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WPA - Enterprise Health - Pre June 2018

Flexible insurance for your business



Designed for smaller businesses (2-15 employees) who are new to health insurance. Enterprise Flexible Benefits requires a minimum of 2 employees (not including family members and residing at separate UK addresses) to be on cover at all times. You can tailor the cover for each employee, by building upon the Core Cover and choosing to add a range of Extras to enhance the benefits.
Why choose Enterprise Flexible Benefits

Enterprise Flexible Benefits does not cover pre-existing or chronic conditions. For more details see what´s not covered.

View our Enterprise Flexible Benefits FAQs for answers to many common questions.

Benefits

Cover level All Standard Comprehensive
Cash extras All Yes No
Dental extras All Yes No
Emergency Worldwide Cover All Yes No
Six week wait All Yes No
Comprehensive O/p Option All No £500 £1000 Unlimited

Key Facts - In-patient & Day Case Charges

Hospital accommodation charges including theatre fees, nursing costs, prosthesis, in-patient drugs & dressings
Cover level - Comprehensive
Cover level - Standard
Full refund of customary and reasonable fees
Surgeon / Consultant / Specialist & Anaesthetists fees
Cover level - Comprehensive
Cover level - Standard
Full refund of customary and reasonable fees
Physicians fees & diagnostic tests
Cover level - Comprehensive
Cover level - Standard
Full refund of customary and reasonable fees
Cancer Treatment Costs - Chemotherapy / Radiotherapy
Cover level - Standard
Cover not available
Cover level - Comprehensive
Full refund of customary and reasonable fees
Psychiatric treatment
Cover level - Standard
Cover not available
Cover level - Comprehensive
Full refund for up to 28 days or nights in any 5 year period
Six week option
Six week wait - No
Cover not available
Six week wait - Yes
Where treatment is required and the NHS waiting list for the treatment required is longer than six weeks from their initial private consultation (covered in line with customary and reasonable limits), employees are eligible to receive treatment straight away, privately. NHS cash benefit is available where treatment is provided on the NHS.
Please note that cancer treatment, once diagnosed, is not covered under this option (both privately or on the NHS).

Key Facts - Out-patient Charges

Complementary medicine
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for Physiotherapy and other therapies.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for Physiotherapy and other therapies.
Comprehensive O/p Option - Unlimited
Unlimited. Combined benefit with Specialist consultations / Tests and for Physiotherapy and other therapies.
Diagnostic tests (excluding scans)
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
GP referred consultations
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Physiotherapy consultant referred
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Physiotherapy GP referred
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Psychiatric cover
Cover level - Standard
Cover not available
Cover level - Comprehensive
Up to £750 p.a. includes psychotherapy and psychiatric treatment.
Radiotherapy / Chemotherapy
Cover level - Standard
Cover not available
Cover level - Comprehensive
Full refund
Scans - MRI / CT / PET
Full refund for complex diagnostic scans (MRI, CT & PET scans at the request of a specialist and 1 MRI or CT scan arranged by your GP)
Surgical Procedures
Full refund of customary and reasonable fees for surgical procedure / diagnostic endoscopic procedure.

Key Facts - Additional Benefits

NHS cash benefit
Cover level - Standard
Up to £4,500 p.a. (£100 per night/day for in/day-patient or out-patient diagnostic scans and procedures)
Cover level - Comprehensive
Up to £4,500 (£100 per night/day for in/day-patient or out-patient diagnostic scans and procedures)
Cancer Cover
Up to ££30,000 (£100 per night/day for in/day-patient or out-patient diagnostic scans, procedures, pathology and radiotherapy/chemotherapy)
Nursing at home
Cover level - Standard
Cover not available
Cover level - Comprehensive
Full refund (up to 4 weeks following in-patient treatment)
Parental accommodation
Cover level - Standard
Cover not available
Cover level - Comprehensive
Full refund
Primary care
Not covered
Private ambulance
Cover level - Standard
Cover not available
Cover level - Comprehensive
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
Not covered
Annual maximum limit
No annual maximum
Children covered
Up to age 21 or 25 in FTE
Chiropractors & Osteopaths
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Dental treatment
Dental extras - No
Cash extras - No
Cover not selected
Cash extras - Yes
Cash benefits available up to the amounts shown (100% cashback)
£150 for General dental treatment, benefit towards routine general dental treatment
£150 for Optical, towards the cost of sight tests and glasses/contact lenses
£100 for New baby, a cash benefit on the birth or adoption of a child (10 month qualifying period applies)
£200 for Health screening – every 2 years, towards the cost of 1 health screen (e.g. well man or well woman check
Dental extras - Yes
Dental extras
£250 for General dental treatment (100% of costs)
£1,000 for Dental emergencies (100% of costs up to £250 per episode, maximum 4 per year)*
£20,000 for Dental injuries
£10,000 for Oral cancer (restorative dental treatment only)*
*14 day qualifying period applies
GP minor surgery
Not covered
GP Referred Chiropody, Podiatry or Homeopathy
Comprehensive O/p Option - £500
Comprehensive O/p Option - No
Up to £500 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - £1000
Up to £1,000 p.a. Combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Comprehensive O/p Option - Unlimited
Unlimited, combined benefit with Specialist consultations / Tests and for cover of one or a combination of the following treatments: Acupuncture, Chiropody/Podiatry, Chiropractic Care, Dietary Services, Homeopathy, Osteopathy, physiotherapy, Speech and Language therapy.
Note: there is a maximum of 10 sessions per person per group policy year for GP referred therapy.
Hospice care cash benefit
Not covered
Infertility investigations
Not covered
Maternity cash benefit
Cash extras - No
Cover not selected
Cash extras - Yes
See Cash extras benefits
Optional cash benefit
Cash extras - No
Cover not selected
Cash extras - Yes
Cash benefits available up to the amounts shown (100% cashback)
£150 for General dental treatment, benefit towards routine general dental treatment
£150 for Optical, towards the cost of sight tests and glasses/contact lenses
£100 for New baby, a cash benefit on the birth or adoption of a child (10 month qualifying period applies)
£200 for Health screening – every 2 years, towards the cost of 1 health screen (e.g. well man or well woman check
Out of pocket expenses
Not covered
Overseas cover
Emergency Worldwide Cover - No
Cover not selected
Emergency Worldwide Cover - Yes
Emergency Worldwide Cover
£500,000 for treatment for medical emergencies, Evacuation/repatriation by air ambulance when local medical facilities
are inadequate. Up to 70 days per trip (35 days if outside the EU – see below *)
* Trips outside the European Union are covered for bona fide business purposes only. Documentary evidence will be required to make a claim. The Emergency Worldwide Cover extra is not a substitute for a comprehensive travel insurance policy. It does not include destinations that are considered ‘at risk’ by the Foreign & Commonwealth Office (FCO) website.
Personal & total disability benefit
Not covered
Post hospital recovery bonus
Not covered
Pregnancy
Not covered
Stress counselling helpline
Available via the Employee Assistance Programme (EAP)
Transplants
Not covered
 
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