How to optimise private medical insurance’s effectiveness

This article is supplied by Cigna HealthCare.

If you read nothing else, read this…

  • Effective use of private medical insurance (PMI) can help to attract and retain staff.
  • Employers can boost the effectiveness of PMI by offering it to staff as part of a holistic health and wellbeing strategy.
  • Claims cost management is a useful PMI feature.

There has been a shift from employers investing in private medical insurance (PMI) to attract and retain key talent to organisations offering PMI benefits as part of a holistic health and wellbeing strategy.

This is why it is more important than ever for employers to make the most effective use of their PMI plan. This requires them to focus on four key things: choosing the right scheme, promoting it effectively, joining up all of their employee benefits, and making use of their plan data.

Choosing the right plan

Employers should first consider their employees and the access they have to the PMI scheme. Is a comprehensive medical plan on offer to some but not all staff? Could the employer introduce a core level of out-patient cover for all staff and allow employees to flex up their option to include in-patient cover, for example? What if none of its employees has medical cover?

Lower-cost medical plans are available for employers to offer their staff. These focus on the key causes of absence, including mental health problems and musculoskeletal conditions

Another consideration for employers is whether their PMI scheme offers an effective approach to managing claims costs.

Various options are available in the market, but one of the most established is care management. Delivered by experienced nurses, these plans manage every aspect of an employee’s claim. This ensures employees always receive the right treatment in the right setting. It also delivers effective cost control by making appropriate use of the National Health Service, highlighting more appropriate hospital stays and working closely with medical providers.

Effective promotion

Once an employer has selected the right PMI plan, it must ensure its staff know how to use it. It is even more important for employees to understand the fast-track options available.

For example, medical plans increasingly include telephone-based initial assessments and self-referral to physiotherapy; faster access to a range of diagnostic tests via doctors, reducing delay and expense; and online self-help tools, such as computerised cognitive behavioural therapy.

By promoting these services to employees, employers will help them access treatment more quickly while reducing claims spend.

Healthcare providers should be able to help employers promote these features through various communication channels, including online self-help portals.

Joined-up benefits

Another vital step to getting the best use from a PMI plan is for employers to join up their benefits. Each of their benefit providers should be aware of everything else that is available to employees. 

Employers should also ask their providers to establish transfer processes that enable them to work together and transfer calls between each other.

For example, if someone contacts us at Cigna HealthCare for a psychiatric claim, some counselling is often all that is needed. Where there is an employee assistance programme in place, we will make sure the employee accesses the counselling there because it is typically free of charge. This reduces medical plan costs for the employer. 

Simple processes like this go a long way to maximising PMI cost-efficiencies for employers, while delivering an exceptional employee experience.

Using the data

Finally, employers should ask to receive management information from their providers that gives them an insight into the health and wellbeing of their workforce. This will help them identify key health trends and plan effectively to tackle these. 

Managing the health of their employees will help employers to reduce the cost of their medical plan in the longer term, and choosing the right PMI plan in the first place will optimise this outcome. 

Kirsty Jagielko is head of product management at Cigna HealthCare