A group health insurance coverage can protect a group of people who are members of a company, organization, association, or community. Group health insurance is a type of health insurance that provides coverage to the employees working for an organization. It is a necessary service supplied to all employees in order to protect them from any potential health problems. Because the premiums are paid by the employer, it is a vital benefit for any employee who works for a corporate organization.
The Indian work culture is completely interlinked in terms of processes where people and work require constant discussions, communication and coordination on a regular basis. Therefore, various companies, working on the work from home model, have either reverted to work from the office or introduced a hybrid model where selective employees are being called to the office.
While, the employees are inching back towards their workplace, but, with a worry in mind that what if they catch the infection and above all if they infect their family members as well. Therefore, the employer must take the initiative to ensure the safety of the lives of their employees with the help of Employee Group Health Insurance.
Employee Group Insurance is a service provided to the employees of an organization in the form of a health insurance plan. In an employee insurance policy, the employees get insurance cover at a reduced cost as the provider's risk is spread across a big number of policyholders.
This initiative will help workers in working with a free mind and without any tension worrying about the medical expenses to meet in case they catch the coronavirus. Also, in times when the life requirements and priorities have changed, employee health insurance can help the organization in increasing the retention rate, employees' motivation, their physical health and mental well-being.
Ideally, the organization should offer a health care plan to their employees that seriously turns out to be a supportive entity at the time of emergency as well as come affordable for the employer. Hence, here are some parameters to consider at the time of buying an employee group insurance:
Sum Insured is the amount that is allotted to each employee in the case of hospitalization. The sum insured allotted to each employee should be enough to manage the expenses of medical requirements of any disease, especially in the times of COVID19 when the medical inflation has increased. Also, the sum insured should be finalized as per the residing city of the employees as the medical cost varies from metro cities to Tier I & II cities.
Room rent is the bill for the hospital rooms except for the cost of medication, doctors' visits and medicines. It is generally seen that the room rent limit has been kept the lowest to save the cost. However, in an employees group insurance, the lower room rent limit can cost high to the employee who is admitted in the hospital, if they take a room with a higher cost. In this case, the employee will have to pay from his pocket which can create a burden on his/her shoulders. Hence, the health insurance plan for employees must cover the cost of up to a single private room.
A health insurance plan can come at a very low cost as well but they might not be able to serve employees with a sufficient number of hospitals for the cashless facility. The health insurance service provider must offer a long list of network hospitals located in different parts of cities to be accessed by all employees.
Adding riders into the plan is a good option to enhance the plan to make it more helpful and supportive for employees. The organization can select riders depending upon the nature of the business or the majority of staff members. For instance, if a company has a huge number of riders then accidental rider benefit can be clubbed with the plan or if the company has a majority of young employees then maternity benefit can be taken for the employees.
The biggest distressing aspect of insurance plans is the waiting period where some diseases are put under the cap of a certain duration for compensation by the insurance company. But a medical emergency can arise anytime without any prior intimation. Employees Group Scheme helps in eradicating the waiting period by paying an extra premium. As a rule of thumb, it is strongly advised to opt for waiver of waiting periods in group health insurance plans.
Group mediclaim policy is not only limited to cover the employees of an organization but the benefit is also extended to their family members like self, spouse, dependent children and dependent parents. This plan is also known as corporate health insurance or employee health insurance by individuals across the globe. A plethora of features and benefits are offered under the group health insurance like hospitalization expenses, pre-existing diseases, pre and post-hospitalization, daycare expenses, maternity expenses, and more.
| Group Health Insurance | Individual Health Insurance |
| The organization is the one-point contact for all the necessary details required by the insurance provider | Individuals are themselves responsible to disclose their personal information and fill out their details correctly in order to avail an individual health insurance |
| Individuals can not cancel their policy on their own, the employer has the right to discontinue any health insurance policy purchased for the employees | Individuals can cancel their own health insurance policy |
| Group Health Insurance Policies are valid for an employee as long as he/she is the part of the organization | Individual health insurance policy is valid for the policy tenure mentioned in the policy after which individuals must renew their health insurance policy |
| Group health insurance policy is relatively affordable | Individual health insurance policy is comparitively expensive |
| No pre-policy medical check-ups required to avail a group health insurance policy | Pre-policy medical check-ups may be required under certain terms and conditions in an individual health insurance policy |
Employee Health Insurance provides coverage for the following things depending on the requirements of an employee:
Group Health Insurance Policy does not cover the following:
There are multiple key features surrounding a group mediclaim policy through which an employee and their family member can benefit from that are listed below:
Organizations cherish their employees and with a global pandemic destroying several enterprises owing to staff loss, the corporate industry has realized the importance of being employee-centric even more.
Employees and organizations profit from being employee-centric and putting themselves and their immediate families under the protection of group health insurance. We have mentioned a few reasons why group medical insurance is essential below.
We have listed below the benefits of group health insurance policies:
The first step to understanding the working of a group health insurance is to understand that first and foremost, a group Health Insurance provider is selected to cover the employees of an organization. After the selection of the insurance provider, the working plan is selected and customized based on the industry the organization belongs to. For example, if someone works with a mining company the coverage of a group medical insurance will replicate the risks taken by the employee. The premiums are paid by the organization providing the group mediclaim policy.
The organization provides a uniform mediclaim policy to all its employees. However, the employee has the freedom to opt for additional coverage for their spouse, dependent children, or parents on an additional premium.
To understand the claim process of a group health insurance read the points given below:
There are certain documents required for the claim settlement process of a group health insurance that is mentioned below:
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Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.
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