A 100-employee scheme typically costs £42,000–£130,000 a year (£35–£110 per head per month, average ~£57). At this size pricing is experience-rated on your own claims history, medical history disregarded underwriting is standard, and insurers provide claims-data reviews, benefits-platform integration and a dedicated account team. Most schemes this size are broker-managed and re-tendered periodically.
- ✓At ~£57/head, a 100-life scheme runs around £68,000 a year plus Class 1A NIC.
- ✓Pricing is experience-rated: your own claims history drives your renewal, not book rates.
- ✓MHD underwriting, claims-data reviews and named account teams are standard at this size.
You're now in corporate territory
Below roughly 50 lives, insurers price schemes on book rates — standard tables based on age, postcode and industry. Somewhere past that point, and firmly by 100 lives, pricing becomes experience-rated: your own scheme's claims history is the main driver of your premium. Claim well and your renewal reflects it; have a heavy year and you'll see it in the price.
That changes how you should think about the scheme. It's no longer just an insurance purchase — it's a managed risk pool you can influence through plan design, employee health support and renewal negotiation. The employers who treat it that way consistently pay less per head than those who auto-renew.
What 100+ lives gets you
Scale buys real advantages at this size, and you should expect all of the following as standard rather than as favours:
| Feature | What it means at 100+ lives |
|---|---|
| MHD underwriting | Medical history disregarded is the norm — no pre-existing condition exclusions for any member |
| Experience-rated pricing | Premiums driven by your claims fund, with detail on how the rate was built |
| Claims-data reviews | Quarterly or twice-yearly reports: claims spend, top specialties, utilisation trends |
| Named account team | Dedicated account manager plus service team for member changes and escalations |
| Platform integration | Feeds into benefits platforms and HR systems for joiners, leavers and flex windows |
| Bespoke plan design | Custom tiers, excess structures, hospital lists and add-ons priced to your census |
MHD matters more than it sounds. On a moratorium-underwritten scheme, employees with existing conditions get partial cover; on MHD, everyone is fully covered from day one, which makes the benefit genuinely equal across the workforce — and makes your recruitment story cleaner. Platform integration matters more prosaically: with monthly joiners and leavers across 100+ heads, manual membership admin becomes a real workload, so automated feeds between your HR system, the benefits platform and the insurer stop being nice-to-have and start being the thing that keeps the scheme accurate.
Claims data: the review rhythm that controls cost
Experience rating cuts both ways: your claims drive your price, so understanding your claims is how you control it. At 100+ lives insurers will provide regular claims reporting — insist on at least twice-yearly reviews, quarterly if your broker can get them. A good review covers claims spend against premium (the loss ratio), top claiming specialties, large individual claims, and utilisation of pathways like digital GP and mental health support.
- Watch the loss ratio. If claims consistently run well below premium, you have a renewal negotiation case; consistently above, expect increases and start mitigating early.
- Spot the patterns. Heavy musculoskeletal claims suggest ergonomics and physio pathways; rising mental health claims suggest EAP promotion and manager training.
- Track utilisation, not just claims. Digital GP and EAP usage cost little and often divert claims from expensive routes. Low utilisation means wasted premium — see our utilisation guide.
- Mind data protection. Reports are aggregated and anonymised; at 100+ lives that's workable, but be careful drawing conclusions about small subgroups.
Our claims-data review guide goes deeper on running these meetings well.
Put your 100+ scheme out to the market
Plan design: tiers, flex and voluntary top-ups
At 100+ employees a single flat plan is rare. Most schemes tier cover by seniority or role band, and many sit inside a wider flexible benefits arrangement: the employer funds a core level, and employees trade flex budget or salary for upgrades — fuller outpatient cover, lower excess, partner and family additions — through an annual enrolment window on the benefits platform.
Voluntary top-ups are worth designing deliberately. Employee-funded upgrades at group rates are a genuinely valuable perk that costs the employer little beyond admin, and platform integration makes the payroll side manageable. The trade-off is complexity: every tier and option adds comms burden, and unused options quietly clutter renewals. Two or three well-chosen tiers with a couple of upgrade paths beats a menu of ten.
Buying it: brokers, tenders and renewals
Schemes this size are overwhelmingly broker-managed, and for good reason: an employee benefits consultant runs the market exercise, negotiates with insurers' corporate teams, manages the claims reviews and handles the renewal. Broker remuneration is typically commission built into the premium or an agreed fee — at 100+ lives, ask for fee-based terms and full commission disclosure so you can see what you're paying.
The procurement norm is a market tender every two to three years: your broker takes an anonymised census and two to three years of claims experience to the market, and insurers — Bupa, AXA Health, Aviva and Vitality dominate the corporate space — bid for the scheme. Annual renewals in between are negotiations, not formalities: with claims data and a credible willingness to move, mid-single-digit increases are routinely negotiated down from higher opening positions. Switching insurer at this size is very manageable — continuation terms (CPME) with MHD preserved are standard asks — but weigh the disruption against the saving. See our renewal negotiation checklist and direct vs broker guide.
Frequently asked questions
How much does health insurance cost for 100 employees?
Typically £42,000–£130,000 a year, based on the £35–£110 per employee per month range — around £68,000 at the ~£57 UK average. Your actual price depends on cover level, workforce age profile, industry and, at this size, your own claims history, since 100-life schemes are experience-rated.
What is experience-rated pricing on a 100-employee scheme?
It means your premium is driven primarily by your own scheme's claims history rather than standard book rates. Insurers look at your claims fund over recent years and price forward from it. Good claims experience becomes a negotiating asset; a heavy year feeds directly into your renewal.
Is medical history disregarded underwriting standard at 100 employees?
Yes — at 100+ lives MHD is the norm across the corporate insurers. Every member is covered without pre-existing condition exclusions, which makes the benefit equal across the workforce. If you're quoted moratorium terms at this size, ask why; it usually signals the quote isn't from the insurer's corporate book.
What claims data should a 100-employee scheme get from its insurer?
At minimum: claims spend against premium (loss ratio), top claiming specialties, large-claim summaries and utilisation of services like digital GP and mental health pathways — aggregated and anonymised. Push for quarterly or twice-yearly reviews; this data is what lets you manage cost rather than just receive renewals.
Should a 100-employee company use a broker or go direct?
At this size, broker-led is the strong norm. An employee benefits consultant runs tenders, negotiates with corporate teams and manages claims reviews — work that's hard to replicate in-house. Ask for fee-based remuneration or full commission disclosure so the economics are transparent.
How often should a 100-life scheme go to tender?
Every two to three years is the common rhythm: a full market exercise with anonymised census and claims experience, with negotiated renewals in the years between. Tendering more often burns goodwill and admin for marginal gains; never tendering lets pricing drift upward.
Can a 100-employee scheme integrate with a benefits platform?
Yes — corporate insurers routinely feed membership data to benefits platforms and HR systems, handling joiners, leavers and annual flex windows automatically. If you run flexible benefits, confirm the insurer supports your platform and the enrolment-window mechanics before you commit.
How do flex and voluntary top-ups work on large schemes?
The employer funds a core cover level, and employees buy upgrades — fuller outpatient cover, family additions, lower excess — through an annual enrolment window, usually via a benefits platform. It's valuable and low-cost to offer, but design carefully: optional rich layers attract the heaviest claimers, and those claims feed your experience-rated renewal.
What happens to claims history if a 100-employee scheme switches insurer?
It moves with you as evidence, not liability: the new insurer prices your scheme using your claims experience, and continuation terms (CPME) with MHD preserved are a standard ask, so members keep cover for ongoing conditions. Confirm continuation terms in writing before switching — see our mid-term switching guide.
What tax applies to a 100-employee health insurance scheme?
The same rules as any size: premiums are generally allowable for corporation tax relief, cover is a benefit in kind for employees, and the employer pays Class 1A NIC at 15% on the benefit value — around £10,000 on a £68,000 scheme. P11D reporting applies until payrolling becomes mandatory in April 2027.