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Group Health Insurance

Who can be covered under Group Health Insurance Plans?

By December 2, 2021No Comments

Group health insurance plans are suitable for any organization or business. Whether your business is large-scale or small-scale, employee insurance plans are certainly beneficial in the long run. It not only helps the employees to lead a stable life but also brings better employee retention for the business. But not every business can offer group health insurance plans for the employees. There are certain rules and regulations specified by the Insurance regulatory body, IRDAI, that a business must follow for getting policy approval. 

Who may be covered under Group Health Plans?

As an employer or business owner, when you offer a group health insurance plan to your employees, they get benefits through the insurance coverage. But who are all the beneficiaries of the policy? The employee benefits are similar for any insurance company plan that you pick, but the family benefits may vary. In many insurance policies, there is similar medical expenditure support for the family members of the employee. Along with the direct employee, the dependents (including parents, spouse, and children) also get plan coverage. However, the norms and features of the selected insurance specify if anyone other than the employee can get the benefits or not. 

Usually, the insurance plan that includes family members as beneficiaries does not include support to extended families like the in-laws and relatives. The rules are variable; thus, as a policy-holder or a beneficiary, you should review them before getting admitted to a hospital or claiming a reimbursement. 

Who is eligible for group health insurance policy?

Is every business eligible to provide its employees with a group health insurance plan? No. The rules defined by IRDAI mention the employee-related eligibility criteria that the businesses must ensure for getting the policy approval. The insurance regulatory body in India specifies that for acquiring a group health insurance policy for the employees in a business, the minimum number of working employees must be at least six. For buying an insurance policy from an insurer, the number of employees should range between 6 to 450 for mid to small-sized businesses. But the regulations of the insurance companies vary, which you should always discuss before buying one. 

Can all businesses buy group health insurance?

Every business cannot offer group health insurance policies to their employees and their families. If the business or organization does not satisfy the eligibility criteria, then the policy will get rejected. Reading the guidelines is a must, or you can directly connect to a professional to clarify the matter. The insurance brokers or representatives of the insurance companies can help you out by providing specific and authentic details about the concerned policy. Follow the mentioned guidelines for avoiding rejection. For example, if you own and run a business with no full-time employees, your business can not get approval for the policy

What about family businesses?

In India, there are many family businesses where most of the employees are related to each other. These businesses can also fall under the eligibility bracket for the approval of group health insurance. The minimum criteria of six primary members ( employees) should be satisfied to purchase a group policy. For family businesses, the relation between employer-to-employee needs to be mentioned rightly for getting the policy approval. 

What are the benefits of group health insurance for employers and employees?

Whether it is a family-run enterprise or a regular business, the need for having employer group health insurance is a must. It encourages the practice of employee rights and thus develops a healthy relationship between the employer and the employees. Both the employer and employee gain through the policy features and coverage. While the employer gains long-term employee retention and tax cuts, on the other hand, the employee enjoys the coverage benefits. 

Medical expense coverage

For an employee working at an organization, nothing is more significant than the treatment that they get from their employers. Providing them with a medical insurance benefit acts as a gesture of gratitude and thoughtfulness on the employer’s part. Thus, they get encouraged to work harder and remain associated with the business for availing of the medical expense coverage benefits. With the group health insurance plan, the employee can enjoy – 

  • Cashless treatment at hospitals for the treatment of ailments and surgeries
  • Reimbursement of medical expenses for treatment and diagnosis
  • Extended health insurance support for dependable family members

All inclusive insurance benefits

Health insurance plans bring shared benefits and stability for employers and employees. The higher employee retention aspect is profitable for both parties for gaining stability. Insurance acts as a tool for bringing better productivity. With the onset of the pandemic, the need for group insurance has increased, and thus, more businesses are finding the right insurance service to protect the well-being of their employees. 

How do I choose the right Group Health Insurance for employees?

As a business owner or an employer, the key task for availing of the mutual benefits of group health insurance is to identify the right policy. Either you can approach an insurance company directly or seek the assistance of an insurance broker. Opting for an insurance seller is a wiser call as you get to browse so many different policy options with them. They offer a range of insurances from the leading IRDA-approved list of companies. 

Leading insurance broker at your service

Get the group health insurance plan for your employees by connecting to a leading insurance broker like PlanCover. 

PlanCover brings you a one-stop solution with the available list of insurance companies that offer group health insurance for businesses of all sizes. Connect to the assisting team of PlanCover and resolve the requirements and doubts that you have in mind. 

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