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Company Health Essentials

Company Health Essentials

Company health essentials are two low cost alternative products to standard health insurance.

Company Cancer Essentials – provides an up front cash benefit for eligible claims and access to drugs recommended by, but not funded by, the NHS, as well as ongoing support throughout an employee's treatment.

Company Physio Essentials – our 3 step process that aims to get employees back on their feet faster. This product provides access to physiotherapy and self-management plans that can fit around an employee’s busy life.

We wanted to create products with which employers can support all employees, not just those at the very top of the business. By having company health essentials as part of their benefit package they can help protect themselves from lengthy employee absences.

Essentials products require no underwriting meaning they are very easy to set up providing a lower cost product for businesses.

Want to know more? Click one of the pods below.

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Company Cancer Essentials

Company Cancer Essentials is currently only available to company paid or company paid flex schemes insuring 250+ lives or more, or Employee paid flex schemes where the product is offered to 2,500 lives or more.

It’s important to fully understand this product’s details as this will help you conduct a compliant sale. Full details of cover options and exclusions are listed in the product's brochure.

Company Cancer Essentials ‐ Brochure(PDF 658KB)

The diagnosis and treatment of cancer can prove a difficult time for members and their families. It’s important that beneficial medical advice is readily available before, during and after treatment, as well as access to the necessary drugs – sadly this is not always available under the NHS.

Our Company Cancer Essentials product provides valuable financial and emotional support to employees, should they be diagnosed with cancer.

What’s covered?

Cancer essentials will give employees:

  • £5,000 cash benefit when diagnosed with cancer
  • Up to £100,000 for cancer drugs recommended by but not funded by the NHS
  • Cancer support – phone based practical advice and support for members and their families provided by qualified nurses.
What’s not covered?
  • Pre-existing cancer if the member has been treated for, suffered from, or been diagnosed with cancer in the ten years prior to joining the policy
  • Non melanoma skin cancer unless it has spread to lymph nodes or organs
  • Prostate cancer (unless active treatment is recommended by an NHS specialist)
How will the cost be calculated?

For company paid policies including those provided through flex systems of 250 lives or more.

The base price will be flat rated based on experience and paid per capita, and as such each policy will have a different rate.

For Flex schemes – using salary deduction for 2,500 lives or more

For flex schemes the individual employee (and dependent spouses, should the company allow this) will determine whether they wish to take out the offer on a set date per annum, or when they join the company.

Eligibility

Employees are not eligible for cover if at the time of joining the policy the employee has been:

  • diagnosed with, treated for or suffered with cancer in the last ten years

For employee paid flex schemes the following will also apply, if the employee has been:

  • awaiting any tests or the medical results from tests that have already been undertaken or were aware of any symptoms when they joined the scheme, for example an unexplained lump or a new or abnormal mole
  • placed by their GP or any other medical professional, on a health screening or review programme because they are considered to be at a higher risk of developing cancer. Or had been advised by their GP or other medical professional to join such a scheme.

    For the avoidance of doubt this does not include any routine cancer screening programme provided for the general population based on age, rather than their own medical history. For example breast screening or prostate screening programmes.

If any of these were true when they joined the policy, then they will be ineligible for benefit. It is important this is explained to the employees at the point of offer, and they are informed that they should opt out of this scheme, if it is a company paid policy or they should not select cover if it is a flex scheme, to avoid a P11D benefit charge for benefit they cannot claim.

The eligibility questions will not apply again unless a member has left the policy and wants to join again.

Making a claim

To make a claim for cancer cash benefit, employees will need to phone the claims helpline. We will provide the employee with a claim form which the employee's GP will need to complete.

Once we have received the claim form, we’ll review the claims and, if accepted, we’ll pay the benefit directly to the employee. We’ll also provide the phone number of the cancer helpline at that time.

To make a claim for cancer drugs an employee will need to call the helpline. We'll ask them to provide us with:

  • a letter from their specialist that describes the recommended drug treatment in detail and confirms that it's appropriate
  • a letter from their local commissioning body that clearly rejects the recommended drug treatment on financial grounds, and
  • an estimate from their local NHS trust for the cost of the recommended drug treatment on a self‐pay basis.

We'll review the claim and if eligible, we'll work closely with their NHS provider to arrange payment for their cancer drugs so that the member can focus on treatment and recovery.

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Company Physio Essentials

Only available for company paid schemes covering 250+ lives, and for flex schemes where the employee is paying through salary sacrifice. We will only cover flex schemes where the potential number of eligible lives is 2,500+.

Company Physio Essentials is our low cost option for employers who are concerned about the long and short term health of their employees. It gives employees access to a physiotherapist and exercise programmes which fit around their lives, meaning they get better, faster.

It’s important to fully understand this product’s details as this will help you conduct a compliant sale. Full details of cover options and exclusions are listed in the brochure.

Company Physio Essentials ‐ Brochure(PDF 695KB)

We want to be there to support members through difficult times by offering flexible health cover. Our Physio Essentials product provides support and guidance which aims to help restore your employees’ body movement after an injury or illness.

What’s covered?

Company Physio Essentials offers employees a simple three step process that aims to get them back on their feet.

This service can be used for 5 musculoskeletal conditions per year.

Step 1

If an employee becomes ill or gets injured, and requires support to restore muscle and joint movement, they can simply book a telephone clinical assessment (TCA) online. Physio Essentials cover provides a up to a maximum of 5 TCA calls per policy year.

Step 2

They will be contacted by a qualified clinician who will discuss their symptoms and assess the severity of their condition.

Step 3

Depending on the outcome of your employee’s assessment, and their clinical need, the physiotherapist will offer either:

  • an online personalised programme of exercises to complete, supported by videos, as well as emails with further information and guidance to help ease symptoms.

    They’ll also receive follow up calls to check on their progress.
  • or, they’ll be given access to the network of physiotherapists to book a treatment session in their local area for a physiotherapist to assess their symptoms face-to-face.

    If further face-to-face physiotherapy is appropriate, they’ll recommend a number of sessions to help resolve your employee's symptoms.
  • if the clinician believes the employee's condition can't be managed by physiotherapy, they will provide the employee with details of their assessment that the employee can take to their GP, who may then arrange for them to see a specialist.

Physio Essentials cover also provides:

  • access to an exclusive online portal, providing information to encourage and support good back, neck, muscle and joint health.
What’s not covered?

Employees will not be able to apply for a telephone clinical assessment with a physiotherapist during the first 30 days after they have joined the policy. This restriction does not affect corporate paid policies.

  • Domiciliary physiotherapy - that is face-to-face treatment by a physiotherapist in an employee's home
  • Exercise equipment and appliances - recommended by your physiotherapist, for example orthotics, TENS machines or exercise equipment
How will the cost be calculated?

For company paid policies of 250+ lives or more.

The base price will be flat rated based on experience and paid per capita, and as such each policy will have a different rate.

For Flex schemes – using salary deduction for 2,500+ eligible lives

For flex schemes the individual employee (and dependent spouses, should the company allow this) will determine whether they wish to take out the offer on a set date per annum, or when they join the company.

Underwriting

Company Physio Essentials has no specific underwriting criteria.

Making a claim

To make a claim, employees can simply call us. We’ll review the claim and, if the employee hasn’t used all of their telephone clinical assessments for the policy year, we’ll confirm by email and provide them with access to the online booking portal to arrange their assessment.

A telephone clinical assessment (TCA) is a consultation with a fully qualified physiotherapist from our physiotherapy provider. They’ll review any musculoskeletal problem and recommend the most appropriate course of treatment, which could include virtual or face-to-face physiotherapy.

Each TCA call can only cover one condition or set of symptoms. If the employee needs to discuss musculoskeletal symptoms affecting different parts of their body, for example the knee and the elbow, they’ll need to book a separate TCA for each condition or set of symptoms.

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Can we help you?

Call the team on

0800 014 272

or email them at

ncnd@aviva.com

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