Enterprise Flexible Benefits - Shared Responsibility
How it works
- If your company has chosen to have Shared Responsibility there are maximum annual limits per policyholder of £250, £500, £1,000, £3,000 or £5,000.
- For all eligible claims the policyholder agrees to pay 25% up to the chosen maximum annual limit, and WPA will pay the remaining 75%.
- Once the policyholder has reached their maximum annual limit for one or all medical conditions, WPA will pay 100% of their eligible claims until the next policy year.
For example...
| Order of treatment | Claimed treatment | Policyholder pays (with an annual limit of £1,000) | WPA pay |
|---|---|---|---|
| Specialist | £100.00 | £25.00 | £75.00 |
| Tests | £400.00 | £100.00 | £300.00 |
| Hospital charges | £3,500.00 | £875.00 | £2,625.00 |
|
The policyholder has now reached their Shared
Responsibility limit of £1,000. WPA will pay 100% of eligible claims until the next policy year. |
|||
| Specialist | £100.00 | -- | £100.00 |
| Therapy | £200.00 | -- | £200.00 |
| Total | £4,300.00 | £1,000.00 | £3,300.00 |
Please note that the example assumes that the Options chosen allow for the types of treatment illustrated.
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