Corporate Health Insurance - Corporate Medical Insurance

Corporate health insurance is a type of group insurance that provides coverage for employees, their families and dependents. It's designed to protect your business from rising health and medical costs by providing coverage for critical illness, accidents and disability to you and your workforce.

Several different types of corporate plans are available today; each has its own set of benefits and features that make them unique. But all these plans share one thing in common: they protect against catastrophic events (medical emergencies that requisites immediate hospitalisation) at little or no cost to you! The most common types of corporate medical plans for employer-employees in India are.

Group medical health insurance plan, also known as GHI/GMI/GMC
Group term life insurance plan, also known as GTL/GTLI
Group personal accident insurance plan, also known as GPA

The following sections will explain corporate health insurance, how it works, and why it's essential for your company's long-term financial security.

Corporate health insurance - how does it work?

Corporate health insurance is a form of group insurance that covers the risk of incurring medical expenses during the course of active employment. It is a type of group mediclaim that provides financial protection against the risk of medical treatment expenses in the event of an unforeseen hospital emergency, specifically to the employee and their respective families. Many plans allow workers to cover their parents-in-law with super-top, critical illness coverage, outpatient department benefits, and much more.

In short, if you or your family person gets hospitalised, the employer-sponsored corporate medical insurance coverage can be utilised to pay the cost of hospital bills.

As a salaried employee, you must check with your human resources department to check the complete details of your corporate medical plan.

The importance of corporate medical insurance (GMC + GPA + GTL) cannot be overstated for an employer as well, as it protects your business from high costs and potential lawsuits or other legal issues if a worker gets sick or injured on their own time off work. In India, which has a large working population, employer-employee insurance benefits salaried individuals with limited access to health care coverage through their employer's plan, especially for those who cannot afford an individual healthcare policy.

Modern healthcare is expensive, so it makes sense why companies and young co-founders would want to shield themselves from those costs by purchasing a group plan to protect their workforce's interests and well-being. A happy and secure workforce is ideal for any organisation.

Features of Online Corporate Health Insurance by PLUM

In today's digital age, the availability of online corporate health insurance has revolutionized the way businesses manage their employees' healthcare needs. These online platforms, such as the one offered by Plum, come with a host of benefits and features tailored to meet the evolving requirements of modern businesses. Let's delve deeper into the importance and features of online corporate health insurance:

1. Easy Online Enrollment Process for Employees:

One of the standout features of online corporate health insurance is the streamlined and user-friendly enrollment process for employees. Through online portals or mobile apps, employees can conveniently enroll in the insurance program with minimal paperwork and hassle. If they lack contacts for reaching out, they should be able to access mobile carrier lookup for different institutions.This accessibility and convenience eliminate the need for manual paperwork and lengthy administrative procedures, saving time for both employees and HR personnel.

2. Customizable Coverage Options Based on Employer's Requirements:

Online corporate health insurance platforms often offer customizable coverage options that can be tailored to meet the specific needs and preferences of employers. Employers have the flexibility to choose from a range of coverage options, including different benefit limits, deductible amounts, and additional coverage features. This customization ensures that the insurance plan aligns with the organization's budget constraints and healthcare priorities.

3. Quick and Hassle-Free Claim Settlement Process:

Another significant advantage of online corporate health insurance is the expedited and hassle-free claim settlement process. Through digital platforms, employees can submit their insurance claims online, eliminating the need for manual paperwork and reducing processing time. Additionally, online claim tracking features provide real-time updates on claim status, ensuring transparency and accountability in the claims process. This swift and efficient claim settlement process enhances employee satisfaction and reduces administrative burden for HR teams.

4. Access to a Wide Network of Hospitals and Healthcare Providers for Cashless Treatments:

Online corporate health insurance platforms typically collaborate with a vast network of hospitals and healthcare providers, offering employees access to cashless treatments and services. This extensive network ensures that employees can receive quality healthcare services from trusted providers without the hassle of upfront payments or reimbursement claims. By providing access to cashless treatments, online corporate health insurance promotes timely medical interventions and enhances the overall healthcare experience for employees.

5. Comprehensive Coverage for a Range of Medical Expenses:

Perhaps the most crucial feature of online corporate health insurance is its comprehensive coverage for a wide range of medical expenses. These policies typically cover expenses related to hospitalization, doctor's consultations, diagnostic tests, discounted medications and other healthcare services. Moreover, online corporate health insurance may also provide coverage for pre-existing conditions, maternity benefits, wellness programs, and preventive care services, ensuring holistic healthcare coverage for employees.

What else do we get with PLUM Health Cover?

Plum Insure: It provides customized comprehensive health cover for your team’s diverse needs with transparency at affordable prices.

Plum health: It provides primary care for your team’s health concerns. With telehealth for online consultations, health check ups, discounted medicines, your team’s health is in safe hands..

Plum well-being: specially curated wellness sessions for your team. Engage with interactive sessions with content from various genres all in one app.

In essence, online corporate health insurance platforms like Plum play a vital role in simplifying and optimizing employee healthcare benefits management for modern businesses. By offering easy enrollment processes, customizable coverage options, efficient claim settlement procedures, access to a vast network of healthcare providers, and comprehensive coverage for medical expenses, these platforms empower employers to prioritize the health and well-being of their workforce effectively. Moreover, by leveraging digital technology and innovative features, online corporate health insurance enhances the overall employee experience, fosters employee satisfaction, and drives organizational success.

Advantages of corporate health insurance for employers and employees

You will be covered for medical expenses from day 1
You will be covered for critical illnesses (this also depends on the scope of cover of the group cover)
You will be covered for in-patient hospitalisation
You will be covered for emergency treatment due to an accident
You will be covered for outpatient treatment and surgery (OPD benefits can be availed at the cost of an additional premium payment)
You can go ahead with the flexible premium payment options
You get to save income tax
You get to pick and select the right kind of employee benefits and sum insured on a single platform with the best quote possible from multiple insurers
No agents, no commission, no paperwork. Your decision is free from human bias and error
No need to visit the bank; you get to customise your digital health insurance plan online
Get the option to include additional benefits such as critical illness and maternity cover for employees and their dependents.

What is covered under your corporate health insurance policy?

The coverage you receive depends on the type of group policy selected by your company. Some policies include:

Hospitalisation - This coverage can pay for hospital stays for individuals and their families up to a set amount, equal to the sum insured per employee. It also pays for medical expenses related to childbirth and certain pre-existing conditions post the waiting period (for example, if you have asthma or diabetes, if your policy comes with maternity and childbirth coverage).
Physician visits - Your plan may cover basic medical care for preventative purposes (such as yearly checkups) and pre/post hospitalisation expenses, including prescription drugs that your doctor or specialist recommends. If you're injured while at work or on vacation, this benefit will help with treatment costs related to the injury itself and rehabilitation afterwards.

What is not covered under your corporate health insurance plan?

Out-of-network care - This is the type of care you may have to pay for yourself if your plan doesn't cover it.
Critical care - Your health insurance company may not cover urgent visits or surgeries, like those related to childbirth or cancer treatment or heart stroke. The complete list of non-covered critical conditions is mentioned in the policy document.
Pre-existing conditions and other medical conditions that are not covered under your plan's benefits package (such as diabetes). If a person with a pre-existing condition enrols in an employer's group health plan, they may be denied coverage for these additional services unless they've been approved by the insurer beforehand; this is known as "pre-approval" surgery procedures that are sometimes requested by employees who want more flexibility over their health choices without having them put off until later when necessary medical care becomes unavailable due lack funds needed funds. The other option is to complete the waiting period.

It's no secret that healthcare costs are rising. According to the Bureau of Labor Statistics, the average cost for hospital stays has increased by about 50% since 2010. Keeping this in mind, it is a good decision to secure yourself and your family's future by choosing a corporate health insurance plan. Not only are you covered for health expenses but also critical illnesses.

Not only do these plans provide peace of mind by covering medical bills when they arise, but they can also help you plan for the future. It's never too early or late to start saving money on premiums so that when something does happen—whether it be an emergency visit to the doctor or surgery—you won't have any issues paying out-of-pocket costs due to lack of funds available at the time (and if there isn't enough saved up). As we all know, corporate health insurance comes at no cost to an employee's paycheck.

Eligibility Criteria for Corporate Health Insurance

Corporate health insurance is a valuable employee benefit provided by employers to ensure the health and well-being of their workforce. While the specific eligibility criteria may vary depending on the insurer and the policy terms, there are some common requirements that employees must typically meet to qualify for coverage. Let's explore these eligibility criteria in detail:

1. Full-Time Employment Status:

One of the primary eligibility requirements for corporate health insurance is having a full-time employment status with the employer offering the insurance. Full-time employment typically refers to working a minimum number of hours per week as defined by the employer. Employees who meet this criterion are considered eligible for enrollment in the corporate health insurance plan.

2. Active Enrollment During the Specified Enrollment Period:

Employees must actively enroll in the corporate health insurance plan during the specified enrollment period to be eligible for coverage. The enrollment period is typically determined by the employer and may occur annually or during specific times of the year. During this enrollment period, employees are required to complete the necessary paperwork and provide any required documentation to enroll themselves and, in some cases, their eligible dependents in the insurance plan.

3. Compliance with Additional Requirements:

In addition to the basic eligibility criteria mentioned above, employees may be required to comply with any additional requirements set forth by the employer or insurer. These requirements may vary depending on factors such as the employee's job role, tenure with the company, or participation in wellness programs. Common additional requirements may include attending health screenings, participating in wellness initiatives, or meeting certain health-related criteria.

Factors Impacting Eligibility:

While the eligibility criteria outlined above are standard, certain factors may impact an employee's eligibility for corporate health insurance. For example:

Part-time employees or contractors may not be eligible for coverage under the corporate health insurance plan.

Temporary or seasonal employees may have limited eligibility or may not be eligible for coverage depending on the employer's policies.

Some employers may extend coverage to eligible dependents of employees, such as spouses and children, subject to certain conditions and documentation requirements.

Employer-Specific Policies:

It's essential to note that eligibility criteria for corporate health insurance may vary depending on the specific policies and practices of the employer. Employers have the discretion to set eligibility requirements based on their business needs, budget constraints, and strategic objectives. Therefore, employees should refer to their employer's policies and consult with HR or benefits administrators to understand the eligibility criteria applicable to their specific situation.

How to Buy Corporate Health Insurance

Purchasing corporate health insurance is a significant decision for employers, as it directly impacts the well-being of their workforce. To ensure comprehensive coverage that meets the organization's needs and budgetary constraints, a systematic approach to buying corporate health insurance is essential. Here's a detailed breakdown of the steps involved in purchasing corporate health insurance:

1. Evaluation: Assess Your Organization's Healthcare Needs and Budgetary Constraints:

Before diving into the purchasing process, it's crucial for employers to evaluate their organization's healthcare needs and budgetary constraints. This assessment involves considering factors such as the size of the workforce, demographics of employees, existing health benefits offered, and any specific healthcare challenges faced by employees. Understanding these factors will help employers determine the scope and level of coverage required in the corporate health insurance plan.

2. Research: Explore Different Insurance Providers and Policies:

Once the organization's healthcare needs are assessed, employers should conduct thorough research to explore different insurance providers and policies available in the market. This research phase involves comparing features, coverage options, premium rates, claim settlement processes, network of hospitals, and customer service reputation of various insurers. Employers can leverage online resources, seek recommendations from industry peers, or engage with insurance brokers to gather relevant information and make informed decisions.

3. Customization: Customize the Coverage Options Based on Your Organization's Needs:

Customization is a critical aspect of buying corporate health insurance, as it allows employers to tailor the coverage options to align with their organization's specific needs and priorities. During this stage, employers can work closely with insurance providers to customize the policy features, coverage limits, deductible amounts, and additional benefits based on factors such as employee demographics, healthcare utilization patterns, and budgetary considerations. By customizing the policy, employers can ensure that the corporate health insurance plan addresses the unique healthcare requirements of their workforce.

4. Enrollment: Enroll Eligible Employees in the Corporate Health Insurance Plan:

Once the policy customization is complete, the next step is to enroll eligible employees in the corporate health insurance plan. Employers typically conduct an enrollment period during which employees can opt into the insurance coverage. This enrollment process may involve providing employees with relevant information about the insurance plan, assisting them in completing enrollment forms, and collecting any required documentation. Employers should communicate clearly with employees about the enrollment process, eligibility criteria, coverage details, and any deadlines or requirements to ensure a smooth enrollment experience.

5. Payment: Pay the Premiums to the Insurer as per the Agreed-Upon Terms and Conditions:

Finally, employers are required to pay the premiums to the insurer as per the agreed-upon terms and conditions of the corporate health insurance policy. Premium payments are typically made on a periodic basis, such as monthly, quarterly, or annually, depending on the payment schedule specified in the policy. Employers should ensure timely premium payments to maintain continuous coverage for their employees and avoid any lapses in insurance benefits.

Once you are all set with the above pointers, go to Plum’s website PLUM HQ and get your quote today.

Things to Consider While Buying Corporate Health Insurance

When purchasing corporate health insurance for your organization, it's essential to consider several factors to ensure that you select a policy that meets the needs of your employees while also aligning with your budgetary constraints. Here's a detailed look at the key factors to consider:

1. Coverage Options:

Inpatient and Outpatient Care: Evaluate the coverage options for both inpatient (hospitalization) and outpatient care (doctor's visits, diagnostic tests, etc.). Ensure that the policy provides adequate coverage for medical expenses incurred both within and outside hospital premises.

Maternity Benefits: If your organization includes employees who may require maternity benefits, such as expecting mothers or those planning to start a family, ensure that the policy offers comprehensive coverage for maternity-related expenses, including prenatal care, childbirth, and postnatal care.

Pre-existing Conditions: Review the policy's stance on pre-existing conditions. Some policies may offer coverage for pre-existing conditions after a waiting period, while others may exclude them altogether. Consider the health status of your employees and opt for a policy that provides suitable coverage for pre-existing conditions.

Additional Benefits: Assess whether the policy offers any additional benefits beyond basic medical coverage. These may include wellness programs, preventive care services, dental and vision care, mental health services, and alternative therapies. Choose a policy that offers a comprehensive suite of benefits to address the diverse healthcare needs of your employees.

2. Network Hospitals:

Check if the insurer has a wide network of hospitals and healthcare providers where employees can avail cashless treatments. A robust network ensures that employees have access to quality healthcare services without the need for upfront payments or reimbursement claims. Evaluate the geographical coverage of the network to ensure that employees located across different regions can access healthcare facilities conveniently.

3. Claim Process:

Review the claim settlement process and turnaround time to ensure a smooth experience during claim filing. Evaluate the ease of filing claims, documentation requirements, and the efficiency of claims processing. Look for insurers that offer online claim submission facilities, real-time claim tracking, and dedicated customer support to assist employees throughout the claims process. A transparent and responsive claims process contributes to employee satisfaction and reduces administrative burdens for HR teams.

4. Premium Costs:

Compare premium rates across different insurers to find the most cost-effective option without compromising on coverage. Consider factors such as the extent of coverage, deductible amounts, co-payment requirements, and any discounts or incentives offered by insurers. While cost is a significant consideration, prioritize value for money by selecting a policy that offers comprehensive coverage at competitive premium rates. Strike a balance between affordability and the level of coverage provided to ensure that the policy meets your organization's healthcare needs within the allocated budget.

How is Corporate Health Insurance Different from a Regular Health Insurance Policy?

Corporate health insurance and regular health insurance policies serve the common goal of providing financial protection against medical expenses. However, they differ in various aspects, including coverage, customization, and premium payment. Let's delve into the details of these differences:

1. Group Coverage vs. Individual Coverage:

Corporate Health Insurance: Corporate health insurance provides coverage to a group of individuals, typically employees of a company or members of an organization. The coverage extends to all eligible employees and may also include their dependents, such as spouses and children, depending on the policy terms. Group coverage allows insurers to spread the risk across a larger pool of individuals, resulting in potentially lower premium rates and broader coverage options.

Regular Health Insurance Policies: In contrast, regular health insurance policies provide coverage to individuals and their families on a standalone basis. These policies are purchased by individuals directly from insurance companies or through agents or brokers. Coverage is tailored to the specific needs of the policyholder and their family members, with premiums based on factors such as age, health status, and coverage requirements. Regular health insurance policies offer personalized coverage options but may have higher premium rates compared to group coverage.

2. Customization Options:

Corporate Health Insurance: Corporate health insurance policies may offer customization options tailored to the employer's requirements and preferences. Employers have the flexibility to choose coverage options, benefit limits, deductible amounts, and additional features based on the needs of their workforce. Customization allows employers to design a policy that aligns with their budgetary constraints while meeting the healthcare needs of their employees effectively.

Regular Health Insurance Policies: Regular health insurance policies are typically standardized with limited customization options. Policyholders may have the flexibility to select from predefined coverage options and benefit limits, but the extent of customization is often limited compared to corporate health insurance. Individuals can choose a policy that best fits their healthcare needs and budget but may have fewer options for tailoring coverage compared to group policies.

3. Premium Payment:

Corporate Health Insurance: In corporate health insurance, premiums are often paid by the employer on behalf of the employees. Employers bear the cost of insurance premiums as part of their employee benefits package. Premiums may be paid in full by the employer or shared between the employer and employees, depending on the policy terms and the employer's contribution policy. This arrangement allows employees to access healthcare coverage without directly bearing the cost of premiums.

Regular Health Insurance Policies: Individuals are responsible for paying the premiums for regular health insurance policies. Premium rates are based on factors such as age, health status, coverage requirements, and the chosen insurance provider. Policyholders pay premiums directly to the insurance company or through authorized channels. While employers may offer group rates or facilitate premium payments for employees, the ultimate responsibility for premium payment lies with the individual policyholder.

Conclusion

Corporate health insurance is the best way to protect employees and their families from unnecessary costs. With corporate health insurance coverage, you can rest easy knowing that you have taken care of all those medical emergencies that come up unexpectedly. Not only are you covered for health expenses, but also for critical illnesses and accidental emergencies.

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FAQ: Corporate Health Insurance

Q. What is the corporate insurance coverage?

A. Corporate insurance coverage encompasses medical expenses incurred by employees for illnesses, injuries, or accidents, as outlined in the policy terms. This coverage typically includes hospitalization, outpatient services, doctor's consultations, diagnostic tests, surgical procedures, and other healthcare services necessary for the treatment of covered medical conditions. Corporate insurance aims to provide financial protection to employees and their families against unexpected healthcare expenses, ensuring access to quality medical care without undue financial burden.

Q. What is the minimum number of employees for corporate health insurance?

A. The minimum number of employees required for corporate health insurance coverage may vary depending on the insurer and the specific policy terms. While there isn't a universal standard, many insurers require a minimum threshold of employees to qualify for group coverage. This threshold could range from as few as two employees to larger groups, such as ten or more employees. The purpose of this requirement is to establish a viable risk pool and ensure that the insurance plan remains sustainable and cost-effective for both the employer and the insurer.
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Q. Is corporate health insurance mandatory?

A. Corporate health insurance is not mandatory by law in most countries, including India. However, many employers offer it as part of their employee benefits package to attract and retain talent, enhance employee satisfaction, and demonstrate corporate responsibility. Providing health insurance coverage is often seen as a valuable perk that contributes to employee well-being and loyalty. While not legally required, offering corporate health insurance can be advantageous for employers in competitive job markets and may also yield tax benefits under certain circumstances.
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Q. Does corporate health insurance exclude hospitalization during pregnancy?

A. Some corporate health insurance policies may exclude coverage for hospitalization during pregnancy, depending on the policy terms. It's essential for employees to review the details of their health insurance policy to understand the extent of coverage provided for maternity-related expenses. While some policies may offer comprehensive maternity benefits, including prenatal care, childbirth, and postnatal care, others may have limitations or exclusions regarding pregnancy-related hospitalization. Employees should carefully review the policy terms and consider additional coverage options if necessary.

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Q. Should we buy separate health insurance if my company already provides it?

A. Whether to purchase separate health insurance in addition to the coverage provided by your employer depends on your individual needs, preferences, and circumstances. While employer-provided health insurance offers valuable coverage, it may not always be sufficient to meet all your healthcare needs. Factors to consider include the extent of coverage offered by your employer's policy, coverage limits, network of hospitals and healthcare providers, and any gaps or limitations in coverage. Evaluate your healthcare requirements, financial situation, and the level of risk you are comfortable with to determine whether additional coverage is warranted.

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Q. Do you keep multiple health insurance, or the one from your employer is enough?

A. Keeping multiple health insurance policies can provide additional coverage and financial protection, but whether it's necessary depends on individual circumstances. While employer-provided health insurance offers valuable coverage, it may have limitations or gaps that could be addressed by purchasing additional coverage independently. Consider factors such as coverage limits, deductibles, co-payments, network of hospitals, and premium costs when deciding whether to maintain multiple health insurance policies. Assess your healthcare needs and risk tolerance to determine the most suitable insurance strategy for your situation.
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Q. Which is better, buying new personal health insurance or topping up your personal health insurance in India?

A. The decision to buy new personal health insurance or top up your existing policy depends on various factors, including your health status, coverage needs, budgetary constraints, and existing insurance coverage. Topping up your personal health insurance policy allows you to increase coverage limits or add additional benefits without purchasing a separate policy. This can be a cost-effective option if you're satisfied with your current insurer and want to enhance your coverage without starting over with a new policy. However, if your existing policy doesn't meet your healthcare needs or has limitations, purchasing a new personal health insurance policy with comprehensive coverage may be a better option. Consider consulting with an insurance advisor to evaluate your options and make an informed decision based on your individual circumstances and priorities.

What is Corporate Health Insurance?