Fair value products for our customers

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment, as they are intended to provide similar cover and outcomes for customers, and the target markets are consistent other than for the minimum number of employees as described below. Where there is potential for a product variant to have a different impact on value, this has been considered within the review:

• Standard Employer Funded Policies.
• Pay Direct Policy: a policy which gives the option to pay basic benefit to a former employee after they have left service.
• Flexible Policies: Includes a core benefit funded by the employer with the option for employees to increase their cover.
• Simplicity Income Protection: An Income Protection policy with simplified options and administration.
• Policies arranged through a special agreement with one of our distributers or a bespoke policy with non-standard terms.
• Policies arranged through a special distribution or Introducer Appointed Representative (IAR) agreement.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

Group Income Protection cover meets the demands and needs of an employer who wishes to provide financial support to their employees if they cannot work due to illness or injury beyond the period outlined in their policy (the deferred period), by paying a proportion of their salary as a monthly benefit.

Product features 

• Where appropriate Unum provides absence management support to help employees stay at work or return to work following illness or injury.
• The product allows employers the option to cover additional costs such as pension contributions and National Insurance Contributions.
• The employer can choose for the policy to provide additional lump sum benefits to be used at the policyholder’s discretion.
• Simplicity Income Protection provides a flat benefit of £12,000 p.a.
• Products distributed through IARs are typically marketed at a fixed price and a flat level of cover.
• Our Group Income Protection customers have immediate access to a range of value-added services (VAS) providing health and wellbeing support at no additional cost, including virtual GP appointments, mental health support and a fully integrated Employee Assistance Programme. 

Key exclusions

• Policies provide a non-medical limit to eligible employees, above which cover is subject to providing satisfactory medical evidence and may therefore be restricted as a result
• Initial lump sum benefits, where provided, are subject to a pre-existing conditions exclusion.

2. Target market

• The target market is employers with 3 or more employees based primarily in the UK who want to protect their employees’ incomes in the event they are unable to work due to accident or illness. 
  • An employee can be a permanent or fixed-term employee, a director, equity partner, member of a limited liability partnership (LLP) or a barrister who is a member of the set of chambers.
  • An employee who is based overseas must have a contract of employment with a UK resident employer.
• On occasion we will offer policies to employers with fewer than 3 employees under a special arrangement.
• Simplicity Income Protection is aimed at employers wishing to give a basic level of cover with simplified options and administration. The minimum number of lives for this product is 20.
• Flexible policies are available to employers with 250 or more eligible employees.
• Any special distribution or IAR agreements typically apply to policies covering between 3 and 100 employees.

We aim to have a balanced book of business across small, medium, and large employers.

Customer needs and goals

The policy meets the needs of employers who wish to: 

• Provide financial support to employees who are unable to work for a period of time due to illness or injury. 
• Have independent validation of employee absences. 
• Provide access to absence management services and in-work support for employees struggling to work due to illness or injury. 
• Promote employee health and wellbeing including providing access to employee assistance programmes and support services. 
• Provide an attractive employee benefits package to attract and retain staff. 

The product is not suitable for:

• Employers not based in the UK, or do not have a UK branch registered at Companies House.
• Employers with fewer than the required number of employees.
• Non-commercial customers (i.e. individual retail customers).
• Flexible policies are not available for equity partners, LLP members or barristers.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extend of the cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution, and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The policy meets a clearly defined need.
  • The customer can use the policy under the circumstances they expect.

This rating is based on metrics and data including:

• Customer feedback and research findings
• Numbers and causes of complaints
• Sales and persistency
• Underwriting outcomes
• Claims acceptance rates
• Claims ratios
• Broker remuneration and commission
• Utilisation of Value-Added Services
• Performance against Service Level Agreements (SLAs).

Learn more about Group Income Protection

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment, as they are intended to deliver similar cover and outcomes for customers and the target markets are consistent (other than for the minimum number of employees as described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review:

• Standard employer-funded policies.
• Flexible policies: includes a core benefit funded by the employer and gives the employees the option to increase their cover.
• Spouse and partner cover: Allows employees to buy Life Insurance which pays them a lump sum if their spouse or partner dies.
• Simplicity Life: a Life Insurance policy with simplified options and administration.
• Dependants’ pensions: Provide a pension for the member’s dependants on the death of a member.
• Voluntary policies arranged through our Benni distribution channel: 
  • Employees choose whether to join the policy and their level of cover within the policy limits. 
  • Policies arranged through a special agreement with one of our distributors or a bespoke policy with non-standard terms. Benni products were closed in June 2024. For the remaining contractual period Zest Technology have been appointed to manage their platform services and day to day support. Benni policy trends and figures have been included under ‘Voluntary’ funding option with figures updated as Q2 2023.  
• Policies arranged through a special distribution or Introducer Appointed Representative (IAR) agreement.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

The policy meets the demands and needs of an employer who wishes to provide a lump sum payment, either a multiple of salary or a fixed amount for a member’s dependants if the member dies.

Product features 

• Registered Group Life policies (RGLPs) can insure schemes registered within the HMRC regulations for an occupational pension scheme, or set up under the rules for an Excepted Group Life Policy (EGLP).
• The policy is held by trustees, who will administer and maintain the trust, and distribute the proceeds to the member’s dependants.
• Voluntary policies arranged through our Benni distribution channel have a choice of five benefit amounts from £10,000 to £50,000.
• Products distributed through IARs are typically marketed at a fixed price and a flat level of cover.
• Our Group Life customers have immediate access to a range of Value-Added Services (VAS) providing health and wellbeing support at no additional cost including virtual GP appointments, mental health support and a fully integrated Employee Assistance Programme.
• Group Life customers have access to Cancer Assist¹ which offers in-the-moment guidance from an experienced team of client navigators who can help at any stage of the cancer journey.

Key exclusions

• Policies provide a non-medical limit to eligible employees, above which cover is subject to providing satisfactory medical evidence and may therefore be restricted as a result.
• There may be a requirement for employees to be actively at work at the start of cover.
• Policies have an overall maximum benefit limit for multiple claims as a result of a catastrophic or travel event.
• Cover is not provided for the death of a member as a result of, or during business travel to, a country or region where the Foreign Commonwealth and Development Office (FCDO) advises against all travel.
• Pre-existing conditions and suicide exclusion apply to voluntary policies arranged through our Benni distribution channel. 

2. Target market

• The target market is employers with 3 or more employees based primarily in the UK who want to provide life cover for their employees. 
  • An employee can be a permanent or fixed-term employee, a director, equity partner, member of a limited liability partnership or a barrister who is a member of the set of chambers. 
  • An employee who is based overseas must have a contract of employment with a UK resident employer.
• On occasion, we will offer policies to employers with fewer than 3 employees under a special arrangement.
• Simplicity Life is aimed at employers wishing to give a basic level of life cover to their employees for the first time.
• Flexible policies are available to employers with 250 or more eligible employees.
• The minimum number of eligible employees for spouse and partner cover is 250 and the minimum membership is 50.
• Voluntary policies arranged through our Benni distribution channel are available for employers with 50 or more employees. 
• Any special distribution or IAR agreements typically apply to policies covering between 3–100 employees.

We aim to have a balanced book of business across small, medium and large employers.  

Customer needs and goals

The product meets the needs of employers who wish to:

• Provide peace of mind to employees in the knowledge that their dependents will receive financial support in the event of their death.
• Provide death benefits to their employees in a tax efficient way.
• Have the benefits of a Master Trust to take away the responsibility of managing their own trust. 
• Offer employees the opportunity to top up their own cover or choose cover to pay in the event of the death of their spouse or partner.
• Promote employee health and wellbeing including providing access to employee assistance programmes and support services.
• Provide an attractive employee benefits package to attract and retain staff.

 

The product is not suitable for:

• Employers not based in the UK or without a UK branch registered at Companies House.
• Employers with fewer than the required number of employees.
• Non-commercial customers (i.e. individual retail customers).
• Flexible and Simplicity Life policies are not available for equity partners, LLP members or barristers.
• Simplicity Life is not available for certain high-risk industry types.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers are able to use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The product meets a clearly defined real need.
  • The customer can use the policy under the circumstances they expect.

This rating is based on metrics and data including:

• Customer feedback and research findings
• Numbers and causes of complaints
• Sales and persistency
• Underwriting outcomes
• Claims acceptance rates
• Claims ratios
• Broker remuneration and commission
• Utilisation of VAS
• Performance against service level agreements (SLAs).

Learn more about Group Life

^{1 Cancer Assist (the ‘Service’) is provided to Unum Limited (“Unum”) customers by third-party specialist providers chosen by Unum. Unum is not the provider of the Service. The Service is entirely separate from the insurance policy provided by Unum. Access to the Service is facilitated by Unum at no cost to the Unum customer, and Unum may change or withdraw access to the Service at any time. Use of the Service is subject to the terms and conditions of the relevant third-party specialist providers. Services are available to UK residents only. For further information, please go to frequently asked questions.}

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment, as they are intended to provide similar cover and outcomes for customers, and the target markets are consistent (other than for the minimum number of employees as described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review:

• Standard Employer Funded Policies.
• Flexible policies: Includes a core benefit funded by the employer with the option for employees to increase their cover.
• Voluntary policies: Employees choose whether to join the policy and their level of cover within the limits set.
• Simplicity Critical Illness: Designed for employers with 50 or more employees who want to give a more basic level of Critical Illness Cover to their employees for the first time
• Voluntary policies arranged through our Benni distribution channel: 
  • Employees choose whether to join the policy and their level of cover within the policy limits. Benni products were closed in June 2024. For the remaining contractual period Zest Technology have been appointed to manage their platform services and day to day support. Benni policy trends and figures have been included under ‘Voluntary’ funding option with figures updated as Q2 2023.  
• Policies arranged through a special agreement with one of our distributers or a bespoke policy with non-standard terms.
• Policies arranged through a special distribution or Introducer Appointed Representative (IAR) agreement.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

Group Critical Illness cover meets the demands and needs of an employer who wishes to provide a tax-free lump sum benefit if a member is diagnosed with one of the defined medical conditions or undergoes (or, where applicable, is placed on an official UK waiting list for) one of the surgical procedures covered under the policy.

For benefit to be payable:

• The condition or surgical procedure must meet the policy definition; and
• The member must survive for at least 14 days after the critical illness event.

Product features 

• Member’s children are automatically covered at no additional cost from birth until their 18th birthday (or 21st birthday if they are in full-time education).
  • Member’s children are provided with the same type of cover as the member and are covered for several children-specific critical illnesses.
  • Children’s benefit is 25% of the member’s benefit up to a maximum of £25,000.
• Provides the option of covering the spouses and/or partners of employees included in the policy for an additional cost.
• Offers a choice of base cover which insures against some of the most common critical illnesses, or a base and extra cover, which includes a number of additional conditions.
• Voluntary policies arranged through our Benni distribution channel have a choice of five benefit amounts from £10,000 to £50,000.
• Simplicity Critical Illness provides a flat benefit of between £10,000 and £60,000 for 10 of the most common critical illnesses.
• For Simplicity Critical Illness, members’ medical histories will not prevent claims for events arising after they join.
• Products sold through special distribution IAR are typically sold at a fixed price and a flat level of cover.
• The product complies with the Association of British Insurers’ (ABI) Guide to Minimum Standards for Critical Illness Cover 2018.
• Our Group Critical Illness customers have immediate access to a range of Value-Added Services (VAS) providing health and wellbeing support at no additional cost, including virtual GP appointments, mental health support and a fully integrated Employee Assistance Programme.
• Every employee (and their insured partner) covered by a Unum Group Critical Illness policy can access the cancer support service, which is provided by Reframe.¹ Those covered can contact Reframe as soon as they are diagnosed for immediate support.

Key exclusions

• A pre-existing conditions exclusion applies to members’ and children’s benefits up to the automatic entry limit.²
  • Where a member has experienced a critical illness before joining the policy, or when they have made a claim under the policy, other than for cancer – second and subsequent, they will not be able to claim for a recurrence of that condition or certain other critical illnesses. 
  • A member will not be able to claim for a critical illness where they were aware of, or being treated for, a related condition on or before cover started. Some related conditions are disregarded once the member has been covered under the policy for at least 2 years.
  • The pre-existing and related conditions exclusions apply:
    • From when the member joins the policy;
    • After a successful claim; and
    • To all increases in benefit that are not related to an increase in salary. 

2. Target market

• The target market is employers with 3 or more employees based primarily in the UK who want to provide Critical Illness Cover for their employees.  
  • An employee can be a permanent or fixed-term employee, a director, equity partner or a member of a limited liability partnership (LLP).
  • An employee who is based overseas must have a contract of employment with a UK resident employer.
• On occasion we will offer policies to employers with fewer than 3 employees under a special arrangement. 
• Flexible and voluntary policies are available to employers with a minimum of 150 eligible employees.
• Policies arranged through our Benni distribution channels are available for employers of 50 or more employees.
• Simplicity Critical Illness is available for employers of 50 or more employees.
• Any special distribution or Introducer Appointed Representative (IAR) agreements typically apply to policies covering between 3 and 100 employees.

We aim to have a balanced book of business across small, medium, and large employers.

Customer needs and goals

The policy meets the needs of employers who wish to:

• Provide financial support to their employees in the event they or their children suffer one of the defined list of illnesses or undergo one of the covered surgical procedures.
• Offer employees the opportunity to top up their own over or choose cover to pay in the event of their spouse or partner suffering a critical illness event.
• Promote employee health and wellbeing including providing access to employee assistance programmes and support services.
• Provide an attractive employee benefits package to attract and retain staff.

The product is not suitable for:

• Employers not based in the UK or without a UK branch registered at Companies House. 
• Employers with fewer than the required number of employees.
• Non-commercial customers (i.e. individual retail customers).
• Flexible policies are not available for equity partners or LLP members.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The policy meets a clearly defined real need.
  • The customer can use the policy under the circumstances they expect.

This rating is based on metrics and data including:

• Customer feedback and research findings
• Numbers and causes of complaints
• Sales and persistency
• Underwriting outcomes
• Claims acceptance rates
• Claims ratios
• Broker remuneration and commission
• Utilisation of Value-Added Services
• Performance against Service Level Agreements (SLAs).

Find out more about Critical Illness

^{1 Cancer Support Service (the ‘Service’) is provided to Unum Limited (“Unum”) customers by third-party specialist providers chosen by Unum. Unum is not the provider of the Service. The Service is entirely separate from the insurance policy provided by Unum. Access to the Service is facilitated by Unum at no cost to the Unum customer, and Unum may change or withdraw access to the Service at any time. Use of the Service is subject to the terms and conditions of the relevant third-party specialist providers. Service is available to UK residents only. For further information, please go to frequently asked questions}

^{2 For Simplicity Critical Illness, members’ medical histories will not prevent claims for events arising after they join.}

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment, as they are intended to deliver similar cover and outcomes for customers, and the target markets are consistent (other than for the minimum number of employees as described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review:

• Standard Employer Funded Policies.
• Flexible and Voluntary Policies: Employees choose whether to join the policy and their level of cover within the limits set.
• Policies arranged through our Benni distribution channel.
• Policies arranged through a special agreement with one of our distributors or a bespoke policy with non-standard terms.
• Policies arranged through a special distribution or Introducer Appointed Representative (IAR) agreement.
• Benni products were closed in June 2024. For the remaining contractual period Zest Technology have been appointed to manage their platform services and day to day support. Benni policy trends and figures have been included under ‘Voluntary’ funding option with figures updated as Q2 2023.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

Dental Cover meets the demands and needs of an employer who wishes to provide employees and their dependants (where covered) reimbursement towards the costs of routine and essential dental treatment.

Product features

• Clear policies provide up to 6 levels of cover with increasing amounts of benefit against fixed treatments.
• Radiant policies provide up to 6 levels of cover, divided into preventative care, major treatment and minor treatment.
• Policies include:
  • Cover for pre-existing conditions (excluding mouth cancer)
  • Worldwide Cover
  • 100% reimbursement of NHS charges
  • Immediate cover from the day the policy starts
  • Visit any NHS or private dental practice
• Cover can be extended to the employee’s adult and child dependants.
• Policies arranged through our Benni distribution channel include three levels of cover to choose from ‘Essential’, ‘Standard’ and ‘Premium’.
• Policies distributed through IARs are typically marketed at a fixed price and a specified level of cover.
• Members of the policy have access to BenefitHub, a platform which offers a range of discounts, rewards and perks on a range of brands across a variety of categories.¹
• From 1st May 2024, the ‘Extra’ dental products offering improved cover will be available to new and existing customers. Key changes include:
  • A reduced treatment list to streamline claim journeys and simplify cover.
  • Increases to benefits using data insights to focus on the most claimed preventative and restorative treatments to maximise customer impact.
  • Digital dental services at employee’s fingertips, with immediate access to high quality virtual dentistry services, support and guidance for everyday preventative dental care.

Key exclusions

The policy will not cover:

• Cosmetic treatment.
• Mouth cancer which existed prior to joining the plan.
• Prescription fees.
• Treatment carried out before cover starts and after cover ends.
• Benefits for overnight hospital stays in the Republic of Ireland (ROI).
• An additional exclusion applies to the new improved cover, which excludes implants or bridges which are fitted to a pre-existing gap in the mouth unless previously insured for dental treatment under another insurer’s policy immediately before joining Unum’s Dental policy.

2. Target market

The target market is employers with 4 or more employees based primarily in the UK who want to provide their employees access to reimbursement towards the costs of routine and essential dental treatment.

• An employee can be a permanent or fixed-term employee.
• An employee who is based overseas must have a contract of employment with a UK resident employer.
• On occasion we will offer policies to employers with fewer than 4 employees under a special arrangement.
• For flexible and voluntary policies, the minimum number of lives is 150.
• Voluntary policies arranged through our Benni distribution channel are available for employers with 50 or more employees. 
• Any special distribution or IAR agreements typically apply to policies covering between 3–100 employees.

We aim to have a balanced book of business across small, medium, and large employers.   

Customer needs and goals

The product meets the demands and needs of an employer who wishes to:

• Provide employees access to reimbursement towards the costs of routine and essential dental treatment.
• Offer employees the opportunity to top up their own over or choose cover for their family members.
• Promote employee health and wellbeing including providing access to employee assistance programmes and support services.
• Provide an attractive employee benefits package to attract and retain staff.

The product is not suitable for:

• Employers not based in the UK or do not have a UK branch registered at Companies House.
• Employers with fewer than the required number of employees.
• Non-commercial customers (i.e. individual retail customers). 

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution, and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The policy meets a clearly defined real need.
  • The customer can use the policy under the circumstances they expect.

This rating is based on metrics and data including:

• Customer feedback and research findings
• Numbers and causes of complaints
• Persistency
• Participation
• Customer satisfaction (CSAT) scores
• Underwriting outcomes
• Claims paid
• Claims ratios
• Broker remuneration and commission.

The new, enhanced ‘Extra’ Dental product was developed with consideration to the four measures of customer value to ensure good customer outcomes will be achieved by the enhancements. Fair value will be measured using the above metrics through Unum’s ongoing value monitoring and assessment process once data is available.

Learn more about Corporate Dental Insurance

^{1 Savings and discounts services (the ‘Services’) are provided to Unum Limited (“Unum”) customers by third-party specialist providers chosen by Unum. Unum is not the provider of the Services.  The Services are entirely separate from the insurance policy provided by Unum. Access to the Services is facilitated by Unum at no cost to the Unum customer, and Unum may change or withdraw access to the Services at any time. Use of the Services are subject to the terms and conditions of the relevant third-party specialist providers. Services are available to UK residents only. For further information, please go to frequently asked questions}

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbookand the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment as the products are intended to deliver similar cover and outcomes for customers and the target markets are consistent (other than for the minimum number of employees as described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review.

• Standard Employer Funded Policies.
• Voluntary and flexible policies.
• Policies arranged through a special agreement with one of our distributers or a one-off policy with non-standard terms.
• Policies arranged through a special distribution or Introducer Appointed Representative (IAR) agreement.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

Optical Cover from Unum Dental can help employees and their dependants maintain good eye health by providing cover towards regular eye exams, as well as providing help towards the cost of frames and lenses, including contact lenses.

Product features 

• In 2021, Unum enhanced its Optical Cover to offer greater choice and better coverage.
• The previously (pre-2021) policy provides:
  • One level of cover.
  • Benefit for a member’s first set of glasses/lenses, or where there has been a change in prescription.
• The current policy provides:
  • Cover towards examinations, lenses and frames, including contact lenses, off-the-shelf reading glasses and digital protection lenses.
  • A choice of up to four levels of cover.
  • The option to insure family members at an additional cost.
  • A single lump sum benefit of £10,000 in the event of accidental loss of sight, which can only be claimed once by an insured adult in their lifetime under the optical policy.
• Both policies include:
  • Free choice of optician, including outside the UK.
  • Immediate cover; claims can be made from the policy start date.
  • Members of the policy have access to BenefitHub - a platform which offers a range of discounts, rewards and perks on a range of brands across various different categories.¹

Key Exclusions

The previous policy does not provide cover for:

• Optical expenses relating to the cost of replacing spectacles or contact lenses due to loss, theft, scratching, breaking or accidental damage.
• Any optical procedure which is purely cosmetic and not necessary to maintain claimants’ optical health.

The current policy does not provide cover for:

• Optical sundry items or consumables such as cleaning solution and carry cases
• Optical expenses relating to the cost of repairing lenses or frames.
• Laser eye surgery.
• Any optical procedure or purchase which is purely cosmetic and not necessary to maintain, restore, or correct your vision.
• Loss of sight as a result of an accident when already claimed for previously under any optical policy with Unum.
• Loss of sight for any reason other than as a result of an accident as described in this policy.
• Eye examinations, purchases, or any accident which occurs before cover starts or after cover ends.

2. Target market

• The target market is employers with 4 or more employees based primarily in the UK who want to provide optical cover for their employees. 
  • An employee who is based overseas must have a contract of employment with a UK resident employer.
• On occasion, we will offer policies to employers with fewer than 4 employees under a special arrangement.
• There are currently four policies on risk with fewer than the minimum number of employees of the target market. These policies were analysed as part of the 2023 Fair Value Assessment. Policies were either originally sold to more than four employees or were part of a parent company. No new policies with fewer than four employees has gone on risk since the last fair value assessment carried out in 2023.
• For flexible and voluntary policies, the minimum number of employees is 150.

We aim to have a balanced book of business across small, medium and large employers.

Customer needs and goals

The policy meets the needs of employers who wish to:

• Help employees and their dependants maintain good eye health by providing access to reimbursement towards optical expenses including regular eye examinations, the cost of frames and lenses, including contact lenses.
• Give employees access to financial benefits if they lose their sight in an accident.
• Offer employees the opportunity to top up their own cover or choose cover for their family members.
• Provide an attractive employee benefits package to attract and retain staff.

The product is not suitable for:

• Employers not based in the UK or do not have a UK branch registered at Companies House.
• Employers with fewer than the required number of lives.
• Non-commercial customers (i.e. individual retail customers).
• Employers who do not have one or more of the needs or goals listed above.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The product meets a clearly defined real need.
  • The customer can use the policy under the circumstances they expect.

This rating is based on metrics and data including:

• Claims acceptance rates
• Numbers and causes of complaints
• Scheme and Employee Persistency
• Customer Satisfaction (CSAT) scores
• Claims ratios
• Broker remuneration and commission.

Learn more about Corporate Optical Insurance

^{1 Savings and discounts services (the ‘Services’) are provided to Unum Limited (“Unum”) customers by third-party specialist providers chosen by Unum. Unum is not the provider of the Services.  The Services are entirely separate from the insurance policy provided by Unum. Access to the Services is facilitated by Unum at no cost to the Unum customer, and Unum may change or withdraw access to the Services at any time. Use of the Services are subject to the terms and conditions of the relevant third-party specialist providers. Services are available to UK residents only. For further information, please go to frequently asked questions}

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

1. Product description

Sick Pay Insurance meets the demands and needs of an employer who wishes to provide short-term financial support to their employees if they cannot work due to illness or injury beyond the period outlined in their policy (the deferred period), by paying a proportion of their salary as a monthly benefit. 

This product was closed to new employers from May 2022 and allows new employees to join existing employer policies and for employers to continue cover subject to periodic re-rating and/or re-underwriting.

Existing customers were migrated from a self-serve administration platform to our core operating platform in January 2023.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

Product features 

The policy allows an employer when taking out the policy to choose:

• Who to insure.
• The level of income benefit to provide (between 50% and 80% of an employee’s salary.
• How soon after the employee is absent payments start with 1, 2 or 4-week deferred periods.
• How long the income benefit is paid between 13 and 52 weeks.

Key exclusions

The policy does not provide cover for employees who are required to hold a license or certificate only issued when they meet certain medical standards.

2. Target market

• The target market is employers with 10 or more employees based primarily in the UK who want to protect their employees’ incomes in the event they are unable to work due to accident or illness. 
  • An employee can be insured if they satisfy the conditions of eligibility defined in the policy, meet the definition of being Actively at Work, and successfully complete Evidence of Insurability, if required.
  • An employee who is based overseas must have a contract of employment with a UK resident employer.
  • Once in force, the number of insured employees may fall below 10.

We aim to have a balanced book of business across small, medium and large employers.   

Customer needs and goals

The policy meets the needs of employers who wish to:

• Provide financial support to employees who are unable to work in the short-term due to illness or injury.
• Obtain independent validation of employee absences.
• Provide access to absence management services and in-work support for employees struggling to work due to illness or injury.
• Promote employee health and wellbeing including providing access to employee assistance programmes and support services.
• Provide an attractive employee benefits package to attract and retain staff.

The product is not suitable for:

• Employers with fewer than the required number of employees.
• Individuals subject to Schedule D taxation (i.e. taxation of the profits of trades, professions or vocations under Schedule D of the Income and Corporation Taxes Act 1988).
• Non-commercial customers (i.e. individual and retail customers).
• Employers who do not have one or more of the needs or goals listed above.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The policy meets a clearly defined real need.
  • The customer can use the product under the circumstances they expect.

This rating is based on metrics and data including:

• Claims ratio
• Broker remuneration and commission
• Claims acceptance rates
• Persistency
• Utilisation of Value-Added Services (VAS)
• Numbers and causes of complaints
• Process failures
• Customer satisfaction.

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment as they are intended to deliver similar cover and outcomes for customers and the target markets are consistent (other than for the minimum number of employees as described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review.

• Continuation options: Policies taken out by members when leaving corporate dental plans (Clear and Radiant), Ex-Cigna members when leaving corporate dental plans.
• Dencover Boost: Individual policies chosen by members through a corporate distribution.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

These policies are individual (retail) products, which provide the policyholder and their dependants (where covered) reimbursement towards the costs of routine and essential dental treatment.  

Product features 

• Continuation options provide the same cover as the Corporate Dental policy under which the member was previously covered: 
  • Clear provides a choice of up to 6 levels of cover with increasing amounts of benefit against fixed treatments.
  • Radiant provides a choice of up to 5 levels of cover, divided into preventative care, major treatment and minor treatment.
• Dencover Boost provides a choice of up to 5 levels of cover, divided into preventative care, major treatment and minor treatment.
• Continuation members have access to BenefitHub, a platform which offers a range of discounts, rewards and perks on a range of brands across a variety of categories.¹
• Policies include: 
  • Visit any dentist of the policyholder’s choice - National Health Service 'NHS' or private.
  • Worldwide Cover (Continuation option only).
  • 100% reimbursement of NHS charges (Continuation option only).
  • Immediate cover from the day the policy starts.
  • Cover can be extended to the policyholder’s adult and child dependants.

Key exclusions

We will not cover:

• Cosmetic treatment.
• Mouth cancer which existed prior to joining the plan.
• Prescription charges, missed appointment fees, and dental sundries and consumables such as toothbrushes and dental hygiene products.
• Treatment carried out before cover starts and after cover ends.
• Benefits for overnight hospital stays in the Republic of Ireland (ROI).
• Orthodontics for insured adults.
• Treatment carried out before cover starts and after cover ends.

For Dencover Boost we will not cover:

• Treatment arising from, traceable to or caused by a pre-existing condition.
• Treatment which was identified, started or completed during any applicable qualifying period.
• Injury caused to the teeth, gums or mouth during any type of hospital procedure.

2. Target market

• The target market for Continuation options are former employees of an employer with either a Clear or Radiant policy who are within 30 days of leaving that employer at the time of taking out the policy and wish to continue their cover on leaving their employer.
• Ex-Cigna group policy holders who are within 30 days of leaving that employer at the time of taking out the policy and wish to continue their cover on leaving their employer.
• The target market for Dencover Boost is employees of large employers who have chosen to offer dental cover to their employees without being the group dental policyholder.
• Dencover boost also includes ex-Cigna policyholders who had an individual continuation policy with Cigna.

Customer needs and goals

The product meets the needs of employers who wish to:

• Former employees of an employer who, within 30 days of leaving that employer, need to continue their existing dental cover including reimbursement towards the costs of routine and essential dental treatment.
• Dencover Boost meets the needs of those individuals who need to have access to reimbursement towards the costs of routine and essential dental treatment.
• It is not suitable for individuals whose needs are being met by accessing dental cover funded by their new employer.

The product is not suitable for:

• Individuals who receive Dental coverage from their new employer.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The product meets a clearly defined real need.

The customer can use the product under the circumstances they expect.

This rating is based on metrics and data including:

• Claims acceptance rates
• Customer feedback and research findings
• Numbers and causes of complaints
• Sales and persistency
• Process failures resulting in customer detriment; claims ratio
• Broker remuneration and commission.

^{1 Savings and discounts services (the ‘Services’) are provided to Unum Limited (“Unum”) customers by third-party specialist providers chosen by Unum. Unum is not the provider of the Services.  The Services are entirely separate from the insurance policy provided by Unum. Access to the Services is facilitated by Unum at no cost to the Unum customer, and Unum may change or withdraw access to the Services at any time. Use of the Services are subject to the terms and conditions of the relevant third-party specialist providers. Services are available to UK residents only. For further information, please go to frequently asked questions}

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Scope

The following policy types have been grouped together for the purposes of this assessment as the products are intended to deliver similar cover and outcomes for customers and the target markets are consistent (other than any differences described below). Where there is potential for a product variant to have a different impact on value, this has been considered within the review.

• Executive Income Protection (EIP): Designed for small and midsized enterprises ‘SMEs’ providing selected employees the benefits of an extended sick pay arrangement.
• Individual Income Protection (IIP), including:
  • All versions of the product sold between 1977 and 2012 including Personal Income Replacement Plan, Primary Income Protection Plan and Tax guard policies.
  • Products sold through a private label arrangement.

Individual Income Protection business closed to new customers in 2012, and Executive Income Protection closed to new customers in 2022.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product description

Income Protection meets the demands and needs of an individual who wishes to protect their income if they cannot work or lose essential abilities due to accident or illness beyond the period outlined in their policy (the deferred period), by paying them a monthly benefit.

Product features 

• Insured benefits can include inflation-linked increases in line with Retail Price Index (RPI).
• Policies can include automatic benefit increase options which allow the customer to increase their benefit without the need for medical underwriting.
• If the policyholder is not working policies can include:
  • Cover while not in occupation offering an alternative definition of incapacity for up to 60 months.
  • A career break for up to 12 months.
• The Executive Income Protection product also includes:
  • Portability of cover:
    • If the employee leaves the employment of the policyholder, cover can be transferred to a new employer. 
    • If the new employer does not wish to continue the policy or the employee becomes self-employed, the employee can transfer ownership to themselves. 
  • Employers can choose to cover additional costs such Pension Scheme Contributions and National Insurance Contributions.
• Additional Disability Plus option for 20% more benefit to be paid.

Key exclusions

• Cover is subject to providing satisfactory medical evidence and as a result may be subject to underwriting restrictions or exclusions.
• During a career break, we will not consider a claim or pay benefit and we will not collect premiums.

2. Target market

The target market for IIP prior is anyone who: 

• Works and needs an income to cover their regular outgoings, and  
• Is not fully covered under a group income protection policy.   

The target market for EIP is:

• Single employee limited companies who want to arrange Income Protection cover through their business.
• SMEs looking to provide cover for selected employees.

Customer needs and goals

This policy meets the needs of an individual who: 

• Requires financial support if they are unable to work due to an illness and/or a disability. 
• Does not have Income Protection cover through their job's compensation package and/or enough savings to cover ongoing living expenses.
• Executive Income Protection customers need Income Protection through their single employee limited companies or they are SMEs who need to provide Income Protection cover only for selected employees in case those employees are unable to work because of an illness and/or disability.

The product is not suitable for:

• Individuals or employers not based in the UK or without a UK branch registered at Companies House.
• Individuals whose non-UK taxable earnings arise in the currency of any country not in the following list: 
  • Australia
  • Any member state of the European Union
  • Canada
  • Channel Islands
  • Gibraltar
  • Iceland
  • Isle of Man
  • New Zealand
  • Norway
  • Switzerland
  • United States of America.
• EIP is not suitable for individuals wanting to protect an income that does not come via the named policyholder
• IIP may not be suitable for those who would qualify for means tested benefits.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The product meets a clearly defined real need.
  • The customer can use the product under the circumstances they expect.

This rating is based on metrics and data including:

• Claims acceptance rates
• Numbers and causes of complaints
• Persistency
• Underwriting outcomes
• Claims ratios
• Broker remuneration and commission.

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

1. Product description

The policy provides a guaranteed cash lump sum if the policyholder is diagnosed with a medical condition or undergoes one of the specified surgical procedures and survives the event by at least 14 days.

For benefit to be payable:

• The condition or surgical procedure must meet the policy definition; and
• The member must survive for at least 14 days after the critical illness event.

The product closed to new business in 2012.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

Product features 

• Policyholders can choose different levels of benefit to match the relative severity of three different types of critical illness event.
• Once a claim has been paid for a critical illness event, no further claims can be made for that category. Any remaining cover in other categories is reduced by the amount of benefit paid.
  • Once the overall maximum benefit has been paid, then plan will end.
• Member’s children are automatically provided with the same type of cover as the member, excluding Total Permanent Disability and Loss of Independent Existence.
  • Children’s benefit is 25% of the member’s benefit up to a maximum of £25,000.
• Other features include:
  • Waiver of premium benefit.
  • Option to increase benefit amounts.
  • Inflation-linked increases.
  • Reducing cover in line with a repayment mortgage.

Key exclusions

• Cover is subject to providing satisfactory medical evidence and as a result may be subject to underwriting restrictions or exclusions.
• Children’s cover excludes Total Permanent Disability and Loss of Independent Existence.

2. Target market

The target market is individuals between the ages of 16–65 who require Critical Illness Cover. This includes:

• Individuals who wish to protect themselves financially in the event of a critical illness diagnosis
• Individuals who have a mortgage on their home
• Individuals with financial dependants 
• Self-employed individuals
• Individuals who have caring responsibilities

Customer needs and goals

The policy meets the needs of individuals who require financial support in the event they or their children suffer one of the specified illnesses or undergo one of the covered surgical procedures.

The product is not suitable for:

• Employers looking to provide group cover for their employees (i.e. commercial customers).
• Individuals who have sufficient levels of Critical Illness Cover elsewhere. For example:
  • Through their employers.
  • Dependants who have Critical Illness Cover through their parent/legal guardian or their spouse/partner.
• Individuals who have no financial commitments or financial dependants.

3. Value assessment

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between loss ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an event occur.
• Customer support
  • The product meets a clearly defined real need.
  • The customer can use the product under the circumstances they expect.

This rating is based on metrics and data including:

• Numbers and causes of complaints
• Customer feedback and research findings
• Claims acceptance rates
• Persistency
• Claims ratios
• Process failures resulting in customer detriment
• Broker remuneration and commission.

Purpose

This review assesses whether the product provides fair customer value as required under FCA Policy Statement (PS21/5), which includes feedback to CP20/19 and the final rules, and the updated governance requirements in section PROD 4.2 of the FCA handbook and the requirements of Consumer Duty PS22/9.

Overall value rating: Provides fair customer value.

Date published: 30th September 2024

1. Product Description 

Essential Ability Cover meets the demands and needs of an individual who wishes to protect their income if they lose essential abilities to perform 3 of the 11 physical tests at any given time; or suffer serious symptoms of mental illness or any serious impairment in social or occupational functioning where certified with a Global Assessment of Functioning (GAF) Scale score of under 51 by a Consultant Psychiatrist or Psychologist. 

Product features 

• Maximum benefit payable is £25,000 pa (at start of policy), unrelated to earnings. The cover can increase to a maximum level of £50,000 a year.
• The definition of incapacity for EAC is a physical or mental health test.
• Customers can choose between 4, 8, 13, 26 or 52 weeks. 
• Policy will pay based on the either of the 2 distinct tests: the physical and the mental health test.
• Policies can end at any age between 50 and 70. However, the plan must last at least 5 years.
• When receiving benefits, Unum’s team of Vocational Rehabilitation Consultants can provide support and assistance in rehabilitation. 

Key exclusions

• Cover is subject to providing satisfactory medical evidence and as a result may be subject to underwriting restrictions or exclusions.
• The plan is not available to non-UK residents. But policy holders are covered if they decide to live, work or travel in the world.
• The cover can’t be suspended under this plan.

2. Target market

The target market for EAC is higher risk occupations (where traditional Income Protection is not available or may be prohibitively expensive) or those who do not have an occupation.

Customer needs and goals

The product is suitable for:

• Customers who are in higher risk occupations requiring financial support if they are unable to perform certain physical activities and can't provide for themselves and/or their dependants. 
• Customer who don’t have an occupation yet would need some form of financial support in the event they were unable to perform certain physical activities so would need to pay someone else to carry them out if they could not.
• Although this group of products are not currently being sold to new customers, their needs were known when the product was open to new business.

The product is not suitable for:

• Individuals who do not have a UK bank account in pounds sterling.
• Individuals who need more traditional Income Protection that would provide financial support if they were unable to perform their occupation.

3. Value assessment 

The product is shown to continue to provide good value to our target customers in each of the following measures of customer value:

• Suitability for the target market
  • Target customers can use the cover at the appropriate time.
  • The extent of cover appropriately mitigates risks as would normally be expected.
  • Underwriting rules create inclusivity for the target market.
• Price and value for money
  • Appropriate balance between claims ratio, distribution and administration expenses.
  • Profits are reasonable with a long-term view.
• Customer understanding
  • Customers understand the product for the peace of mind it gives should an insured event occur.
• Customer support
  • The product meets a clearly defined real need.
  • The customer can use the product under the circumstances they expect.

This rating is based on metrics and data including:

• Claims acceptance rates
• Numbers and causes of complaints
• Persistency
• Underwriting outcomes
• Claims ratios
• Broker remuneration and commission.