TL;DR
Securing 'Medical History Disregarded' (MHD) private medical insurance for a 15-person UK team is highly achievable, bypassing individual health checks for pre-existing conditions. As an experienced broker, WeCovr negotiates with top insurers to find the best terms for your SME.
Key takeaways
- Medical History Disregarded (MHD) underwriting is the gold standard for group PMI, covering eligible pre-existing acute conditions.
- Many UK insurers now offer MHD terms for groups as small as 15 employees, and sometimes even fewer.
- Using an expert broker like WeCovr significantly increases your chances of securing MHD for a smaller team.
- MHD simplifies administration, boosts employee morale, and is a powerful tool for attracting and retaining top talent.
- While MHD covers many pre-existing conditions, it does not typically cover the ongoing management of chronic conditions.
As a leading UK private medical insurance (PMI) broker, the team at WeCovr has helped countless small and medium-sized enterprises (SMEs) navigate the complexities of group health cover. One of the most common and valuable goals for any business owner is securing a policy that covers their team's pre-existing medical conditions. This article provides an authoritative guide on how a 15-person team can achieve just that.
SME size requirements to bypass individual medical underwriting
For UK businesses, the size of your team is the single most important factor in bypassing individual medical questionnaires for private health insurance. Insurers are willing to take on more risk for a group than for an individual because that risk is spread across multiple people.
The key is to secure Medical History Disregarded (MHD) underwriting. This is the most comprehensive type of underwriting available and is typically reserved for group schemes. While historically this was only accessible to large corporations with 20, 50, or even 100+ employees, the market has become far more competitive.
Today, securing MHD for a team of 15 is not just possible—it's a realistic goal with the right approach and expert guidance. Insurers now recognise the value of the SME market and have adapted their criteria, often allowing brokers to negotiate favourable terms for smaller groups.
What is Medical History Disregarded (MHD) Underwriting?
Medical History Disregarded underwriting means the insurer agrees to ignore the past medical history of your employees when they make a claim. If an employee needs treatment for an eligible, acute condition after the policy starts, the insurer will cover it, even if they've had symptoms or treatment for it before.
It's crucial to understand a core principle of all UK private medical insurance: PMI is designed to cover acute conditions, not chronic ones.
- An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery (e.g., joint replacement, cataract surgery, hernia repair).
- A chronic condition is an illness that continues indefinitely and has no known cure. It can be managed but not resolved (e.g., diabetes, asthma, hypertension). MHD will cover acute flare-ups of chronic conditions, but not the day-to-day management.
To fully grasp the value of MHD, it's helpful to compare it with the other main types of underwriting.
Underwriting Types Compared
| Underwriting Type | How It Works | Best For | Key Consideration |
|---|---|---|---|
| Medical History Disregarded (MHD) | Ignores most prior medical history for eligible acute conditions. No medical questionnaires needed. | Group Schemes (15+ employees) | The 'gold standard'. Provides the most comprehensive cover and peace of mind for employees. |
| Moratorium (Mori) | Excludes any condition you've had symptoms, advice or treatment for in the 5 years before joining. Cover may be added after a 2-year claim-free period. | Individuals, families, and very small groups (2-10 people) | Simple to set up but can lead to uncertainty and disappointment at the point of claim. |
| Full Medical Underwriting (FMU) | Requires every member to complete a detailed health questionnaire. Insurers then apply specific exclusions to each person's policy based on their history. | Individuals who are very healthy and want potential long-term cost savings. | Can be administratively burdensome and results in permanent exclusions for known conditions. |
For any SME, MHD is the clear winner. It removes the administrative headache of health declarations and ensures your team has fair and equal access to care, which is a powerful message for employee wellbeing.
The Magic Number: How Many Employees Do You Need for MHD?
While there's no single, universal "magic number," the landscape for small business health insurance has shifted significantly in favour of smaller teams.
The traditional threshold for MHD was 20 employees. However, for a well-advised application, 15 employees is now a very common entry point. Some insurers will even consider groups of 10, particularly for businesses in low-risk sectors or those working with an experienced PMI broker.
Why the flexibility? Insurers are competing for business. A broker like WeCovr, with strong insurer relationships and significant market leverage, can present your 15-person company as a high-quality risk, negotiating terms that you might not achieve by going direct.
Indicative Insurer Thresholds for MHD (2026 Market)
This table provides an estimated guide. The final decision always rests with the insurer's underwriters and can be influenced by industry, employee demographics, and the negotiating power of your broker.
| Insurer | Indicative Minimum Group Size for MHD | Notes & Considerations |
|---|---|---|
| AXA Health | 15+ employees | Often flexible, especially for professional services firms. May consider smaller groups on a case-by-case basis. |
| Aviva | 15+ employees | A strong contender in the SME market. Their criteria can be favourable for established small businesses. |
| Bupa | 20+ employees (officially) | While often stricter, they may negotiate down to 15-20 for the right business profile via a trusted broker. |
| VitalityHealth | 10-15+ employees | Known for being innovative and flexible. Often willing to offer MHD to smaller groups, especially if a wellness programme is included. |
| WPA | 10+ employees | A specialist in the SME space, WPA is frequently competitive for smaller team sizes. |
Key Broker Insight: Do not be discouraged if your team is slightly under a published threshold. An insurer might offer MHD to a 14-person team if the demographics are favourable (e.g., a younger workforce) or if the business commits to a higher level of cover.
A Practical Scenario: Securing MHD for 'Innovate Ltd's' 15-Person Team
Let's look at a real-world example.
The Company: Innovate Ltd, a 15-person digital marketing agency based in Manchester. The average age of the team is 34. The director, Sarah, wants to introduce private health cover to compete for talent and look after her existing staff.
The Challenge: Sarah knows that two key employees have pre-existing conditions: one has a history of back pain requiring physiotherapy, and another had a knee injury from playing football. A standard moratorium policy would exclude these issues, defeating the purpose of the benefit.
The Process with WeCovr:
- Initial Consultation: Sarah contacted WeCovr. We discussed her budget, the importance of covering pre-existing conditions, and the desire for good mental health support.
- Data Collation: We provided Sarah with a simple, anonymous template to collect the necessary data: date of birth and postcode for each of the 15 employees wishing to join the scheme. No medical details were required.
- Market Review: Armed with this data, our experts approached the entire UK PMI market, including AXA, Aviva, and Vitality. We presented Innovate Ltd as a professional, low-risk group and specifically requested MHD terms.
- Negotiation: One insurer initially came back with a moratorium quote. Leveraging our relationship, we pushed back, highlighting the group size and professional nature of the business. We secured three competitive MHD quotes.
- Comparison & Decision: We presented Sarah with a clear comparison table. The VitalityHealth option was particularly attractive. Not only did it offer full MHD underwriting, but it also included their comprehensive wellness programme, rewarding staff for staying active. The price was only marginally higher than the inferior moratorium quote.
- Implementation: Innovate Ltd chose the Vitality policy. The setup was simple—no intrusive forms for staff to fill out. The employee with back pain could now access private physiotherapy, and the team member with the knee injury had peace of mind for any future flare-ups.
The Outcome: Innovate Ltd secured a top-tier private medical insurance plan with MHD for their 15-person team. The benefit was hugely well-received, improving morale and demonstrating the company's commitment to its staff.
Key Benefits of MHD for Your 15-Person SME
Opting for Medical History Disregarded underwriting offers tangible advantages that go far beyond just health cover.
- Covers Pre-Existing Acute Conditions: This is the primary benefit. It gives your team confidence that they can get prompt treatment for recurring issues, subject to policy terms.
- Boosts Employee Morale & Loyalty: Providing cover that actually works when needed shows you genuinely care. It's a high-value benefit that fosters loyalty and reduces staff turnover.
- Attracts and Retains Top Talent: In a competitive job market, a comprehensive PMI plan can be the deciding factor for a potential hire choosing you over a rival.
- Simple and Dignified Onboarding: Your employees don't need to disclose their personal medical history to their employer or the insurer. This respects their privacy and simplifies administration.
- Reduces Sickness Absence: With faster access to diagnosis and treatment through PMI, employees can get back to health and work more quickly, minimising disruption to your business. The NHS waiting list in England stood at 7.54 million cases in early 2024, highlighting the value of prompt private care.
Are There Any Catches? The Limitations of MHD
MHD is the best underwriting available, but it is not a blank cheque. It's vital to be aware of its limitations to set correct expectations.
- Chronic Conditions: As stated, UK PMI does not cover the routine management of long-term, chronic conditions like diabetes or asthma. MHD will cover an acute flare-up of a chronic condition, but not the day-to-day monitoring, check-ups, or prescription costs.
- Specific Policy Exclusions: Every policy has a list of standard exclusions. These typically include things like cosmetic surgery, normal pregnancy, experimental treatments, and self-inflicted injuries.
- "New for Old" Principle: Some insurers may have clauses relating to conditions that were being actively treated in the immediate run-up to the policy start date. An expert broker can help clarify these specific terms.
- Cost: An MHD policy is generally more expensive than a moratorium or FMU policy because the insurer is taking on a greater, unknown risk. However, for a group scheme, the per-person cost difference is often surprisingly small and far outweighed by the superior coverage.
How to Prepare Your Business for an MHD Application
To get the fastest and most accurate quotes, you should have the following information ready:
- Employee List: A list of all employees you wish to cover.
- Anonymous Data: For each employee, you'll need their date of birth and postcode. This is for pricing purposes only and is entirely anonymous.
- Budget: A rough idea of your monthly or annual budget per employee. Prices can range from £30 to over £100 per person per month, depending on age, location, and cover level.
- Benefit Level: Think about what you want to include.
- Inpatient/Day-patient cover: This is standard.
- Outpatient cover: Do you want to cover specialist consultations and diagnostic tests? You can choose a full-cover option or a capped amount (e.g., £1,000 per year).
- Therapies: Do you want to include physiotherapy, osteopathy, etc.?
- Mental Health: This is an increasingly important benefit.
- Dental & Optical: These are usually optional add-ons.
- Decision-Maker: Appoint one person in the company to be the point of contact. This streamlines communication with your broker.
The Role of an Expert Broker in Securing MHD
For an SME with 15 employees, partnering with an FCA-regulated broker like WeCovr is not just helpful—it's essential.
A specialist broker adds value in several critical ways:
- Market Access: We have access to the entire UK insurer market, including specialist policies not available to the public.
- Negotiating Power: Insurers offer preferential rates and more flexible underwriting terms to brokers who bring them significant business. We can leverage this relationship to get you MHD where a direct approach might fail.
- Expertise: We understand the nuances of each insurer's criteria. We know which provider is most likely to offer MHD to a 15-person tech firm in London versus a manufacturing company in the Midlands.
- Time-Saving: We do all the legwork, from gathering quotes to comparing policy documents, saving you hours of administrative work.
- No Cost to You: Our service is free. We are paid a commission by the insurer you choose, which is already built into the premium. You get expert advice and support without paying a penny extra.
Understanding the Tax Implications of Employer PMI
When a company pays for private medical insurance for its employees, there are tax considerations for both the business and the individual.
| Entity | Tax Consideration | Explanation |
|---|---|---|
| The Company | Corporation Tax Relief | The cost of the PMI premiums is generally considered an allowable business expense, meaning you can deduct it from your profits to reduce your Corporation Tax bill. |
| The Employee | Benefit-in-Kind (BIK) Tax | The value of the health insurance premium is treated as a taxable 'benefit in kind'. Your company must report this to HMRC on a P11D form, and the employee will pay income tax on the value of that benefit. |
Even with the BIK tax, employer-paid PMI is a highly tax-efficient way to provide a valuable benefit, as the corporate rate is much lower than an individual policy premium.
Beyond MHD: Enhancing Your Employee Benefits Package
Once you have a strong health insurance policy in place, you can enhance it further.
- Wellness Programmes: Many insurers, like Vitality and Aviva, offer integrated wellness programmes that reward healthy behaviour with perks like cinema tickets, coffee, and gym discounts.
- Complimentary Apps: At WeCovr, we provide all our clients with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app, helping your team stay on top of their health goals.
- Bundled Insurance: When you arrange your PMI through us, we can also provide highly competitive quotes for other business protection, such as Group Life Insurance or Key Person cover. Our clients often benefit from discounts when bundling different types of cover.
Is a Medical History Disregarded (MHD) policy more expensive?
Can we add new employees to our MHD group scheme?
What happens if an employee leaves the company?
Securing the best private medical insurance for your team is one of the most impactful investments you can make in your business. For a 15-person team, achieving Medical History Disregarded underwriting is the key to unlocking the true value of PMI. It transforms the cover from a simple perk into a robust, reliable, and deeply appreciated benefit.
Ready to find out how WeCovr can secure MHD terms for your team? Our expert, friendly advisers are ready to provide a no-obligation market comparison.
Sources
- NHS England
- Office for National Statistics (ONS)
- Financial Conduct Authority (FCA)
- gov.uk
- National Institute for Health and Care Excellence (NICE)
Disclaimer: This is general guidance only and does not constitute formal tax or financial advice. Tax treatment depends on individual circumstances, policy terms, and HMRC interpretation, which cannot be guaranteed in advance. Whenever applicable, businesses and individuals should always consult a qualified accountant or tax adviser before arranging such policies.
