PMI for SMEs and Employee Health Schemes
As FCA-authorised experts who have helped arrange over 900,000 policies, WeCovr understands the vital role private medical insurance plays in the UK. This guide explores how it can be a game-changer for your business, boosting both employee health and your bottom line.
Overview of private health insurance options for businesses, tax implications, perks for employee well-being, and latest 2025 market trends
In today's competitive landscape, attracting and retaining top talent is a major challenge for Small and Medium-sized Enterprises (SMEs). While salary is crucial, a comprehensive benefits package is often the deciding factor. This is where private medical insurance (PMI) for businesses, also known as a group health scheme, becomes a powerful strategic tool.
This article provides an exhaustive overview of business PMI, covering everything a UK business owner needs to know.
What is Business Private Medical Insurance?
Business Private Medical Insurance is a company-funded policy that gives your employees access to private healthcare. Instead of relying solely on the NHS, they can receive eligible private treatment for acute medical conditions that arise after they join the scheme.
For a monthly premium per employee, you provide a highly valued benefit that helps your team bypass long waiting lists and receive prompt medical care, often in a private hospital with a private room.
Crucial Point: What PMI Does and Does Not Cover
It is vital to understand the fundamental purpose of private medical insurance in the UK.
- PMI is for Acute Conditions: It is designed to cover the diagnosis and treatment of acute conditions. An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for hernias.
- PMI Does Not Cover Chronic or Pre-existing Conditions: Standard UK PMI policies do not cover chronic conditions (long-term illnesses like diabetes, asthma, or high blood pressure) or any medical conditions an employee had before they joined the policy (pre-existing conditions).
Think of PMI as a way to get you back on your feet quickly after a new, unexpected health issue, rather than a service for managing long-term health problems.
Why Should SMEs Consider a Group Health Scheme in 2025?
The case for business health insurance has never been stronger. The benefits extend far beyond simply being a "nice perk" – they directly impact your business's health, productivity, and profitability.
1. Tackling NHS Waiting Lists and Absenteeism
The strain on the NHS is a well-documented reality. According to the latest NHS England data (2024), millions are on waiting lists for consultant-led elective care. For an SME, an employee waiting months for a hip replacement or a diagnostic scan isn't just a personal issue; it's a business problem.
- Reduced Absenteeism: PMI allows employees to get diagnosed and treated faster, significantly cutting the time they need to take off work.
- Combating 'Presenteeism': An employee who is unwell but still comes to work (presenteeism) can be up to 33% less productive. Faster treatment means a quicker return to full health and productivity. Data from the Office for National Statistics (ONS) consistently shows that minor illnesses and musculoskeletal problems are leading causes of work absence. PMI directly addresses these issues.
2. A Powerful Recruitment and Retention Tool
In a tight labour market, a strong benefits package sets you apart. Offering private health cover demonstrates that you are an employer who genuinely invests in your team's wellbeing.
- Attracting Top Talent: For many candidates, a health insurance plan is a significant differentiator, often valued more highly than a small salary increase.
- Improving Employee Loyalty: When an employee or their family member uses the policy and experiences the speed and quality of private care, it builds immense gratitude and loyalty towards the company.
3. Boosting Morale and Creating a Positive Culture
Investing in your team's health sends a powerful message. It shows you care about them as people, not just as employees. This fosters a positive, supportive workplace culture, which in turn boosts morale, engagement, and overall team performance.
How Does Business Health Insurance Work?
Setting up a group scheme is more straightforward than you might think, especially with the help of an expert broker. Here are the key components.
Group Schemes vs. Individual Policies
A group scheme for your business is typically cheaper and offers more generous terms than if each employee were to buy a policy individually. Insurers provide lower per-person rates because the risk is spread across a group of people.
- Minimum Group Size: Most insurers will offer a group scheme for as few as two employees. Larger groups often get access to even better terms and more simplified underwriting.
Understanding Underwriting Options
Underwriting is how an insurer assesses risk and decides on the terms of the policy. For business schemes, there are two main types.
| Underwriting Type | How It Works | Best For |
|---|---|---|
| Moratorium (Mori) | Simpler and faster. The policy automatically excludes any condition the employee has had symptoms, medication, or advice for in the 5 years before joining. However, if the employee then goes 2 full years on the policy without any issues related to that condition, the exclusion may be lifted. | Smaller businesses (2-20 employees) looking for a quick and easy setup without lengthy medical forms. |
| Full Medical Underwriting (FMU) | Each employee completes a detailed health questionnaire. The insurer then assesses their medical history and explicitly lists any conditions that will be excluded from cover from the outset. | Businesses that want complete clarity on what is and isn't covered from day one. It provides certainty for both the employer and employee. |
For larger groups (typically 20+ employees), insurers may offer even more favourable underwriting options like 'Medical History Disregarded' (MHD), which covers eligible pre-existing conditions. This is a highly prized benefit for corporate schemes.
Core Cover and Optional Extras: Building Your Policy
A key advantage of business PMI is its flexibility. You can design a plan that fits your budget and your team's needs. Policies are built from a 'core' module, with the option to add extra benefits.
Core Private Health Insurance Cover
This is the foundation of every policy and typically includes:
- In-patient and Day-patient Treatment: This covers costs when an employee is admitted to hospital for a procedure and requires a bed, either overnight (in-patient) or just for the day (day-patient). This includes hospital fees, specialist fees, and anaesthetist fees.
- Cancer Cover: This is a cornerstone of modern PMI. Most policies offer extensive cancer care, including chemotherapy, radiotherapy, and surgery. Some policies include access to new and experimental drugs not yet available on the NHS.
Popular Optional Extras
You can enhance your core cover by adding modules that provide more comprehensive protection.
| Optional Benefit | What It Covers | Why It's Valuable |
|---|---|---|
| Out-patient Cover | Consultations with specialists, diagnostic tests, and scans that do not require a hospital admission. | This is one of the most used benefits. It speeds up diagnosis, allowing treatment to begin much faster. Without it, employees must rely on the NHS for their initial diagnosis. |
| Therapies Cover | Treatment from physiotherapists, osteopaths, and chiropractors for musculoskeletal issues. | Back, neck, and muscle problems are a leading cause of sickness absence. This cover helps employees recover from injuries and pain quickly. |
| Mental Health Cover | Access to psychiatrists, psychologists, and therapists. This can include cover for in-patient and out-patient mental health treatment. | With employee wellbeing now a top priority, this is an increasingly essential benefit. It provides fast access to professional support for stress, anxiety, and other conditions. |
| Dental and Optical | A contribution towards routine dental check-ups, treatments, eye tests, and glasses/contact lenses. | A simple, highly-valued perk that encourages preventative health and is used regularly by employees. |
An expert PMI broker, like WeCovr, can help you navigate these options, explaining the cost-benefit of each and tailoring a package that delivers maximum value for your budget.
The Tax Implications of Business Health Insurance in the UK
Understanding the tax treatment of your PMI scheme is crucial for both the company and its employees.
For the Business (The Employer)
Good news: the premiums you pay for your employees' health insurance are generally considered an allowable business expense. This means you can offset the cost against your corporation tax bill.
- Example: If your company's annual PMI premium is £10,000 and your corporation tax rate is 25%, you can reduce your tax bill by £2,500.
For the Employee
Because the company is paying for their private health cover, HMRC considers this a 'benefit-in-kind'. This is a non-cash benefit that has a monetary value and is therefore subject to tax.
- P11D Form: As the employer, you must declare the value of the health insurance premium for each employee on a P11D form at the end of the tax year.
- How Tax is Paid: The employee pays income tax on the value of the premium. This is usually handled automatically through an adjustment to their tax code, meaning they will pay slightly more tax each month. The amount of tax depends on their income tax bracket (20%, 40%, or 45%).
| Stakeholder | Tax Treatment | How It Works |
|---|---|---|
| The Company (Employer) | Premiums are an allowable business expense. | The cost of the policy can be deducted from pre-tax profits, reducing the company's Corporation Tax liability. |
| The Employee | It's a taxable 'benefit-in-kind'. | The value of the premium is treated as extra income. The employee pays income tax on this amount, usually via their tax code. The company pays Class 1A National Insurance on the benefit. |
Even though the employee pays tax on the benefit, the cost is still significantly lower than if they were to purchase an equivalent policy themselves.
2025 UK Market Trends: The Future of Employee Health
The private medical insurance UK market is constantly evolving. Here are the key trends shaping business schemes in 2025.
1. The Rise of Digital and Virtual Healthcare
Insurers are heavily investing in digital health services. This is no longer a futuristic concept; it's a standard feature.
- Virtual GP Services: Most policies now include 24/7 access to a virtual GP via phone or video call. This is incredibly convenient for employees, who can get medical advice, prescriptions, and referrals without leaving their home or office.
- App-based Support: Insurers offer sophisticated apps for policy management, making claims, and accessing wellbeing resources.
2. An Unwavering Focus on Mental Health
The conversation around mental health has transformed. Employers and insurers now recognise that mental health is as important as physical health.
- Integrated Mental Health Pathways: Insurers are moving beyond simply offering a set number of therapy sessions. They are creating integrated pathways that guide employees from initial assessment (often via an app or helpline) to the most appropriate level of care, whether that's self-help resources, therapy, or specialist treatment.
- Proactive Support: Many schemes now include access to Employee Assistance Programmes (EAPs) which offer confidential support for a range of life issues, including financial worries, legal problems, and stress – tackling problems before they become critical.
3. Personalisation and Preventative Wellness
The model is shifting from reactive treatment to proactive wellbeing. Insurers are rewarding employees for living a healthy lifestyle.
- Wellness Programmes: Leading providers offer programmes that reward employees with discounts, cinema tickets, or coffee for tracking their activity, getting health checks, or improving their nutrition.
- Personalised Health Journeys: Using data and AI, insurers are starting to offer more personalised health advice and nudges, helping employees manage their own health more effectively.
4. Added Value and Ecosystem Benefits
PMI providers are no longer just paying claims; they are building entire health and wellbeing ecosystems. When you choose a policy, you're not just buying insurance; you're gaining access to a suite of benefits.
As an example of this trend, when businesses arrange PMI through WeCovr, their employees can receive complimentary access to the AI-powered calorie and nutrition tracking app, CalorieHero. Furthermore, clients who purchase PMI or Life Insurance often receive exclusive discounts on other types of cover, creating a holistic and cost-effective insurance solution.
Employee Wellbeing Perks and Healthy Living Tips
A great PMI policy is the start, not the end, of supporting your team's health. Here are some simple, low-cost ways to build a culture of wellbeing.
Promote Movement
- Walking Meetings: Encourage teams to take meetings on the move.
- Stretching Breaks: Set a culture where it's normal to take 5-minute breaks to stretch, especially for desk-based roles.
- Cycle-to-Work Scheme: A government initiative that helps employees save money on a new bike and spread the cost.
Encourage Healthy Eating
- Fruit Bowl: A simple, classic, and effective way to provide a healthy alternative to biscuits and cake.
- Hydration Stations: Ensure fresh, cool water is always available.
- Lunch and Learns: Host informal sessions with nutritionists (many PMI providers offer access to these experts).
Support Mental Resilience
- Mental Health First Aiders: Train designated employees to be a first point of contact for colleagues who are struggling.
- Quiet Zones: Create a small, screen-free area in the office where people can decompress.
- Flexible Working: Where possible, offering flexibility in start/finish times or location can massively reduce stress and improve work-life balance.
Choosing the Best PMI Provider for Your Business
With so many providers and policy options, the market can feel overwhelming. This is where an independent PMI broker is invaluable.
A specialist broker works for you, not the insurer. Their role is to:
- Understand Your Needs: They take the time to learn about your business, your employees, and your budget.
- Scan the Market: They use their expertise and relationships to compare policies from a wide range of top UK insurers.
- Explain the Options: They translate the jargon and present you with clear, like-for-like comparisons, highlighting the subtle but important differences in cover.
- Help You Choose: They provide impartial advice to help you select the policy that offers the best value and protection for your team.
- Support You Long-Term: A good broker will assist with claims queries and help you review your policy each year to ensure it still meets your needs and remains competitive.
WeCovr is an FCA-authorised broker with a strong track record and high customer satisfaction ratings. Our expert team specialises in helping SMEs find the right private health cover at no extra cost to you – our service is paid for by the insurer.
Final Thoughts
In 2025, offering private medical insurance is no longer a luxury reserved for large corporations. For SMEs, it's a smart, strategic investment in your most valuable asset: your people.
By providing fast access to high-quality healthcare, you reduce sickness absence, boost productivity, and build a loyal, motivated team. A well-structured group PMI scheme demonstrates your commitment to employee wellbeing, making your business a more attractive place to work and giving you a crucial edge in a competitive market.
Is business health insurance a taxable benefit in the UK?
Does company private medical insurance cover pre-existing conditions?
How many employees do I need to set up a group health insurance scheme?
What is the difference between in-patient and out-patient cover?
Ready to explore how private health insurance can benefit your business? Contact the friendly, expert team at WeCovr today for a free, no-obligation quote and a clear comparison of your options.
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!