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Group Health Insurance

Enhance your team's well-being with group health insurance. Enjoy premium benefits for your employees while enjoying tax advantages as an employer.

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Coverage worth
50 Lakhs
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at just
7,000*
annually

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Insurance Expert

Free Consultation

50+ years of collective insurance experience

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5,000 Cr+ of cumulative risks insured

What Is

Group Health Insurance?

Group Health Insurance is an insurance policy tailored for a collective of employees within the same company. This plan encompasses an extensive array of medical expenses, from ambulance services, medications, to specialist consultations. Under this policy, the coverage begins the moment an employee joins the company and persists until their departure. Premiums for these group medical insurance plans are borne by the employer. Such plans are typically procured by companies or organizations as a value-added benefit, ensuring medical coverage for their workforce.

Features of Group Health Insurance Plan

  • The primary intent of this policy is to grant medical benefits to employees. Extended coverage can also be provided for spouses, children, and dependent parents as additional beneficiaries.
  • Many plans accommodate pre-existing health conditions and maternity care provisions.
  • Cashless hospitalization is generally facilitated at affiliated network hospitals.
  • Provisions exist in some plans to compensate specialists and various medical practitioners for post-hospitalization consultations.
  • A distinctive feature of group health insurance, as opposed to individual health plans, is the lack of a prerequisite for medical screenings.

Who Needs

Group Health Insurance?

Business owners with an official registration can consider offering health insurance to their employees. Regardless of the business size, from startups to large enterprises, ensuring your team has health coverage promotes well-being and health security for all members of the organization.

Early Stage Startups Investing in a group personal accident insurance policy for your team can accelerate growth by both attracting and retaining top-notch talent.

SMEs Group health insurance aids SME employees in navigating healthcare expenses and obtaining quality healthcare services. SMEs have the opportunity to purchase tailored healthcare plans and simultaneously enjoy tax benefits.

Large Organizations It's customary for large organizations to extend group health insurance to their employees. Such policies offer uniform coverage to all members, independent of age, gender, or hierarchical position. Here at BimaKavach, we present a spectrum of benefits tailored for sizable enterprises.

Why Get

Group Health Insurance?

Corporate health insurance stands as a pivotal strategy to attract and retain premier talent within your organization. An exhaustive health insurance policy alleviates the burden of hefty hospital bills, bestowing peace of mind upon employees. This not only curtails turnover but also fosters a nurturing workplace environment.

Benefits of Group Health Insurance

For Employers For Employees
Tax Benefits
Tax Benefits

Comparable to other business insurance premiums, the expenditure on Group health insurance premiums is tax-deductible as a legitimate business expense.

Fostering a Healthy Workplace Culture & Amplifying Productivity
Fostering a Healthy Workplace Culture & Amplifying Productivity

A comprehensive insurance plan underscores your commitment to your employees' health and welfare. The more palpable your care, the healthier and more efficient your workforce becomes.

Employee Retention
Employee Retention

In an age where companies are extending myriad benefits, retaining talent poses a formidable challenge. Group Health Insurance acts as a strong incentive, enhancing employee loyalty.

Coverages & Exclusions in

Group Health Insurance
CoveragesExclusions
Coverage for pre-existing diseases
A pre-existing disease is a medical condition or illness that an individual already has before seeking insurance coverage. Group health insurance coverage starts to cover pre-existing diseases from the very day an employee joins the company. Usually, there is no waiting period as such for any pre-existing disease.
Maternity coverage
Group Health Insurance policy offers financial protection for childbirth-related expenses for both C-sections and normal deliveries. Usually, there is no waiting period for maternity coverage in these policies. However, some providers may have a 9-month waiting period. Expenses covered may include hospitalization for childbirth, room charges, nursing fees, operation theater charges, and other medical services specific to the delivery. The policy may have a specified sub-limit for such expenses. Group Health Insurance policies often cover pre and postnatal care expenses as well.
Newborn baby coverage
New-born babies are covered from the moment they are born. The coverage includes medical expenses incurred for the baby during the coverage period. This can include hospitalization expenses, consultations with pediatricians, vaccinations, diagnostic tests, medications, and any necessary medical treatments related to the baby's health. However, such expenses may have certain limits and sub-limits.
Ambulance costs
The insured can claim the cost of a road ambulance to travel to the hospital or from the hospital to the place of residence under this cover. The policy may cover both emergency and non-emergency ambulance services. The policy specifies the criteria for availing ambulance coverage, which can include the distance of transportation, the severity of the medical condition, and the recommendation of a medical professional. A defined coverage limit is usually set for ambulance expenses.
Pre and post-hospitalization expenses
The policy specifies a predefined period of pre and post-hospitalization coverage, typically ranging from 30 to 90 days before and after the hospitalization. The coverage may include the costs related to diagnostic tests, consultations, medications, and other medical services directly linked to the hospitalization, within this specified period. It may also include follow-up consultations, rehabilitation services, and other necessary treatments after hospitalization.
Expenses for domiciliary and daycare
Domiciliary coverage refers to the reimbursement of medical expenses incurred for treatment received at home when hospitalization is either not possible or not medically necessary. The policy specifies the criteria for availing of such coverage, which may include the need for continuous medical supervision and the recommendation of a medical professional. Similarly, daycare treatment refers to medical operations that do not require 24-hour hospitalization. These include cataract surgery, tonsillitis surgery, and others.
Medical practitioners and specialist’s fees
This policy offers financial protection for the fees charged by doctors and specialists for in-patient hospitalization, outpatient consultations, and treatments. However, the policy may specify a maximum limit on the coverage for such fees.

Most Popular Extensions:

Upon purchasing group health insurance, employers can opt for enhanced coverages:

  • Immediate maternity cover, devoid of waiting periods.
  • Newborn coverage within the maternity limit.
  • Optional OPD (Outpatient Department) coverage.
  • A corporate buffer, in case an employee's existing sum assured is depleted and further funds are needed.

Group Health Insurance Claims Example

Claim for Medical Expenses Cover
An electrical cable manufacturer in Gurgaon, with a workforce of 100+ members, procured a Group Health Insurance Policy. Mr. Rajiv, an employee, unfortunately, suffered a heart attack. Post-angioplasty, cardiologists inserted a stent. Owing to the company's insurance policy, Mr. Rajeev was granted a lump sum payout per the policy stipulations. This aided in offsetting his medical charges and offered financial support during his convalescence and rehabilitation.
Incident Img

About Group Health Insurance Policy

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How does group health insurance offer maternity benefits? Plus Icon
Do we require a pre-existing disease waiver? Plus Icon
What distinguishes a cashless claim from a reimbursement claim in Group Health Insurance? Plus Icon
How do you file a cashless claim for Group Health Insurance? Plus Icon

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Your Story
Indore-based BimaKavach caters to the Business Insurance needs of Small & Medium Enterprises

This is an article by YouStory written by Palak Agarwal and published on October, 2022

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