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WPA - Enterprise Flexible Benefits - Old - Pre June 2018

Because of its flexibility and true community rating, Enterprise Flexible Benefits (EFB), is the ideal healthcare solution for any company with 3+ employees.

Why chose Enterprise Flexible Benefits (EFB)?

For more information please contact WPA broker business development team on 01823 625304.

Benefits

Step 1: Choose one of the policy types to begin building your company´s cover
Core Cover All Essential without Wellness Essential with Wellness Wellness ony Dental (Standalone)
Step 2: Enhance the cover:
Out-Patient Option All Yes £1000 limit No
Therapy Option All Yes No
Worldwide Option All 70 Days 35 Days No
Step 2: Enhance the cover: NHS Top-Up Extras
Cosmetic All Option 1 Option 2 Option 3 No
mycancerdrugs All Yes No
A&E Abroad All Yes No
Dental - add to the PMI or Top-Up cover or buy as a stand alone
Dental Plan All Yes No

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund of customary and reasonable fees
Surgeon / Consultant / Specialist & Anaesthetists fees
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund of customary and reasonable fees
Physicians fees & diagnostic tests
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund of customary and reasonable fees
Cancer Treatment Costs - Chemotherapy / Radiotherapy
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund of customary and reasonable fees
mycancerdrugs - Yes
mycancerdrugs:
Pays for the expensive drugs the NHS denies.
Cover for licensed(1) cancer drugs that are not available on the NHS - Up to £50,000 lifetime benefit

(1) For further details please refer to ´A Guide to Your Group Policy´.
There is a 90 day deferment period for this cover. This option is not available if you already have private medical insurance with WPA or another provider.
Psychiatric treatment
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund for up to 28 days or nights in any 5 year period
Six week option
Not available

Key Facts - Out-patient Charges

Complementary medicine
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Therapy Option - Yes
Therapy Option provides £1,000 benefit per person pa for Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, Physiotherapy, Psychology and Speech and Language Therapy.
Diagnostic tests (excluding scans)
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only
£150 per attendance for endoscopic investigations, MRI CT or PET scans and/or out-patient surgical procedures (including pain relief injections) with an overall combined benefit of £4,500 per person per policy year with NHS Cash benefit
Out-Patient Option - Yes
Out-patient option provides full cover for diagnostic tests. Up to a maximum benefit of £500 is available for diagnostic tests carried out by your GP
Out-Patient Option - £1000 limit
Out-patient option provides up to an overall out-patient limit of £1,000 of cover for diagnostic tests
GP referred consultations
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only provides £150 pa for consultations
Out-Patient Option - Yes
Out-patient option provides full refund for consultations with a Specialist, Up to a maximum benefit of £500 is available for diagnostic tests carried out by your GP
Out-Patient Option - £1000 limit
Out-patient option provides up to an overall out-patient limit of £1,000 for consultations with a Specialist
Physiotherapy consultant referred
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Therapy Option - Yes
Therapy Option provides £1,000 benefit per person pa for Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, Physiotherapy, Psychology and Speech and Language Therapy.
Physiotherapy GP referred
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Therapy Option - Yes
Therapy Option provides £1,000 benefit per person pa for Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, Physiotherapy, Psychology and Speech and Language Therapy.
Psychiatric cover
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Out-Patient Option - Yes
Out-patient option provides full cover for up to 6 months for Specialist treatment
Out-Patient Option - £1000 limit
Out-patient option provides an overall out-patient limit of £1,000 of cover for up to 6 months for Specialist treatment
Radiotherapy / Chemotherapy
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund
Scans - MRI / CT / PET
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund on MRI/CT/PET scans only
Surgical Procedures
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund of customary and reasonable fees for surgical procedure / diagnostic endoscopic procedure.

Key Facts - Additional Benefits

NHS cash benefit
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
£150 per night / day or £200* for in-patient stays of 3 nights or more with an overall combined benefit of £4,500 per person per policy year with out-patient diagnostic tests
Nursing at home
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund (up to 4 weeks following in-patient treatment)
Parental accommodation
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund
Primary care
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Private ambulance
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Full refund when required for medical reasons to go to, from or between hospitals for treatment which is covered by your Group Policy.

Additional Benefits

Alcohol & drug abuse
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Annual maximum limit
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
No annual maximum
Children covered
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Up to age 21 or 25 in FTE
Chiropractors & Osteopaths
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Therapy Option - Yes
Therapy Option provides £1,000 benefit per person pa for Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, Physiotherapy, Psychology and Speech and Language Therapy.
Dental treatment
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Dental Plan - Yes
Dental Option
75% of costs up to £250 per person per policy year for general dental treatment
£1,000 (up to £250 per episode, maximum 4 per year) for dental emergencies
£10,000 for serious dental problems,
£20,000 for dental injuries,

Other benefits
Full cover for hospital charges
Customary and reasonable fees, whilst in hospital for Specialist/Consultant fees
£200 for each night you spend in an NHS hospital for hospital cash benefit
Up to a maximum of 10 nights for parent and child
Rules apply.
GP minor surgery
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
GP Referred Chiropody, Podiatry or Homeopathy
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
Therapy Option - Yes
Therapy Option provides £1,000 benefit per person pa for Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, Physiotherapy, Psychology and Speech and Language Therapy.
Hospice care cash benefit
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
£70 per day / night, max £700 per group policy year
Infertility investigations
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Maternity cash benefit
Cover not selected
Core Cover - Essential without Wellness
Essential only - Nil
Core Cover - Essential with Wellness
Core Cover - Wellness ony
See Wellness option
Optional cash benefit
Cover not selected
Core Cover - Essential without Wellness
Essential only - Nil
Core Cover - Essential with Wellness
Core Cover - Wellness ony
Wellness:
Helps with the everyday healthcare costs and the extra costs when admitted to hospital.
Prescription Charges - 100% cash back up to £40
Specialist/Second Opinion - 100% cash back up to £250
Eye Test - 100% cash back up to £40
Optical Treatment - 75% cash back up to £150
Routine Dental Treatment - 75% cash back up to £150
Physiotherapy and other therapies - 75% cash back up to £300
GP Services - 75% cash back up to £150
Health Screening - 75% of the cost of a health screen up to £200
NHS Hospital In/Day-patient Admission - £65 per day/night for up to 20 days
Post Hospital Recovery Bonus - £400 after 7 consecutive nights in hospital
A&E Attendance* - £40 for each emergency attendance up to £80
Maternity Paternity - £200 each time you have a child
Health & Medical Information* - We provide 24/7 telephone support
Confidential Stress Counselling Service* - We provide 24/7 telephone support
Important - Please Note: There is a 10 month qualifying period for maternity/paternity benefit, 6 months for health screening and 1 month for all other benefits unless marked *.
* No qualifying period applies
Out of pocket expenses
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Up to £5 per night / day whilst in hospital
Overseas cover
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Essential only - Nil
A&E Abroad - Yes
A&E Abroad:
It´s like annual travel insurance - but without the baggage.
Treatment abroad including x-rays, tests, prescription medication, dental (1) Up to £150
Hospital treatment for medical emergencies overseas (including evacuation/repatriation) Up to £100,000
Worldwide multilingual network of medical professionals 24/7 telephone support

(1) Your £150 dental benefit under Wellness can also be claimed abroad.
Important - Please Note: Benefits apply for trips of no more than 21 days and a maximum total of 90 days abroad in each plan year. Excludes any trips to the USA or where the FCO advises against travel. We will not pay for any medical conditions from which you have previously suffered prior to joining this plan.
Worldwide Option - 70 Days
Worldwide Option provides emergency overseas treatment, Evacuation/Repatriation and family assistance is provided for trips abroad for up to 70 days per trip subject to an annual maximum of 180 days and an annual maximum benefit of £500,000
(Not USA)
Worldwide Option - 35 Days
Worldwide Option provides overseas treatment, Evacuation/Repatriation and Family assistance (to cover the cost of all immediate family members to return to the UK by scheduled flight) cover is for 35 days per trip, annual maximum of 90 days up to a total of £250,000 of treatment.
Personal & total disability benefit
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Post hospital recovery bonus
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Pregnancy
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
Not covered
Stress counselling helpline
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
24 hour advice line
Transplants
Cover not selected
Core Cover - Essential with Wellness
Core Cover - Essential without Wellness
No cover except for cornea transplants or skin grafts, and bone marrow or stem cell transplants where this forms part of treatment for cancer
Other benefits
Cosmetic - Option 1
Cosmetic Surgery: Option 1
Plastic surgery to repair looks after an accident or injury.
Up to £20,000 treatment costs for the upper body includes arms, face, neck & breasts

Please Note: Hands and Feet are excluded from cover. There is a 1 month qualifying period for Cosmetic Surgery. Benefits are only available for scars in excess of 1cm in length that have been caused by accidents and injuries. Deliberately self-inflicted injuries, disfigurement through illness or treatment received are not covered. We will not pay for any treatment which results from accident or injury sustained which has, or may be, the subject of a criminal proceeding or conviction, including road traffic offences.
Cosmetic - Option 2
Cosmetic Surgery: Option 2
Plastic surgery to repair looks after an accident or injury.
Up to £20,000 treatment costs for the lower body Includes stomach & legs

Please Note: Hands and Feet are excluded from cover. There is a 1 month qualifying period for Cosmetic Surgery. Benefits are only available for scars in excess of 1cm in length that have been caused by accidents and injuries. Deliberately self-inflicted injuries, disfigurement through illness or treatment received are not covered. We will not pay for any treatment which results from accident or injury sustained which has, or may be, the subject of a criminal proceeding or conviction, including road traffic offences.
Cosmetic - Option 3
Cosmetic Surgery: Option 3
Plastic surgery to repair looks after an accident or injury.
Up to £20,000 treatment costs for the total body

Please Note: Hands and Feet are excluded from cover. There is a 1 month qualifying period for Cosmetic Surgery. Benefits are only available for scars in excess of 1cm in length that have been caused by accidents and injuries. Deliberately self-inflicted injuries, disfigurement through illness or treatment received are not covered. We will not pay for any treatment which results from accident or injury sustained which has, or may be, the subject of a criminal proceeding or conviction, including road traffic offences.
 
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