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HEALTH INSURANCE
HEALTH INSURANCE
Simply Healthworks puts private medical insurance within your company’s reach
Simply Healthworks - making private medical insurance more accessible
Simply Healthworks has been created to make private medical insurance more accessible to an even greater number of businesses and their employees. It combines simplicity with affordability to deliver real, tangible advantages for employers and employees alike. Created with small and medium sized businesses in mind, Simply Healthworks is a flexible solution that allows you to choose the options that meet your company’s needs and budget, and leave out the elements that you don’t require. This modular plan offers all the essential benefits that employees associate with and value from private medical insurance.
All elements are designed to give your employees the care they need to help them get well and return to work, whilst enabling you to build a solution that is tailored to your needs.
This annual cover offers initial private consultations, scans and tests, out-patient, day-patient and in-patient investigations and treatment. Offering Simply Healthworks to your
employees means they have access to help should the worst happen and they fall ill with an eligible condition covered by the policy.
At Simplyhealth, our policies are designed to be easy to understand and simple to use. Our dedicated team of advisers are here to arrange treatment and guide your employees through every step.
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Why you should consider PMI cover
Key benefits for you
• A simple and cost effective way to experience the essential benefits of private healthcare
• Retain talented staff by providing tangible healthcare benefits your employees will value
• Enhance your recruitment package and attract the best talent
• Help improve your long term absence rates and costs
• 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
Benefits for your employees
• Peace of mind that they can access the best possible care at our specially chosen hospitals
• 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
• The flexibility to upgrade their cover to include a spouse or partner and children under the age of 21, or 24 if in full time education
• Covers everyday healthcare needs too
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Simply Healthworks Core Cover
All employees covered by Simply Healthworks benefit from Core Cover. You can then choose which additional Choices you would like for employees based on criteria such as their salary banding and your budget.
Core cover - In-patient, out-patient and day-patient treatmentPlease note core cover does not include psychiatric cover (see Choice 1) or diagnosed cancer conditions (see Choice 3)
* NHS cash benefit: up to 91 days / nights per claiming year
Healthworks
Treatment Cover
Specialist consultations fees Full cover
Scans and tests Full cover
Surgery fees Full cover
Hospital charges Full cover
NHS cash benefit £100 per day or night*
Parent accommodation charges Full cover
Post operative physiotherapy Full cover
Oral surgery Full cover for specific conditions
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Choice 1 – Psychiatric cover
Choice 2 - Complementary therapies
Choice 3 - Treatment for cancer conditions
Choice 4 - Dental and optical cover Amounts shown are per year. Payback for all levels is at 100%.
For further details about what is and is not covered under each Choice, including plan exclusions such as pre-existing conditions, chronic conditions and emergency treatment, please refer to the Simply Healthworks policy document.
Treatment Cover
In-patient and day-patient treatment Full cover up to 28 days per claiming year
Out-patient treatment £2,000 per person per claiming year
Treatment Cover
Physiotherapy Full cover
Chiropractic Full cover
Osteopathy Full cover
Acupuncture Full cover
Homeopathy Full cover
Treatment Cover
Level 1 £30,000 per claiming year
Level 2 Full cover
Treatment Level 1 Level 2 Level 3
Dental £75 £100 £150
Optical £75 £100 £150
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Help is always at handWith 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 counsellors are highly experienced and are members of the British Association of Counselling and Psychotherapy Code of Ethics and Practice.
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+.
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Scales of coverPrivate hospitals are classified according to how much they charge for treatment. The hospital scales are Capital and National, where Capital covers the most expensive hospitals (such as those in central London), and National 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.
Excess optionsExcesses 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
You can reduce your premium by taking up an excess option. For flexibility we offer different excess levels.
Excess level National and capital scales
1 £75
2 £150
3 £300
4 £375
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How excesses workWe’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 your 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.
The example below shows how excesses may work in a single claiming year and across claiming years with a £150 excess.
Healthworks
Year 1 March Group joins Simplyhealth with £150 excess
June Member joins
December Member receives physiotherapy, cost £90
Full excess£150
Member pays £90
We pay £0 Remaining excess £60
February Member has a consultation with a specialist, cost £150
Remaining excess £60
Member pays £60
We pay £90 Remaining excess £0
Member has diagnostic tests, cost £500
Remaining excess £0
Member pays £0
We pay £500
Year 2 March Group renewal date with £150 excess
Member receives surgery, cost £8,000
Full excess£150
Member pays£150
We pay £7,850
Remaining excess £0
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About SimplyhealthExperts 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 20,000 companies choose us as their healthcare providers 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 2011.
We follow mutual values and care about our communities. Last year we donated over £1 million to local causes and national charities.
www.simplyhealth.co.uk
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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 email
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.
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What ‘We can be bothered’ means to youOur 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
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SA-COC-001765
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Private health insurance Health cash plans Dental plans Self funded health plans
www.simplyhealth.co.uk/socialmedia
Simplyhealth is a trading name of Simplyhealth Access, registered and incorporated in England and Wales, No.183035. 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.
We’re here to help your employees and your business
For more information about Simplyhealth, please visit:www.simplyhealth.co.uk/forbusiness
Call 0845 075 0063Email [email protected]
Follow us on Twitter:@simplyhealthUK
Find us on LinkedIn:www.linkedin.com/company/simplyhealth
Watch our videos on YouTube:www.youtube.com/user/simplyhealthUK