Report: Health Cash Plans and Private Medical Insurance - UK

Issues in the Market
Key issues
Definitions -- the difference between PMI and health cash plans
Abbreviations
Market in Brief
The corporate PMI sector is likely to suffer most in 2009...
- Figure 1: Gross earned premiums (GEP) for PMI, by sector, 2002-09
...with the HCP market also seeing a fall in sales
- Figure 2: Number of healthcare cash plan subscribers, people covered and contribution income earned, 2003-09
NHS concerns influence the PMI market
The NHS is the main competitor against PMI
Bupa is the leading PMI provider...
- Figure 3: Subscription income of the top ten PMI providers, 2005-08
...while Simplyhealth dominates the HCP market
- Figure 4: HCP provider market shares, by contribution income, 2008
The PMI market is more intermediated than that of HCPs
One in five people own a healthcare cover product
- Figure 5: Ownership of healthcare products, by gender, age and socio-economic group, April 2009
PMI and HCP holders are reluctant to cancel their cover
Internal Market Environment
Key points
Infection fears at NHS hospitals boost demand for PMI
- Figure 6: Top ten reasons for taking out PMI, 2008
A shortage of investment may also be an issue
- Figure 7: Total public spending on the NHS, 2003/04-2010/11
Access to cancer drugs may tempt some people to go private
The NHS has slashed waiting times
- Figure 8: Inpatient and outpatient waiting times (England), 2005-09
A new approach for the NHS
Consumers are still confused about PMI
The impact of swine flu
Growth in sales outpacing growth in claim costs
- Figure 9: Value of total PMI claims, and as a proportion of gross earned premiums (GEP), 2002-08
Providers trying to retain their corporate customers
- Figure 10: Average PMI premiums, by sector, 2002-08
Broader Market Environment
Key points
Reduced consumer expenditure presents a challenge...
- Figure 11: PDI and consumer expenditure, 2004-14
...but over the longer term affluence is increasing
- Figure 12: Size of the AB population and the proportion of ABs out of the total population, 2004-14
PMI is a popular benefit to offer...
- Figure 13: Proportion of employers offering particular benefits as core*, top 15 benefits, January 2009
...and is highly valued by employees
- Figure 14: Top ten benefits most highly valued by employees*, February 2008
Don' t forget small businesses -- there' s a lot out there
- Figure 15: Number of private sector enterprises, employees and turnover -- UK, start 2007
The rising number of cancer cases benefits PMI providers
Unhealthy lifestyles may also impact the market
Competitive Context
Key points
A variety of options exist in healthcare options
- Figure 16: The main methods of obtaining healthcare treatment in the UK, 2009
Self-insurance is an option for large companies
- Figure 17: Number of subscribers and people covered by healthcare trust schemes, 2003-08
Personal savings and self-pay are also an option
SWOT Analysis
- Figure 18: Healthcare cover market SWOT analysis, 2009
Market Size and Forecast
Key points
The total number of PMI subscribers increased by 4% in 2008...
- Figure 19: Number of subscribers and people covered by PMI, by sector, 2002-09
...and many think the industry will hold up relatively well this year
The corporate sector is expected to suffer the brunt of any fall
- Figure 20: Gross earned premiums (GEP) for PMI, by sector, 2002-09
Demand for health cash plans fell slightly in 2008...
- Figure 21: Number of healthcare cash plan subscribers, people covered and contribution income earned, 2003-09
...although contribution income held up relatively well
Market forecast
The number of people covered by PMI will fall this year...
- Figure 22: Number of subscribers and people covered by PMI, by sector, 2002-14
...but the market should pick up in 2010
- Figure 23: Gross earned premiums (GEP) for PMI, by sector, 2002-14
Low growth expected in the health cash plan market
- Figure 24: Number of healthcare cash plan subscribers, people covered and contribution income earned, 2003-14
Market Share
Key points
Bupa is the market leader by some way
- Figure 25: Subscription income of the top ten PMI providers, 2005-08
The top four providers account for 85% of the market
- Figure 26: PMI provider market shares, by subscription income, 2008
Simplyhealth dominates the health cash plan market...
- Figure 27: Contribution income of the main HCP providers, 2005-08
Companies and Products
Company profiles
Aviva (formerly Norwich Union Healthcare)
AXA PPP healthcare
Bupa
Standard Life Healthcare
Simplyhealth
Westfield Health
Brand Communication and Promotion
Key points
PMI adspend fell by 13% in 2008
- Figure 28: Top ten categories of general insurance advertising, by expenditure, 2006-08
Bupa is the biggest advertiser of PMI
- Figure 29: Top 15 PMI advertisers, by expenditure, 2006-08
TV adspend fell significantly last year
- Figure 30: PMI advertising expenditure, by media type, 2006-08
Channels to Market
Key points
The corporate PMI sector is heavily intermediated...
- Figure 41: Proportional distribution of PMI sales, by channel, 2005-08
...whereas in the personal sector, direct sales dominate
Most HCPs are sold direct, but intermediation could grow
- Figure 42: Sales of HCPs, by distribution channel, 2008
The Consumer -- Product Ownership
Key points
Ownership of healthcare cover increased slightly in 2008
- Figure 43: Healthcare cover ownership, 2004-08
PMI makes up the majority of the healthcare cover market...
- Figure 44: Types of healthcare cover owned, 2008
...with two thirds of owners having cover for all conditions
- Figure 45: Conditions/treatments included in healthcare cover, 2008
Most people with healthcare cover arrange it independently
- Figure 46: Healthcare cover ownership, by method of arrangement (ie who pays for the insurance), 2008
ABs are a lot more likely to have healthcare cover...
- Figure 47: Healthcare cover ownership, by demographics, 2008
...especially where PMI is concerned, though less so for HCPs
- Figure 48: Ownership of healthcare products, by demographics, April 2009
Unlike PMI, cash plans are popular amongst older people
The Consumer -- The Impact of the Recession on Healthcare Cover
Key points
The recession is a threat to health cover providers...
- Figure 49: Attitudes towards healthcare cover in light of the recession, April 2009
...but not everyone is suffering
35-44-year-olds are most likely to cancel health cover in bad times
- Figure 50: Attitudes towards healthcare cover in light of the recession, by demographics, April 2009
High earners are clearly the best target
Larger households may be a better target
Independent PMI and HCP owners really value their policy...
- Figure 51: Ownership of healthcare products, by attitudes towards healthcare cover in light of the recession, April 2009
...and are reluctant to cut their cover
The Consumer -- Health Cash Plan Benefits
Key points
Dental cover is the most desirable benefit of HCPs
- Figure 52: Benefits most desired in health cash plans, April 2009
Women value health screening and maternity benefits
- Figure 53: Benefits most desired in health cash plans, by demographics, April 2009
- Figure 54: Benefits most desired in health cash plans, by demographics, April 2009 (continued)
For young people, information and accessibility are important
ABs are more appreciative of the benefits offered by HCPs
Health cash plan owners really value their benefits
- Figure 55: Ownership of healthcare products, by benefits most desired in health cash plans, April 2009
PMI holders are still worth targeting
Appendix -- Product Ownership
- Figure 64: Ownership of healthcare products, April 2009
- Figure 65: Healthcare cover ownership, by demographics, 2008
- Figure 66: Ownership of healthcare products, by demographics, April 2009
Appendix -- Health Cash Plan Benefits
- Figure 68: Benefits most desired in health cash plans, by demographics, April 2009 (Table 1 of 2)
- Figure 69: Benefits most desired in health cash plans, by demographics, April 2009 (Table 2 of 2)

Health Cash Plans and Private Medical Insurance - UK - August 2009