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Group Health Insurance: benefits, cost and coverage

See how group health insurance works, what it covers, who should buy it and what it costs for your team.

Premium starts at ₹2,000 per person Excluding taxes. Terms and conditions apply.

Smiling family protected by group health insurance

Benefits

  • Comprehensive cover for hospital and day-care treatment
  • No waiting period and no disease-wise limits
  • No medical check-up before joining
  • Dedicated support from us during a claim

What is group health insurance?

Group health insurance is one medical policy that covers many people, usually the employees or members of an organisation. The employer or organisation buys the plan and pays the premium. Every member gets the policy's benefits.

A group mediclaim policy aims to give affordable healthcare cover to a large number of people. It typically covers preventive care, hospitalisation, medical procedures and other healthcare services. Some plans add wellness programmes, health education and tele-medicine access.

Examples

Employer-sponsored cover: The employer pays some or all of the premium. In some companies, employees pay the rest from their salary. The plan covers doctor visits, hospital stays and preventive care, and some plans add dental and vision cover.

Association cover: Professional and trade associations buy plans for their members. This gives small businesses and self-employed people affordable cover they would not get from an employer.

We tailor each plan to the group's needs, so coverage options and cost-sharing vary. These plans may not carry the same rules and protections as an individual health policy.

How group health insurance works

  1. Form the groupPeople or an organisation come together to get cover.
  2. Choose a planThe employer or a representative picks a group mediclaim policy that fits the team's needs and budget.
  3. Pay the premiumThe employer or organisation pays for the members' cover.
  4. Pool the riskPremiums from all members fund the claims of any one member, so no single claim hits one person hard.
  5. Use the coverThe plan pays for doctor visits, hospital stays, medicines and preventive care, as per the plan you choose.
  6. Make a claimSubmit a claim after treatment. The insurer either pays the hospital directly or reimburses the member.
  7. Get cashless treatmentAt network hospitals, members pay nothing upfront. The insurer settles the bill with the hospital.

Who should buy a group health plan?

Employers. Group health insurance is a core employee benefit. It helps you attract and retain talent and improves satisfaction and productivity.

Frequently Asked Questions

Maternity benefits in group health insurance cover the costs of pregnancy and childbirth-related medical care. These benefits may include coverage for prenatal and postnatal consultations, delivery charges, hospitalization costs, and other related expenses. Some group health insurance policies also provide coverage for complications arising during pregnancy and childbirth.
Individuals generally cannot buy group health insurance on their own. Employers or organizations often buy group health insurance for their employees or members. Certain insurers might extend group health insurance plans to self-employed or association-affiliated individuals.
No, group health insurance is not mandatory for employers or organizations to provide to their employees or members. However, in some countries, like the United States, employers must provide health insurance to their employees. If not, they are subject to penalties as stipulated by the Affordable Care Act (ACA).
You should consider getting a group health insurance cover for your employees as soon as you start hiring them. Offering health insurance as a benefit can help attract and retain top talent and improve employee satisfaction and productivity. Furthermore, health insurance coverage can shield your employees from unforeseen medical costs. It also offers them access to high-quality healthcare.

Its crucial for businesses promoting employee well-being to grasp the intricacies of group insurance in India. Choose the right group medical insurance for employees to foster a healthy and secure work environment.
Corporate health insurance plan or corporate medical insurance can be cheaper than individual plans. Companies negotiate lower premiums because of their buying power and larger coverage. However, factors like company size and policy benefits underlie these variations.
A floater sum insured extends coverage to multiple individuals under a combined amount. In contrast, a non-floater sum insured policy allocates separate coverage amounts to everyone covered.
The main difference is in coverage distribution: floater policy shares coverage, non-floater policy is individual based.
A corporate buffer covers unforeseen healthcare costs. Its for employees not under standard insurance. It covers medical costs that go beyond policy limits. Also, for employees not covered by the policy.
Group health insurance plans or corporate medical insurance plans may cover different modern treatments depending on the policy. Further, it may include treatments such as chemotherapy, radiotherapy, dialysis, organ transplants, robotic surgeries, and stem cell therapy. Some policies may also cover alternative treatments such as Ayurveda, yoga, and naturopathy, among others.

Employer health insurance, often referred to as group mediclaim policy for employees, provides comprehensive medical insurance coverage.
IRDAI in India establishes rules and guidelines for group health insurance policies. Rules address policy tenure, benefits, coverage, premium rates, claims, and grievance redressal in group health insurance. While providing group health insurance policies, insurers must adhere to these rules.