Looking after the backbone of Britain Business Health Select Private healthcare for small and medium businesses
Jack of all trades card V1-09.04.14 Cornerstone V1-09.04.14 ack of all trades J ack of all trades J The cornerstone of our recovery You re the first through the door, and the last to leave. The jack of all trades and the master too. Small businesses are the fuel that powers Britain. You re the future employment prospects for millions, the cornerstone of our recovery, and the backbone of our economy. And it s our job to keep you healthy. We can help you build a healthcare plan that s as unique as your business. A plan to fast track you and your people with access to diagnosis and treatment. And to support you all back to health, and back to work as quickly as possible. We re committed to working together with you to ensure your business healthcare scheme is tailored to your business and that you and your employees are supported every step of the way. 2
Contents Benefits of healthcare cover for your business....4 Support for you to help ease the pressure...16 Building a plan for your business...6 Support for your team as part of your membership..18 Manage the cost of your plan...8 Your choices explained...20 What you can expect from us...11 Your options explained...23 Our Heart and Cancer Commitment...14 Start small think big... 30 3
Nothing compares to the independence of managing a business, but it can be tough too. You have to wear all the hats, juggle all the balls (and budgets), and keep going long after everyone else has downed tools for the night. One thing is certain, it s a lot easier to keep all the plates spinning when you and your team are fit and healthy. We ve thought of everything we can do to help get you better and back to work fast. Benefits of healthcare for your business 4
Benefits of healthcare for your business Build a healthcare plan as personal as your business We offer a wide range of flexible choices that can be tailored to suit the needs of your business and your budget. Get appointments that fit around work and remove the hassle You need to be in work, not waiting in queues feeling unwell. With our Fast Track Appointments service, we can save you precious time and trouble by booking your appointments fast. When your GP refers you or one of your team for treatment, just ask for an open referral (which is a referral that doesn t name an individual specialist) and we ll arrange and book everything to suit you, including the right time, the right location (near home or work) and even outside of normal working hours. We aim to have booked your appointment by the end of the next working day. Fast telephone access to expert physiotherapy services As a member of AXA PPP healthcare, with our Working Body service you can arrange a phone call with a physiotherapist about all types of conditions that affect bones, joints and muscles, to make sure you're getting the advice and treatment that's right for you. And there's no need to see your GP first. See an experienced specialist or practitioner every time Know that you re always seeing someone who s an expert in their field, someone with all the specialist knowledge, skills and training needed for your diagnosis and treatment. We work with over 24,000 experienced specialists and practitioners. Expert help Imagine having a medical expert you could call anytime you or your team have a health worry, big or small. Our nurses and counsellors are available by phone 24/7 to give health information and help support your team whenever they need it. With health constantly in the news and all over the web, it s tough knowing what to trust. Our online health centres bring together the latest information and facts from our own doctors and nurses, leading medical authorities, specialist charities and NHS resources so you get straight to the information you need. Dedicated Heart and Cancer Nurses at the end of the phone If you or one of your team should fall ill with cancer or a heart condition, one of our qualified nurses will support them and their family, offering expert guidance on treatment, side effects, feelings and even how to talk to friends and family about their condition. Added value to your team with our member offers You and your team will have access to member discounts at health clubs across the UK making keeping fit and healthier a lot easier. And you can also get money off expert lifestyle health assessments so you know just how well you re looking after yourself. Meeting your duty of care We ll help to keep your employees as fit and healthy as possible so that they re able to work productively for your business. The services included with your healthcare plan can also help towards meeting your duty of care. And it costs less than you may think A healthcare plan probably costs much less than you may think. For many of our members, subscriptions are less than everyday costs like mobile bills, a daily visit to the coffee shop, or even printer cartridges. Your budget is an important part of all the points we consider and we can easily talk you through your choices so you get healthcare at a price that suits you. 5
Building a plan for your business With such a wide range of flexible choices there s a healthcare plan just waiting to be created for every business and budget. You can tailor everything from the kinds of treatments you want to cover to how you pay. 6
1. Start with the Core plan 2. Add or take away these options until you get a plan that fits your business Building a plan for your business Core Plan Out-patient options Standard out-patient or Enhanced out-patient or Full out-patient See Your choices explained on page 20. More options Therapies Mental health Extra care Extended cover Extra Cancer cover Your choice of Employee Assistance Programmes Additional options Dentist and Optician Cashback Travel Cover 3. Manage the cost of your plan Six week Excess How to pay Two year fix option Six or more of you? You can create a plan that provides different levels of cover for different groups of people. Some businesses provide more cover for their management teams or other key staff. Add the family too Add family members to get healthcare cover at business rates. Let us help If this is the first time you ve looked at buying healthcare insurance, there can seem a lot to take in. The best way to work out what s right for you is to call us on 0800 38 77 54. To find out more about your core plan and other options go to page 20. 7
Manage the cost of your plan 8
Manage the cost of your plan Control your subscriptions in a number of ways: Choose an excess You can choose an excess of 100, 250 or 500 as a way of controlling your subscription. The six week option If you re comfortable using the NHS but worry about potentially long waiting times, then the six week option could be for you. If eligible treatment is available on the NHS within six weeks from the date it should take place, then you will use the NHS. However if the wait for treatment is more than six weeks from when it should take place, then you can go private straight away. As a guide, choosing this option for each of your employees could save you up to 20% off your annual subscription. Choose how you want to pay You can save 5% by paying your subscription yearly. Choose to fix your subscription for two years You can choose the reassurance of knowing what subscription you ll pay for each employee for the next two years. Your underwriting options: Two-year moratorium How members are covered for pre-existing conditions If they have experienced symptoms or been treated for a medical condition in the last five years, they'll only be covered for that condition after: they ve been covered by us for two consecutive years (this is the moratorium period) they ve been completely free of any form of treatment, investigations, medical advice, drugs or medicines or special diets relating to that condition for a consecutive one-year period Medical declaration form not needed. Continued medical exclusions How members are covered for pre-existing conditions Continued medical exclusions is usually an option if you switch to us from another health insurer. This means that in most cases, we will give you the option to continue any medical underwriting that was applied by your previous insurer. When you switch, remember that our membership terms will start to apply to your plan and these are likely to be different to those of your previous insurer. If you re not sure how this might affect your cover, please call us on 0800 38 77 54. Medical declaration form not needed in most circumstances.* Fully underwritten How members are covered for pre-existing conditions Pre-existing medical conditions will be excluded from cover where necessary. ü Medical declaration form needed we may also ask for a GP medical report. Medical history disregarded How members are covered for pre-existing conditions Cover is provided for treatment of previous medical conditions, subject to the membership terms. Only available if you cover 15 or more people. Medical declaration form not needed. * Please note a medical declaration form will be required for groups of 1-2 members. 9
What you can create These are four fictional businesses created to show how flexible cover and costs are. The businesses are based in Guildford, Surrey, each with six employees aged 25, 30, 35, 40, 45 and 50. The businesses all have core cover and Extra Cancer cover as standard. We chose an excess of 100, a two-year moratorium and annual payment for all four. Plan costs are representative as of October 2016. Here are some examples of how we tailored a plan to suit their business. Daisychain Holdings In addition to core cover Daisychain Holdings included two out-patient consultations a year. Whilst diagnosis is carried out privately, members will use the NHS for treatment when available within six weeks of when it should take place. Equivalent weekly subscription: 28.34 or 4.72 per employee Appletree Trading Appletree Trading has opted to include the Standard Out patient Option with their core cover. Because their work is physically demanding cover for physiotherapy was also included. Equivalent weekly subscription: 38.55 or 6.43 per employee Bluebell Wood Enterprises Bluebell Wood wanted to give their employees the options of cover for private GP consultations and using any hospital in the UK, so extended cover was added. They also have the standard out-patients option and therapies included. Equivalent weekly subscription: 47.34 or 7.89 per employee Cloverfield Associates Cloverfield Associates has unlimited out patient consultations. Their work is in a high pressured industry and things can get stressful now and then so mental health and extra care cover was added too. Equivalent weekly subscription: 54.30 or 9.06 per employee 10
What you can expect from us 11
Your access to specialists and private healthcare We hope you ll never need to see inside a private hospital, but if you do, you can be sure you re putting your health in the hands of expert specialists. You ll also appreciate just how the little things like eating great food and having your own room make such a big difference to getting you back to health, and work, faster. Everything is designed to help you get better, whether your stay is long or short. You ll also find that the nurses and staff have that extra time needed to make you feel at home. Over 250 hospitals and 250 scanning centres Means you re never far from where you need to be. With access to over 24,000 specialists You can relax knowing that you will be seen by an expert in their field. You ll usually have your own room, with a TV, an en-suite bathroom and usually Wi-Fi To help you stay connected. No restrictions on visiting hours So your friends and family can visit you whenever you want. 12
Fast Track Appointments When your GP refers you or one of your team for treatment, we can find the right specialist, at the right time and place for you. What you can expect from us All you need to do We ll do the rest To find the right specialist for you: Your GP gives you an open referral (which is a referral that doesn t name the specialist you should see). Just call us and we ll check where and when will suit you best and book your appointment for you, making it simple and hassle free. Alternatively if you d prefer, we can provide you with the names of up to three specialists, all experts in their field, who you can contact directly. In fact, with our Fast Track Appointments service, on average our members with an open referral are seen twice as fast as those members whose GPs have referred them to a named specialist.* We re ready to help you, just call us If you need to see a specialist, ask your GP for an open referral, and then call us. We ll tell you what you re covered for, and help you make the most of your membership by taking care of everything for you. We ll make sure you see the right specialist. All of our recognised specialists have a consultancy level which means they can provide advice and treatment for the most complex and challenging health conditions. We ll make it quick, convenient and easy We ll make sure your appointment is at a time and place that s convenient to you, so you won t have to worry about travelling further away than necessary. We ll act with urgency If you were to call us with suspected cancer or a heart condition, the moment we get off the phone with you we ll act with urgency to get you an appointment with an appropriate specialist. *based on 2015 AXA PPP healthcare data. 13
We are committed to better care and support for the conditions that worry our members most: heart disease and cancer. Despite all the advances of modern medicine, these are still the words you never want to hear from your doctor. They are also two conditions that have seen dramatic improvements in treatment and survival rates over the last few years, with new treatments and drugs constantly making headlines. Our Heart and Cancer Commitment extensive cover and care With these advances and changes to the way people are treated, the needs of our members have changed too. With increasing survival times*, people are more likely to need treatment and care for longer. It s vital our private healthcare cover reflects this. That s why we ve enhanced our cover with our Heart and Cancer Commitment and also give you the choice of extending your cover for cancer when you take out your plan. *Source: www.ons.gov.uk 14
Our Heart and Cancer Commitment Our heart cover Extra cover and care for heart conditions. Members diagnosed with a heart condition will now have access to our successful Dedicated Nurse service which will be available by phone throughout their treatment and recovery: listening, understanding and giving information, with the time to give the member and their family all the support they need. Our cancer support Our Dedicated Nurses have a lot of experience and expertise in supporting our members who have been diagnosed with cancer. It means there s a consistent, reliable person at the end of the phone there for members and their families to talk to about everything from eating well during chemotherapy to how to cope at home after surgery. This is the kind of long-term, committed help that we know members value. 15
Support for you to help ease the pressure 16
Support for you With Working Body, we re helping to keep businesses like yours moving Life can be tough on your body. It s no surprise that musculoskeletal conditions like back, neck and muscle problems cause more prolonged work absences than any others*. Yet busy working people can often put off going to see a doctor about their conditions until it starts to impact their daily lives. That s understandable when you ve got lots to do, and aren t able to take time out of your day for arranging appointments and visiting a GP. So we ve made things much easier. With Working Body, we re helping to keep businesses like yours moving. With quick access to diagnosis and treatment this could really benefit your business and your team. As part of your core cover, you or your team can call and speak to one of our physiotherapists without needing to see a GP first. If a course of hands-on treatment is what s needed, they ll let you know if you re covered and make the arrangements for you to see someone who s a convenient distance from work or home. Work related Musculoskeletal Disorders represent 44% of all work related illness** 55% 55% of SME business decision makers agree that employees don t generally take time off work when they have back problems. GP OPEN 9am to 5pm We know how busy work keeps you, so whenever you need to call us about your plan, you ll get straight through to an Account Manager from our small business team. Company membership information that s always to hand You can check and manage your business membership at our secure online site. You can access membership documents such as your Group Secretary Guide, membership handbook and our Directory of Hospitals. Take a look at our Business Health Centre Created specifically for small businesses, with a host of articles, videos and tips to help support the health of you and your employees at work. axappphealthcare.co.uk/bhc You can also sign up to our monthly business healthcare e-bulletin. 76% of SME businesses agree that there aren t enough out of hours GP appointments. *Labour Force Survey, Office for National Statistics 2013. ** Work Related Musculoskeletal Disorder Statistics in GB 2014/15, Health and Safety Executive. One Poll Survey, September 2014 17
Your team will have online access to their membership and should they need to make a claim our Personal Advisers are ready to help. Employee membership made easy for you and your team Each member of your scheme gets their own secure online member area called Customer Online where they can contact us, check details of their cover, find out how they go about claiming, and see the range of services and benefits available to them. There s also a link to our online health information services so they can find out more about health and wellbeing issues, or look up any health issue that s troubling them. Support for your team as part of your membership 18
Support for your team Claims made simple We ask members to always call us before they go ahead with any kind of treatment they plan to claim for. All they need to do is call our expert Personal Advisers with details of their proposed treatment. Our Personal Advisers have lots of experience and training, and can access your specific plan details immediately. This means they can usually confirm the cover that s available there and then. Pre-authorising treatment like this means that you and your employees can be confident of knowing whether they are covered before treatment. Expert help just ask, any time of the day Imagine having a medical expert in the family. Someone your team could call anytime they have a health worry, big or small. That s exactly what Health at Hand gives them. They can call our medical experts any time of the day or night. Member offers We can help make it easier for people to be healthier and well. With AXA Fitness Works, they ll be able to access a range of discounts at gyms nationwide, including discounted annual PureGym membership. Our Second Opinion Service We want to make sure that you are completely happy with any experience you have with us. Our Second Opinion Service provides you with extra reassurance if you re uncertain about a diagnosis or treatment plan. Where you have an out-patient option on your plan we ll pay for all eligible costs involved with the second opinion, such as the initial appointment with the new consultant and any new tests needed. This ensures that we help get you back to health and work as quickly as possible. They will also have access to our online Health Centres which bring together the latest information, facts and figures from experts and NHS resources so they can find everything they might need to know quickly and easily. Your team will also be able to put questions to our panel of experts at our regular live online discussions. 19
Your choices explained If your business involves manual labour you may want to include therapies cover, or if you operate in a high pressure environment mental health care may be important. It s all entirely up to you. 20
Your core plan Here s what s included for everyone on your plan. Your choices explained Your benefits What we pay If you re an in-patient or day-patient Private hospital and day-patient unit fees including accommodation, diagnostic tests, using the operating theatre, drugs and dressings, radiotherapy and chemotherapy and surgical appliances that the specialist uses during surgery ü Paid in full so long as you use a hospital or day-patient unit in our Directory of Hospitals Specialist fees including surgeons, anaesthetists and physicans ü No yearly limit Hospital accommodation for one parent while a child under 16 is receiving eligible treatment ü Paid in full Hotel accommodation for one parent while a child under 16 is receiving eligible treatment ü 100 per night up to 500 a year If you re are an out-patient Surgery ü No yearly limit so long as you use a hospital or day-patient unit in our Directory of Hospitals We will cover the cost of CT, MRI or PET scans referred by a specialist ü Paid in full at a scanning centre, or a hospital listed as a scanning centre, in our Directory of Hospitals 21
Your core plan continued Other benefits Ambulance transport to transfer you to another medical facility if you are receiving private treatment ü Paid in full Cash payment if you have out-patient or day-patient chemotherapy or radiotherapy free on the NHS ü 50 a day up to 2,000 a year Expert Help ü Direct access to healthcare experts for members 24/7 What s not covered As with most private healthcare plans, there are some general exclusions and limitations. The plan does not cover members for: Medical conditions that existed prior to joining unless you have transferred on a Continued Medical Exclusions or Medical History Disregarded basis Routine pregnancy and childbirth Long term chronic conditions for example diabetes or asthma Cosmetic treatment We ll make you aware of all the key exclusions when we speak to you or in the literature so there are no surprises. 22
Your options explained 23
Out-patient options Here s what s included in the out-patient options you choose. Your benefits What we pay Standard out-patient option Specialist consultations ü Up to two consultations a year Diagnostic tests when your specialist refers you ü No yearly limit Enhanced out-patient option Specialist consultations ü A combined yearly limit of 1,000 Diagnostic tests when your specialist refers you Practitioner fees including nurses, dieticians, orthoptists and speech therapists Full out-patient option Specialist consultations ü No yearly limit Diagnostic tests when your specialist refers you 24 Practitioner fees including nurses, dieticians, orthoptists and speech therapists 24
Options Here s what s included in the option you choose. Your options explained Your benefits What we pay Therapies option Fees for out-patient treatment by physiotherapists, acupuncturists, homeopaths, osteopaths or chiropractors Access to Working Body (for more information see page 17) ü No yearly limit on fees: up to an overall maximum of 10 sessions in a year when your GP refers you, or when you have therapist treatment through our Working Body team further sessions (as long as we agree them first) when your specialist refers you. Mental Health option If you're an in-patient or day-patient Private hospital and day-patient unit fees for psychiatric treatment, including accommodation, diagnostic tests and drugs ü Paid in full at a hospital or day-patient unit in our Directory of Hospitals Specialist fees for psychiatric treatment ü No yearly limit If you re an out-patient Specialist consultations for psychiatric treatment ü No yearly limit Psychiatric treatment by psychologists and cognitive behavioural therapists ü No yearly limit 25
Options continued Extra Care option Nurse to give you chemotherapy or antibiotics by intravenous drip at home ü Paid in full Cash payment when you have free in-patient treatment under the NHS. You can also receive this cash payment if you have treatment in an NHS Intensive Therapy or Intensive Care unit, whether it follows private treatment or not. ü 100 a night up to 2,000 a year Oral surgery so long as your dentist refers you ü Paid in full so long as you use a facility that we have an agreement with covering oral surgery Chiropody fees so long as as your chiropodist is qualified ü Up to 150 a year Extended cover option Extra cover for treatment at any hospital, day-patient unit or scanning centre in the UK that is not listed in our Directory of Hospitals ü Paid in full up to the normal daily rates published and charged by the facility Extra cover for treatment received outside of the UK ü Up to the cost we would pay for equivalent treatment in the UK Extra cover for fee limited specialists ü Paid in full Private GP fees for consultations ü Up to 500 a year Doctor@Hand consultations ü Up to five on-line, video or telephone consultations a year with a Doctor@Hand GP 26
Extra Cancer Cover option Your options explained Here s what s included. Due to the nature of cancer we cover it a little differently to other conditions. You can increase your benefits to include: Your benefits What we pay No time limits on cancer treatment ü No yearly limit Experimental drugs if you take part in a randomised clinical trial that the appropriate ethics committee has approved, so long as we agree it first ü Your stay in hospital, including specialist fees, is paid in full Specialist consultations with the specialist treating your cancer even if you don t have an out-patient option on your plan ü Consultations not deducted from out-patient limits Diagnostic tests as an out-patient even if you don t have an out-patient option on your plan ü The tests are not deducted from out-patient limits Hospice donation ü Donation to a hospice where you are having end of life care or a donation to a service providing hospice at home care We will pay for external prostheses (such as limbs) and for wigs ü 5,000 for external prostheses and 150 for wigs We will provide cover for cancer no matter what path it takes, even if it recurs or spreads and so long as you remain a member we ll continue to cover treatment if the cancer becomes terminal 27
Additional options Here are some other options to complement your plan. Your benefits What we pay Dentist and Optician Cashback option Dentist fees ü 80% of your dentist s fees, up to 400 a year Optician fees ü 80% of the cost of prescribed glasses and contact lenses, up to 200 a year Eye test ü Up to 25 a year for an eye test Travel cover Travel Cover is an annual policy making it easier for you and your employees to travel abroad on business or leisure. What s more if you make two or more trips abroad each year it s cost effective too. The benefits include: ü No medical history required when you take out cover ü A broad range of medical benefits ü Business and leisure travel covered ü On-piste winter ski cover included 28
t Your Employee Assistance Programme (EAP) choices Your options explained Balancing the demands and pressures brought about by today s busy world, an EAP needs to do much more than simply help you meet your duty of care. You can plan access to professional expert help with telephone guidance and online support for everything from childcare to debt, and legal to relationship issues. It s a bit like the Citizens Advice service just for you and your team. You can choose from: EAP Essential EAP Premier Unlimited access to telephone support available 24/7 for psychological and mental issues Offers all the support of EAP Essential but in addition provides: Telephone access to a fully qualified counsellor Face to face counselling with up to five sessions per team member with a clinical specialist E-counselling for those who prefer to communicate digitally Complex cases escalated to a psychologist LifeManagement a unique combination of services with telephone access to skilled consultants to help with everyday issues such as debt management, relationships and legal concerns Managerial Consultancy to help managers meet day to day team challenges Online information and guidance for your team including a dedicated website 24/7 telephone helpline for health information from our Health at Hand team 29
33,000+ small and medium business like yours with 220,000+ employees covered Start small think big 30
Business Health Select is the result of everything we ve learnt over 75 years of looking after our members. We started small but, by showing that what we do really does work, we now look after thousands of small and medium businesses each one different from the next, with their own concerns and priorities. Of course, our members and their needs are very different today. But the nurses, doctors, practitioners, underwriters, advisers and other professionals in our team continue the traditions we ve become known for embracing groundbreaking treatments and creating new, faster ways to access them. Being part of the AXA Group one of the world s largest insurers means added financial security. And being looked after by our small and medium business dedicated teams gives you the best of personal service and choice, plus the better value that our size allows us to bring you. 31
We can help you create a healthcare plan that s just right for your business and your budget. We know how busy you are, so we ll be fast but thorough. We also guarantee that we won t contact you again using the details you give us unless you want us to. 95% Member satisfaction. Based on a survey of 592 small and medium business members 95% were satisfied with AXA PPP healthcare (October 15 July 16) Call our small business experts 0800 38 77 54 8.30am to 5.30pm, Monday to Friday Get a quote online axappphealthcare.co.uk/business We may record and/or monitor calls for quality assurance, training and as record of our conversation. Our Business Health Select plan allows you to build an excellent level of cover, as indicated by a Defaqto 5 Star Rating. The Defaqto 5 Star Rating is based on an assessment of the overall product, including the optional components. Where not all of the options are taken, this might affect the rating of the product. PB59506/04.17 AXA PPP healthcare, Phillips House, Crescent Road, Tunbridge Wells, Kent TN1 2PL. AXA PPP healthcare Limited. Registered Office: 5 Old Broad Street, London EC2N 1AD, United Kingdom. Registered in England No. 3148119. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. AXA PPP healthcare 2017. We may record and/or monitor calls for quality assurance, training and as a record of our conversation.