Group medical insurance, as the name implies, covers the medical expenses for a specific group of individuals. These types of insurance policies are bought by employers for their employees. It not only provides coverage to the employees, but also provides coverage to their family members or dependants (based on the plan). Having said that, there are some group insurance companies that allow the covered employees to enhance the coverage of their group plan by paying an additional amount. The group plan is also highly beneficial for employees who do not have any other health plans and therefore can serve as excellent financial assistance, especially during the ongoing pandemic situation.
Here are some basic benefits of group medical insurance:
- Claims can be made for domiciliary expenditures.
- They pay for medical expenses incurred as a result of illness, disease, or accident.
- It covers pre- and post-hospitalisation expenses as per the policy coverage.
- offers cashless services in the network hospitals as mentioned in the policy document.
The premium for the group insurance plan is sometimes deducted from the employee’s CTC, while in some cases, the employers offer it free of charge. As a result, paying for premiums is a quick and painless process, as the minimum amount contributed towards this plan is deducted directly from the salary, either monthly or annually. This further eliminates the possibility of missing the premium payment deadline. Moreover, having comprehensive coverage, group health plans have become the biggest deciding factor for employees while selecting any employer.
In addition to this, here are some of the top reasons you should consider when buying a group insurance policy:
The group plan provides coverage at an affordable premium rate, and it is highly beneficial to those who do not have any existing health plan. The premium amount is established by the insurance companies based on the risk factor of the entire group. The premium payment can be made in one of two ways:
- The organization or group owner that owns the insurance for the employees pays the premium amount in its entirety.
- The employer pays a portion of the premium, while the remaining premium is paid by the employees.
As a result, the arrangement is the best for both parties.
Claims are processed faster.
Claims for group health insurance plans are processed faster as compared to other plans, and, thus, the employee need not have to deal with any hassle. The third party administrator and the insurance company are primarily responsible for carrying out this process seamlessly.
While maternity and childbirth would be considered add-on features under certain health insurance plans, that’s not the case for a group health plan. All the expenses for both types of delivery – normal as well as C-section – are borne by the employer’s insurance company. Moreover, the baby is also covered under the plan for up to 90 days after delivery.
There is no need for a prior medical examination.
The majority of employee health insurance companies do not require the employees to undergo any kind of physical or medical examination prior to enrolling in the plan, which otherwise might be needed for other health plans.
No Waiting Time For Pre-Existing Diseases (PED)
This is one of the most exciting benefits of having a group plan. Under a typical health plan, the treatment for PEDs, such as diabetes, hypertension, and so on, requires a waiting period before it is covered under the plan. However, a group health insurance plan has no such limitations and covers these conditions from Day 1. As a result, if an employee is covered under his or her health insurance plan, they need not worry about the treatment costs for pre-existing conditions.
The productivity of employees plays a substantial role in the success of any company. When an organization has a group of motivated and productive employees, the outcome is always better. By including a group insurance plan under an employee benefits package, the employer is able to offer a safe working environment for its employees without having to worry about medical emergency expenses for themselves and their families.
To sum up, a group insurance plan not only protects the employees but also safeguards the employers’ funds at the most affordable rates. Hence, it is a win-win situation for both of them.
The author is the director of Probus Insurance
(Disclaimer: Views expressed are the author's own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.)