Basis of Operation

Staff sickness insurance or mutual schemes are just different ways of distributing money between schools to alleviate the financial impact when schools have varying amounts of absence. The main difference between methods is in the level of overheads applied. Mutuals win hands down as many elements of these on-costs are removed.

Esphera’s miniMAX Virtual Mutual is again an alternative way of schools reimbursing other schools. The process is almost identical in that schools will choose benefit levels and waiting days for different staff categories and will need to agree to contribute an amount to achieve those benefits. The difference is that we wait until all the absences have occurred to then re-evaluate what everyone would have paid and received and then rebalance the contributions necessary. We miss out all the interim payments and schools just make a handful of payments between themselves which has the same overall effect. High claiming schools receive a net payment and low claiming schools pay a reduced amount to cover those payments.

The chronological process is as follows

  1. Schools Express Interest – complete form here
  2. Esphera requests schools’ absence history
  3. Schools provide absence history into an online form
  4. Esphera calculates absence rates and factors as if part of conventional scheme
  5. Schools requests quotes for required benefit levels via an online form
  6. Esphera informs schools of virtual contributions required e.g. £10000
  7. Schools accept quotes
  8. Schools make requests for payments for absences throughout year (e.g. £1000). This is offset against the virtual contribution (e.g. virtual balance reduced to £9000).
  9. Esphera assesses scheme as a whole and calculates equalised balance (say £2000 after further £7000 equalisation due to low claims).
    1. If this is lower than zero (i.e. school is owed funds) then a payment is received from other school(s).
    2. If this is above zero but lower than the virtual contribution then this amount (£2000 in this example) is paid to another school(s).

Outline Scheme Rules

  • As the scheme is a virtual scheme there is no fund held by anyone, it is a mechanism to allow schools to fairly reimburse each other to alleviate financial loss they suffer as a result of staff absence.
  • Esphera Solutions is paid an admin fee to calculate and keep track of the payments that would have been made by schools had they been part of a physical staff absence fund and to determine a final equalised balancing payment.
  • By joining schools are agreeing to be part of a discretionary voluntary arrangement whereby they will pay other schools based on Esphera’s recommendations at the end of an annual period. Ultimately this means that schools with lower absence (and therefore reimbursement) levels pay smaller amounts to schools with higher than expected absences.
  • Schools have no contractual agreement with other schools or Esphera Solutions.
  • Schools voluntarily pay other schools at the end of the period based on Esphera’s calculations.
  • Schools do not have to pay other schools but if they fail to do so then they will not be able to participate any further and will therefore lose the benefits of being part of the virtual mutual.
  • Esphera Solutions will keep schools informed of their virtual balances, absence virtual payment requests, physical payments and efficiencies of all schools in the scheme so that it is always apparent that all schools are receiving equal treatment and that all schools are minimising net costs.

Scheme Inclusions

Schools can choose virtual absence protection by joining the miniMAX Virtual Mutual according to the following guidelines

  • staff must be categorised into one of the following staff categories
    • Administrative staff
    • Caretakers and Premises Management staff
    • Cleaners and Catering staff
    • Headteachers (and deputy Headteachers)
    • TAs/LSAs
    • Teachers (and HLTAs)
    • Support Staff
  • schools must select Teachers and may choose any additional categories they wish to have protection for and all staff in that category must be protected.
  • There is no upper age limit.
  • There are no adjustments to virtual contributions on new staff joining or staff leaving the school during the period of protection.

Schools can request virtual scheme reimbursements for all absences that take place within the Period of Protection (April 1st – March 30th annually) provided they

  • start within the Period of Protection
  • or are ongoing absences that started later than 90 days prior to the Period of Protection (max payment 100 days)
  • are for absence from school due to
    • illness or bodily injury
    • part of a phased return to work
    • an accident at work
    • suspension
    • emergency care for dependents
    • parental leave
    • bereavement
    • being stranded outside UK due to weather or natural disasters
    • organ or bone marrow/stem cell donation
    • religious observance
    • paternity leave
    • jury service
    • union duties
    • * limits apply to some of the above causes and full details will be made available when quotes are requested
  • are not within the “waiting days” period (if 20 working days elapse then the waiting days begins again)

Schools can choose

  • The categories to be covered
  • The daily virtual benefit for each FTE in each category (options from £25-£500)
  • The number of waiting days for each category (options from 0 – 30 days)
  • The maximum number of days virtually payable for each episode
  • Optional maternity and adoption leave protection – schools may choose
    • Choice of categories to be protected
    • Lump sum required for full maternity leave (pro-rata if return to school earlier than 39 weeks)

Exclusions

The scheme will not apply virtual absence reimbursements for absences

  • that take place before the period of protection
  • that take place after the period of protection
  • covering more than 5 days of bereavement
  • due to any fraudulent, dishonest or criminal act committed by the school, any member of staff at the school or any person(s) with whom they are in collusion
  • by any scheme member engaging in air travel except as a passenger in a properly licensed multi-engine aircraft being operated by a licensed commercial air carrier or owned and operated by a commercial concern
  • due to ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from the combustion of any nuclear fuel or a radioactive toxic explosive or other hazardous properties of any explosive nuclear assembly or component
  • due to any consequence of pregnancy or childbirth occurring within 4 weeks of the anticipated date of confinement
  • due to a scheme members’ active participation in riot, civil commotion, strikes, labour disturbances, protests or disputes, and conduct against the public interest
  • due to any act of terrorism which involves the use or release of or threat thereof of any nuclear weapon or chemical or biological agents
  • due to a scheme members’ active participation or involvement in any act of terrorism war invasion act of foreign power
  • due to drug, alcohol or substance abuse

More details to follow – please check back soon. Or if you’d like to register interest now so that you can be advised of next steps please click here. PLEASE NOTE: We have no sales team, there will be no sales calls, you cannot call to join, everything is automated online so you must register to be able to participate.