Group Health Insurance
Group Health Insurance

Group Health Insurance:

If you understand individual insurance. Group insurance is not difficult. Insurance means to have a financial protection of an asset value.

In case we have a loss of an asset we are able to get some value for it and keep us protected against financial burden of that loss.

These services from years are subject to terms and conditions depending on the insurance.

Now group insurance. Say you speak of a family – it’s a group of individuals of at least to members/ couple ( adult).

Now to go a step further you know several companies, banks industries have a policy for their employees or clients or customers.

The number is fixed. The insurance cause is common, say, health insurance.

They need a common pool of money which is collected as premium which acts as the fund to pay the losses that may occur incidentally.

Also Read: National Health Insurance Plan

The claim is made the settlement is made by this pool of money. The companies invest in several means of investment like fixed deposits to generate secured interest to grow money.

It is the burden of claim within the group that decides your premium for sustaining the pool of money to repay.

Say in case of mass affliction like epidemics.

The burden is high, hence, sometimes they give reduced payouts to meet the mass demand to the affected.

However, they are better off than others because they still get some relief.

So, although group insurance usually favors a lower premium, common need it may have a pitfall also!

Also Read: Religare Health Insurance Plan

Summarily, insurance is divided into an individual for one single person, family for two adult couples + two dependent children ( usually), group is a number of people with a common interest or need e.g. a school, a college, a company, industry, society etc. That’s all I have to say about group insurance!

When you are investing your money in group healthcare some points to remember:

  • Only one master policy will be issued to the Manager of the group and will be in the name of the group (e.g. the association).
  • You are entitled to get a certificate of insurance if you participate in a nonemployer-employee group policy for your records.
  • This certificate should contain
  1. the schedule of benefits
  2. premium charged and
  3. terms and conditions of the cover
  • Your cover could cease if you leave the group
  • When you leave the group the insurer should offer you continued coverage under an individual policy.
  • The Manager of the group should disclose the premium rate and terms of the policy including the premium discounts offered to the group and should pass on the discounts to all members.
  • The manager of the group has to disclose any administrative or other charges he is collecting from members over and above the premium charged by the insurance company.

Group Health Insurance Plan:

Group health insurance is a type of medical insurance package that covers a group of people, or employees working in an organization, or of a society or of a registered residential apartment.

The plan covers medical benefits for the employees (insured), their spouse, their children and the dependent parents (if mentioned).

The consolidated premium is calculated on the basis of the headcount working in the organization, their nature of the job and their area of operation.

Although, the premium paid by the employer is tax deductible for the employer, nowadays, companies deduct a certain percentage of this premium from the employees’ salary.

If we have to compare the group health insurance against the individual plans, then the group health insurance plans are usually cheaper than the individual plans because the risk to the issuer is spread out to the entire group, making it affordable for both the parties i.e. the employer and the employees.

Add-on Cover:

The following additional covers can also opt on payment of additional premium which shall depend upon the group size & its profile.

  • Critical Illness Cover (Paralytic stroke/ Cancer/Chronic renal failure/Coronary Artery Bypass/Transplant of organs –
    • Kidney
    • Lung
    • Pancreas
    • Bone Marrow NB,
    • Liver Transplant is not covered under this extension.
    • Maternity Benefit Cover
    • Hospital Cash Cover – is an inbuilt cover
    • Pre-existing
    • Family Floater
    • By choosing the add-on, the coverage for such named critical illness beckons double the basic sum insured
The scope of coverDescription
Disease/InjuryTreated medically/surgically, Hospitalization/domiciliary, At hospitals in India only
Age Limit1 day-80 years
Pre-hospitalizationRelevant medical expenses 30 days prior to hospitalization
Post-hospitalizationRelevant medical expenses 30 days prior to hospitalization
Pre-existing diseasesNo waiting period for maternity
MaternityUp to Rs.50k for 2 children
Newborn baby coverCovered from day 1
Pre-post natalCovered within maternity/full sum insured
Corporate FloaterAdditional coverage over and above SI
Daycare expenses coverCoverage for 156 surgeries which need less than 24-hour hospitalization
Add One*OPD

Also Read: Star health Insurance Plan

Features & Benefits:

Medical benefits:

Get a sum insured from Rs.1.5 lakh to Rs.50 lakh for each individual.

Provide your employees with the best medical facilities by covering their medical expenses through a group health insurance.

Cover dependents:

Not just your employees get a medical coverage for their spouse and kids as well, to give them a complete peace of mind.

Save time and money:

Pay just one single premium amount instead of taking individual policies. Also, get discounts and waivers for covering a group of people together.

Cashless claims:

Your employees can avail the cashless facility for medical treatments at our network hospitals.

Comprehensive coverage:

Provide a comprehensive coverage of medical expenses, including the cost of specialists, ambulance, or even medicines.

Flexible terms:

Choose a policy tenor according to your specifications and group size.

Also Read: Corporate Insurance Plan

Apply online:

Applying for a health insurance from is quick and easy with an online application.

Extended benefits:

Get a medical cover for pre-existing diseases or maternity expenses with an add-on cover.

No strain on employees:

Show your employees that you care by protecting them and their loved ones from any medical expenses.

Group Health Insurance is the Midiclaim Policy majorly taken by the organizations for the welfare of the employees.

The name itself suggests that it covers the whole group of employees in one single policy.

The best policy suitable for your organization can be customized or tailored according to the employee needs by the employer itself or it can be selected from the Pre-designed Group Health Insurance policies from the Insurance companies.

Also Read: Group health Insurance Policy

The premium and coverage will be according to the selection of the policy.

To avail the maximum benefits, you can select the policy providing high coverage to the employees. It solely relies on the choice of the employer.


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