How Many Employees Are Needed For A Company To Get Group Health Insurance?

More often than not, while interacting with business leaders, startup founders, and HR managers, we’ve have encountered a common question. How many employees do I need for Group Health Insurance in India? Well, there are other versions of this question too. Some folks who we approach tell us they are too small in number to have group health insurance. Some say that we don’t have 50 employees and so we can’t buy group health insurance. 

All of these questions point to the same thing: a lack of awareness about the number of employees needed for group health insurance in India. And so, we decided to rectify the situation. 

In this post, we’d only answer the question of how many employees are needed for group health insurance in India but also discuss the subtleties related to it. 

How many employees are needed to get group health insurance?

According to the Insurance Regulatory and Development Authority, any group with 7 or more members can get group health insurance. That being said, they’ve also given the discretion to the insurance providers to decide on the minimum size of the group they’d provide insurance to. So, most public insurers offer group cover only if you have 100 or more lives. And most private insurers need 50 or more lives.

What are the exceptions to the number of employees for group health insurance rule?

When it comes to the number of employees, there are two exceptions that you must be aware of: 

Family members can be counted as well: 

Even with less than 7 employees, group health insurance policies can still be issued if you add the family members of the employees. So, if your company has 4 employees and you ensure 3 dependent family members along with them, you qualify for heath insurance. 

Group Dynamics of the Company: 

Certain companies can qualify for group health insurance with less than 7 employees if they have a specific group dynamics. First, if there’s a company that works mostly with contractual or part-time workers only, who are otherwise not qualified for group insurance, can get so. This is only if their workforce primarily is part-time. Secondly, a company with most employees above 65 is also treated as a special case. This is because most insurers limit the entry age for the group health policy at 65 years (as per regulations). So, there are special provisions for companies with an old workforce to qualify for group health insurance. 

At Plum, we’ve had the opportunity to interact with a lot of startups. A common concern that they have is how their policy gets affected when the group dynamics change. 

What If The Employee Count Becomes Smaller After the Issue of Policy?

Imagine your company had 21 employees when you bought the group health insurance. Three months down the line, two employees decided to jump ship. Please be assured that the limit applies only at the time of issue of the policy. Post that, these considerations will be taken into account only at the time of renewal of the policy, which is usually one year. (Note: the renewal period can vary for different companies) At the time of renewal, the limit can be relaxed and will lead to a reduced premium amount. The terms and conditions are therefore renegotiated at the time of renewal. 

Are You Looking For Group Health Insurance For Your Team?

At Plum, we offer customizable health insurance plans starting at just ₹999/year. We offer healthcare plans to teams as small as 7 members. Not just that, you can avail all sorts of additional benefits for the holistic wellbeing of your employees including mental health consultations, dental and eye-care, and fitness and nutrition plans.

You can play around with various options and benefits to get an estimate of how much Plum’s group health insurance would cost. We’ve created an insurance premium calculator that’ll tell you an estimate for your policy, based on your team size and the benefit options you want to chose.

Go ahead, take it for a spin!