How to Choose the Right Group Health Insurance?

Choosing the right group health insurance means striking a balance between comprehensive employee benefits and organisational budget. Therefore, there are certain factors that one needs to keep in mind while choosing the right insurance. Some of them include selecting the right sum insured, going for low waiting periods, and looking into the insurer’s CSR.

So, if you are planning to get group health insurance for your company, whether it is a small business or a multinational organisation, this blog will guide you. Read ahead to make the best choice.

8 Things to Look for Before Choosing a Group Health Insurance

One of the most important questions to ask before looking into group health insurance for your company is what does a workforce actually need from a health insurance cover. To answer this question, you will need to look into these factors:

Choose the Right Sum Insured

This is the most crucial factor while selecting a group health insurance policy. This is because you just do not have to consider your employee’s health needs, but also factor in inflation. For instance, a minimum of ₹5 lakh is often recommended for employees in metro cities like Kolkata and Mumbai.

Look Into the Network of Hospitals

Make sure that the insurer you are choosing has a vast network of hospitals that offer cashless medical treatment. This should specifically be true for the area where your employees live and work. Having the benefit of cashless hospitalisation also makes it easier to manage the claims of the employees directly.

Get Maternity Coverage

Make sure to include maternity coverage in your group health insurance policy. This is important as it helps employees manage expenses related to pregnancy and childbirth. Offering this benefit not only supports employees during an important life stage but also improves overall job satisfaction and retention.

Opt for Coverage with Low Waiting Periods

Always look into the policies that offer a lower waiting period. You should aim for zero waiting periods for pre-existing diseases (PED), so employees are covered from day one. This is because it ensures immediate financial protection, which allows the employees to access necessary medical treatment without delays or out-of-pocket costs.

Consider the Reputation of the Insurance Provider

Always check the reputation of the insurer you are choosing. This matters a lot in terms of determining the company's credibility, transparency and trustworthiness. To make sure that the insurer is credible, you can look into its customer reviews or consult someone who has used the company’s services.

Look Into Their Claim Settlement Ratio (CSR)

Remember to check the CSR of the insurance company. When you buy a group health insurance, look for a ratio above 90%. Do this as a higher claim settlement ratio indicates the insurer's reliability in paying out claims. The higher the CSR, the higher the chance that the claim made will be successfully settled.

Read the Policy Document Carefully

Always go through the policy document in detail before making a decision. This is because it helps you understand what is covered and what is excluded. For instance, you should check sub-limits, exclusions, and conditions related to claims. Doing this also ensures that you avoid confusion later.

Check the Renewability and Portability Options

You should always check whether the policy offers easy renewability and portability options. This is important as it allows employees to continue their coverage without interruption. For instance, portability helps them switch insurers without losing benefits. Having flexible options ensures long-term security.

Also Read: Comprehensive Group Mediclaim Policy: Health Insurance for Employees

Why Should You Purchase a Group Health Insurance?

According to Business Today, the medical inflation in India is rising at an average yearly rate of around 14%. This makes it much more difficult for people to access quality healthcare services.

Buying a group health coverage provides your employees with access to financial aid whenever they are facing any medical emergencies. Some of the coverages that group medical insurance provides are as follows:

1. Hospitalisation & Day Care Expenses: They get coverage for hospital stays. The plan also pays for day care, treatments, and surgeries.

2. In-patient Hospitalisation Treatment: This policy covers treatments where employees need to stay in the hospital for more than a day. It also includes surgeries.

3. Pre and Post-Hospitalisation Expenses: Your employees receive coverage for expenses before and after hospitalisation. This includes doctor visits, tests, medicines, and more.

4. Option to Cover Pre-Existing Diseases (PEDs) from Day 1: They can get coverage for existing medical conditions from the start, as it removes waiting periods.

5. Maternity Benefit: The policy covers expenses related to pregnancy and childbirth. Female employees can use this benefit for delivery and related medical care.

6. AYUSH Hospitalisation: Employees can claim expenses for treatments under Ayurveda, Yoga, Unani, Siddha, or Homoeopathy if prescribed by a doctor.

If you want to get a group health insurance cover that provides all of the above benefits, then go for Bajaj General Insurance. With it, you can also get 24/7 claim assistance, access to more than 18,400 hospitals, and quick online claim settlement. Click here to get started!

Also Read: 11 Things to Consider Before Filing Your Health Insurance Claim

Final Word

Looking into every little aspect while choosing a group health insurance is important. This is because it ensures that you choose a policy that includes all of the things that your employees want and get cost-effective coverage.

Remember, by choosing the right inclusion, you not only add to your employees' job satisfaction but also improve your company’s performance!

Frequently Asked Questions

Can employees customise their coverage in a group health insurance plan?

Yes, many insurers offer flexibility where employees can enhance their sum insured or add optional covers, such as critical illness or personal accident riders, by paying an extra premium.

What happens to the group health insurance policy after leaving the company?

Once you leave the organisation, the group policy usually ends. However, many insurers offer an option to convert it into an individual health insurance policy without losing the benefits.

How does premium payment work in group health insurance?

Generally, the employer pays the premium for group health insurance. However, in some cases, employees may contribute partially or pay extra for additional coverage.

Can start-ups or small businesses also purchase group health insurance?

Yes, many insurers, such as Bajaj General Insurance, offer group health plans tailored for start-ups and small businesses.

What is the difference between group health insurance and individual health insurance?

Group insurance is provided by an employer and usually has lower premiums. On the other hand, individual insurance is purchased personally and offers more long-term continuity.

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Disclaimer: Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet and is subject to changes. Please consult an expert before making any related decisions.