The Buyt Desk
A group health insurance policy is an insurance plan offered to a group of people mainly by employers to all its employees and their dependents in a group.
A Group Health Insurance is a sort of health insurance plan that provides coverage to a group of people who fall under the same umbrella-like those who work under the same organization. This kind of policy is usually offered by organizations, housing societies, business groups, banks and employers. Premiums of such policies are borne by the organization and not the individual. The same can be extended to dependents like parents and children of the employee. Employees are benefited from this as premiums of individual policies are very costly. But the coverage of individual policy cannot be compared with group health policy. The cover is provided only till the employee is working for the organization. Corporate health insurance and Employee health insurance are other names of the same.
How helpful is a Group Health Insurance Policy for the Employees?
The intentions of Group health insurance are to increase employee satisfaction and provide better health benefits to the employees of the organization. Below are a few ways it is helpful for employees.
-
Default Health Insurance Cover – The employee just needs to join the organization to avail of the policy and all employees are covered under the same policy.
-
Easy Claim Process – The employee just needs to show the health card to initiate the claim and the claim is settled in a speedy and hassle-free manner as the employer is the brand.
-
No Pre-medical Screening is needed – No medical checkup prior to enrolling under group health policy, unlike individual health policy. No pre-existing medical conditions are listed in the policy.
-
Economical – The employee will avail of the benefits of a group health insurance policy mostly without spending any money as the premium is paid by the employer mostly.
How helpful is a Group Health Insurance Plan for Employers?
-
Employee retention and loyalty – Organizations are employee-centric as retention is an issue. Employers use many tools to gain the loyalty of their employees and a Group medical insurance policy is one such tool.
-
Premium payment flexibility – The organization can choose to pay a premium either monthly, quarterly or annually.
-
Tax benefits – Tax deductions can be availed under different sections of the Income Tax department of India.
-
Lower cost of Premiums – The organization needs to pay a lesser premium for the group health insurance.
-
Motivates employees – The policy gives the employee a piece of mind and such stress-free minds will perform better.
How does a Group Health Insurance Plan Work?
A group health insurance plan presents a fixed sum assured. The coverage is different for each organization but mostly covers accidental hospitalization and medical treatment of listed diseases. And the same coverage is provided for dependents too. The sum assured is based on the employee’s salary and each company has different plans. Employees can increase the sum assured amount by paying an extra amount of premium. The policy holds good only till the last day of employment. The moment an employee leaves the organization, the health cover is withdrawn.
Is coverage provided by group health policy enough?
Now that we know the pros of group health insurance policy, let us look into the cons. Maybe individual health insurance is also needed besides this.
-
Insufficient coverage – Coverage offered by group policies is usually Rs.10 lakh or even less. In today’s world, this is not enough for the whole family. Also, there might be restrictions on the number of dependents, hence not covering your entire family.
-
Restrictive clauses – Group policies have co-payment clauses, capped hospital room tariffs, sub-limits on hospitalization, diagnostic and ambulance charges.
-
Lack of flexibility – In group policies, the employer decides on diseases covered, critical illnesses, dependents and the sum insured. What you need may not be covered. If the employer fails to pay a premium, you have no coverage.
-
Job changes – If you have a medical emergency in between jobs then you have no cover.
Summing up
Reap all benefits of group health insurance yet have individual health insurance as well for you and your family’s safety. You can never predict a medical emergency. When you have both health policies, always claim from group insurance as it is faster and hassle-free.
