Private medical insurance: UK benchmark 2026

About the data

This paper reports how UK employers answered lumi's questions on private medical insurance and health benefits. The lumi reward benchmark covers 269 UK organisations across 14 sectors and five size bands. Data was collected in the 2026 H1 collection window. Each figure gives its base (n): the number of organisations that answered that question. Percentages are rounded to one decimal place, so a distribution can add up to 100.1%. Figures here are national. Sector and size comparisons are available to lumi members. See how lumi works for the method.

The legal context

Private medical insurance and the health benefits reported here are not set by statute, and the optical question, by its own wording, covers only provision beyond DSE (display screen equipment) statutory requirements.

What health benefits do UK employers offer?

lumi asked every organisation: Which of the following benefits are currently offered to employees? (n = 269). It is multi-select, so the percentages overlap. The table shows the health and protection items on the list.

PMI is selected by 69.5% of organisations (187). This counts organisations, not employees: an organisation that offers PMI may cover only some of its workforce, as the eligibility questions below show.

Income protection appears on this list at 35.3% (n = 269). A different question, Does your organisation offer income protection?, is reported in the group risk paper with its own answer options and base, so the figure there measures something else and is not in conflict with this one.

Mental health, menopause and fertility support appear here as separate benefits. The PMI scope question later asks about some of the same areas as features of a PMI scheme. For someone designing reward, the list shows health provision spread across several vehicles, and a decision about PMI sits next to each of them.

Who is eligible for private medical insurance?

The first eligibility question asks: What are the private medical insurance (PMI) eligibility rules? (n = 187). The base is the number of organisations that answered this question, not the number offering PMI. Grade/level restricted is the common answer, given by 85.0% (159 organisations). All employees is rare, at 7.5% (14), and so is a service length requirement, at 7.5% (14).

Each rule says something different about what PMI is for. A grade or level restriction ties PMI to seniority. An all-employee rule treats it as a health benefit for the whole workforce. A service length requirement links access to tenure rather than role.

The second question measures breadth directly: What proportion of employees are eligible for employer-funded PMI? (n = 187). Here, 82 organisations answered "Not applicable" and are excluded from the base.

The common answer is 10–24% of employees, at 71.7%. Taken together, 77.0% of organisations report that under 25% of employees are eligible (71.7% + 5.3%). At the other end, 8.6% report that 50% or more are eligible (1.1% + 7.5%).

The two questions are separate, but both describe PMI as a benefit for a defined group.

What does PMI cover, and what do employees pay?

Scheme scope is measured by: Which of the following does your PMI scheme include beyond standard cover? (n = 187). This is a multi-select question, so the percentages overlap.

Out-patient cover is included by 75.4% and virtual or digital GP access by 67.9%. Full mental health cover is included by 48.7%, and a cancer care pathway by 43.3%. Core cover only is reported by 3.2%. Schemes differ in scope as well as in who is eligible, so two organisations that both offer PMI may provide quite different cover.

The cost-share question asks: What employee cost-share or excess applies to PMI (if any)? (n = 186). Here, 83 organisations answered "Not applicable" and are excluded from the base.

These figures add to 100.1% because of rounding. No excess is the common answer, at 49.5%. Excess per claim is an alternative, at 22.6%. Excess per year (16.7%) and employee co-pays premium (11.3%) are rare.

Each form places cost differently. With no excess, employees pay nothing towards a claim. An excess per claim charges employees each time they claim. An excess per year limits what a claimant pays in any one year. An employee contribution to the premium spreads cost across every member, whether or not they claim.

Do UK employers provide virtual GP access outside PMI?

Virtual GP provision outside PMI is measured by: Do you provide a standalone virtual GP service (independent of PMI)? (n = 269). The base includes organisations that do not offer PMI.

Yes all employees is the common answer, at 43.5%. No is an alternative, at 32.3%. Yes some (13.4%) and via PMI only (10.8%) are rare. In total, 56.9% provide a standalone virtual GP service to all or some employees (43.5% + 13.4%). Counting provision through PMI as well, 67.7% provide virtual GP access by some route (43.5% + 13.4% + 10.8%).

A standalone service can have its own eligibility rule. Offered to all employees, it reaches staff outside a grade-restricted PMI scheme. Delivered only through PMI, it follows PMI eligibility.

Two further questions cover specialist access. The first asks: Do you fund private diagnostics or fast-track cancer pathways (beyond core PMI)? (n = 267). No is the common answer, at 76.8%. Yes dedicated pathway is rare, at 15.4%, as is via PMI, at 7.9%. These figures add to 100.1% because of rounding.

The second asks: Do you provide a second-medical-opinion service? (n = 266). No is the common answer, at 66.2%. Yes is an alternative, at 33.8%.

These services concern the speed of diagnosis and confidence in it. Funded as distinct benefits, they can reach beyond PMI eligibility. Left to PMI, they reach only those the scheme covers.

Do UK employers pay for health cash plans, dental and optical cover?

Health cash plans are measured by: What health cash plan do you provide? (n = 269).

No is the common answer, at 71.0%. Voluntary only (13.8%), employer-paid all (9.3%) and employer-paid some (5.9%) are each rare. Taken together, 29.0% provide a health cash plan in some form (13.8% + 9.3% + 5.9%). Employer-paid all or employer-paid some accounts for 15.2% (9.3% + 5.9%).

Dental funding is measured by: Is dental cover employer-paid or employee-funded/voluntary? (n = 60). Employer-paid is the common answer, at 58.3% (35 organisations). Voluntary (employee-funded) is an alternative, at 41.7% (25).

Optical provision is measured by: Do you provide optical cover or eye-care vouchers beyond DSE statutory requirements? (n = 267). Yes is the common answer, at 86.9%. Statutory DSE only is rare, at 13.1%. The question groups optical cover and eye-care vouchers together, so the 86.9% includes both forms of provision.

These benefits share one design question: who pays. A voluntary arrangement gives employees access to cover they fund themselves. An employer-paid arrangement makes it part of the funded package. The dental answers show both designs in use.

What the data means for reward decisions

The figures describe PMI as a benefit offered by 69.5% of organisations and, in the common case, restricted by grade or level. Each design choice around it carries a trade-off.

Eligibility. Restricting PMI by grade or level concentrates spend on a defined group and makes PMI a marker of seniority. It also creates a difference in health support between those inside and outside the rule. Extending eligibility widens support and adds members to the scheme. A reward team might ask: is PMI a recruitment and retention tool for senior roles, or a health benefit for everyone? What health support do employees outside eligibility have?

Scope. Each addition beyond standard cover extends what the scheme pays for. Which additions do members use? Which were included by default rather than by choice? How does mental health cover in the scheme sit alongside an EAP?

Cost-share. Excess design decides who bears the cost of claims. No excess keeps the benefit simple for the employee. An excess places part of the cost on those who claim; a premium contribution places it on every member. How often do members claim, and how would each form fall on them?

Where services sit. Virtual GP access, diagnostics, cancer pathways and second opinions can be funded inside PMI or separately. Does any service appear twice, once in PMI and once as a standalone benefit? Does anyone outside PMI eligibility have access to it?

Employer-paid or voluntary. For cash plans and dental cover, the choice is between funding a benefit and making one available. How many employees take up voluntary cover, and who are they?

A rare answer in these tables describes a choice made by under 20% of organisations answering. It says nothing about whether that choice suits a particular workforce.

Related

• How to review your private medical insurance scheme — how to check eligibility, scope and excess against the benchmark.
• Group risk benefits — life assurance, income protection and critical illness cover.
• Wellbeing and financial wellbeing — the wider wellbeing provision sitting alongside PMI.

Notes

• Base, "Not applicable" handling and rounding as described in "About the data".
• The question on the proportion of employees eligible for employer-funded PMI excludes "Not applicable" from its base (82 organisations answered N/A; base 187).
• The question on employee cost-share or excess for PMI excludes "Not applicable" from its base (83 organisations answered N/A; base 186).
• The benefits-offered and PMI scope questions are multi-select: percentages are the share of the base choosing each option and can sum to more than 100%. Prevalence words apply only to single-select questions.
• Combined figures add the listed percentages of options within one question, with the parts shown.
• Health cash plans appear in two separate questions with different wording and answer options: the benefits-offered list (26.0%) and the health cash plan question (29.0% in some form). Each figure is reported against its own question.
• The benefits table shows health and protection items only. The full list is in the data appendix.

Data appendix

Every question on this page, with its base and full distribution, as a spreadsheet: download the CSV.

All national figures used in this paper, as recorded in the lumi reward benchmark (collection window 2026 H1).

Which of the following benefits are currently offered to employees?
Base: 269 organisations · more than one answer allowed

What are the private medical insurance (PMI) eligibility rules?
Base: 187 organisations

What proportion of employees are eligible for employer-funded PMI?
Base: 187 organisations · "Not applicable" excluded from base

What employee cost-share or excess applies to PMI (if any)?
Base: 186 organisations · "Not applicable" excluded from base

Is dental cover employer-paid or employee-funded/voluntary?
Base: 60 organisations

What health cash plan do you provide?
Base: 269 organisations

Do you provide a standalone virtual GP service (independent of PMI)?
Base: 269 organisations

Do you provide optical cover or eye-care vouchers beyond DSE statutory requirements?
Base: 267 organisations

Do you fund private diagnostics or fast-track cancer pathways (beyond core PMI)?
Base: 267 organisations

Do you provide a second-medical-opinion service?
Base: 266 organisations

Which of the following does your PMI scheme include beyond standard cover?
Base: 187 organisations · more than one answer allowed

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