Category: Group risk fundamentals · Reviewed by Taylor Watts, Broker · New Business · Last reviewed 2026-06-10
An eligible employee under a group risk scheme is an individual who satisfies the scheme’s eligibility category as set out in the trust deed and policy schedule. The eligibility category typically defines a class of employees by reference to their employment status (permanent, contracted), category (all employees, executive only, hourly paid etc.), age range (16 to cessation age), and any qualifying period of service.
Category: Group risk fundamentals Also known as: Eligibility category Related concepts: Active member, Continuation option group risk
Eligibility is the gateway to membership; only employees who fall within the defined eligibility category are insured. Categories vary — a single all-employee category is the simplest; some schemes have multiple categories (for example, executives covered for higher multiples of salary). Eligibility may include a qualifying period of service (e.g. six months) before which a new joiner is not yet covered, although for group life many schemes provide cover from day one.
The eligibility category must be drawn so as not to indirectly discriminate against any protected characteristic under the Equality Act 2010. Particular care is needed in age-based categories (the Equality Act 2010 (Age Exceptions) Order 2012 permits certain age-related distinctions for insurance, but employers should take advice before using age in eligibility design). HMRC also requires that registered group life schemes do not target a single member or an artificially narrow category.
The eligibility definition affects: (i) the headcount used for premium calculation; (ii) which employees are covered on day one of joining; and (iii) the scheme’s underwriting basis (broader categories qualify for higher free cover limits).
A scheme’s eligibility category is “all permanent UK employees aged 16 to age 70, on completion of three months’ service”. A new joiner on a six-month fixed term contract is not eligible (not permanent); a permanent employee aged 71 has ceased eligibility (over cessation age); a new permanent joiner on day one is not yet eligible (three-month qualifying period).
This entry is part of the Apex Insurance Wiki. Last reviewed by Matt Bartlett on 2026-06-10. Next review: 2026-12-10.
Apex Insurance Brokers Limited. Authorised and regulated by the Financial Conduct Authority, FRN 724952. Registered in England and Wales, Companies House 07014570. This entry provides general information about UK insurance concepts and is not regulated advice. Consult your insurance broker on your specific position.
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