Your Ultimate Guide to
Group Health Insurance

Picking group mediclaim policy for your team? Our guide can help you understand group medical insurance to choose the right plan for your team.

Part 1 - Basics

Why is group health insurance necessary?

Think about the times you have heard of someone dealing with a health emergency. These situations rip apart our financial savings and cause emotional stress. Recent global health crises like COVID-19 have made the importance of having health insurance coverage even more evident.

Despite such occurrences, health cover penetration in India is poor. Almost 30% of the Indian population has no health scheme. High premiums and complex terms & conditions are the top reasons for this trend.

This is why opting for group health insurance at employee-first companies is a no-brainer. Putting the well-being of your employees at par with organisational goals can create healthier and more productive teams. It gives your leaders an opportunity to lead by example. And by valuing your team’s health, you incentivise them to care about their well-being and bring their best selves to work.

A bonus benefit of group health insurance: your organisation just took another leap at becoming people-centric and empathetic.

What is group health insurance?

Group health insurance is an umbrella policy offered to a group of individuals. The most common example is when an employer promotes a corporate insurance plan to their employees, who can roll it out to their spouse, children, parents or parents-in-law. Employer-employee insurance benefits are comprehensive and affordable, depending on the plan your company opts for.

For instance, all your pre-existing conditions are covered from day one without any waiting periods. This extends to common illnesses, maternity benefits, daycare treatments and personal accidents, to name a few.

Group insurance is unlike an individual health policy, where the waiting periods cannot be waived, and the premiums are worth a king’s ransom even if they could be. This makes group health insurance a necessity and not just a nice-to-have benefit.

Why buy a group health insurance policy?

Here’s the problem

You already know that building a talented team is a herculean task. But, retaining great talent and keeping them motivated is a hamster-on-wheel assignment. Losing even a single member after all your hard work is a kick in the gut.

It’s more difficult when you know that you could’ve addressed their concerns in hindsight. These include things that improve employee morale and organisational culture, like providing adequate paid time off, flexible work-life balance and a comprehensive group health insurance plan.

Here’s how to fix it

Today’s workplaces are synonymous with human-centric policies. When potential hires imagine their ideal work culture, it involves organisations building a culture of care, inclusivity and innovation. This fosters a team of happy individuals who are not only engaged at work but are also bagging the best outcomes.Choosing group medical insurance is the first step to showing your employees that you care. The ripple effect is that employees feel happy, and retention is high as they feel prepared for unforeseen events. This also makes them more productive at work, nudging them to build a healthy lifestyle resulting in lower sick leaves.

Who should buy group health insurance?

  • Group insurance for teams as small as 2

    Plum is tailored for young startups from the get-go. We believe there’s no “right team size” for picking a group health insurance policy. The sooner, the better.

  • Group health insurance for SMBs

    Scale your business by offering the best group health insurance policy. Group health insurance policy for employees is a holistic perk that places your workforce’s health in the front and centre, increasing employee satisfaction.

  • Large organisations

    With big business comes big responsibility. Organisational culture and employee benefits play a massive role in talent retention. Prioritise your employees’ needs with corporate health insurance as the onus is on you to take care of the people who look after your business.

Part 2 - Deep dive

Advantages of a group health insurance policy

Group health insurance is a win for employees and employers. The biggest benefit everyone gets is equal access to good quality healthcare without worrying about skyrocketing medical costs.

For employers

  • Attract and retain top talent

    Employees are less likely to leave the organization when they are happy, and the work culture is focused on people-centric policies. Offering employee health insurance as a benefit shows your employees that you care for them and gives them a positive outlook on your organization.

  • Value for money and tax benefits

    Employees are less likely to leave the organisation when they are happy, and the work culture is focused on people-centric policies. Offering employee health insurance as a benefit shows your employees that you care for them and gives them a positive outlook on your organization.

  • Boost focus and job satisfaction

    Offering your team great benefits and perks can be a great motivator to make them happier at work, thus, improving their job satisfaction and productivity.

For employees

  • Smooth and easy claims

    Employees don’t have to bear tedious settlements. With a group health insurance policy, they can simply route their hospital bills through the employer for easy reimbursement.

  • Family coverage at zero cost

    Employees can add their family members, including their parents, depending on the group health insurance plan their organization selects. Employees can avail these benefits at zero cost, boosting company goodwill.

  • Preventive health care

    Most modern insurers focus on wellness initiatives apart from nudging for regular health check-ups. This could range anywhere from educating employees on different aspects of health to providing them with doctor consultations or exclusive discounts on medicines, health check-ups, gym memberships and more.

Features of group health insurance plans

  • Cashless process

    Cashless process enables the insured to get treated at any network hospital without any upfront payment. This helps your employees get treated for ailments without any financial burden.

  • Pre and post-hospitalization 

    Many medical expenses could be incurred before hospitalisation and even post-discharge. All these expenses are also covered under a group health insurance plan. 

  • Added health benefits

    Health benefits are preventive measures that can be opted for by an organisation for its employees. These could range from OPD consultations, routine health check-ups and mental wellness support. This encourages employees to take better care of themselves proactively.

How is group medical insurance different from individual health cover?

Group medical insurance

Individual healthcare plan

Premium cost

Lower premiums since the risk is spread across the group.

Relatively higher premiums since only one individual and their dependents are covered.

Pre-existing diseases

A group health insurance plan can cover people with pre-existing diseases.

You will not be able to purchase personal health insurance at an affordable price if

Policy structuring

Here, the company taking the cover will structure a common policy for all the employees.

With personal health insurance, you can structure a policy according to your preferences.

Waiting periods

Group health insurance plans can be claimed from day 1.

There is usually a 30 day waiting period associated with personal insurance plans

Added benefits

The benefits are chosen by the company. Certain benefits are exclusively available only on a group health insurance policy.

With personal health insurance, you can choose the benefits best suited for you and your dependants.

Part 3 - Made better with Plum

Why should you buy group health insurance with Plum?

Your responsibility to care for your team increases when your team grows. This is when you start looking for a group health insurance plan.

Then comes the nerve-wracking negotiation before you make the final payment, and oh — lastly, a two-week waiting period before you can roll out the policy to your team members. At the very least, you will catch your patience flying out the window. At worst, you won't even get a policy if you’re a smaller team (we’re speaking of less than ten members).

Here’s where Plum enters the picture

At Plum, we understand how overwhelming the process can be for founders and HRs. Our human-led digital experience enables organisations to pick a tailored plan to suit their needs. This includes constructing the right group health policy, choosing a top insurer, selecting the right health benefits and even negotiating with the insurer on your behalf.

This support extends once the policy is placed as well – with our admin dashboard allowing you to enrol employees efficiently and our claims team helping them navigate any medical emergencies.

- plum’s marketing team

Why is Plum the best choice for your company

  • One-stop admin dashboard

    Say goodbye to employee management on spreadsheets & emails

    With our admin dashboard, you can add and remove employees from your group health policy at any time, invite an employee to add their details and modify them at your convenience. No frills, just easy functionality. Can’t beat that.

  • Simplified employee experience

    All your information in one profile

    Insurance is no longer a hassle. Access your Plum employee dashboard on the go. Know your group health insurance cover and health benefits. Learn what’s covered and uncovered in your policy. Start a claim, and check the status of your claims with a click.

  • Make claims seamless

    Say hello to the Plum app, your new buddy for everything insurance-related

    With Plum's app, your employees can file, track and manage claims on the go. You can also check your policy details and download your health card, all from the comfort of the app.

Part 4 - Final takeaways

Things to know before buying an online group health insurance plan

  • Family coverage

    Group health insurance allows you to cover your employees and their family members. Understanding your workforce dynamics and budget helps you pick the right kind of cover for your team members. 

  • Sum insured (SI)

    This is the monetary cap the insurer can pay for a particular year if you’re hospitalized. Typically, you can choose SI from 50K to 10L. But, this decision also depends on your team’s average salary and whether or not you opt for family coverage. High salaries and family coverage require high SI. 

  • Claims experience and settlement ratio

    The crux of a group health insurance plan is its feasibility. Always check the insurer’s claims experience, process and support. Verify the claim settlement ratio. Higher settlement ratios are always better!

Conclusion

A comprehensive group mediclaim policy shows employees that you care about their well-being. This helps them prepare for unforeseen circumstances that could be an unpleasant surprise. Add a few customisations to your policy, and you have a healthy, motivated and happy team.

At Plum, we help you provide the best experience to your employees while keeping the cost low. If this sounds like your cup of tea, schedule a call with our insurance experts now.

FAQs

Is COVID-19/Coronavirus covered in a group health insurance policy?

Yes. All group health insurance policies cover COVID-19 and related illnesses.

Is it mandatory to provide health insurance to employees in India?

Yes. As part of, order No-40–3/2020-DM-I (A), the government of India has declared that all employers must provide corporate medical insurance to employees.

How many employees are required for a group health insurance policy?

Teams as small as seven can be covered using a group health insurance policy. For example, you can also take a group health insurance policy if you're in a five-member team (and two spouses).

What is the benefit of group medical insurance for employees?

Buying a comprehensive group cover scheme for young startups and small companies is a great way for founders to retain and attract good talent. Employees often prefer organizations with good health benefits and wellness programs.

How does group health insurance policy work?

An employer purchases a group healthcare coverage plan for their respective employees based on the number of workers. The employer entirely bears the cost of group healthcare. In return, the employees can avail medical insurance as per the sum insured.

Is group health insurance cheaper than individual health insurance?

Yes. A group health insurance policy is five to ten times cheaper than an individual policy.

Are group health insurance premiums tax-deductible?

Yes, you can avail of certain tax benefits through group health insurance.

How to buy group health insurance as an individual person?

A group health insurance can only cover individuals who belong to the same organization. You cannot buy group health insurance as an individual.

Who is eligible for group health insurance?

Any company registered with the MCA and has greater than seven lives (including dependents) qualifies to buy a group health insurance policy.

How much does group health insurance cost?

Group health insurance costs vary based on the number of employees, sum insured, and benefits opted for. Get a group health insurance estimate using our premium calculator.

How many people can be in a group health insurance?

The minimum number of people that can be covered in a group health insurance policy is seven. There is no such fixed upper limit on the total number of employees covered.

Can small businesses take employee medical insurance?

Yes. Companies of any size can take employee medical insurance. You can generate an estimate for your company using our premium calculator.

How to check room rent limits in group mediclaim insurance for employees?

Every group cover comes with a specific room rent limit or no room rent limit. You can check the policy document. The upper limit is around 1% of the sum insured.

How much is the premium for group health insurance?

The cost of the premium amount depends on the number of employees and their family members that you want to cover.

Are health check-ups included in group mediclaim policy?

Most of the group plans provide annual health check-ups for free. This depends on your employer's type of group plan and benefits.

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Plum is tailored for young startups from the get-go. We believe there’s no “right team size” for picking a group health insurance policy. The sooner, the better.

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