What are the benefits of a group insurance policy? Does your company provide a group insurance cover? Read ahead and find out.
Apart from private health insurance policies, there are also other types of insurance policies available in the market. One such example is of a group insurance plan. A group insurance plan is offered by health insurance companies to employers in order to provide cover against health related risk to a specific list or group of people. The specific group of people comprises of the employees. In short, a group cover is given by the employer to the employees. Almost by default, all major corporations (Public/Private/Government) offer group health insurance plans to their employees.
Group health insurance policies are highly customizable and come in all shapes and sizes. Companies can customize the group cover as per the size and requirements of the employees. Many companies offer group insurance cover for the family members of the employee as well.
Under a group health insurance policy, both employer and the employee are the beneficiaries. Let us know more about the benefits and features offered by a group health insurance policy.
Benefits To The Employer
- Low Cost - A group health insurance policy comes at a relatively lesser cost in comparison to purchasing individual health policies for each employee.
- Employee Retention - Group insurance cover helps in reducing attrition. The chances of an employee staying in the company increases if they are given the benefits of a health cover for themselves/families.
- Employee Motivation - Having a group insurance policy motivates employees to work efficiently.
- Tax Benefits - Both employer and employee are eligible for tax benefits under a group insurance cover.
Benefits to the Employee
Pre-Existing Diseases - All pre-existing diseases are covered from day one. There is no waiting period involved in comparison to an individual health insurance plan.
Extensive Cover - A group insurance health plan offers an extensive range of cover with no limit on diseases along with cover for pre-existing diseases.
Maternity Cover - A group insurance plan provides coverage for both C-section and normal deliveries. This is ideal for young women employees who are planning for children. Some plans also provide cover for expenses post-delivery with a standard 90 days of maternity cover.
Features of a Group Health Insurance Policy
The Common Features Of A Group Health Insurance Plan Are:
- A group health insurance plan provides coverage for self (insured employee), spouse, children or dependent parents.
- Provides cover for pre-existing diseases and maternity expenses without any waiting period.
- A group health insurance plan comes with the facility of cashless hospitalization at listed network hospitals.
- Some group insurance plans provide cover for ancillary charges such as the cost of ambulance/emergency transportation to the hospital.
- Many group insurance health plans provide reimbursement of treatment taken by specialists/medical practitioners, follow up check-ups.
Is Group Health Insurance necessary?
Absolutely! As an employer, you need to take care of your employees at all times. Monetary benefit is not the only source of employee happiness. Creating a healthy working environment and becoming more employee-centric will definitely keep your workers happy and motivated.
Three reasons why a group health insurance is necessary for both employer and the employee:
- Wide Cover - A group insurance plan provides wide coverage and additional health benefits to employees at minimum cost to the employer.
- Customization - With a group insurance plan, you can take full advantage of customization. Example, an employer can select a plan which provides both OPD and maternity cover.
- Affordable Premiums - As mentioned before, a group health insurance plan is much more affordable than an individual health plan. Also, the premiums offered per employee under a group plan is lesser than the premium of an individual health plan.
Exclusions under a Group Health insurance Plan
Like every health insurance policy, there are certain exclusions which are not entertained by any group insurance provider.
- Some plans do not provide cover for family (dependent parents).
- Addictive conditions and disorders.
- Rehabilitation from addictive conditions and disorders, or from any kind of substance abuse or misuse.
- Treatment to relieve symptoms caused by ageing, puberty.
- Artificial life maintenance, including life support machine.
- Ayurvedic and Homeopathic streams of treatment.
- Treatment for any Illness or Injury resulting from nuclear or chemical contamination, war, riot, revolution, or any similar event (other than natural disaster or calamity)
- Treatment undergone purely for cosmetic or psychological reasons to improve appearance.
- Treatment for any dental or oral condition, which includes Surgical Procedure for the treatment of bone disease when related to gum disease or damage, or treatment for, or treatment arising from, disorders of the temporomandibular joint.
- Treatment for any External Congenital Anomaly.
- Treatment to correct refractive errors of the eye.
- Unproven / Experimental treatment
- Unani, Yoga and Siddha treatment
- Treatment or services received in health hydros, nature cure clinics or any establishment that is not a Hospital.
- Any treatment for or treatment arising from, Human Immunodeficiency Virus (HIV) or Acquired Immuno Deficiency Syndrome (AIDS), including any condition that is related to HIV or AIDS.
- Treatment of abnormalities, deformities, Illnesses arising out of hereditary conditions.
- Treatment of any mental Illness or sickness or disease including a psychiatric condition, disorganization of personality or mind, or emotions or behaviour, Parkinson’s or Alzheimer’s disease, even if caused or aggravated by or related to an Accident or Illness or general debility or exhaustion.
- Treatment for obesity
- Treatment for, or arising from, an injury that is intentionally self-inflicted, including attempted suicide.
- Treatment of any sexual disorder including impotence (irrespective of the cause) and sex changes or gender reassignments or erectile dysfunction.
- Any condition as a result of Insured Person committing or attempting to commit a breach of law with criminal intent.
- Any genetic disorders resulting from a defect in the genes.
- Treatment for sleep apnea, snoring, or any other sleep-related breathing problem.
Note: The above list is a comprehensive list of exclusions, but it may vary across different policies.
Employees are the most valuable resource in any organization. Employers need to ensure that their workforce is happy. An unhappy workforce can have grave implications for the entire organization. Having a group insurance policy is good for both the employer and the employees.