Group health insurance policies offer coverage benefits to a group of individuals such as employees of a company or members of an organisation. This type of health insurance comes in various forms. To be eligible for this insurance type, an organisation must employ more than 20 individuals. Nonetheless, there are exceptions for microfinance companies, where the provision of group health insurance is made available if they employ more than 5 individuals.
Following is a list of the types of group health insurance plans, their coverage, exclusions, benefits, and more.
|Small employer group||Eligible for companies with less than 50 employees. Covers services like primary health care, and physical and laboratory examination. Some policies include annual claim benefits. In some cases, insurance companies group several small groups in the same industry into one large master policy. This enables small business employees to get coverage at affordable premium rates.|
|Fully insured employer group||In this plan, an employer will pay for the insurance premiums fully or partially. The insurer is responsible to pay any additional costs related to the benefits as per the policy terms. Fixed annual premium rate. Employees might need to pay a part of the total premium amount. Their contributions vary depending on the number of participants enrolled in the plan yearly.|
|Self-funded health care||An employer covers all employee healthcare costs and other benefits. Employers also need to pay the administrative costs related to this group insurance. Suitable for large companies.|
|Health Maintenance Organisation (HMO) insurance plan||This is a prepaid health plan where policyholders pay for the health benefits in advance via monthly premiums. Affordable compared to other group insurance types. Policyholders can avail treatment from doctors and medical facilities that are included in the HMO list.|
|Preferred Provider Organisation (PPO)||More flexibility in terms of choosing doctors and other medical facilities compared to HMO plans. Policyholders can get treatment from hospitals that are not included in the PPO list.|
These group insurance types take a look at the coverage under these plans.
Inclusions under the group health insurance plan include:
Some common exclusions under group insurance plans are:
Reading about group insurance types helps in the selection of the best plans but then you must also know why it is important to maximise benefits. Let’s take a look at the same:
It is evident from the above section that group insurance covers a number of health benefits and guarantees financial security to the policyholders.
Group insurance policyholders can customise their plans as per their requirements. For instance, they can choose a plan that offers maternity or OPD covers.
In an individual health insurance plan, policyholders get limited coverage for a high premium. However, group health insurance plans offer high coverage against the same premium amount.
Alternatively, now you can also choose to avail comprehensive health benefits coverage for you and your family in under 5 minutes from Navi. Download Navi App if you consider buying a plan from Navi and avail yourself of the same via an entirely paperless process with benefits from over 10,000 plus network hospitals.
Here are a few factors to consider before purchasing any one of the group insurance types:
Sum insured amount
An employer should look for a high sum insured before purchasing group health insurance. A high sum insured means higher coverage, which makes it convenient for employees’ medical treatment.
One should factor in the premium amount of a group health insurance policy to ensure that all the features are available at affordable rates.
Medical emergencies can arise anytime, and a large network of cashless hospitals ensures that individuals can seek treatment easily.
Purchase policy online
Buying a group insurance policy online is less time consuming and hassle-free than the offline procedure.
Individuals planning to obtain health insurance can consider Navi Health Insurance because of the following reasons:
Even though there are several group insurance types available, offering a wide scope of coverage, it is better for individuals to have other comprehensive health insurance policies in place.
Nonetheless, one can compare the types of group insurance plans mentioned in the aforementioned section and choose one best suited to the employee’s benefits.
Ans: Some of the group health insurance policies cover Covid-19 treatment costs. However, you should check with your insurance company before settling for a plan.
Ans: No. This is a standard exclusion with most insurance providers. However, one can waive off this exclusion and include it in his/her group insurance plan.
Ans: The premium of a group health insurance depends on the number of employees in an organisation, their age, location and number of dependents.
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