Business Healthcare benefits at a glance

Transcription

1 Business Healthcare benefits at a glance The below table shows the benefits and cover options you can get with a Business Healthcare plan from PruHealth. All plans start with Core Cover, which has a variety of benefits. They also include Vitality, which is our wellness programme designed to help your employees look after their health. You can then tailor your plan by picking any number of optional benefits, and premiums can be reduced with a range of excess levels and a choice of hospital lists. This table provides a summary of the benefits offered by our Business Healthcare plan. The full benefits, terms and conditions are available on request. All benefits are per insured member, per plan year, unless stated otherwise. Core Cover In-patient and Day-patient treatment Hospital fees Specialists fees Diagnostic tests MRI/CT/PET scans Out-patient treatment MRI/CT/PET scans Additional benefits NHS Hospital Cash Benefit in-patient treatment day-patient treatment Childbirth Cash Benefit Home Nursing Private Ambulance Parent Accommodation Oral Surgery Pregnancy Complications Assistance at Home Lifestyle Surgery** 250 per night up to a total of 2, per day up to a total of per child* if recommended by a specialist where medically necessary (children under 14, one parent) for specified procedures in specified circumstances Up to 2 hours care per day for a maximum of 2 weeks for each eligible in-patient stay Maximum 6 weeks in total per plan year Cover for specified Corrective surgeries subject to a 25% contribution to the cost of consultations and package of treatment Cover for specified Weight loss surgeries subject to a 25% contribution to the cost of consultations and package of treatment * This is a single cash payment of 100, which we pay following the birth or adoption of a child if the employee has been on the plan for at least 10 months. ** Applicable for schemes with 20+ insured employees.

2 Your plan automatically includes one of two Cancer Cover options as well as one of two Vitality options. These benefits are detailed below. Please check your quote document to see which has been included in your plan. Please contact us or speak to your adviser if you would like to receive a quote for the other options. Cancer Cover Full Cancer Cover All in-patient and out-patient costs related to the treatment of cancer, once diagnosed: Radiotherapy, chemotherapy and follow-up consultations Biological therapies Hormone and bisphosphonate therapies Cancer surgery and reconstructive surgery Stem cell transplantation Core Cancer Cover Core Cancer Cover applies a 12 month limit on the use of biological therapies. It will also apply a 3 month limit on hormone or bisphosphonate therapy when prescribed on their own*. This will result in a discount on your premium (subject to the limits specified) * These limits apply for the whole of the time a member is covered by PruHealth, whether under this plan or any other plan with us. Vitality (with Vitality Plus) We help your employees understand their health and suggest ways they can improve it through our online health tools. We make it cheaper for your employees to get healthy through our Vitality Healthcheck, free fitness assessments with Virgin Active or LA fitness, discounted monthly gym membership fees and bonus Nectar points when they buy certain healthy food from Sainsbury s. We also give your employees discounts with our health partners and help them track their healthy activities. We give your employees rewards to keep them motivated. We ve chosen rewards that will help your employees rest, relax and live life well. They range from the everyday to the extraordinary. Visit pruhealth.co.uk for full details of the rewards your employees could receive. Please note these rewards are specific to Vitality Plus. If you remove the rewards from your plan, there will be an impact on your premium. And if your employees are non-smokers, we could give them cashback every quarter if they have taken the Vitality Healthcheck to confirm they are a non-smoker. If you took out the plan from 1 January 2013, your employees will automatically have our quarterly non-smoker s cashback. If you took out the plan before 1 January 2013 your employees will have been on the 3-yearly Vitality Cashback and from 1 April 2013, they have had the option to switch to the non-smoker s cashback. Your employees can find information about the non-smoker s cashback and how to switch on the Member Zone. Please note, if you took out the plan before 1 April 2013, and an employee joins the scheme after your scheme has gone through renewal from 1 April 2013, then our non-smoker s cashback will automatically apply to their plan.

3 COVER OPTIONS CHOOSE ANY OF THE BELOW OPTIONAL BENEFITS Out-patient Cover Consultations, specialist fees, physiotherapy and diagnostic tests such as blood tests and x-rays (in addition to the MRI/CT/PET scans included within Core Cover) 500/ 750/ 1,000/ 1,250/ 1,500/ Out-patient Diagnostics for out-patient diagnostics can be added so that out-patient diagnostic tests are covered in full and only specialist consultations and physiotherapy would be subject to the Out-patient Cover limit Therapies Cover Chiropractic treatment, osteopathy, chiropody/podiatry, acupuncture, homeopathy, and two consultations with a dietician following GP or specialist referral 350/ Psychiatric Cover In-patient, day-patient and out-patient psychiatric treatment. Out-patient psychiatric treatment is covered up to 1,500 within the limit 15,000/ 20,000 Employee Assistance Programme (Can be chosen for a specified number of employees only but must be health insured members) Up to six face to face counselling sessions and unlimited access to a confidential telephone advice service, 24 hours a day, 365 days a year Private GP Helpline 24 hour phone line giving access to a practising GP seven days a week (Also included within the Personal Health Fund, if selected) an additional premium will apply if any of the Cover Options are selected.

4 Dental Cover Major Dental Treatment Major and Routine Dental Treatment All benefits are per insured member, per plan year unless otherwise stated Maintenance: routine examinations Maintenance: routine scaling and polishing Maintenance: dental x-ray Charges for radiography of teeth or jaw Up to 30 per claim Up to 40 per claim Up to 40 per claim Treatment: fillings Up to 40 per claim Crowns: new or replacement Up to 300 Up to 400 Inlay/onlay/overlay: new or replacement Up to 100 Bridges/implants: new or replacement Up to 200 Up to 300 Root canal treatment Up to 150 Up to 250 Apicectomy Up to 100 Up to 150 Extractions Up to 150 Up to 250 Dentures: new or replacement Up to 250 Up to 350 Accident and emergency: Accidental dental: charges made by a dentist or specialist for a dental accident Maximum of four claims per plan year Emergency dental: charges for immediate relief of severe pain, haemorrhage and/or infection Up to 2,500 per claim Up to 2,500 per claim Up to 300 per claim Emergency call-out fees: Up to 50 per claim Up to 50 per claim To be eligible for this benefit, a member must have undergone a check-up with their regular dentist in the 12 months before the start of cover and completed all recommended dental treatment. If they haven t seen a dentist in that time, then they ll need to have a check-up and complete all recommended dental treatment before they are eligible for cover. This requirement doesn t apply for routine examinations or routine scaling and polishing under Major and Routine Dental Treatment. Terms, conditions and exclusions apply and these are provided in full in the documents that the member receives when the plan is taken out.

5 Worldwide Travel Cover (up to 120 days per trip) Overseas Medical Expenses Medical cover if taken ill overseas, including accommodation costs and travel expenses for one person to remain behind with the sick or injured member* Up to 10 million Repatriation expenses* Transfer of body or ashes back to the UK Cost of burial or cremation outside the UK Up to 1,000 Other travel expenses Loss of or damage to personal belongings* Up to 2,000 Loss of personal money* Up to 1,000 Loss of or damage to business machines* Up to 1,000 Delayed departure Up to 100 Missed departure* Up to 500 Cancelling the trip or cutting it short* Up to 4,000 Personal accident Up to 25,000 Personal liability Up to 2 million Loss of passport* Up to 250 Delayed baggage* Up to 200 Legal expenses Up to 25,000 Replacement employee travelling costs* Up to 1,000 Winter Sports (cover is limited to 21 days in total each plan year) Loss of or damage to ski or snowboarding equipment* Up to 500 per plan year Loss of ski pass* Up to 500 per plan year Piste closure ( 30 a day)* Up to 500 per plan year Loss of use of hired skis and ski pass due to illness Up to 500 per plan year or injury* Benefits are per holiday/business trip unless otherwise stated. *A 50 excess applies. Terms, conditions and exclusions apply to the plan and are provided in full in the terms and conditions that the member receives when the plan is taken out.

6 Emergency Overseas Cover (up to 90 days per trip) Medical cover if taken ill overseas, including accommodation costs and travel expenses for one person to remain behind with the sick or injured member* Up to 100,000 Repatriation or evacuation expenses* Up to 1 million Transfer of body or ashes back to the UK Cost of burial or cremation outside the UK Up to 1,000 All benefits are per member, per trip, unless otherwise stated. * A 50 excess applies Personal Health Fund (PHF) Helping employees pay for everyday healthcare expenses such as optical and dental treatment, health screens, physiotherapy and the cost of prescription prepayment certificates. Employees and each adult on the plan must complete an online Health Review to make use of their PHF and at each renewal they can carry over any funds left from the previous plan year. They will also have access to a free Private GP helpline. Start off with Bronze 75 When they reach Silver Add 50 Silver 125 When they reach Gold Add another 50 Gold 175 When they reach Platinum Add another 50 Platinum 225 Plan options Excess 0, 100, 250, 500 or 1,000 Option to choose between per claim or per plan year Vitality-linked excess (Available to schemes with ten or more employees) All employees start with a 250 excess and when they improve their Vitality status, their excess amount will reduce: Bronze status = 250 excess Silver status = 100 excess Gold/Platinum status = 0 excess Hospital lists Underwriting basis Local, Countrywide, Premier Moratorium, full medical underwriting (FMU), medical history disregarded (MHD), continued personal medical exclusions (switch) PruHealth is a trading name of Prudential Health Services Limited. Registered number Registered in England and Wales. Registered office at Laurence Pountney Hill, London EC4R 0HH. Prudential Health Services Limited is authorised and regulated by the Financial Conduct Authority. GM_18287PH_PRUHT19734_09/2013