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Benefits of Group Health Insurance Policy for Employees

Updated On Nov 21, 2023

Employers provide group health insurance policies to provide both health and wealth to their employees. The group mediclaim insurance policy lets employees obtain basic coverage against unforeseen critical illnesses. Every employee must know about the policy in detail to avail of the benefits at the maximum level.

Let’s read this article and discuss a few basic things about the group mediclaim insurance policy for employees.

What is a Group Mediclaim Insurance Policy?

A group mediclaim policy which is also known as a group health insurance plan is provided by employers to their employees covering a variety of benefits. To offer this policy, some employers deduct a certain amount from the CTC of the employees. The deducted amount is the premium cost of the employer-provided health plan. However, some organisations offer a group policy to their employees for free.

Group health insurance for employees offers various benefits including security for an employee and their family members. This extended support is a jackpot and is of great benefit to working professionals. 

Key Features of a Group Health Insurance Plan

Highlighted below are some of the common features of a Group Mediclaim Insurance Policy for Employees:

  • Certain group health insurance policies may cover boarding costs in addition to anesthetist, surgeon, and consultation fees. Other expenses covered include oxygen, anesthesia, and diagnostic materials, as well as dialysis and X-rays.
  • Some of the group medical insurance plans offer coverage for maternity-related expenses.
  • Group health insurance plans extend coverage for specific critical illnesses above the hospitalisation cover.
  • Offers cover for less than 24 hours of hospitalisation for specific treatment procedures like eye surgery, chemotherapy, tonsillectomy, etc.
  • Other optional benefits of group health insurance plans include a waiver of the waiting period, the exclusion for the first year other than reimbursement for ambulance expenses, etc.

Benefits of the Group Medical Insurance Policy

The following are some of the most common advantages of a Group Medical Insurance Policy:

  • Low cost because of larger risk: Group health insurance plans are always less expensive than individual or family floater health insurance plans. This is due to the employees sharing the premium amount.
  • Employees feel valued: With group health insurance coverage, the employees feel happy that the organisation values them. In return, they also work hard to deliver their best and make it better for all. 
  • A higher number of people increases the plan advantages: As a higher number of people are covered under group health insurance plans, its advantages increase for the policyholders. They get a higher value with added benefits like cover for pre-existing diseases, hospitalisation expenses, etc.
  • Family protection is included: It may depend on policy to policy, but group medical insurance plans often cover your family members too. These plans protect the dependents of the employees by offering them financial help in their time of need. If not, the family members may have to purchase another family floater health insurance plan and pay the premium out of their own pocket. 
  • Easy to claim: Instead of running around health insurance companies for a claim, all you have to do in group health insurance plans is connect with your employer with relevant bills. Because a large number of employees are insured, the employer makes certain that your claim is approved. Employees can even receive cashless treatment.

Pre-existing conditions and maternity-related costs are covered by these policies. Employees may be able to add more family members to the plan with a little greater deduction in specific circumstances.

Also read, How to Opt for Suitable Health Policies for Employees?

Which Company Offers Group Health Insurance For Employees?

Every organisation, be it private or government, is liable to provide a group mediclaim policy to its employees. However, the schemes may differ. Government sectors offer schemes like CGHS, while Private sectors offer plans or health services like ESI. 

However, policies provided by government firms are much more explicit and extensible. The sum insured or coverage is unlimited. But even so, network hospitals and cashless hospitalisation benefits may differ from one organisation to the next, whether government or private.

Should You Buy Personal Health Insurance Even If You Have Group Health Insurance?

Yes, you should buy a personal health insurance plan despite having group health insurance because even if you are covered with the benefits under a group plan, sometimes it can be a drawback. Some of the reasons for this may include-

  • There is a cap on some coverage features.
  • It is a loss for the employee when they leave an organisation.
  • Not beneficial for retired employees.
  • Everyone pays the same premium amount, even if they are fit or not.
  • The high claim amount may escalate renewal premium costs.

Conclusion

Besides advantages, a group health insurance plan comes up with certain disadvantages too. Let's put some light on the drawbacks with an example. 

You join an organisation but the employer asks you to leave within a few months without any notice. In this case, you may be worried about not only finding a new job but also a new health insurance plan. There you may have to again start from scratch- choose a plan, buy it, and serve a waiting period and you won’t even be able to enjoy accumulated benefits from your last policy. 

Therefore, regardless of your reason for leaving the workplace, the benefits of group health insurance policies expire the day you go. Additionally, the plan you find in another company might not be as advantageous as the one in your current company.

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