Top 10 Features Of Group Health Insurance Policy | Loop
Full-time employment has countless benefits, but the one winner that rules them all is the eligibility for a group health insurance plan.
With the rising cost of healthcare and the need for quality care, which became apparent after the pandemic, corporate health cover is an increasingly valuable perk.
The features of group health insurance help keep your team happy and healthy. Plus, it signals to your workforce that you care about their well-being. Group health insurance has countless other advantages.
With so many players emerging, it’s important to keep the features in mind before you buy group health insurance with an insurance broker.
This blog will outline all the features you need to be aware of when you’re looking for health insurance coverage for your workforce.
Why Is Group Health Insurance Important?
The short answer is: healthcare is really expensive. In first-world countries like the United States, the expenses on healthcare increased steeply by close to $4.1 trillion in 2020. This has tripled from $1.4 trillion in 2000!
With respect to India, there was a 73 percent rise in costs from 2021 to 2022 to Rs 4.72 lakh crore from Rs 2.73 lakh crore in 2019 to 2020.
Enough with the statistics. Surely you get where this is headed.
With this in mind, individuals are increasingly looking to health insurance to help give them peace of mind should they find themselves ill or injured.
From a business point of view, it may seem going without healthcare can boost your bottom line. However, this thought can strangle your business's chances for long-term prosperity. Better be penny wise than pound-foolish, we say!
The positive side to this coin: offering the right group health insurance plan with added benefits will help jump-start business growth.
The instant you give your workforce the benefits they value, they have a higher commitment to meeting the company's goals, they’re less likely to quit, miss fewer workdays, are more productive, and they’re more satisfied.
No more is it just “nice to have” a group health insurance plan for your staff – it’s necessary!
What Are The Features Of Group Health Insurance?
Group health insurance comes loaded with features like:
- Medical coverage for family members and dependents
- Pre and post hospitalization expenses
- No waiting period
- Medical coverage for pre-existing diseases
- No pre-medical screening
- Maternity cover
- Hassle-free claims
- Added benefits
Let’s delve deeper into this and understand each of these features in detail.
Whether it’s something as simple as buying a phone or a washing machine, there are multiple brands and options out there. Besides online retailers, there are the official stores, partner stores, and more. The same goes for group mediclaim.
In general, the insurance space is very large and extensive. There are numerous players along with an abundance of intermediaries, like agents and brokers. Although they’re helpful, as an HR, you have to dip your hands into many processes and follow-ups. This is extremely time-consuming.
The simplicity comes in when you pick a reliable partner that handles all the tasks and ensures your plate is not full with work related to health benefits.
At Loop, from the start of the process, we simplify insurance for you and your organization.
With Loop, you can set up health insurance coverage in minutes, not days. Moving further along, whether it’s claims, endorsements, or customer support, everything is available on the go.
Plus, we handle all processes from start to finish. It’s almost like auto-piloting your health benefits process, so we reduce your workload while ensuring employees are healthy and happy!
Don’t believe us? See it for yourself! Check out How Livio's HR Saves 99% of Time on Health Benefits With Loop
From choosing your own pizza toppings to choosing the color of your iPhone, everything nowadays is customizable. This includes group mediclaim too!
In fact, it’s one of the key features that makes corporate insurance stand out.
As an organization, you can survey your employees, analyze your needs, and based on this, tailor make a plan designed specifically to meet your unique requirements.
Every policy comes with a base plan and sum insured in place, to which you can add what you desire. For instance, if your business is into manufacturing and your workforce comprises largely blue-collar workers, you can easily opt for a Group Medical Cover (GMC) with an add-on of Group Personal Accident (GPA) cover.
This GPA cover gives your staff additional protection and financial support for unexpected and unforeseen circumstances.
3. Medical coverage for family members and dependents
Managing health insurance policies, such as a family floater plan from different insurers, especially with large family members, is not easy! Each plan comes with different terms and conditions, claim processes, and additional requirements that can make the entire process a burden on top of the illness.
Compare this to group medical insurance where you have the option of seeking medical coverage for your family members and dependants under the same policy. It makes life so much easier and it’s straightforward!
Typically, GMC plans cover the insured member, i.e., the employee, their spouse, children, their parents, and in-laws. This extended medical coverage may come for free or there’s a small fee - it varies from insurer to insurer.
4. Pre and post hospitalization expenses
Pre-hospitalization expenses are medical expenses you incur before the insured member is admitted to the hospital. This can include various tests or screenings as prescribed by a doctor, like X-rays, blood tests, urine tests, blood count, etc.
Group mediclaim covers these costs, provided they’re borne within or before 30 days of admission to the hospital. Again, this varies from provider to provider.
Similarly, post-hospitalization medical expenses are costs the insured member incurs after you’re discharged. This includes any tests, medicines, screening, etc. to ensure you or the patient recovers well.
Most often, these costs are covered for up to 60 days, but again, this varies from provider to provider.
5. No waiting period
With respect to the waiting period, how individual insurance works is you need to wait approximately 3 to 4 years before your health insurance coverage kicks in. During this time, you cannot make a claim or seek the benefits from your policy. Not only is the wait long, but you’re also unprotected.
Unlike individual insurance, group medical insurance does not have a waiting period. Whether it’s for pre-existing diseases, a critical illness, or related to specific diseases, you have the option to waive off waiting periods.
This ensures that medical coverage kicks in for the insured member, their parents, children, and spouse from day one of the policy.
6. Coverage for pre existing diseases
Pre existing diseases are any conditions you suffer from and were diagnosed within the 4 years before you purchased health insurance. This can include medical coverage for anything like allergies, blood pressure, diabetes, cancer, etc.
When you purchase group medical insurance, you automatically get medical coverage for pre existing diseases. This means you can raise a claim for a pre existing disease almost instantly, as there’s no waiting period either.
This is especially good for policies that cover family members, as older individuals are at higher risk.
7. No pre-medical screening
As a potential policyholder of an individual plan, one of the first things you must do is to undergo a pre-medical test. This test determines the status of your health and helps insurers determine a suitable plan.
Sometimes, the results lead to some individuals not getting covered due to previous conditions like cancer.
Fortunately, for those insured members covered by group medical insurance, this is not the case. Since the policy takes into account a large group, pre-medical screenings are waived off.
Irrespective of age, previous conditions, etc. you are assured of getting medical coverage for medical expenses.
8. Maternity cover
Yet another feature that makes group medical insurance a sought-after option is coverage for expenses related to maternity. Which is typically an additional coverage under a health insurance policy.
Maternity cover under group mediclaim primarily covers medical expenses related to delivery. Furthermore, the newborn baby is covered for up to 90 days. Post this 90-day period, you can add the child to the base plan too.
9. Hassle-free claims
With group mediclaim, especially with providers like Loop, there is no interference from intermediaries.
As the HR or the employee, you’re directly in contact with the claim assistance team at Loop who will help coordinate and settle the claims process. This way, the added follow-ups, lack of knowledge, etc. don’t come into play. Plus, with 24X7 claims support, you can reach the team at any time.
In essence, with a comprehensive group health plan, such facilities ensure that claims are settled quickly, saving you a ton of time, patience, and energy.
10. Added benefits
Group medical insurance is like a cake, it’s incomplete without the cherry on top - aka the added benefits.
Whether you talk about employees or HRs, Loop offers loads of benefits for both at no additional cost.
Some of the top benefits include:
- 24X7 claims support so employees can initiate and get support for claims directly from the Loop app, anytime, anywhere.
- A dedicated in-house medical team who are here to help your employees night and day and keep them healthy through an excellent preventive and primary care
- HR dashboard that’s like a control panel, so you always know what’s happening. You can see the latest data on claims and enrollment anytime
- Engaging wellness activities to keep your employees healthy and reduce the need for expensive care in the long run.
That’s not all! The Loop app makes it easy for your employees to
- Get unlimited doctor consultations with specialists
- Chat with a dedicated Medical Advisor who is like a family doctor and supports you in your healthcare journey
- Book discounted lab tests from home
- Access policy details anytime
- Have your ecards handy for emergencies
Time to bring amazing health benefits to your team starting as low as ₹ 499
Who Is Eligible To Buy A Group Health Insurance Policy?
As you already know, corporate plans are from employer to employee. So to be eligible, one of the requirements is to be an employee of a company.
That being said, non-employer to employee groups are eligible too. In both cases, you must meet the following requirements to be eligible for group health insurance:
- The minimum number of employees - According to the Insurance Regulatory and Development Authority (IRDAI), for a business/enterprise/organization, there must be at least 7 employees to qualify for group health cover. This includes family members too, like in a family business, but the employer-to-employee relationship must be present.
- Registered business - Your business must be officially registered along with the necessary paperwork.
NOTE: You cannot form a business to merely purchase group medical insurance. This will lead to refusal. Ideally, the business must be up and running for a substantial time before enquiring about medical coverage for employees.
Learn more: Read a detailed article on what are employer group health insurance requirements?
Health Is Wealth, Really.
Only when an individual is healthy are they happy, able to work productively, and lead fulfilling lives.
The multiple features of group health insurance help employees if a medical emergency arises as well as help prevent you from getting sick.
At Loop, we’re always there to empower and support your organization. We strive toward ensuring that you always get the best from your plan.
Contact us to find out how you can take advantage of the features of group health insurance and ensure 2X ROI on your employee health!