{"id":1605,"date":"2021-12-01T22:22:02","date_gmt":"2021-12-01T16:52:02","guid":{"rendered":"https:\/\/www.plancover.com\/insurance\/?p=1605"},"modified":"2022-01-22T23:42:49","modified_gmt":"2022-01-22T18:12:49","slug":"is-group-health-insurance-mandatory-for-employees-in-india","status":"publish","type":"post","link":"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/","title":{"rendered":"Is Group Health Insurance Mandatory for Employees in India?"},"content":{"rendered":"\n<p>A group health insurance policy is a form of non-life insurance policy that is applicable for a group of employees working in a company. Each employee who is under the scheme of the insurance policy equally benefits from it. Moreover, the employer gets a wide range of benefits by purchasing the policy. Continue reading the blog to know more details.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_66_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<p class=\"ez-toc-title\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a15477591052\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a15477591052\"  aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#It_is_mandatory_after_the_pandemic\" title=\"It is mandatory after the pandemic\">It is mandatory after the pandemic<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#An_Employer_Pays_All_of_the_Premiums\" title=\"An Employer Pays All of the Premiums\">An Employer Pays All of the Premiums<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#The_policy_aims_for_a_basic_coverage\" title=\"The policy aims for a basic coverage\">The policy aims for a basic coverage<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#IRDAI_has_made_it_mandatory\" title=\"IRDAI has made it mandatory\">IRDAI has made it mandatory<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#The_directions_after_lockdown\" title=\"The directions after lockdown\">The directions after lockdown<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#IRDAI_directed_the_insurance_service_providers_too\" title=\"IRDAI directed the insurance service providers, too\">IRDAI directed the insurance service providers, too<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Employee_State_Insurance_and_Group_Medical_Cover\" title=\"Employee State Insurance and Group Medical Cover\">Employee State Insurance and Group Medical Cover<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#The_amounts_of_premiums_to_be_made\" title=\"The amounts of premiums to be made\">The amounts of premiums to be made<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Full_contribution\" title=\"Full contribution\">Full contribution<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Partial_contribution\" title=\"Partial contribution\">Partial contribution<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Benefits_in_terms_of_hospitalization\" title=\"Benefits in terms of hospitalization\">Benefits in terms of hospitalization<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Post-hospitalization_care\" title=\"Post-hospitalization care\">Post-hospitalization care<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Covering_the_OPD_service_charges\" title=\"Covering the OPD service charges\">Covering the OPD service charges<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Can_cover_charges_for_telemedicine_too\" title=\"Can cover charges for telemedicine, too\">Can cover charges for telemedicine, too<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#There_are_guaranteed_tax_benefits\" title=\"There are guaranteed tax benefits\">There are guaranteed tax benefits<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/www.plancover.com\/insurance\/is-group-health-insurance-mandatory-for-employees-in-india\/#Contact_a_reputable_service_provider\" title=\"Contact a reputable service provider\">Contact a reputable service provider<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\" id=\"it-is-mandatory-after-the-pandemic\"><span class=\"ez-toc-section\" id=\"It_is_mandatory_after_the_pandemic\"><\/span>It is mandatory after the pandemic<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p><em>The Indian Government<\/em> has made it mandatory for companies from every business domain to arrange for a group medical insurance policy for their employees. Currently, it is a regulation. Each company operating in India has to abide by the rule. So the simple answer to the question that whether group health insurance is mandatory for employees in India is YES.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"an-employer-pays-all-of-the-premiums\"><span class=\"ez-toc-section\" id=\"An_Employer_Pays_All_of_the_Premiums\"><\/span>An Employer Pays All of the Premiums<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The usual norms of the group medical insurance policy are in favour of both the employees and employers. The employer needs to pay the premium amounts each month (or annually in some cases). Generally, the employees do not have to worry about contributing to the premiums. The employer takes responsibility in such cases. Availing of medical insurance becomes lucrative for the employees.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"the-policy-aims-for-a-basic-coverage\"><span class=\"ez-toc-section\" id=\"The_policy_aims_for_a_basic_coverage\"><\/span>The policy aims for a basic coverage<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The fundamental features of the insurance policy give basic coverage to the employees. There are certain cases in which the families of the employees also get partial benefits from the insurance policy. The employer needs to enquire about further details from the service provider.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"irdai-has-made-it-mandatory\"><span class=\"ez-toc-section\" id=\"IRDAI_has_made_it_mandatory\"><\/span>IRDAI has made it mandatory<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The Insurance Regulatory and Development Authority of India (IRDAI) has clearly made it mandatory for companies to buy group medical insurance policies for their employees. It is an obligation that companies in any sector have to strictly maintain. There is no exception in this case.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"the-directions-after-lockdown\"><span class=\"ez-toc-section\" id=\"The_directions_after_lockdown\"><\/span>The directions after lockdown<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>After the lockdown, the companies have been instructed by the concerned authorities to undergo the simple process of providing group medical insurance to the employees. The procedure falls within a regulatory framework known as \u2018<strong>Standard Operating Procedure<\/strong>\u2019. It simplifies the implementation of the insurance policy, registering name of each employee.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"irdai-directed-the-insurance-service-providers-too\"><span class=\"ez-toc-section\" id=\"IRDAI_directed_the_insurance_service_providers_too\"><\/span>IRDAI directed the insurance service providers, too<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>The different companies providing insurance policies were also given guidelines by the IRDAI. The instructions simply told about making the group non-life insurance policies simple and east to apply, benefitting both the employees and employers.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"employee-state-insurance-and-group-medical-cover\"><span class=\"ez-toc-section\" id=\"Employee_State_Insurance_and_Group_Medical_Cover\"><\/span>Employee State Insurance and Group Medical Cover<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>As an employer (or an employee), you need to be aware of the basic aspects of both employee state insurance and group medical cover. When you have clear ideas about the insurance policies, you can go ahead and make a final decision.<\/p>\n\n\n\n<p>An employee whose monthly salary is below Rs 21,000\/-, is eligible for the employee state insurance. On the other hand, an employee whose monthly salary is more than Rs 21,000\/-, is eligible for the group medical cover.&nbsp;&nbsp;<\/p>\n\n\n\n<p>As the owner of a small business, you need to talk to the insurance provider about more details. If you are the HR head of your company, then get in touch with a broker who has experience in selling various types of insurance policies.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"the-amounts-of-premiums-to-be-made\"><span class=\"ez-toc-section\" id=\"The_amounts_of_premiums_to_be_made\"><\/span>The amounts of premiums to be made<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Each policy has different terms and conditions. As an interested party who plans to purchase the policy, you need to thoroughly read the policy document.&nbsp;<\/p>\n\n\n\n<p>The premium amounts vary according to the conditions laid by the policy document of the specific insurance service provider. Before buying the policy for your employees, you need to get clear ideas by discussing it with the seller.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"full-contribution\"><span class=\"ez-toc-section\" id=\"Full_contribution\"><\/span>Full contribution<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>As an HR executive of a company, it is your responsibility to understand the nature of contribution while availing of a group medical insurance policy. When the insurance is fully contributory, the company needs to pay the full amount of the premium to the <strong><a href=\"http:\/\/plancover.com\">insurance provider<\/a><\/strong>. The employees do not have to pay anything in this case.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"partial-contribution\"><span class=\"ez-toc-section\" id=\"Partial_contribution\"><\/span>Partial contribution<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>There is also another type of contributory insurance policy, which is mainly partial in nature. In this case, the company or the employer pays a part of the premium. The rest of the portion is paid by the employees. The clauses and guidelines of the group medical insurance policy explain every detail.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"benefits-in-terms-of-hospitalization\"><span class=\"ez-toc-section\" id=\"Benefits_in_terms_of_hospitalization\"><\/span>Benefits in terms of hospitalization<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The employees of an organization avail <strong>huge benefits in terms of hospitalization<\/strong>, especially in cases of cashless hospitalization. They do not have to bother about paying anything to the hospital.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"post-hospitalization-care\"><span class=\"ez-toc-section\" id=\"Post-hospitalization_care\"><\/span>Post-hospitalization care<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>In some insurance policies, there is a provision that lets the employees avail themselves of post-hospitalization care and services free of cost. The employees do not have to be worried about bearing the costs. The group medical insurance policy takes care of everything. The employees can stay relieved about getting the required medical attention.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"covering-the-opd-service-charges\"><span class=\"ez-toc-section\" id=\"Covering_the_OPD_service_charges\"><\/span>Covering the OPD service charges<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The group medical insurance policy also covers the costs of <strong>OPD services<\/strong>. The employees can stay relaxed as they do not have to think about the expenses. The policy details clearly mention about the conditions that benefit the employees of an organization.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"can-cover-charges-for-telemedicine-too\"><span class=\"ez-toc-section\" id=\"Can_cover_charges_for_telemedicine_too\"><\/span>Can cover charges for telemedicine, too<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Modern group health medical insurance policies can also have the facilities to cover the costs of telemedicine. <strong>Telemedicine<\/strong> is fast growing as a viable and practical medical service. Any support from the insurance policy means the employees can stay relieved about not spending anything in availing of telemedicine services.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"there-are-guaranteed-tax-benefits\"><span class=\"ez-toc-section\" id=\"There_are_guaranteed_tax_benefits\"><\/span>There are guaranteed tax benefits<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The employer gets a string of tax benefits when it buys the group medical insurance policy for the employees. More <strong>tax benefits<\/strong> improve the revenue margins for the company. Also, it may lead to accelerated growth of the business, even in a competitive market.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"contact-a-reputable-service-provider\"><span class=\"ez-toc-section\" id=\"Contact_a_reputable_service_provider\"><\/span>Contact a reputable service provider<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>If you handle the HR issues of a company or own a small business, it would be insightful to contact a good service provider such as <strong>PlanCover<\/strong> that has several years of experience in selling non-life insurance policies to many companies in the industry. You can call the service provider or write an e-mail.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A group health insurance policy is a form of non-life insurance policy that is applicable for a group of employees working in a company. Each employee who is under the&#8230;<\/p>\n","protected":false},"author":2,"featured_media":2155,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[17],"tags":[],"_links":{"self":[{"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/posts\/1605"}],"collection":[{"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/comments?post=1605"}],"version-history":[{"count":3,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/posts\/1605\/revisions"}],"predecessor-version":[{"id":2163,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/posts\/1605\/revisions\/2163"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/media\/2155"}],"wp:attachment":[{"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/media?parent=1605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/categories?post=1605"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.plancover.com\/insurance\/wp-json\/wp\/v2\/tags?post=1605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}