Healthcare trusts vs private medical insurance

But rising premiums and broader financial pressures mean many organisations are questioning whether PMI is still sustainable. At the same time, simply removing healthcare benefits risks harming employee loyalty and driving up long-term absence if people have to rely solely on the NHS.

So what’s the alternative?

For a growing number of employers, healthcare trusts are providing a more flexible way to fund healthcare - keeping strong support in place for employees while giving the organisation tighter control over costs.

Before you compare the two models, here's a short video that explains how a Healthcare trust works in practice.

At a glance comparison:

	Healthcare Trust	Private Medical Insurance (PMI)
How it's funded	Employer funds a trust and pays for actual claims, plus agreed admin fees.	Employer pays annual premiums to an insurer.
Cost & savings	Typically around 10% savings vs corporate PMI premiums; employer keeps any surplus in their fund if claims are lower than forecast.	Premiums reflect insurer pricing and claims experience; savings flow to the insurer, not the employer fund.
Flexibility	Employer sets benefit rules and decides when the fund pays out.	Benefits and rules are largely set by the insurer's standard terms.
Control	High level of control over cover and spend, with bespoke admin and managed care support.	Less direct control; the insurer governs how the scheme operates.
Risk	Employer retains more of the financial risk, which can be capped with a 100% stop-loss facility	Financial risk is transferred to insurer.
Employee experience	Can mirror PMI experience, with decisions make quickly and a strong focus on quality and speed of care.	Well-known route to private treatment via insurer networks.

Explore the full findings

Choosing the right healthcare model is a significant decision for any organisation. Our comprehensive report gives HR professionals the detail they need to confidently evaluate both options.

Download the full publication: Healthcare Trusts vs Private Medical Insurance
Understand the benefits, considerations and practical steps to choosing the right model for your people.