PatientChoice Priority. At last, value for money health cover for companies

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1 PatientChoice Priority At last, value for money health cover for companies

2 Introducing PatientChoice Priority PatientChoice Priority is a health insurance plan from PatientChoice that offers a compelling proposition for businesses in the UK easily accessible value for money health insurance. Available to companies with more than 100 employees, PatientChoice Priority provides cover for many of the conditions that could cause major absences from work and affect employee productivity. Developed for large employers with the workforce in mind, these conditions can often require operations, many of which often have long waiting times in the NHS.The plan covers the surgical treatment of these conditions, which include hernias, hip, knee and back joint problems, varicose veins and inflamed sinuses. Should one of your employees need one of the operations covered by PatientChoice Priority, our case managers aim to work with them to arrange treatment in private hospitals, allowing your employees to get treated quickly and in maximum comfort. With PatientChoice Priority, not only will you be providing an employee benefit that is likely to be well received by your staff, you could also save money in the long run by getting your employees back to work more quickly. PatientChoice Priority is brought to you by PatientChoice Limited, a specialist health intermediary that designs and administers medical insurance schemes on behalf of insurance companies.the company is fully authorised and regulated by the Financial Services Authority and is committed to the highest level of service standards for their customers. PatientChoice Priority is insured and underwritten by Great Lakes Reinsurance (UK) PLC. 2

3 How does PatientChoice Priority work? PatientChoice Priority covers your employees for 60 common operations and surgical procedures, which have been graded into three bands according to their complexity. These range from Band A, which covers the most straightforward procedures, through to Band C, which covers the more complex ones. Should an employee require one of the operations covered, our treatment sourcing service will arrange a fixed-price package of treatment from a private hospital, spending up to the amount specified in the table below. This will help your employees return to work as quickly as possible. What s more, should private treatment for a condition be unavailable or should they prefer to be treated in a NHS hospital, then the policy will pay the employer a cash benefit as compensation for their employees time off work. Benefit table Classification of medical procedure Private Hospital Benefits NHS Benefits Band A 3, Band B 6,000 1,500 Band C 10,000 2,500 The 60 specific operations/surgical procedures have been chosen carefully with the workforce in mind. The policy covers various procedures relating to many common conditions including the treatment of: Eyes Ears Sinus Problems Tonsils Hernias Gall Bladders & Gall Stones Heart Blood vessels Varicose Veins Bladders Gynaecological problems Spines & Slipped Discs Hips & knees Please see our Key Facts document for a full list of all operations covered and their respective classifications. It is important to note that full terms and conditions are contained in the PatientChoice Priority policy document, which you should also read carefully. 3

4 The Managed Care approach At the point an operation is required, we aim to work closely with you and your employee to ensure they get the most appropriate treatment possible. We call this Managed Care.We will direct your employees to private hospitals that offer fixed price packages and we ll also arrange their treatment within the specified budget as outlined in the benefit table on page 3. Managed Care benefits both you and your employees.all treatment details included in the fixed-price package will be explained carefully at the point of claim so your employees know exactly what to expect. And as we will be arranging and guiding them through their care, you will benefit in having them back at work quicker and in better shape. Cash benefits for NHS treatment The NHS benefits shown in the benefit table on page 3 are paid directly to the employer.they are paid if a fixed-price package of care for an eligible benefit within the Private Hospital benefits shown is either not available or not wanted by the employee, in which case the employee will need to seek treatment in the NHS. 4

5 How it works an at a glance summary Employee is told that they need an operation or medical procedure that is covered in the plan Employee submits claim for approval and to ensure eligibility Telephone consultation with employee to ascertain preferences and suitability for private care* Employee goes private Employee Employee chooses goes to have private treatment on the NHS or does not qualify for a fixed-price package within a private hospital Managed Care begins - we will work closely with the employee to ensure an appropriate and convenient fixedprice package is chosen Payment is made directly to the private hospital up to the amounts shown in the benefit table NHS cash benefit is paid directly to the employer for the amount shown in the benefit table *over 90% of cases are deemed suitable for private care. 5

6 Prices that speak for themselves PatientChoice Priority Number of employees covered Annual premium per employee Monthly equivalent Weekly equivalent ,000-5, ,001-9, ,000 and over Our premiums are payable annually in advance or you can pay by monthly direct debit (please add 5% to above premiums for the monthly payment option). New members may join or leave the scheme at the start of any month once the plan has started. If you have added or deleted employees during the policy, you will be invoiced or reimbursed for any adjustment to the annual premium at the end of each policy year. All premiums include Insurance Premium Tax (IPT). 6

7 How to join One of the biggest benefits of PatientChoice Priority is its simplicity and applying for cover is no exception. Cover is immediate and no medicals are required. Following a visit to their GP or consultant, any employee who requires an operation that is insured by the policy will be covered, as long as they have not had any advice, treatment or symptoms relating to their operation two years prior to the start of the policy. In order to register your company with PatientChoice Priority follow these three simple steps: Step One Select the group of employees that you wish to cover. Step Two Complete the application form and decide how you wish to pay. You can either pay by cheque annually in advance or monthly by direct debit. Step Three Send a spreadsheet to your intermediary or to PatientChoice ( priority@patientchoice.org) showing each employee s Title, First Name, Surname, Date of Birth and Postcode. Your scheme will then be set up and full details confirming your membership will be sent to you in the post. 7

8 PatientChoice Priority was developed and is administered by PatientChoice Limited who are authorised and regulated by the Financial Services Authority. FSA Registration Number You can check this at or telephone them on PatientChoice Limited 83 Victoria Street London SW1H 0HW Tel: Fax: Telephone calls may be recorded as part of our quality control process. Lines are open between 9am and 6pm Monday to Friday. Calls are free of charge when dialled from a UK landline. PatientChoice Priority is insured and underwritten by Great Lakes Reinsurance (UK) PLC who are authorised and regulated by the Financial Services Authority. FSA Registration Number You can check this at or telephone them on Great Lakes Reinsurance (UK) PLC. Plantation Place 30 Fenchurch Street London EC3M 3AJ

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