Individual or group health policy? A big question mark when it comes to selecting one from the two plans! While many would say individual policies are better as you have the power to pay the premiums and customize them, the same reason can become a financial burden at times. If you think carefully, the benefits of having a group health policy are more than a personal healthcare plan.
Know the basic difference
Before getting into the details of switching the policies, know the features. In an individual health policy, you can pick the insurance plan as per your financial capacity. You decide the insured sum and benefits that you require. On the other hand, in group health policies, the employer picks a policy for the employee. The employer pays for the premiums without charging you for it. You can think of it as a service benefit to the company. Here the employer selects a group plan for the employee that may or may not cover their family members.
Know about the portability regulations
Many are not aware that there are rules to port your insurances. You can now switch from an individual policy to a group health policy and vice versa. IRDA, the insurance regulatory body in India, has set regulations that make you eligible to port.
Know the rights:
- You can port any family or individual healthcare insurance plan.
- You can port from an individual health insurance policy into a group health insurance plan subject to compliance with the coverage conditions under the group insurance policy.
- You can port the group plan to an individual plan by changing the insurance company only after the second year. As per guidelines of portability, the insurer should be the same as per your group plan in the first year when you port the plan to individual.
- The new insurer should offer you pre-earned credits like – waiting period for pre-existing ailments, etc.
Time to port: Certain conditions are also there that determine the right time for porting under the IRDAI guidelines.
- You may port your policy during the time of renewal and not before or after that.
- The premium amount may vary depending on the insurance company you select.
- If you want to port, inform your existing insurer before 45 days from the renewal date. You have to apply for a policy shift and specify the details.
- You have to renew the policy without any breaks. However, if the porting is under process, you can enjoy a grace period of 30days.
How to switch?
As an individual healthcare policyholder, you can switch your plan to employer healthcare insurance. All you require is to follow the regulations mentioned above(stated by IRDAI). The best way is to connect to an insurance company representative and ask them to guide you. The Guidelines on Migration and Portability of health insurance policies published by IRDAI states that any individual policyholder (including family members under family floater policies) may switch to a group healthcare policy if the members agree to the rules and norms of the new policy. **
Reasons to switch
Individual health policyholders may have different reasons to shift their policies or switch them. Of late, many people are preferring employer healthcare policies over personal insurance plans for the following reasons.
- A more economic option: When you select an individual policy, you have to pay the premiums. It is a financial responsibility that you cannot ignore at any point. Not paying the premium within the due date leads to policy cancellation. Thus, you have to stay financially prepared to meet the needs. In contrast, the group health insurance benefits are practically free of cost! Your employer is responsible for paying the premium. You can enjoy the medical coverage and plan benefits without spending a penny from your pocket. Isn’t it a better option?
- A stable professional and personal life: With individual policies, you are the one who benefits from the plan coverage (unless it is a family healthcare insurance plan). The premium you pay only helps in covering your medical expenses during emergencies. On the other hand, in a group health policy, you get a comprehensive solution! The policy covers your medical expenses and that of your dependent family members. Most employer policies offer a comprehensive medical package for employee benefits. Thus, you gain stability in your personal life and get to save those extra bucks for retirement plans.
- Gain peace of mind: When you are responsible for paying the premium on time, there is always mental anxiety. You have to stay well-prepared to meet the requirements. The premium price varies depending on the tax and additional charges. The sudden hike in insurance plans or inflation causes the premiums to rise. It may become a financial concern for you when you go for personal healthcare plans. In group health policies, you can relax as it is no longer a monetary responsibility on your part. The employer will pay the amount at the right time so you can enjoy the plan coverage and medical benefits during emergencies.
- Option to customize: Who said you cannot customize the group plans? There are provisions for add-ons in employer health policies as well. All you require is to consult with your employer and ask their permission to add on medical benefits to the existing insured sum. You may pay the premium for the add-on benefits or, the employer may offer a part of the extra expense. The decision depends on the norms of the organization where you are working and the policy you have selected. You have to consult with the employer and the insurance broker or company representative to know the process better.
Can you keep both?
You can enjoy plan coverage for more than one health insurance. Even if your company offers you a group health policy, you can also buy another one. However, it only increases the financial responsibilities for which keeping one healthcare insurance plan is sufficient for most. There are no legal limitations with the number of insurance policies you can avail of. As long as you pay the premium and due charges in time, you can enjoy the plan coverage without any issues.
Who can offer group health insurance?
The employer of the organization can offer you a group health policy plan. Most companies (small or mid-size) offer such employee benefits. If an organization has more than seven full-time employees, then the employer can buy the policies for them. The employer chooses the sum insured and whether it will include plan benefits for the dependent family members or not.
The validity of a group health policy is usually till the end of your service period. However, the decision-maker is the employer who may extend the benefits even after retirement. In case the employer does not offer such a plan extension, you can always switch the group policy into a personal healthcare plan before retiring or leaving the job. You will continue to enjoy similar benefits after you switch the group plan into an individual policy by paying the premium by yourself.
The advantage of having a group policy throughout your service life is that you can save lots! If you worry about the after-retirement medical facilities, you can always switch it before the plan gets stopped by the employer. An insurance broker may help you with the paperwork and elaborately explain the policy shift.
What happens when you switch jobs?
After you have switched your insurance into a group policy, you can enjoy the medical benefits till the end of your service period. For any unfortunate case of employment sack or if you decide to switch jobs, what will happen to the policy? If an organization sacks you then the decision of continuing the policy tenure depends on the employer. They may continue it till a period or cancel it immediately. When you decide to quit the job, you can switch the group policy into a personal one to keep enjoying the plan coverage. If you join another organization, you can again shift back to the group policy if you want to or keep them both.
Can you increase the limits in group health policies?
As the employer is responsible for paying the premiums, they decide the sum. Usually, for small to mid-size startups or businesses, the insured sum for an employee ranges between Rs.2 lakh to Rs.5 lakh. But you can always use the add-ons to increase the limit. However, you have to seek permission from the employer first and let them know what you additionally need with the existing policy. You can discuss the regulations and procedure of limit increment with your employer and the insurance representative to follow the right way.
Know from the experts
If you hold an individual health policy and want to switch it into a group plan, connect to an insurance expert. They are the ones to guide you with the techniques. Join an organization where they offer such Mediclaim benefits to their employees so that you can easily switch your policy.
PlanCover – Always at your service.
As an employer, you have to find the right insurance company to ensure your employees get the best benefits under the insured sum. PlanCover, a high-rated insurance selling company offers excellent assistance to employers who want to buy a group health policy. They offer policy plans from all the leading IRDA-approved companies in India and present you with the best as per your requirements. Contact their team and know more about the different regulations attached to group health policy.