This new plan for SMEs, which is open to new business from 1 July, replaces the existing Preferential, Accessible and Santé plans. The basic plan includes a number of Core Cover benefits (see website for more details) while cancer cover and psychiatric conditions are optional.
End of life cancer care is limited to £500 and post-treatment monitoring is limited to five years. Psychiatric conditions are limited to 28 days unless arranged through Simplyhealth’s Mental Health Management service.
There are then six choice options, allowing cover to be increased or decreased. They are:
* Choice 1: enhanced benefits. Accidental dental injury (max £5K); face-to-face counselling (max six sessions) and NHS cash increased to £300 per day or night plus new child benefit increased to £300.
* Choice 2: ongoing care. Up to £250 each for private GP and consultations/tests for chronic conditions plus monitoring cancer for up to ten years.
* Choice 3: travel cover.
* Choice 4: limited outpatient cover. Up to £1,000 a year.
* Choice 5: no cover for psychiatric treatment.
* Choice 6: removing cover for cancer.
In addition, clients can choose which excess level and hospital list (there are three: Metropolitan, National and Connections) to have. Two versions of the plan are available: one where Simplyhealth in effect decides where the individual should be treated and the other where his or her GP does.
All plan versions offer access to advice lines and counselling services as well as a second opinion (on medical grounds). In effect there is also a built-in continuation option, although pre-existing conditions may be excluded if the level of cover increases. Underwriting options are moratorium (5/2/2 rolling) or full medical underwriting. Switching from another insurer may also be available.
What They Say
Head of employer marketing, Howard Hughes, said: “Through our commitment to delivering excellent personal customer service and through the development of new partnerships with specialist healthcare providers we are able to provide customers an enhanced experience with fast access to healthcare when they need it.”
What We Say
"This plan offers good scope to tailor a solution to meet most SMEs’ needs in a cost-effective way. The modular design allows cover to be increased or decreased and the choices are different to the typical options we see on PMI and look more customer-focused than some.
"The option which means that Simplyhealth chooses the provider will be seen as a downside for some individuals. However, given some providers’ blacklisting of a few hospital providers, that attitude could well change. In any case, having an option which enables the GP to choose the provider provides an alternative for clients.
"The literature is especially clear and well set out too."