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Group Health Insurance

Who Is Eligible for Group Health Insurance? 

By December 1, 2021December 10th, 2021No Comments
Who Is eligible for Group Health Insurance 1

Whether you are a small business owner, HR manager, accounts executive handling the HR issues, or an administrative head, it is important to be aware of the distinct eligibility criteria for availing a proper group health insurance policy. Such policies fall under the non-life insurance category. Continue reading the blog to get useful details on this topic.

Prioritizing the eligibility requirements 

As the owner of an emerging business or small company, it is your responsibility to know about the eligibility requirements of your employees and your company to buy a group health insurance policy from a service provider. It would be best if you did not rush in making this important decision. 

From where you can buy the policy

There are many types of group health insurance policies available in the market. The priority is to select the most suitable policy for your employees and your company. There are multiple ways available to purchase a group policy. You can either buy the policy from an IRDAI certified broker, or you can purchase it from the insurance company directly. It is more beneficial to buy the policy from a certified broker as there is more trust and convenience. The insurance broker will be better at providing access to the market, products, costs and take up the overall administration of the program. 

Following the guidelines of the policy is crucial

It is vital to follow the detailed guidelines of the non-life insurance policy you plan to buy. You must read the guidelines thoroughly. Do not skip any point. The document mentions and explains the various features and benefits of the insurance policy. The guidelines are very simple to interpret. You will not face any problem understanding the relevant details. As a concerned employer, you may consult an expert to clear doubts, if any.

Having a minimum number of employees

It is an important factor that you need to consider while buying the insurance policy. There are service providers who sell policies to small to medium-sized businesses having between 7 to 450 employees. Check out the profile of the service provider before approaching it.

The minimum employee requirement varies

Keep in mind that the minimum employee criterion varies according to the terms and conditions of individual insurance policy companies. So, it is important to enquire about the features of the group health insurance policy you plan to buy from a specific seller or broker. 

Transparency is important

One of the important criteria of eligibility is transparency in the process. As a team leader, administrative executive, or HR personnel, when you try to find an additional group member for the sake of buying the policy, the insurance company has a valid right to cancel it altogether. So, you need to avoid doing. Their priority here is to keep everything transparent. It is beneficial for the reputation of the company, too.

The basic eligibility is employment

The basic eligibility for an individual to be included in the group health insurance policy is to be an employer of the organization. In most cases, the policy takes into effect from DAY 1 of the employee joining the company. You can enquire further details with the seller. 

Types of employees eligible for the insurance

As a business owner, you must know about the type of employers eligible for the non-life insurance policy. In most cases, the company is eligible to register the names of only permanent employees under the insurance policy. The terms of the employment contract do matter in such situations. It is important to discuss these issues with the insurance provider. The employer-employee relationship should have a clear definition.

There can be some exceptions for groups

There can be cases where the insurance policy seller does not need a clear employer-employee relationship to provide the facilities. For example, a group of workers associated with the employee welfare association can avail the policy, fulfilling certain conditions. It is crucial to go through the group health insurance policy guidelines to be applicable in such situations.

contributory and Non Contributory Insurance Plans

The eligibility criteria of the group health insurance policies may depend on whether the policy is contributory or non-contributory.

When the employees partially contribute to the policy’s premium payments, it is known as a contributory insurance plan. The employees of the organization fractionally pay the insurance premiums from their gross salaries.

When the employees do not contribute to the policy’s premium payments, it is known as a non-contributory insurance plan. The company takes full responsibility for paying the insurance premiums on behalf of its employees. There is no contribution from the salaries.

The policy can get canceled when a member leaves

It is hugely important to check and re-check the terms and conditions of the insurance policy. The service provider may cancel it when one of the group members leaves the group. Different insurance policies have different conditions. It would help if you were sure about them.

Income bracket can also be an eligibility requirement

Some group health insurance policies place some conditions on the income levels of the employees. The employees in a group have to fall within a specific income bracket to avail the features of the policy. The conditions may vary. Moreover, there are insurance policies that do not have such obligations.

A certain designation can be an eligibility requirement

Keep in mind that there can be cases in which the employees of a group need to hold a common designation. It is rare in cases of a small business. But, do not rule out the conditions. 

Long term benefits

A small business or organization can get good benefits when buying a group health insurance policy for its employees. It leads to creating a secure work environment for the employees. The workers remain motivated to deliver their best. It is a cost-effective method to motivate the workers. Also, your organization can get some considerable tax benefits.

Buy the group policy from a reputable seller

PlanCover is a trusted broker of a wide range of group health insurance policies. It has significant goodwill in the competitive market. You can consider purchasing the non-life insurance policy from Plan Cover for your employees. Give a call to the company to know more details. 

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