Small Business Health Insurance in Ireland: Benefits, Best Plans

In Ireland, offering private health insurance is optional.

But it’s an excellent strategic choice for small business owners.

Health insurance can help you recruit and retain skilled employees, enhance employee satisfaction, and positively impact your bottom line in the long run.

But what are the best small business health insurance plans?

And how do you get started?
Lets find out.

Further Reading

• Ever wondered what Excess in Your Insurance means? Check out our detailed guide to find out.  

• Here’s everything you should know about Private Health Insurance in Ireland (+ how it can benefit you).

What Is Health Insurance?

Health insurance is an agreement where an insurance company pays for some or all of your medical expenses in exchange for a payment (also called the premium).

A health insurance plan covers hospital accommodation costs and offers faster access to health services and treatment.

Further Reading

• Wondering if your healthcare plan covers maternity benefit yet? Find out the Waiting Period for Irish Health Insurance plans. 

• Explore our detailed guide to Lifetime Community Rating in Irish Health Insurance.

Types of Health Insurance

There are three main types of health insurance plans, varying in comprehensiveness:

• Inpatient Hospital Cover: This plan covers services you receive while admitted to a hospital — whether you stay overnight or for the day. It includes the total or partial payment of costs associated with accommodation, tests, surgery, etc.
  

  Some insurance plans cover a semi-private room in a public hospital, while others pay for a private room in a private hospital.

• Cash Benefit: A cash plan typically offers fixed reimbursement for various medical treatments. But it excludes reimbursement for inpatient costs.

• Outpatient Only or Primary Cover: This plan covers the treatment you receive from a healthcare provider when you aren’t admitted to the hospital. It includes online general practitioner (GP) consultations, emergency dental care, emergency room treatment, physiotherapist treatments, and so on.
  Limited outpatient plans usually only cover part of your expenses. The portion covered is referred to as the ‘allowable expense,’ and the amount may vary from plan to plan.

  
  For example, a GP visit may cost €40, but the allowable expense may be only €10. In this case, you would only be able to claim the €10.

Side note: You can take the inpatient hospital cover and outpatient cover separately.

But some health insurance companies offer plans with both inpatient and outpatient coverage. Certain policies also include the cost of doctor visits and alternative treatments like acupuncture, osteopathy, etc.

Further Reading

• Find what kind of details you need to provide before filling out the Irish Paternity Benefit Forms.

• Learn about the qualification criteria for Maternity Benefit amongst Self-employed individuals in Ireland.

Why Is Private Health Insurance Important for Small Businesses in Ireland?

To answer this question, we must first discuss how the Irish health system works.

Psst… Already familiar with the Irish health system and just need a small business health insurance solution? Check out Kota.

The Healthcare System in Ireland

Did you know around 47% of the Irish population have private health insurance?

As we mentioned earlier, private health insurance isn’t mandatory in Ireland.

But policyholders enjoy peace of mind knowing that they are covered in the event of a medical emergency.

Wondering what public benefits you can access without private health insurance?

Here’s a brief overview:

• Any Irish resident can access public inpatient and outpatient hospital services.

• Inpatient services will be free from 1 April 2023 (thanks to the Budget 2023). But outpatient services may be chargeable.

• Low-income earners may qualify for a medical card, allowing them to access most Irish health services for free. Those who don’t qualify for the medical card are still entitled to free hospital services but may need to pay for other charges like GP services.

But with all of these public health benefits, you may be thinking…

Why offer a private health insurance plan?

Keep reading to find out.

4 Reasons Small Businesses Should Offer Private Health Insurance

Private medical insurance has several advantages for small business owners, including:

Supporting Employee Wellbeing And Satisfaction

• Reducing Lost Productivity

• Improving Employee Retention

• Gaining An Edge Over Competitors

Let's discuss each benefit in detail:

1. Support Employee Wellbeing and Satisfaction

Offering private medical insurance in your employee benefits package shows that you value your employees.

Now, it’s more than just caring for employees when they’re sick.

Many private health insurance plans offer ongoing benefits to continuously support employees’ health and wellness. These include maternity benefits, mental health support, and dental care.

Even better?

Offering private health insurance can boost employee satisfaction.

Why is employee satisfaction important?

When your employees feel satisfied, they’ll be more motivated and perform at higher levels, contributing to your company’s growth.

2. Reduce Lost Productivity

Employees with private health insurance gain greater access to medical resources.

This, in turn, can contribute to:

• Reduced workplace absenteeism: Since employees have access to premium medical care whenever necessary, they tend to take fewer days off.

  Why is this important?

  Research by the Irish Business and Employers Confederation (IBEC) shows that the equivalent of 11 million workdays is lost annually in Ireland due to employee absences, costing the economy €1.5 billion.

• More efficient and effective workplaces: Public health facilities usually have long waiting lists. Patients often would have to wait until their symptoms were extreme before receiving medical attention.

  In contrast, employees with access to private health insurance can quickly access medical attention from a private facility when necessary — helping them recover sooner.

  Remember, healthy employees perform more effectively and efficiently than sick employees.

3. Improve Employee Retention

Private health insurance should be part of your employee retention strategy because it contributes most to a healthy workforce.

It also fosters employee loyalty, which promotes employee retention. This is critical for small businesses because of high turnover costs.

What do we mean?

Recruiting and training new employees involves a lot of effort and money.

Moreover, finding employees that are the right fit for your business may take time. That's why you must prioritise employee retention.

The bottom line?

A healthy workforce contributes to a lower employee turnover, saving you recruitment and labour costs.

4. Gain an Edge Over Competitors

Providing private healthcare coverage to your employees can make your company more attractive to potential employees.

This is particularly important for a small business in a competitive employment market.

Why?

Skilled and experienced professionals typically prefer companies that offer various employee benefits, which they perceive as offering more job stability.

Offering benefits like health insurance, pension contributions, etc., can motivate potential employees to choose your business over a competitor.

You can partner with Kota to easily manage and provide health insurance to your employees.

Before you jump into small business health insurance, you should consider a few aspects.

What Small Businesses Should Consider When Choosing Health Insurance

Remember these three key points when choosing private health insurance for your Irish small business:

• Consider What Your Business Needs

• Compare All Health Insurance Options

• Review Plans Annually

1. Consider What Your Business Needs

First, determine your company’s health insurance needs.

As a small business owner, ask yourself:

• What level of cover do our employees need?

• Do we want basic health insurance coverage? Or are we willing to pay more for a private hospital, mental well-being benefits, and dental cover?

• Are we looking for insurance for employees only, or do they require dependent coverage for their family members too?

• Should we offer employees a fixed plan or let them choose from pre-selected plans?

• How long should new employees have to wait before joining the scheme?

• How much are we willing to pay for premium costs?

Once you’ve answered these questions, factor in your budget.

These are the health insurance plans available for various budgets:

• Company Paid: Your company will pay for employees’ health coverage.

• Partially Company Paid: Your company can share the cost of health care insurance with the employee. Since employees have to share the cost of the insurance premium, companies make these schemes voluntary.

• Advice Only: Your company can negotiate a health plan package that employees can choose to join and pay for themselves. Typically, with this option, employees get a discretionary discount. So they benefit from a competitively priced plan without your company paying for it.

Once you’ve established your preferred coverage options and what type of plan would suit your company’s budget, you can start evaluating and comparing plans.

But look:

When you purchase a corporate health insurance plan from traditional brokers or service providers, you’ll need to offer it to your entire team.

This might not seem like a problem, but you might be overpaying for benefits.

For instance, a 21-year-old employee might not have the same health insurance needs as a 40-year-old team member. So paying for the same benefits for both could mean you’re just spending unnecessarily.

That’s where a platform like Kota can help you.

2. Compare All Health Insurance Options

Each health insurance plan offers various levels of coverage, benefits, and premiums.

The best plan for your business will depend on your organisation’s requirements, employee needs, and budget.

So what benefits can you expect from private health insurance plans in Ireland?

Some of the services covered by private health insurance plans include:

• Inpatient services: Cover general hospital accommodation, hospice facilities, mental health, and A&E (accident and emergency) overnight stays.

• Outpatient services: Include day-case surgery and hospital treatment that doesn’t require an overnight stay.

• General medical services: May cover emergency or non-emergency dental and optical care.

• Online GP services: Give you access to a GP via your phone, laptop, or personal computer (PC). Prescription costs are generally not covered.

• Complementary therapies: Health care costs may be partially covered for therapies such as osteopathy, acupuncture, and homoeopathy.

• Allied health services: Cover physiotherapy, chiropody, speech therapy, occupational therapy, and psychiatric services.

• Consultation fees: Include referrals from your GP and a second opinion.

• Medical tests and scans: Any medical tests or screenings may be partially covered.

• Maternity benefits: Contributions towards scans, antenatal classes, and consultation costs usually fall under maternity benefits.

Did you know?

Kota can help you pick tailored insurance plans that fit your company’s needs!

3. Review Plans Annually

Found a suitable health insurance plan? Great!

You'll now need to review your choices regularly — when you receive your renewal notice from the insurance company.

Why review your health insurance plans?

Maybe you want to replace rarely used benefits with those more valuable to your team.

You could also change your insurance provider if you find other providers with better coverage.

For example, you may want to switch from Laya Healthcare to Irish Life Health for greater benefits. (Psst… Kota can help you out here!)

In Ireland, you can get information on various health insurance products and prices from the Health Insurance Authority (HIA).

Next, let’s explore an easy way to manage your small business health insurance plan.

Easy Small Business Health Insurance Plans with Kota

With over 320 health insurance plans available in Ireland, comparing them is no small feat.

Why not save yourself the hassle and opt for Kota instead?

What Is Kota?

Kota offers a straightforward way to manage your team’s health and retirement benefits.

It helps you automate all the complex, admin-heavy processes associated with employee health insurance management.

All you have to do is — decide on the contribution amount, and your employees can take care of the rest.

That’s not all!

Here are more reasons to love Kota:

• Flexibility: You can easily create local packages with flexible benefits benchmarked against the health insurance market standard. That way, your benefits are competitive.

• Employee-Friendly: The user-friendly app lets your team take control of their health and retirement benefits.

• HR Software Integration: Kota integrates your health insurance data with your existing human resources (HR) tools, helping you manage employee benefits easily.

Kota also works with Ireland’s most trusted insurers and financial services institutions to provide access to the best local benefits.

So when employees leave your company, they can still keep their benefits.

How Does Kota Work?

You only need to choose the health, dental, and vision insurance plans that work for your team and budget.

Decide on how much you want to contribute towards an employee’s health insurance plan, then let your team members pick the benefits they require — it’s that easy!

Follow these steps to set up your benefits scheme:

• Create your account and add your team members.

• Select the packages you’d like to offer your team.

• Team members join the app — where they can create and manage their benefits with a few taps.

• You can manage your plan and billing directly within the app.

You can sync the HR tools you already use to add your team members. Kota will separate them by region and help you set up contributions.

13 FAQs About Small Business Health Insurance

Still have questions on small business health insurance?

We got you covered.

1. How Can I Save Money on a Small Business Health Insurance Plan?

You could save money on your insurance plan by:

• Looking for a corporate plan with similar benefits but a lower cost.

• Paying an excess when you make an insurance claim.

• Downgrading to a lower plan to save money.

Remember:

If you downgrade now and then decide to upgrade your insurance policy in the future, waiting periods of up to two years may apply on the new benefits.

During the waiting period, you may not be able to claim extra benefits on your new plan.

2. Can I Claim Tax Credits on Health Insurance Premiums?

An employee or individual with private health insurance may get a tax credit.

This health care tax credit, known as Tax Relief at Source (TRS), is usually granted directly by the health insurance company.

3. Does Health Insurance Cover Hearing Aids and Surgical Appliances?

Your health insurance may cover hearing aids and surgical appliances.

Medical appliances are partially or fully covered sometimes, but it’s best to check with your insurer directly. Most insurance providers can supply a specified appliance list on request.

4. Does Health Insurance Cover Overseas Travel?

Health insurance usually covers medical emergencies abroad.

But if you travel regularly or work abroad, you can opt for a more comprehensive plan with travel insurance tailored to your needs.

5. Do My Employees Need Private Health Insurance for Maternity Services?

Your employees may not need private health insurance for maternity services as the public maternity and infant care scheme provides GP and hospital care to all expectant mothers in Ireland.

Under this scheme, the mother is entitled to free inpatient, outpatient, accident & emergency services in a public hospital throughout pregnancy and during the birth.

With that said, private insurance may provide a better maternity experience.

For example, with private health insurance, your employees will have access to their chosen obstetrician throughout the pregnancy and birth. They’ll also have access to private rooms during their stay at the hospital.

6. How Can I Switch My Small Business Health Insurance Plan?

You can switch your small business health care plan whenever you choose.

All you need to do is inform your insurance provider in writing of your cancellation.

But remember:

You may have to pay penalties or cancellation fees to your old insurance provider. The insurer may require you to pay the government health insurance levy upfront if you switch mid-term.

Moreover, there may be a waiting period before you can access the benefits with your new provider.

7. Why Do People Change Health Insurance Plans?

There are many reasons people change health insurance providers, such as:

• When people go through life changes or make plans for the future, such as planning a family, becoming first-time parents, etc.

• When someone requires extra precautions against unexpected ill health or pre-existing conditions.

• If someone’s health changes and the existing plan is no longer sufficient.

• When people are looking to save money and maybe aren’t using all their benefits, they consider downgrading their plan.

• If someone is looking for a better value cover, more comprehensive cover, or becomes dissatisfied with their existing cover.

Moreover, some people may have realised the need for additional cover following the pandemic.

8. What Should I Do When Switching Health Insurance Providers?

Here are some things you must do when switching insurance providers:

• Read your new health insurance policy documents carefully.

• Contact your new insurance provider if you have any questions or concerns.

• Inform your old insurer in advance when cancelling.

• Cancel the direct debit to your old insurer by informing your bank in writing. Check with the insurance provider that they've cancelled the debit on their end.

What happens if I change my mind after switching?

Luckily, all insurers must provide a 14-day cooling-off period from the contract's start. So during this time, you can cancel and receive a full refund.

But if you’ve made a claim during the cooling-off period, you may not receive a full refund as the insurance company will need to recover any benefits they may have paid out.

Read your policy’s terms and conditions carefully for more information.

9. What is a Restricted Membership Scheme?

These health insurance schemes are available only to specific occupational groups. For example, a plan that’s only open to health workers.

Ireland's four leading private health insurance providers operate under the open membership principle.

These providers are open to employees in all industries:

• Irish Life Health

• Laya Healthcare

• VHI Healthcare

• HSF Health Plan

10. What is the Health Insurance Levy?

The national government charges a health insurance levy for every health insurance policy taken out.

This levy is a set amount included in the premium that you pay to your insurance provider. The levy makes up about 33% of your total premium.

11. How Are Health Insurance Providers Regulated?

The Central Bank of Ireland financially regulates all health insurance providers and life insurers. The Health Insurance Authority legally and statutorily regulates them.

Health insurance providers must display a registered address on their website.

12. What is Lifetime Community Rating?

Lifetime community rating is a system where the premium (that individuals pay for health insurance) increases with the age they enter the private health insurance market.

Since May 1st, 2015, you have to pay a loading charge if you’re over 35 years old and haven’t had a continuing healthcare plan. For every year over 35, you have to pay a loading amount of 2%, but it’s capped at 10%.

13. What Health Insurance Plans Can You Access With Kota?

Here’s a brief look at the health plans available with Kota:

1. Kick-Off Plan ILH

Inpatient Benefits:

• Consultants fees — Covered in selected hospitals only.

• Inpatient Scans — Covered in selected hospitals only.

• Public Hospital — Covered in selected hospitals only.

  • Semi-private room — Covered.

  • Private room — Semi-Private Rate.

  • Day case — Covered.

Private Hospital — Covered in selected hospitals only.

• Semi-private room – 65% Cover.

• Private room — 65% of Semi-Private Rate.

• Day case — 65% Cover.

Outpatient Benefits:

• Nurse on call – Covered.

• Digital Doctor — Unlimited.

• Minor Injury Clinic Cover — 50% up to €100 per visit.

• Minor Injury Clinic Cover (Pay & Claim) — 50% up to €100 per visit.

2. BeneFit

Inpatient Benefits:

• Consultant Fees — Fully Covered.

• Inpatient Scans — Fully Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €200 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Private Room — Semi-Private Rate subject to €200 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Day Case — Covered subject to €100 excess per claim.

Outpatient Benefits:

• International Second Opinion Service Covered — refer to your Membership Handbook.

• Life Coaching Session — €50 contribution.

• Sports Club / Gym Membership / Classes — €50 contribution.

• Sports Massage — €50 contribution.

3. 4D Health 1

Inpatient Benefits:

• Consultant Fees — Covered.

• Inpatient Scans — Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €200 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Private Room — Semi-Private Rate subject to €200 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Day Case — Covered subject to €75 excess per claim.

Outpatient Benefits:

• Nurse on call — Covered.

• Digital Doctor — Unlimited. See irishlifehealth.ie for further information.

• Minor Injury Clinic Cover — 70% up to €200 per visit.

• MRI Scan (approved centre) — Covered.

4. 4D Health 2

Inpatient Benefits:

• Consultant Fees — Covered.

• Inpatient Scans — Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €150 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Private Room — Semi-Private Rate subject to €150 excess (first two claims per policy) subject to €2,000 copayment on certain orthopaedic procedures.

  • Day Case — Covered subject to €75 excess per claim.

• Outpatient Benefits:

  • Nurse on call — Covered.

  • Digital Doctor — Unlimited.

  • Minor Injury Clinic Cover — 75% up to €200 per visit.

  • Minor Injury Clinic Cover — (Pay & Claim) 75% up to €200 per visit.

5. 4D Health 3

Inpatient Benefits:

• Consultant Fees — Covered.

• Inpatient Scans — Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €75 excess per claim subject to €2,000 co-payment on certain orthopaedic procedures.

  • Private Room — Covered subject to €75 excess per claim, subject to €2,000 co-payment on certain orthopaedic procedures.

  • Day Case — Covered subject to €50 excess per claim.

Outpatient Benefits:

• Nurse on call — Covered.

• Digital Doctor — Unlimited.

• Minor Injury Clinic Cover — 75% up to €400 per visit.

• Minor Injury Clinic Cover — (Pay & Claim) 75% up to €400 per visit.

6. 4D Health 4

Inpatient Benefits:

• Consultant Fees — Covered.

• Inpatient Scans — Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €50 excess per claim subject to €2,000 co-payment on certain orthopaedic procedures.

  • Private Room — Covered subject to €50 excess per claim subject to €2,000 co-payment on certain orthopaedic procedures.

  • Day Case — Covered subject to €50 excess per claim.

Outpatient Benefits:

• Nurse on call — Covered.

• Digital Doctor — Unlimited.

• Minor Injury Clinic Cover — 75% up to €500 per visit.

• Minor Injury Clinic Cover (Pay & Claim) — 75% up to €500 per visit.

7. 4D Health 5

Inpatient Benefits:

• Consultant Fees — Covered.

• Inpatient Scans — Covered.

• Public Hospital:

  • Semi-Private Room — Covered.

  • Private Room — Covered.

  • Day Case — Covered.

• Private Hospital:

  • Semi-Private Room — Covered subject to €2,000 co-payment on certain orthopaedic procedures.

  • Private Room — Covered subject to €50 excess per claim subject to €2,000 co-payment on certain orthopaedic procedures.

  • Day Case — Covered.

Outpatient Benefits:

• Nurse on call — Covered.

• Digital Doctor — Unlimited.

• Minor Injury Clinic Cover — 75% up to €500 per visit.

• Minor Injury Clinic Cover (Pay & Claim) — 75% up to €500 per visit.

Ready to Manage Your Health Insurance With Kota?

Private health insurance can be a game-changer for your small business.

But to maximise your ROI, you need a solution that benefits your employees and fits your budget and business operations.

Kota ticks all these boxes! Join today to manage your team’s health insurance easily!