Which statement best describes the relationship between an insurer and an employer in a PMI scheme?

Preparing for the CII Certificate in Insurance - Healthcare Insurance (IF7)? Study with flashcards and multiple choice questions, each question has hints and explanations. Get ready for your exam!

In a Private Medical Insurance (PMI) scheme, the relationship between the insurer and the employer is characterized by the employer paying premiums on behalf of employees. This arrangement is often part of an employee benefits package, where the employer takes financial responsibility for the health insurance costs, ensuring that employees have access to medical care without facing large out-of-pocket expenses.

By covering the premiums, the employer not only offers a valuable benefit that can enhance employee satisfaction and well-being but also helps to attract and retain talent in the organization. This creates a partnership where the insurer provides the medical coverage and the employer facilitates the access and payment process for the employees.

The other statements describe scenarios that are not typical in PMI schemes. For instance, the insurer typically does not provide direct payments to employees; instead, they reimburse healthcare providers or pay for services rendered based on the terms of the policy. The insurer is dependent on the employer to facilitate the provision of coverage to the group of employees, rather than operating completely independently. Additionally, the employer does not assume all risk associated with claims; instead, that risk is primarily borne by the insurer, who is responsible for managing claims, payouts, and the overall insurance coverage.

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