When your benefits supplier changes, how to keep care continuous

What can break when a supplier changes

Care breaks at the handover. A person halfway through physiotherapy or a course of therapy can find that the new plan treats their condition as already existing, that their doctor sits outside the new network, that the approval for their next appointment has lapsed, or that nobody holds their notes.

Continuity matters clinically as well as practically. NICE guidance on depression asks services to help people see the same healthcare professional wherever possible, and to record their preferences so that other practitioners are aware of them [1].

Most of these breaks can be prevented with a few weeks of planning and one person who owns the change on each side.

People in the middle of treatment

Find the people in active treatment first, before anything else is agreed. Ask the outgoing supplier for a count of open cases by type, never names, and invite people to contact the new supplier privately so their care can be planned before the date.

For each person, the new supplier should agree in writing to continue the current course, with the same clinician wherever possible, or to arrange a handover appointment before the old cover ends. Nobody should be asked to change doctors halfway through treatment because a contract changed.

Keep managers out of this step entirely. Health details reach the clinicians who need them and nobody else at work.

Look beyond treatment already under way. People waiting for a referral or a planned operation need the same care, and so do people abroad on the day of the change, who should know exactly which number to call from wherever they are.

Records and data protection

Health information is special category data under UK GDPR, which gives it extra protection [2]. A change of supplier is a change in who processes that data, so the rules on both contracts apply.

Where a supplier processes personal data on your behalf, the contract must require it, at your choice, to delete or return all of that data when the service ends, and to delete existing copies unless the law requires them to be kept [3]. Decide which you want before you give notice.

Processing health data on a large scale calls for a data protection impact assessment, and the regulator recommends one whenever there is doubt [4]. Every person can also ask any organisation for copies of their personal information, and organisations usually have one month to respond [5].

The employer’s own role stays small. The regulator’s guidance on workers’ health sets out what an employer must and should do with health information, and the simplest course is to hold as little of it as possible [6].

A communication timetable for the change

Work back from the renewal date. Each step below has one owner in the people team and one at the new supplier, and every message says plainly what changes for the person reading it and what stays as it was.

• Three months before, find everyone in active treatment and agree how each case moves.
• Two months before, tell your people what changes for them and whom to ask, in writing and in person.
• Six weeks before, send each person their membership details and how to request care from the first day.
• On the day, keep the outgoing supplier open for claims already in progress, and have the new concierge contact everyone in active treatment.
• A month after, ask people how the change went and close every open question.

Questions to ask before you sign

The answers decide whether anyone’s care is interrupted. Ask them of the new supplier and keep the replies with the contract.

After the change, the CIPD recommends that employers regularly monitor usage and satisfaction so that benefits continue to meet people’s needs [7].

• Will treatment that began under the old plan continue without a new waiting period?
• Can a person keep their current doctor, and if not, who arranges the handover?
• How will records reach the new clinicians, and with whose consent?
• Will the outgoing supplier delete or return our data, and by when?
• What will the company see after the change, and what stays with the person?

How one membership makes the change once

The Wellness for teams is one membership for the whole firm, its leaders and their families, with inpatient, outpatient and dental care, diagnostics and health programmes in 13 cities. A concierge arranges every appointment, and the company receives one invoice renewed once a year, so the next change of supplier is the last one to plan country by country.

Outside the United States it takes the place of national plans at each renewal, and in the United States it is the global layer above the medical plan. The company sees anonymised reporting only, with small groups left out, under a data processing agreement.