In recent years, wellness and health have taken priority, even in the workplace. Every organisation, regardless of size, understands how vital a healthy workforce is to its success. The most sought-after employee benefits from employee productivity to retention, including attracting new talent. An individual policy for every employee can be cumbersome, expensive, and unpractical, explaining the increasing popularity of Group health insurance plans. The following article elaborates on the features of an employee health insurance plan and its popularity.

Meaning Of A Group Health Insurance Plan

Alternatively known as Corporate health insurance, it is the insurance paid the company for their employees. It covers all employees regardless of age, job role, health conditions, and other factors. The Government has also made it mandatory for organisations resuming operations to put a health policy as a standard operating procedure. Since the employer takes these group plans, they pay for the premiums.

Features of A Group Health Plan

Here are some of the features of a group health plan :

  • Low Premiums
  • In this policy, the employees enjoy medical coverage without paying premiums. Since these policies are for a group, the risk gets shared, making the insurance plans economical. Furthermore, many insurance companies offer a corporate discount.
  • Tailor-Made
  • Health coverage varies with each individual and each organisation. Now, there are multiple group health plans in the market.

Certain insurance companies offer fixed coverage, while others prefer detailed coverage and optional add-ons, such as pre-existing conditions. Conducting a health survey of your employees to see what they seek from your organisation regarding health benefits will help you choose the best package. Sometimes, due to the hazardous nature of the job, they may want a Group Personal Accident Insurance. Customising the health plans with employees’ requirements increases their appreciation and loyalty.

  • No Medical Checkups
  • A Group Health Insurance plan’s primary feature and benefit is the absence of pre-medical checks. Before approving a health policy, every insurance company requires thorough medical checks of the insured. A high-risk medical condition increases the liability of the insurance company. Thus, they may reject an insurance application or increase the premium amount. However, in a group plan, there is no medical check requirement. All employees, including those with pre-medical conditions, are eligible for the benefits.
  • No Waiting Period
  • A waiting period refers to the time you need to wait before you can avail of the coverage benefits. In other words, you cannot file any claims till then. It may be 30 days or 60 days or more. However, there is no such waiting period in the Corporate health plan. You can avail of the benefits from the first day itself.
  • Wide Coverage
  • You can avail of comprehensive health coverage under Group plans. If you have pre-hospitalization expenses like consultation fees, X-rays, CT scans, MRIs, or post-hospitalization expenses like medicines or follow-up tests, you can reimburse them all. Apart from treatment costs, there are other expenses, such as ambulance fees and room rentals. Your group health policy can cover this as well.
  • Cashless Facility
  • For most medical treatments, you need to pay at the hospital. But, with a cashless option, you don’t need to pay for medical expenses. The insurance company pays the hospital directly. However, you can only avail this benefit at one of the insurer’s network hospitals. A cashless benefit is not to be confused with reimbursement. For reimbursements, you will have to pay for the medical expenses and then claim them later.
Group Mediclaim - Money Care
  • Inclusions of Dependents
  • As per the Union Ministry’s health data, there has been a rise in health inflation from 9.12% in January 2022 to 11.64% in March 2022. These rising medical costs can create a financial strain on the employees. The medical problems of family members may even hamper their work productivity. A group medical policy relieves this burden as the benefits of these policies are not only for the employees but include dependents like their spouse, children, and parents.
  • Exclusions
  • The Group policies offer extensive coverage. However, they also exclude certain diseases and medical issues. It will be unnecessary financial stress to pay for medical expenses covered under your insurance plan. Here are some exclusions:
  • Bariatric surgery
  • Lasik surgery
  • Rejuvenation therapy
  • Robotic surgery
  • No Co-Payment
  • A co-payment refers to a percentage of the medical expense that is borne the insured. In the Group medical plan, the employees don’t have to pay any costs. However, if they want additional coverage, they will have to pay the premiums for the same.
  • Tax Deductions
  • When employers offer any benefits to their employees in addition to the salaries, they are known as fringe benefits. The employer can avail of a tax deduction on any such benefits under Section 17 of the Income Tax Act. The group medical premium paid the employer is ‘Profit in lieu of salary’ or a fringe benefit. You don’t have to pay any tax on these. Also, employees can’t take tax benefits since they don’t pay for the premiums. For additional coverage premiums, they can take benefits under Section 80D. Under Group term life insurance plans, the family members can avail of tax deductions on death benefits under Section 10(10D).

Final Words

The above article gives a detailed understanding of the primary features of a Group Health Insurance plan. However, it is crucial to understand your workforce requirements, research the types of available coverage, and review your financial budget. Next, research the insurance company’s reputation, claim settlement ratio, hospital network, waiting period, and customer reviews. With Plum Insurance, you can avail of quick claim settlements, customised plans, coverage, and full transparency of your health plans with their easy-to-use dashboard.