Business health insurance:

self-pay policy registration form

As part of FCA regulation, we’re required to monitor the way your business clients are providing self-pay health insurance to their employees. This does not apply to trusts. You must provide us with the following details each time you enrol a new group or renew an existing one with any element of self-pay within the scheme*. Without you providing this information, we will be unable to process the transaction.

*Self-Pay is defined as payment for benefit under a group policy by an individual member. For example, payment by an employee to their employer (for example, by salary sacrifice):
i) in order to access benefits provided by their employer’s health insurance scheme, and/ or
ii) for their dependents to also receive benefit under their company’s health insurance policy

If you have any difficulties completing the form, please contact your account manager.

(this is in breach of clause 4 of the terms of business)
(If yes to the two previous questions, please email the information or copies of the literature to [email protected] for triage)

Only applicable for Corporate schemes

Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales No. 3829851. Registered office: 1 Angel Court, London EC2R 7HJ

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