Modern-day hospitalisation is an expensive process. It becomes even more difficult if you happen to be ailing for an extended period of time. Certain surgeries can cost you a large chunk of your savings. During such instances, reliance on your emergency fund or savings deposit sounds ideal. But is it the best choice possible? Not at all; this is why you should go ahead and utilise your employee insurance policy. 

Employee insurance policy – what is it?

An employee insurance policy is a unique medical coverage plan that is given to an employee by the employer free of cost. This product is created to financially assist the employee in times of need (medical treatment, emergency accident that requires immediate hospitalisation and more). As a founder of a startup, MSME, or corporate organisation, an employee health insurance scheme must be a core component of your annual operating plan

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We want to be a helping hand in your entrepreneurial journey. Therefore, we have carefully created a list of five points you should oversee with respect to employee health insurance before making the final purchase decision. 

Scope of cover – This is the first thing you should know. The employer’s sole duty is to provide your employees with a group medical health insurance plan. It is for the benefit of employer-employees only. The cost of an employee insurance policy is less expensive because the risk is scattered across your company’s workforce (premium rate risk is split among the members of a huge group).

For the employees, it is primarily corporate-sponsored and free of cost. The medical benefits can also be utilised for the employee’s immediate family members. One can include group term life insurance, group accident insurance cover, and an employee health insurance plan as a supplementary benefit. 

Simple to implement – An employee insurance policy is no longer a traditional brick-and-mortar product. The plans are readily available online via aggregators and digital brokerage platforms. Plum Insurance is a prominent B2B SaaS platform which also offers customisation options.

The entire process, from buying to adding/deleting employees, claims to file and to track, adding family members, WhatsApp assistance, downloading of health ids, chatbot support, adding new benefits and more, can be done from a single dashboard.

Plus, the online process has eliminated the need for a middleman and reduced paperwork. 

Customisation of features – There are multiple features that can be included in the master policy at an affordable premium. You can select a cover based on employee, spouse, children and parents (ESCP) policy for the entire organisation. Many group insurance plans allow employees to include parents-in-law as well.

The company can also select the amount of cover to be given to each employee. Depending on the policy and insurance provider, it can range from INR 5 lakhs to 25 lakhs upwards. Remember, if your sum insured cover is INR 5 lakhs, this amount applies to you and your entire family. It refers to the total coverage for the family and is shared by the beneficiary (employee) and your dependents every year.

Additional coverage – Optional add-on covers can be included in the employer-employee insurance policy by paying an additional premium. Here is a list of rider options. 

  • Cover for Pre­ Existing Diseases
  • Maternity Expenses
  • Out Patient Department (OPD) Expenses
  • Cost of Prescribed External Medical Aid
  • Baby Day One Cover
  • Critical Illnesses Cover
  • Travel Expenses For Medical Treatment
  • Dental Expenses
  • Cover for Alternate Methods Of Treatment
  • Donor Expenses
  • Ambulance Charges
  • Pre and Post Hospitalization
  • Health Check­Up
  • Disease­ Wise Sub­Limit
  • Domiciliary Hospitalization
  • Treatment Outside India
  • Convalescence Benefit
  • Loss of Wages/Salary Due To Hospitalization (Hospital Daily
  • Cash Allowance)
  • Cover for Allied Hospital Charges
  • Limit on Room Rent, Nursing Charges, Consultation Fees,
  • Diagnostic Charges, OT Charges etc.
  • Wellness & Preventive Care

Please note that the above list is standard, non-exhaustive, and varies between insurance providers. This further changes depending on the type of master group insurance plan your organisation has selected for its employees. 

Eligibility criterion – The standard age band is 91 days to 80 years without needing a health check-up. By default, employee health insurance plans cover workmen from day one (when they have joined the organisation successfully). This relieves an employer from the need to buy an individual health policy for your workforce.

One drawback of a group medical cover – GMC policy is that the group mediclaim benefits will not be applicable if an employee leaves the organisation. This applies to your added dependents as well. 

Please note that the content mentioned in this article is purely for informational purposes to help you understand the basic functioning of an employee insurance policy. The written material has been taken from verified sources on the internet and is updated regularly.

If you would like to explore more about group medical health insurance, please read the entire policy document given to you by your group insurance provider. 

Why do you need an employee insurance policy?

A GMC policy covers not only employer-employee but also their respective family members. Supporting your employees and their kin at times of medical distress can help an organisation retain good talent and inculcate long-term loyalty among the workforce. When you good take care of your employees, the employees feel appreciated. In return, this boosts employee morale and overall productivity. 

In addition, medical health benefits such as dental cover, mental wellness sessions, super top-up, discounted medicines, free health check-ups, corporate wellbeing programs, home care treatment, out-patient department cover, reimbursement for lab tests, hospital cash allowance, and much more can be included in an employee insurance policy. 

Even better, a group medical insurance covers pre-existing diseases and conditions from day one. Employer-employee insurance can be a good backup plan if you already have an individual health plan. There is nothing better than having a corporate-sponsored medical cover backup plan for you and your family. 

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Author

Growth Marketing at Plum Insurance