Know About Group Health Insurance
- If your employer offers a group health insurance, take it and include family members if possible
- The cost and benefits of a group health policy make them favourable for anyone who can get one
- The wide scope of insurance cover, flexibility and no waiting period, makes these policies a must have
Everyone likes a good deal and a group health insurance policy is one where you get one of the best deals. You do not have to worry about any health check-ups prior to policy issuance and even qualify for maternity benefits if you have this policy. You get all this benefit with a group health insurance, which is most commonly provided by an employer to its employees.
Group health insurance is designed in such a manner so as to offer comprehensive healthcare coverage to people belonging to a particular group. According to the guidelines by the Insurance Regulatory and Development Authority of India (IRDAI), groups formed for this purpose could be either employer-employee groups or non-employer-employee groups. It is for this reason that even credit card holders, bank account holders and members of alumni, clubs and other such groups are formed to avail the benefits of a group health insurance.
Unlike an individual health insurance plan, which is designed to offer coverage to an individual, a group policy is for group of people. Moreover, under an individual policy, every individual has a separate renewal date, whereas under a group plan, there is no need to remember various renewal dates, as there is only a single renewal date. There is a higher degree of customisation possible with individual plans, but this also entails costs, which may not always work in their favour.
The most common form of group health insurance is the one that is offered by an employer to its employees. This type of group health insurance usually offers health care coverage to the employee, spouse, dependent parents and dependent children up to certain age. When it comes to group health insurance, you are not asked to submit any medical reports, plus there is no waiting period and you also get coverage against pre-existing conditions, thus making it the most sought after health insurance plan. Its reasonable premium is yet another major factor that makes it beneficial.
Working of group health insurance policy
The core nature of a group health insurance policy is that a master policy is issued which offers coverage to each and every individual of the group for which the policy has been bought. In a group insurance plan, the terms and conditions, inclusions as well as exclusions are same for every individual being covered under that very plan.
Almost each and every insurer offers group health insurance, but they all have their own rules and procedures when issuing such policies, which is why the inclusions and exclusions may differ from one insurance company to another. There is also a degree of customisation that goes into structuring a group health policy. Typically, the HR personnel of an employer along with the insurance company representative works towards customising a group health policy including the sum assured offered and benefits offered to family members of the employees.
In a group health insurance plan, each and every individual is given health care coverage despite their pre-existing conditions. Whereas, when it comes to an individual health insurance plan, an individual’s application can be rejected on the basis of medical conditions. Along with this, under individual insurance the insurance company can modify the policy on account of the medical condition of an individual. But, this cannot be done in a group health insurance plan; a group health insurance plan cannot be altered or adjusted because of one individual’s medical conditions.It will remain the same and shall offer the same health care coverage.
Group health Insurance benefits
Lower premium: The premium amount of a group health insurance plan is much lower as compared to an individual health insurance plan. This, in turn proves a group policy to be a cost effective one. A group health insurance plan is typically 20-30% cheaper than an individual health plan.
No medical check-up: You don’t need to undergo any medical tests in order to get enrolled under the group health insurance plan.
Waiting-period: A group health insurance plan has no waiting period in order to avail full benefits of a health care plan as there exists in an individual health plan.
Maternity Cover: A group health insurance plan offers an individual with complete maternity benefits from the day one, whenever the person is enrolled in the policy.
There is one big disadvantage of a group health policy – the policy is valid only till such time that you are part of the group. Once you leave your job and are no longer associated with the company or the group, the policy you were enrolled under will come to an end and so will its benefits. This is yet another disadvantage of a group health insurance plan. However, in some cases, an employee has the choice to buy the very same policy with similar benefits. And, if such is the case he or she should definitely opt for it.
Most organisations offer a group health policy to employees, which may include spouse, dependent children, dependent parents as well as your in-laws. The type of policy and benefits offered by the employer may vary from organisation to organisation, however, that should not be a deterrent for you to not take a policy if it is offered. Make sure you do not limit this to be your only health insurance policy. Have an individual plan, and use the group policy as a supplement or your first choice in case of raising a claim. The cost effectiveness and conveniences offered by this policy definitely has advantages that are hard to ignore.