Preferential The health plan that provides comprehensive private medical insurance cover

Transcription

1 Preferential The health plan that provides comprehensive private medical insurance cover HEALTH INSURANCE

2 Preferential Private Health Cover Preferential provides your employees with extensive levels of private medical insurance cover. It includes a comprehensive range of benefits to provide peace of mind to your employees throughout a period of ill health. It is designed to provide cover to diagnose and treat acute conditions. These are medical conditions that are likely to respond quickly to treatment, leading to a full recovery and returning your employees to their previous state of health. Preferential gives your employees access to some of the finest medical facilities. If they are referred by a GP for further investigation they can have the reassurance that they will be able to see a consultant quickly, have treatment at a private hospital, and if necessary, be covered for physiotherapy to help them recover. At Simplyhealth, our policies are designed to be as easy to understand and simple to use as we can make them. Our dedicated team of advisers are here to arrange treatment and guide your employees through every step. Why you should consider PMI cover: Benefits for your business Retain talented staff by providing tangible healthcare benefits your employees will value Enhance your recruitment package and attract the best talent Help improve your absence rates and costs. Sickness absence cost UK businesses, on average, 673 per employee in 2011 (CIPD/Simplyhealth Absence Management Report 2011) Our Service+ helpline means we ll take care of the administration and manage all claims with your employees Can be used on its own or combined with an existing cash plan or dental plan for a more complete healthcare solution Access to some of the best hospitals in the UK to get your employees back to work quickly 2

3 Benefits for your employees Peace of mind that they can access the best possible care at a comfortable private hospital They can access the consultations and treatment they need quickly We can take care of arranging consultations and treatment appointments on their behalf and ensure all payments are taken care of Table of cover Preferential Benefit Out-patient specialist consultations High cost scans including CT, MRI and PET scans Out-patient services Hospital charges for in-patient and day-patient treatment Surgeons and anaesthetists fees Oncology including radiotherapy and chemotherapy Specialist physicians fees for in-patient and day-patient treatment Oral surgery Psychiatric benefits Out-patient consultations and treatment In-patient and day-patient treatment NHS cash benefit New child payment Parent accommodation charges Private ambulance Home nursing Hospice benefit Emergency in-patient treatment overseas Advice lines and counselling services Cover for specialist referrals for specific conditions 100 per day or night 150 per birth 100 per night 100,000 policy lifetime limit per person for telephone services For further details about what is and what isn t covered, including plan exclusions such as pre-existing conditions, chronic conditions, emergency treatment and overseas treatment, please refer to the Preferential group policy document. 3

4 Help is always at hand With Simplyhealth your employees are covered for a wide range of healthcare benefits. In addition to these, our free, confidential helplines are available 24 hours a day, 365 days a year. By calling our health and wellbeing helpline your employees can speak directly to an expert for assistance. They can discuss matters from health and lifestyle issues, to childcare and hospital procedures. Should your employees need to speak to a professionally trained counsellor, they can call our counsellor helpline. This service provides help to resolve issues from relationship and family difficulties, to bereavement and debt. All our Scales of cover Private hospitals are classified according to how much they charge for treatment. The hospital scales are from A to D, where scale A covers the most expensive hospitals (such as those in central London), and scale D covers the least expensive. The scale does not reflect the quality of the treatment received in these hospitals, merely the associated expenses like the cost of a room. counsellors are highly experienced and uphold the British Association of Counselling and Psychotherapy Code of Ethics and Practice for Counsellors. A simpler way with Service+ For no extra cost, we can take the worry away from your employees by arranging their diagnostic tests, medical treatment and hospital accommodation. When they call, all they need to do is ask for their claim to be handled through Service+. Excess options Excesses are a simple way to reduce premiums. The excess amount is only applied once each year for each person you have included on the policy. They don t have to pay the full excess for every claim made. Get a healthy discount Excess level Scale D Scale C Scale B Scale A You can reduce your premium by taking up an excess option. For flexibility we offer different excess levels. 4

5 How excesses work We ll apply the excess to the first claim. If the excess is not fully paid, usually because the claim is less than the excess, then the rest of the excess amount will be carried over to subsequent claims, until it s paid in full. The excess starts again on the renewal date each year. If an employee is continuing treatment when you renew the policy, the excess will apply twice. The same out-patient limits apply whether you have an excess or not. Excesses don t apply to any cash benefits such as NHS cash benefit or New child payment. The example below shows how excesses may work in a single claiming year and across claiming years with a 200 excess. Preferential Year 1 March June Group joins Simplyhealth with 200 excess Member joins December Member receives physiotherapy, cost 90 Full excess 200 Member pays 90 We pay 0 February Member has consultation with a specialist, cost 150 Year 2 March excess 110 Member pays 110 Member has diagnostic tests, cost 500 excess 0 Member pays 0 Group renewal date with 200 excess Member receives surgery, cost 8,000 We pay 40 We pay 500 excess 110 excess 0 Full excess 200 Member pays 200 We pay 7,800 excess 0 5

6 What our customers say Dear Simplyhealth, In May last year, after feeling unwell for over a year, my GP and several senior consultants at the local hospital were unable to find anything wrong despite me having extensive blood tests and x-rays. In the end I used the Simplyhealth policy to see a specialist consultant at the local Spire Healthcare hospital. In short, and after CT Scans, further blood tests and a biopsy at Papworth Hospital I was diagnosed with Non Hodgkin s Lymphoma. This clearly was a major shock to both myself and my family and frankly was the worst period of my life so far. I was furious with the previous medical professionals for not spotting the disease earlier but at the same time trying to engage and remain positive as the pace of the Simplyhealth approach kicked in. At this stage I make the point that my wife and I have had alternatives to the NHS scheme for most of our working lives be it through company group schemes, our own private medical insurance or in my case military medical services. So we have a broad understanding of what is on the market and the different approaches each has. It is also unusual for me to write this style of letter. But, it is rare to find a company these days that suggests it offers a different and genuinely customer focused approach that is unique but which is any more than marketing hype. In the case of Simplyhealth my assessment is that the company has been outstanding through this personal drama and the unique approach is clearly defined. The approach that Simplyhealth took was to appoint a personal Clinical Care Manager who in my case was Michael Robinson. Michael promptly contacted my wife and I directly and we agreed that he would manage administration directly with my wife in order to take the pressure off me. He then contacted my Hematologist and the practice at the Nuffield Hospital in Cambridge and developed a long term treatment plan with them so that approval and payment for the wide spectrum of tests, scans and chemotherapy could proceed without us having to intervene. This enabled my wife and I to focus on the pressures/family issues that cancer inevitably throws up. Both my Clinical Care Manager and Simplyhealth have been brilliant. Michael has delicately and informally kept in touch throughout the process; the odd telephone call here, the odd there - which was just what I needed. When problems developed and I needed an early MRI scan this was cleared for me over the phone as I drove to the hospital...a superb performance by Michael and as I mention above a company culture that is very different from any similar I have encountered. Even my Hematologist has commented that of all the Private Insurers he works with that Simplyhealth are both the most efficient administratively and best informed clinically. The good news is that I am now in a complete remission and it would not be too dramatic to say that the simplicity, pace and culture of Simplyhealth and Michael in particular has been a major contributor to this more positive position. Many thanks. Yours sincerely, Simplyhealth customer This is a genuine letter received by Simplyhealth. The customer s name has been removed to safeguard their identity. 6

7 About Simplyhealth Experts in healthcare At Simplyhealth we ve been helping people access affordable healthcare for 140 years. We only focus on healthcare, so you can rely on us for our specialist knowledge. We help nearly four million people with their health and 11,000 companies choose us as their healthcare provider including the John Lewis Partnership, British Airways, Royal Mail and Tesco. We re committed to delivering exceptional personal customer service, and go out of our way to do the right thing, not the easy thing. All of our customer care advisors are based in the UK and we always try to avoid automated telephone systems. We ve won many awards for our health plans and customer service. Most recently we were named Best Health Insurance Provider at the Consumer Moneyfacts Awards We follow mutual values and care about our communities. Last year we donated over 1 million to local causes and national charities. What We can be bothered means to you Our vision is to inspire people towards better health. Here s how we show our clients that we can be bothered. Partnership philosophy We specialise in healthcare, which gives us a unique perspective so we can work with you to offer a solution that s tailored to your needs and budget. We won t push one particular plan but instead take the time to understand what s right for your business so you can make an informed choice. Better health Inspiring people towards better health is at the heart of our business. Our plans can offer support with issues in the workplace such as stress, back pain and absence management. We ll even come in to explain how our plans work to your employees, so they can make the most of them. Personal service The Institute of Customer Service recognises that our customer services team is world class, and we have achieved its sought after ServiceMark accreditation. We try to avoid automated telephone systems, so when your employees call during opening hours they ll speak to a person in one of our UK call centres. For complex private medical insurance claims your employees will have a dedicated nurse to help them through diagnosis and treatment. We can also arrange all of their appointments for them. ServiceMark accredited 7

8 We re here to help your employees and your business For more information about Simplyhealth, please visit: Call Follow us on Find us on LinkedIn: Watch our videos on YouTube: Private health insurance Health cash plans Dental plans Self funded health plans corp Simplyhealth is a trading name of Simplyhealth Access, registered and incorporated in England and Wales, No Registered office: Hambleden House, Waterloo Court, Andover, Hampshire, SP10 1LQ. Authorised and regulated by the Financial Services Authority. Your calls may be recorded and monitored for training and quality assurance purposes. SA-COC