With preventative health a key part of their remit, health screenings fit perfectly alongside the dental, optical and physiotherapy benefits included on healthcare cash plans. But, while most providers offer some form of screening benefit, there are questions over whether employees regard it as a valuable addition to a cash plan.
For the providers, its inclusion is a no-brainer.
“Health screening is a valuable benefit,” says Lara Rendell, marketing manager at Health Shield. “A health screen can detect potential health issues before they become a problem, allowing the employee to make lifestyle changes to prevent them. It can save lives.”
Indeed, according to Nuffield Health, the independent sector hospital, screening and gym group, a health problem requiring further investigation is discovered in 5% of people having a health screening while the results of a further third screenings identify health risks that can be remedied through lifestyle changes such as diet or exercise.
When it comes to the health screening benefit on cash plans, there’s little difference between the providers. On their £1 a week plans, most offer an annual benefit of £100.
Some providers take a different approach, notably Westfield Health. It does not include a health screening benefit on its flagship Foresight plan, preferring to include a scanning benefit and an online personal health risk assessment.
“The online health risk assessment will identify areas where an employee can make improvements and suggest ways to do this,” says Paul Shires, sales and marketing director at Westfield Health. “Employers can upgrade to cover the cost of simple biometrics and on-site tests if they want.”
Although health screening is omitted from Westfield Foresight, it is included on its Mosaic plan, where employers can add up to £250 of cover, and on its Advantage Corporate Healthcare Plan, where it features on the two highest levels.
On the Advantage plan, benefits are restricted further too. Benefits, which are £115 on the £19.15 a month plan and £150 on the £28.80 a month plan, are payable over a two-year period and employees can only claim back 75% of the cost of the screening.
BHSF operates a similar model on its health scheme product, extending the benefit period to two years and setting the reimbursement rate at 75%. Likewise, Aviva also has a two-year benefit period with a slightly higher reimbursement rate at 80%. It also imposes a 12 month qualification period on the benefit.
An employee contribution towards a health screen is also expected on Engage Mutual’s One Fund. At £10 a month, employees can access up to £120 of health screening benefit while this increases to £300 at £20 a month. However, on each plan, they must pay an excess of £40.
A different approach is also taken on Medicash’s Reward plan. While other cash plans, including its Proactive plan, require employees to send in a receipt to claim their benefit, this provides them with a voucher to obtain a screening once every three years.
Whether it is a flat annual amount or there are conditions attached, all the health screening benefits share one characteristic – low take-up. Westfield’s Shires says it is in the middle ranges in terms of popularity; Howard Hughes, head of employer marketing at Simplyhealth, describes the usage as low; and Health Shield’s Rendell admits that health screening accounted for a very small percentage of total claims.
“In 2011, health screening accounted for 0.7% of total claims,” she says. “I’m surprised it’s so low but I suspect employees feel they already get value from the three main claims areas – dental, optical and physiotherapy.”
Neither are other cash plan providers overly concerned about the low take-up.
Sue Weir, chief executive of Medicash, explains: “It’s incredibly rare that someone would buy a cash plan for a particular benefit. Across an organisation you’re likely to get all sorts of different health issues and, with their basketful of benefits, a cash plan can deliver value to everyone.”
Some have had more success promoting their health screening benefit. David Castling, commercial sales manager at Engage Mutual, says he is working with one organisation to implement the plan so employees can take advantage of health screening.
“The company has a high proportion of employees who are female and over 50 and it would like to help them with the cost of breast screening,” he explains.
But while the providers defend the low take-up on health screening, Susan Brooks, consultant at Lorica Employee Benefits, is more dismissive of it as a benefit on a cash plan.
“It’s a paper benefit that just doesn’t get used,” she says. “Even if you try to increase usage you find that employees don’t like it as, even if there’s 100% reimbursement on the benefit, they usually have to make some contribution towards the cost of the screening.”
Prices supplied by Bupa for its health screens give an indication of the scale of the contribution an employee might be required to make. Its most basic screening, Bupa Essential Health, costs £400. On a fairly standard entry level cash plan, £100 of benefit would leave the employee paying a further £300 for their screen. Even on the more generous cash plans, such as Simplyhealth’s top level plan at £3.50 a week, which gives £300 of benefit, the employee is left with a £100 bill to pick up.
Cheaper health screens are available too. For instance, Randox Health Checks uses diagnostic screening tests and its packages start at £150 for 35 individual tests through to £1,995 for its most comprehensive screening covering 187 tests. But its head of business Valerie Phillips recognises that cash plan providers have a struggle promoting health screening to employees with their products.
“Health screenings are often low priority for employees with cash plans, especially when it comes to preventative healthcare,” she says. “Accessibility can be an issue too: employers need to make sure they’re easily available to employees in terms of time and location.”
Attention to these details may help to push up take-up but, with employees facing a shortfall on most health screens, employers looking to use a cash plan to deliver this benefit are unlikely to be successful. Brooks says that even when she’s bespoking a cash plan for a client, and has the opportunity to include a higher level of health screening benefit, they’re unlikely to take this option.
“If offering a health screen is part of the employer’s health strategy, they’ll offer it as a standalone benefit to ensure high take-up,” she says. “We have clients that do this and also offer a cash plan.”
On a standalone basis, there can be more flexibility around health screenings too. For example, Nuffield Health’s health screenings cost from £250 to £1,000 and, depending on the size of the employer and its requirements, can be provided onsite or in a medical centre, hospital or one of its gyms.
“We’ll also work with the organisation to understand what it wants to achieve,” adds Dr Andrew Jones, managing director of Nuffield Health Corporate Wellbeing. “A health assessment can be a great way to identify health problems early but the effectiveness can be improved by integrating it with other health initiatives. Employers are starting to think about employee health differently.”