FAQs for Employer Schemes

We offer two types of employer groups:

A Subsidised group – where the premiums for the employees (and sometimes their families) is paid in full or partially by the employer. When an employer fully subsidises a health insurance plan for all employees or all employees and family members, we are able to offer our most attractive terms (discounts and cover for pre-existing conditions).

A Voluntary group – where the employer allows UniMed to promote health insurance plans to its employees at a discounted rate, but does not pay any of the premiums. These schemes have lower employee participation than subsidised schemes which means that the benefits for employers are less (lower impact on reducing absenteeism and improving productivity).

A Voluntary group gives the employer access to a discounted premium. Premiums can be paid by direct debit from the employee to UniMed or through payroll deduction with the employer remitting the money collected to UniMed.

A Subsidised group enables UniMed to offer more competitive premiums than a voluntary scheme, due to higher levels of employee participation. A subsidy may also enable UniMed to offer coverage for pre-existing medical conditions (which are excluded in voluntary schemes).

Employers can choose to offer any of our standard plans to their employees. For employers who fully subsidise their employees premiums, we have developed some exclusive health insurance plans. Our employer group plans tend to offer more generous limits than those available to private individuals.

Standard group plans available are:

  • Hospital Select (a surgery plan covering the reasonable costs of surgery and related specialist and diagnostic costs, with additional optional modules to extend cover).
  • UniCare Advantage (a comprehensive plan providing cover for 80% of reasonable surgical costs, and a high contribution towards the cost of consultations, diagnostics, and some everyday healthcare services such as GP fees).
  • MedicalCare (a surgery and specialist consultations and diagnostics plan covering reasonable costs, with additional optional modules to extend cover).
  • Health Positive (a plan covering 50% or 80% of everyday healthcare costs, consultations and diagnostics but no cover for surgery).

We will work closely with you to determine the right plan to meet your needs and objectives, and if you are moving from another health insurer and wish to match your cover, we will help you work out the most comparable plan.

Our range of standard and group health insurance plans have been designed to meet a variety of health care needs and budgets. This includes options to cater for employers who want to limit their employee subsidy to a defined budget.

However, depending on the number of subsidised employees (and family members) you expect to include in your group scheme, we may be able to tailor a plan to suit your needs.

Depending on the number of employees (and family members) you subsidise, we can cover most pre-existing conditions.

Cover can start immediately or after a stand down period, and can be limited to a dollar value or covered to the full extent of the subsidised plan.

The range of pre-existing conditions which can be covered can be varied to include high-cost conditions such as cancer, cardiovascular or musculoskeletal conditions. Some pre-existing conditions are never covered for any member and these are listed in the exclusions sections of our Conditions of Membership.

Adding cover for pre-existing conditions is a benefit that is only available to employer group schemes, and so provides a real benefit to your employees that they would not be able to access as a private member.

If you subsidise the premiums for family members, they too can access cover for pre-existing conditions.

It depends on the number of employees and family members eligible for your group scheme and the level of subsidy that applies. Please discuss this with your Account Manager.

Employers select the plan (or plans) they will subsidise for employees, and it is possible to subsidise different plans for different categories of employees.

We do require that the same plan is offered to eligible employees in the same category. For example, you might decide that eligible employees must be permanent employees with more than 6 months’ service, but that waged employees will get Plan A and salaried employees will get Plan B. In this situation, waged employees cannot get Plan B unless there is an upgrade option available to them.

Employers select the plan (or plans) they will subsidise for employees, and it is possible to subsidise different plans for different categories of employees.

We do require that the same plan is offered to eligible employees in the same category. For example, you might decide that eligible employees must be permanent employees with more than 6 months’ service, but that waged employees will get Plan A and salaried employees will get Plan B. In this situation, waged employees cannot get Plan B unless there is an upgrade option available to them.

An eligible employee is someone who is entitled to join your health insurance scheme and receive a subsidy. You can define eligibility according to your HR strategy and goals. As long as the eligibility criteria is applied consistently, your scheme will qualify as a subsidised scheme.

Examples of eligibility include a requirement that the employee –

  • has a permanent contract with their employer,
  • has completed a defined period of service,
  • works in a specific role or geographical location,
  • has achieved a specific level of seniority,
  • has a particular type of employment contract.

We understand that some employers do not consider it their role to subsidise family members or may wish to subsidise them but do not have the budget available. In these circumstances we suggest that employees add their family members onto their policy at their own expense.

We collect the premiums from employees directly by Direct Debit, or we can work with employers to set up a payroll deduction process.

Family members will be able to access discounted premiums, and in some situations they may be able to access cover for some pre-existing conditions.

If your employees have adult dependants, they are able to set up a separate policy for that child at discounted premiums. Premiums will be collected by Direct Debit.

We will work with you to determine the best method and frequency for paying premiums. Subsidised premiums are usually billed monthly, although we are able to offer quarterly, six monthly and annual in advance payment options. We invoice you in advance for the subsidised premiums and you can pay by bank transfer.

Employee-paid premiums can be paid by Direct Debit or payroll deduction. If you choose payroll deduction we will provide regular schedules of required deductions which you collect from your employees and then pass on to us. We will provide weekly or fortnightly schedules, depending on the frequency of your payroll. More and more companies prefer the easy administration of Direct Debit which does not require any involvement for your payroll team. Our network of regional Relationship Managers will ensure that Direct Debit forms are completed at the time the employee signs up.

When you are happy with the details of your group scheme (including plans, premiums and terms) your UniMed Account Manager will arrange a time to meet. At the meeting we will agree the process and timeframe for setting up your group scheme. We will do all the legwork and minimise administration effort required by your payroll team. We will agree on an employee communications plan and our regional Relationship Managers will be available to ensure that your employees understand the scheme and complete any necessary paperwork. In many situations we can add subsidised employees into your scheme without the usual requirement to fill-in a membership application form for each employee.

Your Account Manager and Relationship Managers will be available on an ongoing basis to continue employee education and sign up, or to assist with all administration requirements.

As a specialist in employer group schemes we can provide an alternative option to your current insurer. You may wish to maintain the type of cover that you have (with an alternative insurer) or make more significant changes. Our Account Manager can review your scheme and make suggestions for improvements or changes to meet your current business needs and budget constraints.

To make the transition easy, we can offer “no worse underwriting terms” so that your employees do not lose cover for medical conditions they are already aware of or have experienced.

Your UniMed Account Manager will agree a transfer process and timing with you to ensure minimal disruption to your employees, and minimal administration for your payroll team. We will agree a communications process and our regional Relationship Managers will be available to inform your employees and assist them with the transfer and set up of any additional cover (e.g. upgrades or addition of family members). In many cases, we can transfer currently insured, subsidised employees without the need for each of them to complete paperwork.

You should notify the UniMed Sales team or your Account Manager as soon as the person starts work or becomes eligible for your scheme. We will then discuss the cover with your employee and ensure that they complete the correct documentation. We will notify you of the subsidy premiums, and, if applicable, the amount and frequency of any voluntary payments to be deducted from payroll.

You should notify us as soon as you can to let us know when we should remove the employee from your scheme. We will then contact the employee and offer them special terms to continue their cover with us.

Employees who leave your scheme are offered a discounted premium and they retain cover for conditions which arose (for the first time) since they started their policy with us. In addition, in most cases they can also keep cover for their pre-existing conditions. We can advise on the specific terms applicable in different circumstances.