THE GOOD QUESTIONS
Less head-scratching.
A little more clarity.
Find a starting point below. We’ll help you work through the detail that’s specific to your team.
10 questions
How do medical insurance, cash plans and EAPs differ?
Medical cover supports eligible private treatment. Cash plans reimburse routine costs. EAPs provide confidential guidance and counselling.
Who pays for private treatment?
Insurers generally pay eligible hospital claims directly. Outpatient limits and excesses may leave a contribution to pay.
Why do hospital lists matter?
Different policies give access to different hospital networks. Check locations against your team’s needs.
What is an excess?
The member’s contribution towards eligible claims. Its amount and frequency depend on the policy.
What about pre-existing conditions?
Underwriting sets the rules. Previous symptoms, treatment and exclusions need careful review.
Can employees include family?
Some schemes allow immediate family. Eligibility, employer funding and employee contributions need agreeing.
How do cash-plan claims work?
Employees usually pay, keep receipts and claim eligible costs through their provider, within benefit limits.
Can we review an existing scheme?
Yes. Bring current arrangements so Pegasus can compare options and discuss continuity of cover.
What happens when someone joins or leaves?
Update the insurer or ask Pegasus for help. Membership and premium changes follow the scheme’s terms.
What should we consider before choosing?
Workforce needs, budget, eligibility, cover limits, underwriting and communication all matter. Discuss tax treatment with your adviser.
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LET’S MAKE A GOOD START
Your people.
Our starting point.
A conversation is the first step to finding the right fit.