Group Health Insurance
Group Health Insurance or Medical Covers are brought by employers or business owners for the employees of the organization and their dependent family members. Group health plan is the best way to bring a large number of people under the Social Security cover.
Employees in a progressive organisation are provided many benefits, group health insurance policy being one of them. This benefit allows for payment to hospitals in the event of being admitted for treatment. Depending upon the nature of the business and competitive industry scenario, organisations offer this to employees and their families.
If you’re ready to offer better health benefits to your employees, purchase the best group medical policy that meets your employees' health coverage expectations, as well as your budget. Connect with an experienced group health insurance expert at PlanCover and get their help in buying the policy
Group Health Insurance Coverage
The coverage under this policy is anywhere in India and available for 24 * 7 * 365.
Group health insurance covers the cost of treatment for any illness injury or disease which requires hospitalization for a minimum of 24 hours (except in case of Day Care Treatments which can be done in less than the 24 hour period viz Cataract, Dialysis, Chemotherapy, Radiotherapy etc.)
In a group health insurance cover, an organisation can tailor make terms which otherwise are excluded in a typical retail policy. These include:
- Cover for Pre Existing diseases.
- No waiting period of the first 30 days.
- No waiting period for 1st/2nd year excluded treatments/ailments viz Hernia, stones etc.
- Coverage for Maternity - with/without 9 months waiting period.
- Baby Cover from Day 1 of birth ( normally covered after 90 days).
- Amount of Maternity - for Normal Delivery & C-Section.
- Including/Removing capping on certain treatments like Cataract, Hysterectomy, stones etc.
- Corporate Buffer - in case any employee exhausts his sum insured, then, at the discretion of the management, an additional amount can be given by the insurer for that employee/family.
- Co payments ( amount to be borne by the employee as a percentage of claim ) - introducing this feature to reduce premiums.
FAQ's
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What is group health insurance policy?
A group health insurance policy is a type of policy that provides health coverage to a group of people. The size of this group can be any. Employers invest in group health insurance plans to offer their employees health benefits, which is mandatory in many countries.
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How does group health insurance work?
A group health insurance works just like any individual insurance policy, only it’s paid by the employer, or is split between an employee and the employer. Every insurance company has a network of hospitals where treatments for subscribers are covered. Once the employee is enrolled in the group health plan, they will receive a card. They can use this card at select hospitals for treatment under insurance coverage.
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How does group health insurance work?
A group health insurance works just like any individual insurance policy, only it’s paid by the employer, or is split between an employee and the employer. Every insurance company has a network of hospitals where treatments for subscribers are covered. Once the employee is enrolled in the group health plan, they will receive a card. They can use this card at select hospitals for treatment under insurance coverage.
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How much does group health insurance cost?
The cost of group health insurance plans vary, depending on several factors, including the number of subscribers, insured amount, coverage area, and more. Get your free quote of the group health insurance premium.
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Does group health insurance include dental?
This depends on whether or not the employer decides to include dental under the group health insurance coverage. Generally, dental is not included in health insurance and is purchased as an add-on.
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Who offers group health insurance?
Almost every major insurance company in India offers group medical insurance policy for employees. Basic research can help you find a good group health insurance company.
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How to get group health insurance?
You can approach a group health insurance provider to purchase the policy. Alternatively, given there are so many factors that need to be considered, you can approach a group health insurance broker. They can help you find the best group health insurance plans and pick the right one. To that, the brokers can also assist you customize the group health plan if needed to adequately suit your needs and budget.
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What are some exclusions which can be covered in Group Medical or Health Insurance?A HR of a Corporate can cover the following exclusions from day 1 in Group Medical or Health Policy:
- Pre-Existing coverage from Day 1.
- All waiting period can be removed from day 1.
- Dependent Parents can be covered from day 1.
- Maternity and new born baby benefits can be taken from day 1.
- Treatment for named Congenital Disease can be taken for new born baby from day one.
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Do Group Health/Medical Insurance policies cover pre and post hospitalization expenses on treatment?All health insurance policies give pre and post hospitalization benefits generally 30 days of pre-hospitalization benefit are given but some plans give pre-hospitalization benefit up to 60 days. For post hospitalization 60 days is a norm but some plans give 90 days cover for post hospitalization.
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Do the expenses occurred on diagnostic and pharmacy on OPD basis are payable under pre and post hospitalization?If diagnostic tests undertaken lead to confirmation of illness treatment for which needs hospitalization then expenses occurred as OPD for both diagnostic tests and pharmacy bills can be claimed as reimbursement.
All expenses incurred on Pharmacy and diagnostic tests which are recommended on OPD basis as confirmation of treatment and recovery from illness can be taken as reimbursement. -
How period of insurance is defined under the policy?Under the policy the group administrator or HR department of a corporate is issued a master policy with details of existing employees at predefined premium rate per life as and when a new employee joins he is added into the policy and as and when an employee resigns/retires from the organization the policy his name is deleted.
The policy period is defined as:
The master policy is issued for 365 days and person is charged/refunded pro-rata premium from the date of joining/leaving his/her insurance period can vary from 365 days to less than 365 days.
The Term of the policy is 1 year which can be extended by regular and timely renewal every year. -
Can any risks/benefit be deleted or not covered or added?Yes, HR of the corporate can add or delete a benefit before the start of the policy, some have been explained earlier there are few like Co-Payment, Limitation of expenses, and Limitation on eligibility of room. OPD expenses, Dental coverage etc. are few other which can be added.