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Group Insurance

Group health insurance provides coverage to a specific group of people such as employees of a company or members of an organization. Also known as a corporate health insurance policy, the insurance coverage under this health insurance policy usually includes accidental hospitalization COVID insurance, daily hospital benefit, critical illness cover, maternity coverage, etc.

Key Features:

  • Some policies may cover boarding expenses apart from surgeon, anesthetist and consultant fees; charges for anesthesia, oxygen and diagnostic materials in addition to X-rays and dialysis costs among others.
  • Offer cashless facility and direct settlement of bills with the hospital.
  • Offer to cover pre and post-hospitalisation charges for a specific period.
  • Some policies may offer maternity benefits.
  • Less than 24 hours hospitalisation for certain procedures such as chemotherapy, eye surgery and tonsillectomy among others.
  • Extended cover for certain critical ailments above hospitalisation benefits.
  • Some policies may provide cover for pre-existing diseases after payment of extra premium.
  • Some policies may cover domiciliary expenses.
  • Some of the optional benefits include waiver of waiting period, first year exclusions besides reimbursement of ambulance charges among others.

Understanding Group Health Insurance Policy:

  1. Why do companies offer health insurance?

    It not only helps retain but also boost the performance of employees. Also, it goes a long way in creating a loyal workforce. In some cases, employees may accept better health benefits instead of higher remuneration. It helps reduce absenteeism in the company and improves morale of employees.

  2. What are the other benefits companies enjoy for offering employees health insurance?

    Companies get tax breaks for offering health insurance policies. In some cases, a health insurance policy is part of an employer’s statutory obligations.

  3. How do employer health insurance plans fare in terms of pricing?

    Low premiums may get more weightage but it could, in some cases, lead to exclusion of several important features.

  4. How about co-payment clauses in the policy?

    No co-pay plans are ideal for customers but insurance companies resort to co-payments to cut their costs. For instance, about 20 per cent of group health insurance policies offered by New India Assurance include a co-payment clause.

  5. Do group or corporate health insurance policies cover a wide range of diseases?

    Your policy may provide cover for a wide range of ailments in addition to accidents which need ‘in-patient’ hospitalization. Besides, you can opt for a critical illness cover as well.

Advantages of Employee Health Insurance Policies:

  • It provides an additional health cover for employees who already have an family or individual health insurance policy
  • Employees, by and large, are not asked to go for medical check-ups and usually get policy cover from day one.
  • Employees, in some cases, can avail of certain maternity benefit.
  • A group health insurance plan is cheaper (usually 30%) than individual health plans. Premiums in the former are lower in relation to the sum assured compared to individual health insurance policies.
  • group health insurance policy is, by and large, easily available to employees of a company.
  • In many cases, pre-existing medical conditions of the employees are covered by group insurance policies.
  • In most cases, employees are not denied health coverage based on their age or past medical history.

Who should buy this plan?

Group or corporate insurance is provided by employers to employees in an organization as opposed to an individual health insurance policy. The insured employees pool into the policy and can, therefore, claim health coverage as and when the need arises.