What group private medical insurance costs, and the shape it takes at your size

A reference for UK founders, directors and HR leads working out scheme shapes and tax costs before they speak to an insurer or adviser.

Further reading

Where each part of the decision is covered

Each of these covers one part of the decision: how underwriting changes with headcount, where to check an insurer's own terms, and who this guidance is written for.

How group underwriting works

See how medical history disregarded, moratorium and continued exclusions change by group size, and what happens to cover when someone leaves.

Read the guide

Named UK health insurers

A list of UK health insurers with links to their own published scheme terms, for checking a term against the source.

See the directory

Who this site is for

Read about the scope of this resource and who it's written for, before you use any of its guidance.

Read more
Employer and employee tax

How the money flows

Paying for a group private medical scheme puts you in the middle of two separate tax events: one that lands on the business, and one that lands on each employee you cover. The sequence runs in a fixed order, from premium to payslip.

  1. You pay the insurer

    You pay the premium for the group scheme directly to the insurer, covering every employee named on the policy.

  2. You report the benefit and pay Class 1A National Insurance

    You record the cost of each employee's cover on form P11D and pay Class 1A National Insurance on that amount (GOV.UK, read 2 October 2026). This is reported after the tax year ends, on the benefit provided during it.

  3. The employee is taxed through their tax code

    HMRC treats the premium you pay for an employee's cover as a benefit in kind, and that employee pays income tax on it at their own rate. HMRC usually collects the charge by adjusting the employee's tax code.

    Employee only

    The taxable benefit is the cost of that employee's own cover.

    Employee plus family

    The taxable benefit also includes the cost of cover for any family members named on the scheme (HMRC EIM21762, read 2 October 2026).

This sequence describes an insured scheme, where you pay an insurer directly. A healthcare trust moves the money differently.

Where to find the insurers named across this site

A list of named UK health insurers with links to their own published scheme terms, kept separate from any ranking or comparison of them.

National Friendly National Deposit Friendly Society

National Friendly is the trading name of National Deposit Friendly Society, a UK mutual society founded in 1868 offering private medical insurance and other financial services.

  • Cover types inpatient, outpatient, cancer, mental health (outpatient sessions only, no inpatient mental health cover) source
  • Established year 1868 source

Freedom Health Insurance

Freedom Health Insurance is a UK independent insurer founded in 2003, offering private medical insurance for individuals and small to medium businesses.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover source
  • Established year 2003 source

The Exeter

The Exeter is a UK mutual society founded in 1927 offering private medical insurance, income protection and life insurance primarily to individuals.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment source
  • Established year 1927 source

WPA

WPA (Western Provident Association) is a UK not-for-profit private medical insurer founded in 1901, offering health insurance as its sole product.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment within outpatient limit, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1901 source

Vitality Health Discovery Holdings

Vitality Health is a UK-based private medical insurer owned by Discovery Holdings that rewards members for healthy living through a programme of discounts and incentives.

  • Cover types inpatient and day-patient treatment, outpatient consultations and tests, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental cover, travel cover source
  • Established year 2004 source

Aviva Health Aviva

Aviva Health is the health insurance division of Aviva, one of the UK's largest insurance companies, offering tiered private medical insurance plans for individuals, families and businesses.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment within outpatient limit, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover source
  • Established year 1990 source

AXA Health AXA Group

AXA Health is a UK-based private medical insurer and part of the global AXA Group, known for flexible, modular policy options and digital health services.

  • Cover types inpatient and day-patient treatment, outpatient cover, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1938 source

Bupa

Bupa (British United Provident Association) is a UK-based not-for-profit private medical insurer offering policies for individuals, families and employers, with no shareholders and all profits reinvested into the business.

  • Cover types inpatient and day-patient treatment, outpatient consultations and tests, therapies/complementary treatment, psychiatric/mental health as an inpatient, cancer treatment, dental and optical cover, travel cover source
  • Established year 1947 source

Insured scheme or healthcare trust

An insured group scheme is one where you buy cover from an insurer, and under HMRC Notice IPT1 the whole payment you make to that insurer carries Insurance Premium Tax, as read on 2 October 2026. The tax sits inside the premium itself.

The healthcare trust alternative

A healthcare trust is the usual route employers use, and it carries no Insurance Premium Tax liability under that same HMRC notice. Trust arrangements vary from one employer to the next, so what a given trust actually covers and how it is funded has to be set out on its own terms.

Which route a company looks at tends to follow from its size and how much claims administration it wants to take on itself. How underwriting works within an insured scheme, including where cover for a very small group carries restrictions, is covered separately in the group underwriting guidance. The insurers listed in the health insurer directory are companies offering the insured route.