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The group health insurance is a special type of health insurance offered by the insurance company to cover multiple people in single policy. Most commonly, this insurance is taken by employers to cover their employees’ health care needs. The plan is customized based on the size of the group and the type of coverage desired. Many times, employers also offer medical cover to the entire family of the employees.
Key Features of Group Health Insurance
- The entire workforce (a group of employees) working in the organizations is covered under one policy.
- The policy covers the employee, spouse, and dependent parents.
- The policy is on a perpetual basis, with yearly premium. The validity of the policy starts from joining date of the employee and ends on leaving date of the employee.
- The cashless hospitalization is offered as a standar feature under group health insurance.
- The rules for pre-existing illness and maternity expenses are lenient as compared to individual health policy.
How is Group Health Insurance Beneficial to Employers?
The employee feels motivated as medical expenses are continuously on the rise. When the company covers the entire family’s medical expenses, its huge relief for the employee.
The expense incurred on the group health insurance policy of the workforce is given as deduction from the income. Hence the employer’s tax liability decreases.
With group health insurance, the employee can take quality medical treatment without unduly worrying about the hospital bills. The correct treatment on time ensures speedy recovery, and the employee can return to the work early. It increases the overall productivity of the organization.
Value for Money
The group medical insurance covers the pool of people. Hence it is cheaper than individual health policy. The employer can provide more value to employees at a lower cost of employee health insurance premium.
How is Group Health Insurance Beneficial to Employees?
No Waiting Period
If you buy a new medical insurance policy, it comes with a certain waiting period, specifically for pre-existing diseases. To put it simply, the treatment of pre-existing illnesses is not covered up to one year (or more as specified in the policy) from the date of availing the medical policy. However, under a group medical insurance policy, the employee is covered from the very first day of his joining for any treatment.
When you take individual health policy, it comes with several restrictions, riders, and add-ons. For example, your premium increases if you have a smoking habit. Based on your family health history, you may be denied a certain cover. No such restrictions are applied in a group health insurance policy, barring one or two rare exceptions.
The female employees can get wider benefits during medical treatments related to maternity. In the individual health insurance plan, the maternity benefit is not part of the standard scope. You have to buy maternity health insurance plans an add-on to avail the benefit.
The HR or admin department of the company remains in continuous touch with insurance company due to frequent needs of many employees. The employee seeking the treatment can contact his HR manager for faster co-ordination between the insurance company and hospital for cashless process and other related matters. In the case of individual medical policy, such a process has to be done by the person himself or through an insurance agent.
In a nutshell, group medical insurance is boon for employee and employer both. You can consider taking it from reputed company like Bajaj Finserv that has good claim settlement ratio in the insurance services.