As UK employers continue to grapple with rising group private medical insurance (PMI) premiums, a growing concern has become impossible to ignore: a persistent lack of transparency across the private healthcare and insurance market. If you are a HR leader of work in a finance function then trying to manage benefits budgets responsibly, the combination of escalating costs and opaque pricing creates a perfect storm of confusion, inefficiency, and mistrust.
Across the sector, employers are facing significant PMI price increases. I have personally seen increases as high as 70%+ with averages coming in at 20-30%. “Apparently” most of these increases are driven largely by higher volumes of claims and increased medical costs however as an Employee Benefits Adviser, I see that some providers (not all I hasten to add) are very reluctant to provide any specific information around justifying such increase, particularly if the membership in the scheme is less than 50 people. GDPR is cited for the main reason for this. I recently spoke with a 40-person tech company who saw a 50% increase and the insurer provided no claims information or usage. This meant they were considering lowering cover levels without knowing what impact that could have on the service that could be received by their employees.
Now don’t get me wrong, I absolutely understand the importance of GDPR however my question is, why can one provider (they are a pretty big name in the market by the way) share loss ratios over one and three years as well as information linked to claims, but others can’t or choose not too? How is this being transparent and treating customers fairly?
For those not aware, a loss ratio in insurance is a key profitability metric calculated as the ratio of incurred claims (plus adjustment expenses) to earned premiums, usually expressed as a percentage. It measures the portion of premium revenue used to pay claims, where a lower percentage indicates higher underwriting profitability and better financial health.
Lack of this clear breakdown leaves employers, especially HR and finance teams unable to justify benefit spend internally whilst balancing employee wellbeing and retention pressures. They often feel ‘over a barrel’ as they have few options available to them on how to reduce premiums and maintain value.
With NHS waiting lists remaining persistently, the burden on group schemes intensifies, often leading insurers to charge higher premiums to offset increasing utilisation.
Employers are investing more heavily in health benefits as a workforce strategy, contributing further to market demand. In some regions and sectors, insured care pathways have effectively become the default route for receiving timely treatment.
Challenges around transparency are not new. For many years, private healthcare pricing has been described as opaque and difficult for policyholders to navigate. Individuals and employers alike have lacked clear, consistent information on:
- The real cost of procedures
- Differences in consultant fees
- Comparative clinical outcomes
- How preferred provider agreements influence treatment pathways
This opacity has historically created uncertainty, anxiety, and an erosion of trust among policyholders.
Why the Lack of Transparency Is Becoming Unacceptable
Without transparent data, employers struggle to make informed decisions about scheme design, provider selection, and value for money and as costs rise sharply, the absence of clarity becomes a far more serious problem. Employers increasingly need better information to:
- Evaluate whether premium increases are justified
- Understand claim patterns at a granular level
- Identify opportunities to adjust cover, excesses, or provider networks
- Ensure schemes represent genuine value to employees
Without access to transparent reporting, employers are often unable to differentiate between genuine cost pressures and insurer pricing tactics.
Apparently private health insurers have begun improving transparency, particularly around pricing and treatment outcomes. There is growing momentum to give policyholders more visibility and empower them to make informed healthcare decisions. However, progress remains uneven and I am yet to see these changes, demonstrating that the pace of change is not keeping up with the rapid rise in premiums.
My Plea to the PMI market!
Employers overwhelmingly recognise the value of PMI in supporting employee wellbeing, reducing absence, and providing faster access to care. But as premiums continue to rise at unprecedented levels, transparency is no longer optional — it is essential.
A more open, data‑driven approach would help employers understand cost drivers, hold insurers accountable, and design schemes that are both sustainable and genuinely beneficial for their workforce. Until transparency becomes standard practice, frustration will continue to grow alongside the cost of cover. Insurers, you never know, if you are more transparent you may also retain more business!
If your latest private medical renewal quote has left you wanting to rant (like me!) … please reach out to us to see if we can support.
