a multiple of salary common benefi t amounts. In addition, these plans offer much broader cover and will typically include other life threatening conditions such as heart disease, stroke and multiple sclerosis. Both types of plans will often include valuable support services that can help employees diagnosed with cancer. These include medical helplines and advice on treatment options, as well as second opinion service Best Doctors. Benefits of alternatives The pooling of risk, coupled with the cap on payments means that pricing is much more stable than on medical insurance. Further, although there is a risk that an employee s treatment costs will exceed the value of the sum assured on these products, employees do appreciate the fl exibility they have around how they can spend the money. Rather than spend it on treatment, they could choose to pay off some of their mortgage or other debt, fund complementary health interventions, or even take a holiday. Using a critical illness policy to provide cancer cover typically found on medical insurance isn t a common strategy but this is likely to change. As new cancer drugs come onto the market and consumers expectations continue to rise, comprehensive cover on a medical insurance policy could start to resemble a blank cheque. Reviewing your cover - and potential exposure to these high claims costs will become increasingly important. 30,000 - the average cost of treating someone with cancer in 2010 (Cancer Diagnosis and Treatment: A 2021 Projection, Bupa) 5 bn - the annual cost of NHS cancer services** *Cancer Research, Dec 2013 **Department of Health ***Cancer Research UK

5 The hard facts about cancer More than one in three people will develop some form of cancer during their lifetime*** 250,000 people are diagnosed with cancer in England every year** 130,000 people die in England every year as a result of cancer** 30,000 - the average cost of treating someone with cancer in 2010 (Cancer Diagnosis and Treatment: A 2021 Projection, Bupa) 5 bn - the annual cost of NHS cancer services** 18.3 bn - the annual cost of cancer to society** 63% of all new cancer cases are in people aged 65 plus (Cancer Research UK - www. cancerresearchuk.org/cancer-info/ cancerstats/incidence/age/) At age 45-49, the cancer incidence rates are and per 100,000 population for men and women respectively. At age these have increased to and respectively.***

6 Contact us If you d like to discuss options for ensuring you have cancer covered, please call us on Jelf Wellbeing at Work is a trading name of Jelf Wellbeing Ltd (Reg No ) which is part of Jelf Group plc (Reg No ) and is authorised and regulated by the Financial Conduct Authority (FCA). Registered address: Hillside Court, Bowling Hill, Chipping Sodbury, Bristol BS37 6JX (Registered in England and Wales). Not all products and services offered are regulated by the FCA. Jelf13/150 Excep onal Wellbeing at Work

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