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Group Health Insurance

How do I choose the right group health insurance plan for employees?

By December 4, 2021December 10th, 2021No Comments
How do I choose the right group health insurance plan for employees 1

A group health insurance plan for the employees is currently mandatory for all organizations in India. All employers need to find the best group policy for the employees. These policies are beneficial for both the employees and the employer. How? While the employees can enjoy plan coverage during treatment, at the same time, the employers can improve employee retention and get tax benefits. All these reasons make the policy an effective tool for ensuring the well-being of the employees and the organization. 

Know your options first

Are all the group health insurance policies that you find on the internet right for selection? The selection is not that easy with so many options present in the market. Determining the best insurance plan needs careful evaluation. 

  • Firstly, get a clarified view of what you, as an employer, want to offer to the employees. 
  • Secondly, think from the perspective of the employees to get an idea of what insurance would serve best for them. 

After you are clear with the requirements, you can then start looking for the options you can buy. But before browsing the policies, the employer needs to explain the priorities. 

  • Check the eligibility factors

Different insurance companies have a diverse set of rules for policy coverage and approval. If you approach the insurance company directly, they can clear out their norms and regulations. If you connect to an insurance broker, they can offer you a comparative report on the norms and rules of the different insurance companies. The best way of identifying the right group insurance plan is by seeking the advice of reliable insurance brokers. PlanCover brings the best policy offers to you from all the IRDAI-registered insurance companies. You can connect to their team and consult about buying the best policy. All you require is to specify the details to the assisting team, and they will provide all the essential details to make the selection easier. Call their support team and get started without any second thoughts.  There are certain rules as well that define the eligibility of a company for getting policy approval. Know these eligibility factors first and then decide. 

  • Compare the features of the policy

With so many insurance companies and plans available, selecting the right one among the rest can get confusing. In such a case, reaching out to an insurance carrier or a broker can help largely. They have a list of offerings and can guide you with the policy benefits of different insurance companies. Thus, without wasting time by searching by yourself, you can always seek the assistance of the insurance brokers. Always pick the policy that takes care of the interests of the employees and is affordable to the organization’s expenditure estimate. 

Points to note in the policy coverage

The insurance coverages can differ from the opted policy. As an employer, you are responsible for making the final call to buy the policy. You need to ensure that the policy coverage is maximum under the suitable premium plan. Thus, there are certain points that you have to evaluate for determining the right option for your valued employees. 

Following are the seven crucial evaluating points to understand if the coverage benefits are truly advantageous for the employees. 

  1. The network of hospitals

Medical emergencies never come with prior intimation. An employee of your organization may need medical treatment anytime and anywhere. A policy that offers Pan India cashless medical coverage is the best for your choice. The wide network of hospitals under the cashless facility helps the employee to stay worry-free during medical emergencies while they are away from their city or state. 

Cashless facilities at the hospitals help in offering the patient a stress-free experience. They can produce their policy cards and ID proofs to get admitted without any hassles. Many group health insurances do not offer such benefits, for which the employees face troubles in the later stages. Ensure that your employees do not have to go through such inconvenience by choosing a suitable policy for them. 

  1. Treatment coverage for pre-existing diseases

Not every group health insurance plan offers treatment coverage for pre-existing diseases. Thus, they have to undergo financial distress to get the treatment done. As a result, many employees may leave the job and look for better opportunities to avail themselves of such benefits. Why take the risk of losing a valuable resource to the company? As a responsible employer, you should go for a policy that grants complete coverage for any pre-existing ailment treatment and does not require a waiting period for cashless facilities. 

  1. Complete coverage for all medical expenses

When an employee gets hospitalized, the expenses do not limit to the bed charges and doctor fees only. The accessories used for the treatment like medicines, diagnostics charges, , nursing charges, ambulance fees, and much more get added to the overall bill. A policy should support such expenses as well. Thus, you should look for insurances that support treatment coverage and other expenses related to medicinal accessories. 

  1. Testing charges coverage

When a patient gets hospitalized, there are a lot of tests that get done before and after the actual treatment. Even before getting admitted, doctors make the patients undergo several diagnostic tests to determine the treatment course. The medical expense increases when you accumulate all these charges. A health insurance policy needs to cover all these expenditures to provide genuine support to the employee. 

  1. Maternity and newborn medical expenses

Maternity coverage for the female employee or the spouse of a male employee should be a part of the policy benefits. The complete course of pregnancy and delivery is a long process and involves a lot of expense. The policy needs to cover the requirements attached to maternity and childbirth. Check if the policy covers maternity expenses and the medical expense of the infant from their birthday. 

  1. Coverage for employee family members

The purpose of providing group health insurance policies to employees is to help them lead a peaceful life. For this, the policy needs to look after the medical expenses for the family members as well. Comprehensive policy coverage is the most advantageous for any employee. Bearing the medical expense for the dependent family members can create financial and mental pressure. Thus, as an employer, if you want to look after the overall well-being of the employer, always find a policy that covers treatment for the spouse, children, and parents. 

  • Enquire about the settlement process and waiting period

If an employee does not avail of the cashless facilities at the hospital, they can always claim for reimbursement. The procedure of reimbursement and the efficiency of the insurance company can be a tricky point when it comes to selecting a policy plan. How can you determine if the insurance company you have picked has efficient processing for claim settlement? Either go with the word-of-mouth reviews of their policy-holders or get an expert opinion from the insurance sellers. The brokers deal with so many insurance companies, and thus they can clarify the pros and cons of the policies and companies. PlanCover has been helping customers with claims servicing that is impeccable. The team is experienced and subject matter experts who can help in evaluation of both cashless and reimbursement claims under the policy.  

Ensure a hassle-free policy buying experience: You would not want your employees to face troubles with your offered policy as an employer. Ensure that the policy coverage and overall benefits are suitable for them before finalizing the selection. 

Coming to the cost factor

Now that you know what points to look for, the next part is to look after the overall cost that the company has to bear. As an employer, you have to pay the premium so that the employees can enjoy hassle-free plan coverage. Thus, suiting the interest of both employer and employee is a must. So, compare the premium prices alongside the plan offerings to find a complete overview of the right insurance policy under your budget. Some of the most important factors that you need to consider for evaluating the cost include:

  1. Sum insured and premium

What you pay to the insurance company depends not only on the age of each member, but also largely on the sum insured of the plan. It would help if you decided the policy sum by reflecting on the inflation rates and increased charges of medical treatments. Whichever plan you pick, it should insure sufficient sum to the employee to carry out their treatment in metro cities in India. 

  1. Limitations for room rents

The bed charges and hospital room charges may vary depending on the hospital the employee gets admitted to. The rent can be highly expensive in many hospitals, for which the overall expense exceeds the insured sum. Many insurance companies do not support the rental costs, which is a big drawback. As an employer looking for the right policy option, you can easily eliminate this flaw. Go for a policy that does not limit room rents and bears the charges as a part of the insured sum. 

  1. Demographic profile 

The count and the age of the members/lives is an important factor for determining the cost of insurance. Members with a higher age will be required to pay a higher cost of health insurance and hence a company needs to decide the ideal family composition that will be considered for insurance. Adding dependent parents is certainly going to inflate the cost of insurance. You stand to get an additional discount if you include spouse and children in the plan when compared to employees only.

  1. Policy coverage and benefits 

Group health insurance premiums are largely dependent on the coverage you want to provide to your employees. If you opt for day 1 coverage for all diseases, conditions and illnesses, then you will be paying a higher cost. Adding maternity benefit coverage also will increase the cost of insurance as the probability of claims for childbirth and care are far higher than sickness-related hospitalization

All these discussed points play key deciding factors while you purchase a health insurance plan for the employees. Find the right one by consulting a top-rated insurance broker.

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