Group Health Insurance

Very Easy 3 step Process

Group Health Insurance Policy

Medical care in India costs have risen over the past decade at a high double-digit annual rate, reports show. The Indian Institute of Public Health illustrated hospital charges that had risen at over 10% annually-sending families into financial stress when medical emergencies arose.

According to the latest findings of the National Sample Survey, a strong argument suggests that almost 60% of all the population lack health insurance coverage. This clearly underlines the very dire need for comprehensive coverage. Group health insurance has emerged as the chief feature of financial planning available to employ indispensably as cover for employees and their families and to ensure access to good-quality health care without this enforced pain of heavy medical expenses.

IRDAI in its report 2023 showed that companies which offer group health insurance have enhanced the retention and satisfaction of their employees to a level of about 30%. CII has recently conducted a study where it has found that near about 80 percent of the employees chose health benefits as the principal reason for choosing and staying with the same employer. Given that the value that an organization gives to the welfare of the employees becomes clear, group health insurance has remained part and parcel of the employee benefits package of any organization, helping companies build loyalty and productivity while putting a leash on the rising cost of healthcare for all workers.

What is Group Health Insurance?

Group health insurance is that sort of cover provided to a group of people, most importantly, the employees of an organization, under a single insurance policy. This insurance provides full-time and comprehensive coverage for the medical expenses of the group members’ inpatient and outpatient costs and preventive health services. Group health insurance constitutes the largest share of coverage for over 28% of the Indian population as per the IRDAI.

Why Does an Individual Need Group Health Insurance?

Financial Security

The medical expenditure in India has gone crazy over the past few years. National Health Authority report mentions that out-of-pocket health care expenditure had accounted for about 62% of the total health expenditure in the year 2020. Group health insurance curtails the cost implication to an employee when expensive medical treatments take place and thereby enables him to undergo the required treatments without hampering financial security.

Improved Employee Satisfaction and Retention

The polls reveal that 70% of the employees will consider the health benefits before selecting a choice. Health insurance also has other effects on mood, motivation, and retention of employees; thus, the percentage rate at which turnover occurs is lowered. According to Employee Benefit Research Institute, providing health benefits to their companies may boost the retention levels by 25%.

Preventive Care and Wellness

Most of the group health insurance cover preventive services offered by the vaccination program and regular health check-up services. Indeed, it is only with this strategy that a percent 29 has been documented to have a check-up by the National Family Health Survey (NFHS) for the year 2023. Group health insurance keeps the employees healthier through motivating them to seek preventive care.

Tax Benefits

The employer would also be given tax exemptions for the premium paid for the group health insurance policies. The employees’ premium payments could also be exempted under Section 80D of the Income Tax Act, and this would save additional tax.

Group Health Insurance Plans

Employer-Sponsored Group Health Insurance

This is the most popular form of group health insurance. Coverage is provided to the employees by the employers. According to the IRDAI report, 45% of all health insurance policies in India are group plans, which indicates how important they are in the market.

Group Mediclaim Insurance

This mediclaim insurance is majorly designed for organizations which covers the medical expenditure of the employees and their families. The Health Insurance Association of India shows that a survey there revealed that 68% of the employees rely on group mediclaim policies for their health requirements.

Group Health Insurance for Associations and Clubs

Professional organizations, unions, and clubs offer group health insurance to all its members. All the members of such professions or interest-based groups can acquire affordable group health insurance through a collective effort.

Some of the most significant features of group health insurance include

Comprehensive Coverage

Most of the group health insurance plans are found to offer complete cover, hospitalization, surgeries, maternity benefits, and critical illness cover. Nearly 78% of the group health insurance plans have included critical illness coverage within its package as it is very much in demand of the present age in the wake of lifestyle disorders like diabetes and hypertension.

No Medical Underwriting

Group health insurance, unlike individual policies, does not require medical underwriting hence covers all members of the group. This is very critical because a survey carried out by the WHO revealed that almost 37% of Indian people suffer from some form of pre-existing health condition.

Family Coverage

Most group health insurance plans cover the family members of the employee. While most group health insurance corporations protect their spouse and dependents covered under the plan, most group health insurance companies do protect their families. Group Health Insurance

Coverage Statistics

In fact, a report of the IRDAI recently found that 82% of the employers are offering family coverage as an add-on feature of group health insurance.

Cashless Hospitalization

Many group health insurance covers have cashless facilities in the network hospitals that reduces the issues of recovering claims from the employees. According to IRDAI, more than 70% of claims settled on cashless mechanisms ensure that required medical attention reaches the employee in time.

Portability

Employees can change the group health insurance cover into an individual policy on leaving the organization. Therefore, continuity of the coverage is ensured.

Advantages of Group Health Insurance

Cost-Effectiveness

Group health insurance is relatively cheaper compared to the individual one. According to IRDAI statistics, the premium under a group plan decreases by 20-30%. This is quite alluring for both the employer and the employee.

Pretty Simple Claims Process

Group health insurance claims are much more straightforward and quick to settle and hence much faster compared to an individual policy. Claims of up to 85% would have been settled within one month, bringing a much-needed relief from the anxiety that might have been to do with the medical emergency.

It Encourages Healthy Workplace Culture

With group health insurance, the organization creates health awareness and preventive care. According to a survey, 66 percent of organizations giving group health insurance reported that employees started more health and wellness programs.

How to Select a Good Group Health Insurance Plan

Analysis of Employees’ Needs

Take into consideration the needs of your workforce in terms of demographics and healthcare. This way, knowing the needs of the employees will point toward which plan would provide the right coverage.

Compare Plans

Compare various group health insurance providers, comparing and contrasting coverage, benefits, exclusions, and premiums. It shall help in deciding appropriately to meet the goals as per organizational objectives.

Check for Network Hospitals

The insurance company needs to have a vast hospital network. The more expansive its network, the higher the number of cashless treatments that they will be able to avail-most of these in order to seek all kinds of medical care on time.

Repute and Claim Settlement Ratio

Walk through the claim settlement ratio of the insurer. The higher your claim settlement ratio the more dependable is the insurer. As per the latest statistics revealed in the year 2023, the average claim settlement ratio of the group health insurance policies running in India is a delicate balance around 87%. Seek professional advice

Only while consulting with a number of insurance brokers or experts will one know about the best group health insurance options available in the market.

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