Aviva business health insurance

Aviva offers business health insurance policies designed to help businesses manage their employees' health needs. The Solutions policy is available to businesses with fewer than 250 employees, while the Optimum policy is for companies with a larger workforce.

The policies feature many of the same core coverage elements. However, there are key differences in the available financial cover limits. Aviva business health insurance also offers services tailored to suit the challenges of managing smaller and larger teams.

Aviva's Solutions policy for businesses with up to 250 staff. Many business health insurance policies require at least two employees. However, you can choose the Solutions policy with just one employee, making it ideal for one-person businesses and SMEs alike.

Solutions provides core cover and optional extras, allowing you to tailor your health insurance coverage to your needs and budget.

Aviva's core cover includes treatment for acute conditions, including cancer treatment, musculoskeletal issues and mental health concerns.

Solutions health insurance comes with Aviva's 'Expert Select' option as standard rather than a full hospital list. This option gives your employees a guided choice of consultants and hospitals when they claim. These are typically specialists with lower treatment costs, which can help you save money on your premium.

Here's what you can expect to find with a Solutions plan:

In-patient and day-patient treatment

The Solutions plan includes in-patient and day-patient treatment as standard. Policy coverage provides accommodation and treatment costs at a private hospital or day-patient unit, as well as any diagnostic tests and scans requested by their consultant while they're in the hospital.

If an employee spends the night in an NHS hospital, they can claim cashback.

Out-patient treatment

Aviva business health insurance provides extensive out-patient cover as standard. Many health insurers offer diagnostic tests and scans or out-patient surgical procedures, but not both. The Solutions plan includes consultant appointments, tests, scans and treatment as part of its core cover. It also covers physical therapies and mental health treatment through Aviva's other treatment pathways.

Cancer cover

Cancer treatment forms a core part of every provider's health insurance policies. The Solutions plan includes the treatments you'd expect, such as surgery, chemotherapy, and radiotherapy, along with a range of specialist treatments, preventive care, and support services.

Aviva's cancer coverage includes bone-strengthening drugs, bone marrow and stem cell transplants and allowances for wigs and prostheses if needed. There's also follow-up care, including monitoring, for up to 5 years post-treatment and molecular profiling and genetic testing to assess employees' cancer risk.

Finally, should the worst happen, it provides end-of-life care in a hospital if it's medically necessary, or a donation to a hospice or cancer charity.

BacktoBetter service

The BacktoBetter service provides access to specialist care for back, neck and joint problems without a GP referral, which can speed up your employees' access to treatment.

Mental health pathway

If your employees need mental health support, Aviva's mental health pathway provides access to treatment with a range of professionals without a GP referral. Employees can refer themselves and receive treatment based on a clinical assessment. Core mental health coverage typically limits treatment to 8-10 sessions of counselling or CBT. By contrast, Aviva includes unlimited access to specialist talking therapies and out-patient psychiatric care.

Additional benefits

Solutions also covers:

• Treatment for complications in pregnancy and childbirth
• A £100 baby bonus
• A private ambulance for hospital transfers
• Home nursing
• In-patient dental surgery

If you extend cover to include employees' children, parents can also claim for parental accommodation if their child needs in-patient hospital treatment.

Aviva's core coverage includes a comprehensive selection of treatments. If you'd like to offer a broader range of treatment options or enhance your core coverage, there are a range of optional extras to choose from.

Dental and optical cover

Many of your employees are likely already paying privately for their dental treatment and eye tests. Adding dental and optical cover to your private medical insurance policy can help employees save money on their routine healthcare costs. If your employees use display screens, you must also provide them with eye tests. Adding optical cover can be a cost-effective way to pay for these.

Aviva's dental and optical optional extra covers routine check-ups, treatment for accidental dental injuries, and £250 towards the cost of glasses and contact lenses. Your employees must pay a separate excess for routine dental and optical care, so it's vital you clearly communicate this when discussing employee benefits.

Additional mental health care

Aviva's core coverage includes access to its mental health pathway, which provides counselling and out-patient treatment but not in-patient or day-patient care. The mental health upgrade lets you add both and gives you the choice of 28 or 45 days of hospital treatment. It's only available for acute conditions, meaning employees with chronic mental health issues aren't covered.

GP referrals

Some of Aviva's core cover offers treatment following a GP referral, while other services require a specialist referral. However, if you add the routine and GP-referred services option, your employees can access a broader range of services with a GP referral.

The available services include referrals for consultant appointments and diagnostic tests for chronic illnesses or previously acute conditions, and minor surgery at an employee's GP practice.

There are some services where coverage only applies to non-musculoskeletal conditions, including:

• Radiology and pathology investigations
• Physiotherapy, osteopathy, acupuncture and chiropractic treatment
• Chiropody and podiatry treatment
• Homoepathy

Referrals can come from an employee's NHS GP or Aviva's virtual GP service.

An extended hospital list

As we've mentioned, Solutions includes Aviva's 'Expert Select' option as standard, meaning your employees will receive a guided choice of consultants when they claim. However, if you want to offer a wider selection, it's worth considering adding an extended hospital list to your policy. An extended list can offer your employees more choice over who treats them and which hospital they attend, wherever you are in the country. An extended hospital list can be handy if you're based in London, where treatment costs are typically at their highest.

Aviva health insurance offers two options. The key hospital list is their standard list and covers approximately 200 hospitals in the UK. The extended list includes the same hospitals as the key list and adds hospitals in Greater London. Extending your hospital list means paying a higher premium, but it can be worthwhile if it lets your employees access treatment close to home or work.

Aviva has designed its Optimum policy for businesses with more than 250 employees. Optimum's core coverage is similar to the Solutions small business plan. It includes some extras as standard, plus additional options to help you tailor your private medical insurance to suit your needs.

Here's what the policy provides.

Core cover

The Optimum policy provides the same core cover as Solutions, meaning your employees can access in-patient and day-patient treatment, out-patient consultations, treatment, plus diagnostic procedures such as blood tests and complex scans. The policy also includes the Back2Better service, which offers treatment for musculoskeletal issues without a GP referral.

Level 2 cancer cover is a cost-effective option that provides a comprehensive range of cancer treatments and support services, but limits access to higher cost treatments such as proton beam therapy.

Optimum offers a greater choice of hospitals and consultants. While Solutions comes with guided consultant choice as standard, Optimum includes Aviva's key hospital list, giving your employees access to over 200 hospitals in the UK. The policy also provides access to Aviva's menopause service to support your employees' well-being.

Optional extras

Aviva's Optimum policy includes all the same optional extras as Solutions, including:

• Extended hospital list
• GP referred services
• Dental and optical cover

Optimum also offers some additional optional extras that aren't available on Aviva's small business private medical insurance. Here's what's on offer.

Enhanced cancer cover

Optimum includes level 2 cancer cover as standard, but if you want to give your employees access to higher cost treatments, you can upgrade to level 3 coverage.

Your employees will be able to access all the same treatments and cancer support services available with level 2 cover, but they'll also receive a broader range of treatments. Level 3 cover includes targeted therapies such as proton beam therapy, as well as stem cell and bone marrow transplants. Aviva aims to offer flexible coverage, so you can remove some higher-cost treatments to tailor coverage to your requirements and budget.

Gender Identity Services

The gender identity benefit helps you support your transgender employees and provides two benefit levels so you can choose your preferred option.

The core benefit supports employees who are waiting for NHS treatment, with access to counselling with specialist mental health experts, assessment by a specialist consultant who can prescribe the first course of hormone therapy, and consultations to help patients stabilise their medication. It doesn't cover prescription costs or any surgical treatment.

Most services are only available to patients aged 18 or older, but members aged 12 or older can receive counselling.

The enhanced benefit includes all of the above, plus surgery and allowances for voice therapy, hair transplantation and removal, and wigs.

Fertility and family planning support

The Solutions plan provides investigations for employees experiencing infertility, but the Optimum policy expands on this by giving you the option to provide your team with fertility treatment and support. This option is only available to companies with at least 1000 employees. It includes fertility treatment at HFEA-licensed clinics, including IVF and fertility preservation for employees undergoing medical treatment that could limit their fertility.

The policy doesn't cover complementary therapies, surrogacy, voluntary sterilisation, or the reversal of previous sterilisation surgery.

Neurodevelopmental pathway

Adding the neurodevelopmental pathway to your private medical insurance policy helps you support your employees with conditions such as autism, ADHD and Tourette's. It offers direct access to a private diagnosis without a GP referral, working in partnership with NHS services to speed up diagnosis and treatment. Employees can also access specialist support, including tailored cognitive behavioural therapy (CBT), a first prescription for medication if needed, and appointments to help stabilise medication levels.

Clinicians can also refer patients to the mental health pathway for more specialised treatment.

Mental health pathway plus

Aviva's mental health pathway provides unlimited counselling and out-patient psychiatric care. Mental health pathway plus lets you extend coverage to include in-patient treatment and access to the addictions programme.

Most (but not all) private medical insurance providers exclude addiction treatment. Aviva offers one addiction support programme per employee for the duration of the policy. If an employee receives treatment using their private medical insurance but relapses later, they won't be able to claim for a second time. The programme aims to provide early intervention and treatment tailored to each individual's needs.

Many providers now re-classify mental health issues as chronic conditions, thereby excluding them from coverage, if members claim for treatment in multiple policy years. This doesn't apply to this pathway, meaning employees with recurring mental health challenges can receive treatment when they need it.

Optimum Referral

Optimum Referral offers a lower-cost option than the full Optimum policy. Your employees will need a referral from their NHS GP or Aviva's digital GP service to start the process. When they start their claim, Aviva's advisers will offer them a guided choice of consultants, based on high-quality treatment at a lower price point. They'll send the referral to the chosen provider and pay their bills directly.

Whether you choose the Solutions policy, Optimum or Optimum Referral, your employees can access a range of services and additional benefits at no extra cost to you.

These include:

• A digital GP service with video consultations available 24/7
• Discounts on gym memberships and other well-being products and services
• Access to a well-being app for support with setting and achieving healthy lifestyle goals
• Access to the Aviva portal, where they can make claims and monitor progress
• A 24/7 stress counselling telephone helpline
• Online mental health and well-being resources
• The Aviva Line Manager Toolkit provides mental health resources to help managers support their teams.

Optimum also includes menopause support as standard.

All private medical insurance policies have exclusions detailing treatments and conditions that are not covered. Aviva's standard exclusions include treatment for addiction (other than the addiction support programme available with Optimum), straightforward pregnancy and childbirth, cosmetic procedures, and chronic conditions.

Personalised exclusions apply to pre-existing conditions an employee had in the five years before joining the policy if your policy has moratorium or full medical underwriting. With the Optimum policy, you can choose medical history disregarded underwriting. This is the most expensive option, but it allows your employees to access treatment without exclusions based on their medical history.

Providing your team with private medical insurance carries many business benefits. You can claim corporation tax relief on your health insurance premiums and reduce your tax bill. However, it's also vital that your private medical insurance fits your budget. Aviva aims to provide flexible cover options so you can spend more to enhance your coverage or reduce your costs. The simplest way to save money is to reduce the level of coverage your policy provides. However, this may mean losing some of the benefits of business private medical insurance.

The type of underwriting you choose can affect the cost, the claims process, and the amount of paperwork your admin and HR teams must deal with. Seeking advice from a specialist broker can help you consider your options and choose coverage that meets your needs and budget.

Here are some other ways you can reduce your premium.

Choose a reduced hospital list

As we've mentioned, Solutions includes 'Expert Select', a guided consultant option, as standard, while Optimum provides Aviva's key hospital list. You can also choose Optimum Referral for a guided consultant option. Aviva also offers two lower-cost hospital lists with both policies.

Most private medical insurance providers have a network of private hospitals and treatment centres that their policies cover. Standard lists typically also include private patient units at NHS hospitals. Aviva's Trust hospital list only covers treatment at NHS private patient units and NHS partnership hospitals. Your staff will still benefit from quick access to treatment, but will have a limited selection of hospitals to choose from.

Alternatively, if you're in Scotland or Northern Ireland, you can opt for the Signature hospital list, which only covers hospitals in those regions.

Add a six-week wait option

A six-week wait option means your employees can use their health insurance only if they will wait longer than six weeks for NHS treatment. If you choose this option, Aviva will still provide cover for consultant appointments, diagnostic procedures and out-patient treatment following a GP referral. Your employees can also use the Back2Better service. However, they'll only be covered for in-patient and day-patient treatment if the NHS waiting list is longer than six weeks. This can be problematic if an employee receives emergency treatment to stabilise their condition, as they won't be able to claim for any follow-up care. Employees also can't claim an NHS cash benefit if they receive treatment within six weeks.

This option may limit the level of cancer treatment covered under the policy. However, employees can still claim for licensed treatments that aren't currently available on the NHS.

Add an excess

Adding an excess to your policy means your employees must pay for part of their treatment out of pocket. Aviva business health insurance applies a single excess payment per policy year, making it less costly than a policy where employees must pay the excess for each claim.

Aviva offers excess payments of £50, £100, £150, £200, £250 and £500 per year. When deciding on the level of excess to apply, consider whether the payment will be affordable for all staff covered by the policy. Setting the excess too high may mean that staff don't use their private medical insurance, and you lose the business benefits.

Remove some benefits

We've mentioned that you can reduce your premium by limiting the level of cover your policy provides. However, Aviva also lets you remove specific services that they otherwise include as standard. If you wish, you can remove coverage for treatment for pregnancy and childbirth-related complications, investigations into infertility and hospital dental surgery. It's worth considering your business values when adjusting benefits. For example, if you pride yourself on being a family-friendly employer, removing pregnancy, childbirth and infertility benefits may send the wrong message.

With Optimum, you can also reduce the cancer coverage to level 1 instead of 2. Level 1 includes diagnostic services and then focuses on core treatments such as surgery, chemotherapy and radiotherapy. It provides limited post-surgery support and doesn't include high-cost treatments, follow-up care, or medication to support employees' recovery and reduce the risk of recurrence. However, employees can still access support services, including counselling and specialist telephone helplines.

Add an out-patient cover limit

As we've seen, many of Aviva's treatment options provide full coverage, including unlimited cancer treatments and mental health support. You can set a financial limit for out-patient services, meaning each employee can receive treatment only for as long as funds remain available. Aviva offers out-patient cover limits of £0, £1,000 and £1,500.

Each cover limit still includes various out-patient services and procedures. For example, if you select a £0 limit, your employees still have unlimited coverage for seeing a consultant, undergoing out-patient surgical procedures, complex scans, and pre-admission diagnostic tests. It covers radiotherapy and chemotherapy for cancer as well as physiotherapy for back, neck and shoulder problems. However, there's no mental health treatment.

Higher limits provide all of the above, plus mental health cover, non-surgical specialist treatment, and a broader range of musculoskeletal treatment options, including physiotherapy, osteopathy and chiropractic treatment following a specialist referral. Limits don't apply to cancer treatment, meaning your staff can still benefit from comprehensive cancer coverage.

Globacare provides tailored advice to help you find the right health insurance for your business needs. Contact us to find out more.