Group Mediclaim Insurance Policy - Buy Group Health Insurance for Employees in India

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Contents
  1. Group Health Insurance Policy for Employees
  2. What is Group Health insurance?
  3. What is an Employee Group Health Insurance Policy?
  4. What does a Group Health Insurance Policy cover?
  5. What is not covered under a Group Health Insurance Policy?
  6. How is a Group Health Insurance Policy different than an Individual Health Insurance Plan?
  7. What are the Key Features of a Group Health Insurance Policy?
  8. What are the add-on covers available under a Group Health Insurance Policy?
  9. What is the impact of Room Rent Limit on the claim amount payable under the Group Health Insurance Policy?
  10. Should employers opt for a Pre-Existing Disease Coverage from Day 1 in Group Medical Insurance Policy for employees?
  11. Does a Group Medical Insurance Policy provide Maternity Benefits?
  12. What are Waiting Periods under a Group Health Insurance Policy?
  13. What are the benefits of Group Health Insurance Policy for Employers?
  14. What are the benefits of Group Health Insurance Policy for Employees?
  15. Why should you purchase an Employee Group Health Insurance Policy for your organisation?
  16. How many employees do you need to purchase a Group Health Insurance Policy?
  17. Who is eligible for Group Health Insurance for Employees?
  18. Are Employer Group Health Insurance premiums Tax-Deductible?
  19. How much does a Group Health Insurance Policy Cost?
  20. Which are the leading Group Health Insurance Companies in India?
  21. How to purchase a Group Health Insurance Policy?
  22. What are the Documents required to make a claim under a Corporate Health Insurance Policy?
  23. Why should I Purchase a Group Health Insurance Policy through an Insurance Broker?
  24. Compare Plans from 20+ Group Health Insurance Companies and choose the Best Group Health Insurance Policy in India with Qian!
  25. FAQS
  26. Testimonials

Group Health Insurance Policy for Employees

What is Group Health insurance?

Group Health Insurance is a type of insurance policy that provides coverage for medical expenses incurred by employees during hospitalisation.

Secure your Employees with a Group Mediclaim Policy.

After years of hard work, your Company has reached the big stage. Your employees were part of the ups and downs, highs and lows. You couldn't have done it without your employees. The employees have given their life for the growth of the organisation.

>But do you take care of your employees?

Your employees may be going through their own trials and tribulations in their personal lives. A Spouse may be suffering from Cancer or maybe a Child has met with an Accident.

All these Ailments and Injuries require hospitalisation and the treatment requires substantial financial resources. Such unplanned expenses may lead to financial distress for the employee.

An advantage of a Group Health Insurance Policy (also known as Group Mediclaim Insurance or Corporate Health Insurance Policy) is that will assist your employees during such tough times by reimbursing them for their hospitalisation expenses and this is very important. 

Group Health Insurance Policy for Employees

What is an Employee Group Health Insurance Policy?

An Employer Group Health Insurance Policy (also known as Group Mediclaim Insurance Policy for Employees or a Corporate Health Insurance Policy) is an Insurance Policy which reimburses the employees for the hospitalisation expenses incurred by the employees during the year. A Group Health Insurance Plan covers a group of people under a common health insurance plan. Usually, a company purchases Group Health Insurance Policy for employees.

What does a Group Health Insurance Policy cover?

A Group Health Insurance Policy can be tailored to suit customer requirements. Typical features of a Group Health Insurance Policy are as follows:

  1. Hospitalisation Expenses: A Group Medical Insurance Policy offers coverage for Hospitalisation Expenses if the Insured Person is hospitalized for more than 24 hours in a hospital for any injury or illness.
  2. Coverage for Pre and Post-Hospitalisation Expenses: Most Corporate Health Insurance Policies provide cover for Pre and Post-Hospitalisation Expenses for 30 and 60 days respectively.
  3. Pre-Existing Diseases are covered from 1st Day under a Corporate Health Insurance Policy
  4. Coverage for Daycare Procedures: Group Mediclaim Policies also provide coverage for Daycare Procedures which do not require hospitalisation of more than 24 hours.
  5. Maternity Coverage: Group Health Insurance Policies also provide coverage for Maternity Expenses with a Sub Limit without any waiting period.
  6. New-Born Baby Covered from Day 1: Corporate Health Insurance Policies also have an option to cover New-Born Babies from Day 1 under the Policy.

What is not covered under a Group Health Insurance Policy?

Major Exclusions under a Group Health Insurance Policy are as follows:

  1. Coverage for OPD: A Corporate Health Insurance Policy does not provide coverage for OPD (Out-Patient Department) Treatments though OPD Coverage can be opted for by paying an additional premium.
  2. Injuries/Illness caused under influence of alcohol/drugs: A Group Health Insurance Policy does not provide coverage for illnesses or injuries that are caused due to use of intoxicating drugs and/or alcohol.
  3. Investigation & Evaluation Expenses: Coverage for expenses related to any admission primarily for diagnostics and evaluation purposes are excluded under a Group Health Insurance Policy.
  4. Rest Cure, Rehabilitation and Respite Care: Expenses related to any admission primarily for enforced bed rest and not for receiving treatment are not covered under a Group Health Insurance Policy
  5. Cosmetic or Plastic Surgery: Expenses for cosmetic or plastic surgery or any treatment to change appearance are not covered under a Group Medical Insurance Policy
  6. Hazardous or Adventure Sports: Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports such as para-jumping, rock climbing, mountaineering, rafting are not covered under a Corporate Health Insurance Policy

How is a Group Health Insurance Policy different than an Individual Health Insurance Plan?

Group Health Insurance Plans are usually less expensive an Individual Health Insurance Plans and they offer more comprehensive coverage. Group Health Insurance Policies have no waiting period for pre-existing diseases and maternity benefits while Individual Health Insurance Policies have a waiting period of 3-4 years for the same. Group Health Insurance Policies also typically do not require medical checkups of the Insured while an Individual or a Family Floater Health Insurance Policy requires a medical check up of the Insured Person.

What are the Key Features of a Group Health Insurance Policy?

A Group Health Insurance Policy offers various benefits depending on the Group Health Insurance Plan selected by the employer. Some common features of a Group Health Insurance Policy are as follows:

  1. Cover for Hospitalisation Expenses: All Group Health Insurance Policies offer cover for hospitalisation expenses incurred by the employees during their treatment.
  2. Cover for Pre and Post-Hospitalisation Expenses: In addition to cover for Hospitalisation expenses, most Group Mediclaim Insurance Policy for Employees will provide cover for Pre and Post-Hospitalisaiton expenses, usually for 30 days and 60 days respectively.
  3. Room Rent Limit: Group Health Insurance Plans will specify a room rent limit (for eg: 1% and 2% of Sum Insured for Normal and ICU Rooms). The Policy will thus pay the room rent only upto the limit specified. You can opt for a Group Health Insurance Plan with no room rent capping as well.
  4. Maternity Cover and New-Born Baby Cover: Some Group Health Insurance Policies also provide coverage for delivery expenses as well as expenses incurred on new-born baby if this feature is opted for.
  5. Pre-Existing Diseases Cover: Most Group Health Insurance Policy will provide cover for Pre-Existing Diseases without any waiting period. This is a big advantage.
  6. Domiciliary Hospitalisation Cover: Some Group Health Insurance Plans offer benefit of Domiciliary Hospitalisation provides reimbursement for treatment availed at home if the Insured Person is unable to get hospitalised.
  7. Day Care Procedures: Most Group Health Insurance plans have a list of Day Care Procedures which are covered. Day Care Procedures are procedures which do not require hospitalization
  8. Cashless Hospitalisation: Most Group Mediclaim Insurance Policy for employees have a network of cashless hospitals where the Insured can avail treatment without paying treatment expenses from out of their own pocket. The Insurance companies will directly reimburse the hospitals for the treatment cost in case of Cashless Claims Settlement.

What are the add-on covers available under a Group Health Insurance Policy?

Employers can enhance the coverage under a Group Health Insurance Policy by opting for the following add-on covers:

  1. Maternity Coverage: GMC Policies provide the option to provide Maternity Coverage without any waiting periods with a Sub-Limit. This add-on cover is very beneficial for female employees and spouses of male employees.
  2. Coverage for Pre-Existing Diseases: Most Individual or Family Floater Health Insurance Policies provide coverage for Pre-Existing Diseases after a Waiting Period of 3-4 years. However, employers can provide coverage for Pre-Exisiting Diseases from Day 1 under Corporate Health Insurance Policies.
  3. Coverage for Outpatient Department (OPD) Treatment: Coverage for OPD Treatments is usually excluded under Group Medical Insurance. However, coverage for OPD Treatments can also be provided as an add-on cover under a GMC Policy.
  4. Corporate Buffer: There are instances when employees the hospitalisation expenses exceed the Sum Insured provided under the Group Health Insurance Policy. In such a case, employers have an option of approving additional expenses incurred by opting for a Corporate Buffer under the Group Health Insurance Policy.

What is the impact of Room Rent Limit on the claim amount payable under the Group Health Insurance Policy?

Group Health Insurance Plans usually specify a room rent limit as a percentage of Sum Insured (for eg: 1% and 2% of Sum Insured for Normal and ICU Rooms). The Policy will thus pay the room rent only upto the limit specified. If the actual rent of room exceeds the room rent limit, then the Policy will apply a deduction for the room rent and a proportionate deduction is applied for all other expenses incurred.

For example: Consider an employee insured under a Group Health Insurance Policy with a Sum Insured of Rs2 lakhs and a Room Rent Capping of 1% of Sum Insured per day. This means that the maximum expenses payable towards room rent under the Policy is restricted to Rs2000 per day (1% of 2 lakhs)

If the employee gets admitted to a hospital with a room rent of Rs4000 per day, then the Policy will reimburse the employee only Rs2000, that is, 50% (2000/4000) towards the room rent. Additionally, all other expenses such as Doctors Fees, Operation Theatre Charges, will be deducted by 50% by applying a proportionate deduction clause.

Should employers opt for a Pre-Existing Disease Coverage from Day 1 in Group Medical Insurance Policy for employees?

It is important to understand the pros and cons of opting for Pre-Existing Coverage from Day 1 under a Group Medical Insurance Policy. Opting for Pre-Existing Disease Coverage from Day 1 will result in extra premium. However, it could protect the employees from huge medical bills in case they get sick because of a Pre-Existing Condition. Employers should consider the costs vs benefits carefully before opting for Pre-Existing Disease Coverage from Day 1.

Does a Group Medical Insurance Policy provide Maternity Benefits?

Yes, Maternity Benefits can be provided with a Sub-Limit of Rs50,000 to Rs1,00,000 a Group Medical Insurance Policy for Employees. The Policy will typically cover delivery expenses, doctor's visits, and pre and post-natal expenses.

What are Waiting Periods under a Group Health Insurance Policy?

A Group Health Insurance Policy typically has 4 types of Waiting Periods:

  1. First 30 Days Waiting Period refers to the Expenses related to the treatment of any illness within 30 days from the first policy commencement date.
  2. Waiting Period for Pre-Existing Diseases refers to the Waiting Period for Pre-Existing Disease before the Policy pays out any claims for hospitalization on account of Pre-Existing Diseases.
  3. Waiting Period for Specific Diseases: All Group Health Insurance Policies have a list of specified diseases for which the claims are not paid during the Specified Diseases Waiting Period
  4. Waiting Period for Maternity Coverage: Most Group Health Insurance Policies have a Waiting Period of 3-4 years before providing maternity coverage under the Policy.

All the above-mentioned waiting periods can be waived off by paying additional premium under the Group Health Insurance Policy.

What are the benefits of Group Health Insurance Policy for Employers?

A Group Health Insurance Policy offers many benefits for employers as listed below:

  1. Group Health Insurance Plans can be customised: The features of a Group Health Insurance Policy can be customised depending on the budget and requirements of the employers.
  2. Lower Premiums: The premium for a Group Health Insurance Policy is lower than premium for an Individual Health Insurance Plan for similar benefits and coverage.
  3. Tax Savings for Employers: The premiums paid by employers towards a Corporate Health Insurance Policy for employees are a tax-deductible expense for the company. The premiums reduce the taxable profits of the company and hence reduces the tax outgo as well.
  4. Employee Retention: Group Health Insurance Plans are an important perk for employees and helps in attracting talented new employees as well as retaining existing ones.

What are the benefits of Group Health Insurance Policy for Employees?

A Group Health Insurance Policy offers many benefits for employees as well:

  1. Zero Waiting Period for Pre-Existing Diseases: A big benefit of Group Medical Insurance Policy for employees is that the Policy can cover Pre-Existing Diseases without any waiting periods whereas an Individual Health Insurance Plan has a Waiting Period of 3-4 years for Pre-Existing Disease Coverage.
  2. Maternity Coverage without Waiting Periods: Another benefit of a Group Mediclaim Insurance Policy is that it can offer Maternity Coverage without any waiting periods as well.
  3. No Need for Medical Checkup: Employees can be covered under a Group Health Insurance Policy without any medical checkup whereas they may need to undergo a Medical Checkup under an Individual Health Insurance Policy.

Why should you purchase an Employee Group Health Insurance Policy for your organisation?

here are many advantages to insuring your employees with a Group Health Insurance Policy:

  1. A Group Mediclaim Policy for employees boosts their morale. Happy employees result in higher productivity which ultimately benefits the company.
  2. It also helps attract better employees since they are aware that their medical expenses are taken care of with a good Corporate Health Insurance Plan should such a need arise.
  3. Premium paid by the employers for a Group Mediclaim Policy is a Tax-Deductible Expense.
Remember a well-motivated workforce is the biggest asset of your organisation and you as an employer can do your part by providing your employees with a good Group Mediclaim Policy.

How many employees do you need to purchase a Group Health Insurance Policy?

Most Insurance Companies require a group size of 50 employees for a Group Health Insurance Policy. Group Health Insurance Policy is also available for small businesses and some insurance companies do offer a GMC Policy for Employee Size of as little as 15 employees

You can read our detailed blogpost on Group Health Insurance Policy for Small Business.

Who is eligible for Group Health Insurance for Employees?

The following groups can opt for a Group Health Insurance Policy:

  1. A Company can take a Group Mediclaim Insurance Policy for its employees and their families
  2. Registered Service Clubs can avail a Group Health insurance Policy for its Members
  3. Credit Card Companies or Banks can opt for Group Health Insurance for its Members

Are Employer Group Health Insurance premiums Tax-Deductible?

Yes, Group Health Insurance Premiums are a Tax-Deductible Expense for the Company which pays the Premium. The Premiums Paid towards the Group Medical Insurance Policy reduce the taxable profits of the company and hence reduce the tax outgo as well.

How much does a Group Health Insurance Policy Cost?

The Cost of a Group Health Insurance Policy depends on the following factors:

  1. Total Number of Lives (Employees and Family Members)
  2. Age Distribution of Employees and their Family Members
  3. Sum Insured
  4. Features of Group Health Insurance Policy
  5. Claims Experience in Expiring Policy

Which are the leading Group Health Insurance Companies in India?

The leading Group Health Insurance Companies in India are:

  1. SBI General Group Health Insurance Policy
  2. New India Assurance Group Health Insurance Policy
  3. ICICI Lombard Group Health Insurance Policy
  4. GoDigit Group Health Insurance Policy
  5. Tata AIG Group Health Insurance Policy

How to purchase a Group Health Insurance Policy?

Group Health Insurance Providers require the following details for a Group Health Insurance Policy:

  • Employee Name
  • Employee Gender
  • Employee Date of Birth and Age
  • Sum Insured required for each employee
  • Features Required in the policy
  • Claims History in the previous Group Mediclaim Insurance Policy

A Group Mediclaim Policy for Employees can be purchased with the assistance of an Insurance Broker who will help you with the best options among the various Grou Health Insurance Providers at Reasonable Premiums.

How to purchase a Group Health Insurance Policy?

What are the Documents required to make a claim under a Corporate Health Insurance Policy?

An Employee would need to provide the following documents to make a claim under a Group Health Insurance Policy:

  • Photo Identification Proof
  • Duly Filled and Signed Claim Form
  • Address Proof
  • Medical Reports
  • Cancelled Cheque of the employee
  • Diagnostic Reports
  • GMC Policy E-Card
  • Doctor Prescriptions
  • Hospital Bills, Pharmacy Bills
  • Discharge Summary
What are the Documents required to make a claim under a Corporate Health Insurance Policy?
Competitive Quotes

Competitive Quotes

No Room Rent Capping

No Room Rent Capping

Pre Existing Disease Covered from Day 1

Pre Existing Disease Covered from Day 1

Cashless Claims Settlement at Network Hospitals

Cashless Claims Settlement at Network Hospitals

Cover for Small Employee Groups

Cover for Small Employee Groups

Coverage for Maternity Expenses, New Born Baby

Coverage for Maternity Expenses, New Born Baby

Why should I Purchase a Group Health Insurance Policy through an Insurance Broker?

An Insurance Broker has tie ups with multitude of Insurance Companies thus enabling competitive sourcing of quotes.

With the assistance of an Insurance Broker, you can ensure that you have selected the best Group Health Insurance Plan with the best coverages for your employees. An Insurance Broker for Group Health Insurance will also be of great help in servicing of employee claims.

Why should I Purchase a Group Health Insurance Policy through an Insurance Broker?
Compare Plans from 20+ Group Health Insurance Companies and choose the Best Group Health Insurance Policy in India with Qian!

Compare Plans from 20+ Group Health Insurance Companies and choose the Best Group Health Insurance Policy in India with Qian!

Qian has an outstanding service record and has worked with corporates across industries to assist them with their Group Mediclaim needs. We have settled more than 95% of the GMC Claims with great satisfaction and fast turnarounds.

Qian has tie-ups with 20+ Group Health Insurance Companies in India and you can compare the plans and features from various Group Health Insurers to obtain comprehensive coverage at affordable premiums. We assure you of best Group Health Insurance Quotes and a dedicated claims settlement team for fast claims settlement.

If you wish to purchase a Group Health Insurance Policy for your organisation, feel free to reach out to us at support@qian.co.in or  πŸ“ž 022-35134695 πŸ“ž 022-35134695 or fill this Contact Form. We will get back to you within 24 hours, guaranteed.

FAQS

Does Corporate Health Insurance cover Pre-Existing Diseases?

Yes, Group Mediclaim Policies or Corporate Health Insurance Policies cover Pre-Existing Diseases.

Is Group Health Insurance Cheaper than an Individual Health Insurance Policy?
Yes, the Premium per Employee under a Group Health Insurance Policy is generally lesser than the premium for an equivalent Sum Insured under an Individual Health Insurance Policy.
Does a Group Health Insurance Policy cover parents?
Yes, Group Health Insurance Policies can cover parents of the employee.
Are Group Health Insurance premiums tax deductible?
Yes, Group Health Insurance Premiums are a tax deductible expense for the company which pays the premium.
Is Group Health Insurance cheaper than Individual Health Insurance?
Yes, the premiums for each person is generally lower for a Group Health Insurance as compared to Individual Health Insurance.
How can a small business get Group Health Insurance?
There are some insurance companies which offer group health insurance for a small group size of 15 employees also. If you are a small business wishing to purchase a group health insurance policy for your employees, you can email us at support@qian.co.in call us at πŸ“ž 022-35134695.
Does a Group Health Insurance Policy cover Coronavirus Claims?
Yes, a Group Health Insurance Policy covers Coronavirus (CoVID19) Claims.
Does a Group Health Insurance Policy cover spouse and children?
Yes, Group Health Insurance Policies can cover spouse and children of the employee.

Testimonials

Average Customer Rating:

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Hemik of Qian is knowledgable, prompt and very professional - highly recommended. I had to claim for a critical illness under my health insurance policy and Qian’s assistance with the claims process and advice on how to deal with the insurer was invaluable.

Niyati Shah