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AXA PPP healthcare Corporate Health Plan Pathways
AXA PPP healthcare dates back to 1940, so predates the UK’s NHS. Today it is part of the global AXA group and is the UK’s second largest private medical insurance (PMI) provider.
July 2010 Product Reviews
PRODUCT
CHP Pathways is a new, lower cost PMI plan for groups of 75+ employees.
The plan is based on AXA PPP’s existing Corporate Health Plan (which is its most popular plan for larger employers) but instead of having their GP refer them to a named specialist for investigation or treatment, members obtain an open referral from their GP and let AXA PPP decide which healthcare provider they should see. Members can however choose whether to be treated nearer to their home or to their place of work (the latter often being better for initial consultations, tests and scans, for example).
An open referral is where the patient’s own GP refers a patient for specialist treatment, but does not specify the specialist or hospital.
Choosing Pathways should result in savings of up to around 15%, which is reflected in the plan’s premium rates.
As part of the way it works, scheme members must have any treatment pre-authorised. This helps ensure that the required treatment is covered and enables AXA PPP to then make an appointment for the member with its selected provider.
The plan is available to both new and existing customers. Firms can continue to use say an existing occupational health (OH) provider or allow more senior managers to have a higher level of PMI cover.
RATING
| PROS | CONS |
|---|---|
Managed care means 15% cheaper premiums | Takes away patient choice |
Ideal for clients who do not want or need to choose their specialist | May be unpopular with GPs and some specialists and hospitals |
Competitive product from a big brand | Requires clients to trust their insurer to choose in their best interests, not just to save money |
LITERATURE
The membership handbook sets out full details of the scheme.
WHAT THEY SAY
An AXA PPP spokesman said: “CHP Pathways forms an important part of our response to meeting corporate customers’ healthcare needs more cost effectively in what remain challenging economic times. By allowing us to take the lead on directing members to selected providers, we can reward clients with significant savings – without compromising the extent or quality of healthcare cover scheme members receive.”
WHAT WE SAY
This new options will succeed if it does one of two things – either encourages firms to continue their existing cover when they otherwise might not do so or if it attracts new clients in future. But some may see this form of managed care as too “big brother” or even dangerously close to the kind of system that operates in the US.
However, the key is that AXA PPP is not forcing clients down this route – it is simply offering it as an option and, in return, rewarding that with a 15% premium discount. In the current market that is likely to be very valuable to many employers, and it is worth remembering that a 15% discount to employers also means a 15% cut in each employee’s taxable P11D benefit. The Pathways option is therefore likely to be worth considering for any client who has or is interested in an AXA PPP corporate PMI solution. Firms may also want to switch some employees to Pathways, but to allow others a wider choice of where and from whom they have treatment.
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