Employees are the most valuable assets of any organization. Happy employees play a crucial role in the growth of an organization. Employee satisfaction is thus an important factor that can impact a company’s growth in critical ways. Along with an amiable working environment and good pay, employee benefits like Group Medical Insurance (GMC) and Group Personal Accident (GPA) Insurance can contribute to employee satisfaction and talent retention.
Though both Group Medical Insurance (GMC) and Group Personal Accident (GPA) Insurance help an organization in ensuring financial protection for employees, features and benefits are distinct. If you are an organization looking to avail suitable protection for your employees or if you are an employee trying to understand GMC and GPA benefits offered by your employer, read on.
What is Group Medical Coverage? 🤔
GMC is a type of health insurance coverage offered to a group of people with similar interests such as the employees of the same organization. These health insurance policies are customizable as per the requirement of the group (organization) based on their needs.
As the risk in such health insurance policies is spread among all the members of the group of various age groups and medical history, the premium charged for the policy is relatively cost-effective in comparison to individual health insurance policies.
As group medical coverage policies are sponsored by the employer, the cost is either borne by the employer itself or a small amount of premium is shared by the employees. Coverage and premium for group medical coverage policies are dependent on various factors such as group size, needs and requirements, features, demographics like age, income, and the nature of the job, etc.
Let’s take a look 👀 at some of the features of the Group Medical Insurance policy.
- The policy provides hospitalization cover for admission in more than 24 hours.
- The policy provides coverage for pre- and post-hospitalization costs which include medical reports, the cost of medicines, X-rays, etc.
- The policy provides coverage for pre-existing illnesses without any waiting period. The coverage will start from day one.
- Coverage for daycare procedures and domiciliary expenses.
- Cashless facility for hospitalization at the hospitals that are on the insurer’s list of affiliated hospitals.
- Group medical cover policy also provides coverage for dependents of an employee.
- Comprehensive medical coverage at an affordable amount of premium to cover dependents.
- Additional features such as add-on riders to cover critical illnesses can be included in the policy.
- The policy offers coverage for maternity expenses and medical expenses for the newborn baby.
- Some of the GMC policies provide optional coverage for outpatient medical expenses.
- GMC policies come with underwriting guidelines that are simple and hence, can be availed without even pre-medical check-ups.
What is Group Personal Accident Insurance? 🧐
Group Personal Accident Insurance (GPA) policy is a type of group insurance policy that covers a group of people or employees of the same organization. Basically, the policy provides financial protection against unforeseen events such as death, fatal injury, or disability resulting from accidents.
Group Personal Accident policy comes with in-built features and benefits to cover employees in the event of an accident resulting in death or disability that can cause income loss for the dependents.
The premium for GPA policy is usually paid by the organization that is availing the coverage for its employees. However, some employers take a small portion of the premium from employees too.
Let’s take a look 👀 at the major features of the Group Personal Accident Insurance policy.
- The policy covers accidental death.
- The policy provides coverage for disabilities which includes permanent total disability, permanent partial disability, and temporary total disability.
- The policy provides coverage for hospitalization (more than 24 hours) due to an accident.
- Additional coverage features provided by the GPA policy include road ambulance cover and recovery benefit.
- The policy provides optional coverage for outpatient medical expenses.
GMC vs GPA
Now, let’s take a look at the difference between Group Medical Cover and Group Personal Accident.
|Group Medical Cover||Group Personal Accident|
|The policy does not provide worldwide coverage.||The policy provides worldwide coverage.|
|The policy provides coverage against healthcare emergencies that are faced by employees and their dependents. This includes pre-existing illnesses, pre-and post-hospitalization expenses, daycare procedures, maternity expenses, and newborn baby cover.||The policy provides financial protection against accidental death and disabilities caused by an unfortunate event. However, the accidental cover is available only for duty or also for off-duty and is completely dependent on the terms and conditions of the policy.|
|Group medical cover is customizable.||Group personal accident covers are non-customizable.|
|GMC covers employees and their dependents can also be included.||GPA is mostly meant for covering the employees.|
|GMC provides a wider coverage as most of the hospitalization expenses and illnesses are taken care of. Also, a personal accident cover can be added to GMC as an add-on cover.||The coverage range of GPA is comparatively lower as it covers expenses resulting from accidents.|
|General exclusions in GMC are alcohol or drug abuse, HIV/AIDS, suicide, self-injury, congenital diseases, unproven treatment methods, and cosmetic treatments, etc.||General exclusions in GPA are natural death, illegal activities, suicide attempts, self-injury, pre-existing illnesses, and alcohol abuse, etc.|
|Group medical cover is suitable and necessary for all organizations, irrespective of the nature of business.||GPA is an important component and suitable for businesses that involve risk of accidents, for example, construction and travel businesses.|
To sum up, Group Medical Insurance and Group Personal Accident Insurance are an important part of an organization’s employee benefit plans. Understanding the difference between both of these insurance covers helps an employer make a rational decision and an employee to make use of these in times of need. 😎
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