Business Health Insurance Frequently Asked Questions

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Group Scheme detail

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Enterprise Health Group Scheme


Enterprise Flexible Benefits - Frequently Asked Questions

What is the minimum number of employees required to set up a company group scheme?
A minimum of 2 employees are required for a company medical insurance scheme. This applies on joining and at renewal.
Do the employees have to choose the same level of cover?
No.¬†Each employee can be given different level of medical insurance cover.¬†Dependants can also chose a different level of cover to the employee, so it´s totally flexible.
What age can child dependants be included on the business health insurance Group Scheme?
The permitted age of child dependents is 25 years old. The only requirement is that they must be living at the same address as the policyholder, unless they are living away due to being in full time education.
What joining terms does WPA offer?
Full medical underwriting allows us to assess the medical information provided on application forms. As a result we may exclude from cover any current condition or one that is likely to reoccur. Therefore, if your company is taking out medical insurance for the first time, we will ask that all applicants are medically underwritten. If employees already have private medical insurance with another company it may be possible to transfer the current medical underwriting arrangements to WPA. Another option is ´moratorium underwriting´. If you have chosen moratorium underwriting you will not be covered for at least 2 years for any pre-existing conditions (including any related conditions) which you had during the five years before cover starts or which occurred in the first 14 days of cover. If you do not have symptoms, treatment, medication or advice for pre-existing conditions for two continuous years after the Group Scheme starts, cover will then become available.
Can my employees claim for pre-existing conditions?
Cover is not available for pre-existing conditions unless your employee told us about them on their application form and we did not apply any personal medical exclusions.
Are there any qualifying periods?
Qualifying periods apply to the nhs top-up benefits under this Group Scheme. Please refer to the Group Scheme summary for a detailed list of them.
Can the company pay the premiums and then claim the monies back off the employees?
Premiums can be re-couped but only for ´dependants´ and not the employees themselves.
Are there any tax implications if I purchase this for my employees?
There are tax implications, because medical insurance is classed as a taxable benefit, but the tax deducted is relatively minor. Employees are still likely to benefit from an employee scheme compared to individual cover.
Can we mix and match employees cover with medical insurance and cash Group Scheme?
Yes, so long as you have a minimum of 3 employees covered on the Medical Insurance and NHS Top-Up combined.
How does Shared Responsibility (co-payment) work?
If an employee leaves the Group Scheme can we get back part of their premium if we paid annually?
If the whole group leaves then no refund is given. If an individual leaves then a pro rata refund will be made for that individual.
My company has over 500 employees, is this health insurance Group Scheme suitable for us?
No, you should look at our Corporate Healthcare Trusts Plan which has been designed for companies with over 400 employees.

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