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Everything you need to know about Group Health Insurance

group health insurance

Employees are an integral part of an organisation. With growing awareness, companies are focusing on what they can provide to their employees, to improve their overall lifestyle, so that they start providing better results. Corporate health insurance plays a significant role to hold on to that valuable talent. The employee feels protected against any medical incidents/injuries that might occur.

What is Group Health Insurance?

Group Health Insurance is a medical cover provided to a group of individuals in an organisation. According to IRDAI, a group can be an employer-employee or a non employer-employee group. Group health insurance is provided to all the members of the organisation after each member is provided with the certificate of insurance.

Features of Group Health Insurance

  • The group medical cover usually covers the spouse, dependent children and parents in the policy alongside the employees themselves.
  • The employees can avail the benefits of the policy and get the treatment done all over India and the claim will be processed.
  • The maximum age of entry for the policy is 65 years for adults and 18 years for dependent children. However, dependents can be added from day 1 (i.e. from the time of birth) which varies to 90 days (from birth) depending on the policy terms and conditions.
  • The employees can avail cashless hospitalisation in any of the empanelled hospitals which makes the payment process hassle-free. Claims are processed in a jiffy just with the E-Card.
  • Hospital expenses incurred as an inpatient due to an ailment and pre and post hospitalisation of 30 and 60 days respectively is covered.
  • Covers ailments like chemotherapy, cataract surgery which require hospitalisation for less than 24 hours as day care procedures.

Who should buy?

A group health insurance can be bought by any legally formed group of people. It can be a group formed for commercial purposes or for non-profit purposes. The groups can be profit-making organisations, educational institutions and NGOs.

What’s in it for you?

  • Waiver of Pre Existing Diseases – Any disease that existed before the inception of your health cover is waived. So if the patient is suffering from diabetes, he/she will not have to worry as it will be covered under the group health policy.
  • No Medical Examinations – The best part about group health insurance is that no medical checkups are required which is not the case in retail health policies. One can claim for any ailment right from the date of inception of the policy.
  • Maternity Benefit – Employees get maternity benefit for themselves or their spouse for normal delivery as well as C – Section without the waiting period of 9 months. This exclusive benefit is not provided in the individual health policies for such low premiums.
  • Dependent Addition – The employees can add their dependents in their group mediclaim policy including spouse, dependent children, dependent parents and in – laws based on the policy terms and conditions.
  • Waiver of the waiting periods – There is no waiting period for any pre existing disease. A new born baby is also covered from day 1 of birth.
  • Tax Benefits – Not only the employers, benefits are not taxable to the employees as well.

However, there are certain restrictions that employees need to keep in mind.

  • Employees cannot claim after their tenure from the organisation is complete.
  • You cannot make changes to the policy benefits after the issuance of the policy till the date of the renewal of the policy.
  • Companies decide the benefit in the medical cover at their own discretion which makes the policy inflexible and rigid for the employees.
  • Many companies might not offer coverage for parents.

A healthy workforce, surely we can help!

Group Health Insurance helps the company to mollify the risks of the employees which keep the employees motivated at work. A health insurance makes sure that the employees are covered from the financial instability that they may face at the time of health risks. It also attracts talented resources to the organisation.

We at PlanCover are here to provide you get the best group health insurance for your company from the various insurance companies. We will do all the work of finding the right cover for you with the best benefits market has to offer at minimum premium costs by comparing the best health plans.

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