Group Medical insurance

Offering group insurance to your employees will help you benchmark within your industry.

Group Medical insurance

A group health insurance plan is a health insurance plan that provides coverage to members of a group that tends to be employees of a company or members of an organization. Members of group usually receive insurance at a reduced cost because the insurer’s risk is spread across a group of policyholders.

General inclusions:

  • Hospitalisation or medical expenses of employees because of an accident or disease
  • Expenses on the day care treatments like cataract, chemotherapy and such processes which require less than 24 hours’ hospitalisation because of advancement in technology overs pre-and post-hospitalisation expenses.
  • Covers expenses as a part of domiciliary hospitalisation
  • Is flexible to cover expenses incurred as a part of day care treatments.
  • Majority policies covers pre-existing diseases without waiting period and maternity expenses.
  • Is flexible to cover expenses on dental treatment.
  • It Can cover for Ayurvedic, Unani, and Homeopathic treatments and medicines.

Advantages of Group Health Insurance:

  • Better Benefits
  • Lower Cost
  • Customised Cover
  • Guaranteed Issue
  • Coverage

In general, group health insurance covers complete hospitalisation expenses such as room charges, doctor & nursing fees, medical equipment & appliances costs for employees and their dependents. Policy can also be customized to add maternity benefits, corporate buffer, higher room-rent limits, baby day 1 cover, Out-patient expenses (OPD) etc.

Individual health policies offers maternity benefit have a waiting period of upto 4 years. In health insurance the waiting period means the insured should be at least be enrolled in the policy for certain period mention in the policy.

A pre-existing disease is an ailment present before the inception of insurance policy. For instance, many of cardiovascular diseases or diabetes is classified under pre-existing diseases.

Premium:

Premium of group health insurance is based on several factors including size and average age of group, type of occupation, type of coverage and benefits opted, and lastly the employer’s claim history. As every factor can result in change of overall policy premium rates, hence all of the factors are deeply analysed by our experts along with client's requirement to choose the appropriate plan.

In case of group mediclaim policy for employees, only employer can claim premium paid for the group health insurance policy as a tax deduction. An employee is not entitled to income tax exemption under group health insurance provided by an employer. Only under individual health insurance bought directly by an employee will get a tax exemption under Section of 80 D of income tax.

Claim:

Documentation plays very important role while making any of the claim. If we submit the correct documents, claim gets settled easily. Few common documents while filing the claim in case of group health insurance policy are respective claim form signed by hospital/doctor, investigation report, final bill with breakup, medical reports and doctor’s prescription. All the documents needs to be submitted in original.

Other benefits:

As stated above in the coverage section, the employee health insurance plan covers all pre-exsiting diseases from day 1. Hence, an ongoing chemotheraphy of a cancer patient will be paid for all the sesissions of chemo. Important point to note here is that insurance company will only pay upto the sum insured alloted to an employee & his family in the group insurance bought by the employer.

Group mediclaim insurance is beneficial for both, employer as well as employees. As a part of employee welfare, group health insurance helps the employer to attract new talent, foster retention of employees, maximize productivity, increase employee satisfaction, and maximize after tax compensation. Offering group insurance to your employees will help you benchmark within your industry.