Group Insurance for Small Business

A Group Health Insurance policy is a type of health insurance that covers multiple people under one policy. As the name suggests, this plan can only be purchased by a group comprising more than 20 members.

This plan offers financial coverage against numerous expenses with a premium that is usually lower than an individual health insurance plan. Some of the most common covers of Group Health Insurance Plans are:

• Ambulance cover

• Pre and post-hospitalisation expenses cover

• In-patient treatment cover

• Annual health checkup cover

• Psychiatric illness cover, etc

Group health insurance coverage for small business owners remains the same for every member included in the contract regardless of his age, gender, educational qualification, economic status or occupation.

For this reason, it is considered to be one of the best insurance plans for people who do not want to spend extra money on buying multiple health insurance policies with different coverages.

With vast coverage, Group Health Insurance plans offer countless benefits to the insured or policyholder and some of them remain hidden to this day.

The advantages mentioned below will give you a deeper understanding of the level of coverage provided by Group Health Insurance and why you should not be missing out on this superb opportunity.

For Employees

Pre-Existing Illness Coverage

• One of the most exceptional benefits of Group Health Insurance is its coverage for pre-existing illnesses from day one.

• If an employer opts for pre-existing disease coverage when purchasing a Group Health Insurance plan, then his employees become eligible to raise a claim to cover expenses associated with treating pre-existing conditions.

• Unlike other health insurance policies, a group health insurance plan does not have a waiting period for covering pre-existing conditions.

• All you need to do is to disclose details about your disease to the insurer before being covered under the policy and you will be eligible to raise a claim at any time during your policy tenure.

• Most group health insurance policies provide financial coverage for these pre-existing diseases; however, this varies from insurer to insurer. So, it is suggested that you confirm this with the insurer when signing the contract.

No Pre-Policy Medical Tests

• The most time-consuming activity in the process of buying a health insurance plan is the pre-policy health checkup conducted by the insurer to determine the applicant's health condition.

• As there are many members in a Group Health Insurance plan, the insurer does not demand medical checkups for them. This saves the time and energy of policyholders, especially those who are suffering from a critical illness.

• In short, you will get your Group Health Insurance policy without undergoing any medical examination.

Unique Add-Ons

• Every individual has different needs. Some require extra financial protection, while others find basic health insurance offerings sufficient.

• The add-on feature is ideal for those who want financial support for situations not listed in the policy.

• Group Health Insurance plans have a wide variety of add-ons that cover specific situations.

Mental Illness Coverage

As the good psychological condition of the insured is also a part of his well-being, Group Health Insurance plans also cover expenses arising from the treatment of mental illnesses.

However, there may be a waiting period for raising a claim for psychological disorders, and it can range between 22-26 months.

Family Cover

• The best part of purchasing a Group Health Insurance policy is that it also allows you to include your dependent family members in your policy. This will save you from purchasing individual health insurance plans for your family members separately.

• With such a health insurance plan, you will not have to worry about protecting your family from unexpected events, as it will cover your loved ones under the same Group Health Insurance policy.

• In addition, this benefit of Group Health Insurance will allow you to get greater tax deductions without spending more money, as you will not be buying any individual health insurance plan.

Cashless Claim Facility

• Group Health Insurance policies also offer cashless claims, which provides ease and convenience to the policyholders.

• In cashless claims, the insured does not have to pay medical bills out of pocket, as the insurance company directly settles the claim with the hospital. This helps the insured focus only on his recovery.

• Here, network hospitals and non-network hospitals also play a vital role in the settlement of claims. If you have Group Health Insurance, you can raise a cashless claim only if you are receiving treatment from a network hospital or an authorised non-network hospital.

• If you are treated at an unauthorised non-network hospital, you can only raise a reimbursement claim for the expenses incurred.

Annual Health Check-Ups

• Another fantastic benefit of being a part of a Group Health Insurance plan is that you will be provided with reimbursement for the cost of annual health checkups you undergo.

• This health insurance plan encourages regular testing, which helps monitor health and detect potential diseases early.

• Regular medical tests also promote long-term savings as they alert you about your health condition, which, in turn, ensures prompt treatment of health issues.

For Employers

Flexibility in Making Modifications

• Every organisation has employees moving in and out. For this reason, companies have to keep the purchased insurance policy updated to ensure that every employee remains financially covered at all times.

• A Group Health Insurance plan allows the policyholder to add or remove members in the plan according to the movement of employees in the company.

• This flexibility in making changes to the health insurance is not available in other types of policies and this is what makes Group Health Insurance stand out in the crowd.

Better Goodwill in the Market

Buying Group Health Insurance for employees shows that you care about them and their health. This develops a good image of your company among the employees and in the market.

Employee Retention

People like to work in companies with a good work culture and prudent business practices. The more a company thinks about the welfare of its employees, the higher the employee retention rate.

Buying Group Health Insurance is like providing your employees with a financial backup that will help them manage health emergencies without worrying about financial burden.

Enhanced Productivity

Better health conditions ensure better work output. Group Health Insurance covers financial expenses related to medical treatment, helping employees worry less about healthcare costs and ensuring that they get treated on time.

Receiving treatment at the right time supports good health, which enhances the productivity of employees.

Employee satisfaction

Increased employee satisfaction leads to higher productivity, which, in turn, boosts business profitability. With the assurance that Group Health Insurance offers to the insured, you can ensure that your employees remain satisfied and feel valued.

The best group health insurance for small business is a potential tool for decreasing turnover rates and increasing employee engagement and positivity in the company.

Value for Money

The premiums you pay for a Group Health Insurance policy will always come back to you in the form of profits due to increased employee productivity. Hence, it can be said that buying this type of health insurance for your employees is value for money.

In addition, Group Health Insurance also allows employers to get greater tax benefits than other health insurance plans. This is because, in this plan, a business owner pays the premium on behalf of all his employees.

Motivated Employees

• When you provide Group Health Insurance to your employees, they get a sense of security and peace of mind, which motivates and promotes them to work efficiently and produce higher outputs.

• Having motivated employees in your company enhances creativity, efficient resource consumption and improved workspace relationships. They also bring commitment and enthusiasm to the company.

Reduced Absenteeism

• An employee who receives quality healthcare services is more likely to maintain a healthy lifestyle, which will guarantee his presence at work.

• Group Health Insurance allows employees to get first-rate treatment for their health issues, which results in fewer leave requests and reduced absenteeism.

Increased Loyalty

Loyal employees are very hard to find. It takes up a lot of resources and time to gain loyalty. A Group Medical Insurance policy tells employees that the company considers their health as the top priority.

This gives them the much-needed happiness at the workplace and fosters a sense of loyalty and dedication towards the business.

Attracts Talent

A content employee shares positive reviews and feedback about the company. This attracts talented individuals to the company, as everyone prefers to work in a company that offers additional benefits, such as bonuses, rewards and a financial support system in times of need.

Other Benefits of Group Health Insurance Plans

Pocket-Friendly

• Imagine how it would feel to get a myriad of financial benefits without paying even a penny. Being a part of Group Health Insurance is just like that.

• Group Health Insurance is usually bought by employers, hence it remains free for employees. This policy allows employees (and their families, if chosen) to enjoy health insurance benefits for nothing.

• However, it may happen that your employer only pays part of the premium. In this scenario, the policy will cost you something, as you will be paying the rest of the premium amount.

• Furthermore, if you opt for add-ons, you will also have to make the payment to obtain additional benefits of your policy, but ultimately, these charges will be less than the expenses involved in buying an individual health insurance plan.

Tax Deductions

There are two cases in this:

When the Employer Pays the Premium on Behalf of the Employee

In this case, the tax deductions can only be claimed by the employer under Section 37(1) of the Income Tax Act, 1961. This is because employees make no contribution to the premium paid.

When the Employee Pays the Premium

• The employee will be eligible for deduction under Section 80D of the Income Tax Act. The tax benefit that can be claimed is as follows:

• The taxpayer can get a deduction of ₹25,000 per year on the premium paid for a health insurance policy for himself and his family (spouse and children).

• The taxpayer can get a deduction of an additional ₹25,000 or ₹50,000 per year if the policy includes parents or parents aged above 60, respectively.

• The taxpayer can get a deduction of ₹1,00,000 per year if both the policyholder and the parents are above 60.

Ease in Raising a Claim

• A Group health insurance policy has a simple claim process with two types of ways to raise a claim:

• Cashless Claim- Here, the treatment expenses are paid directly by the insurer to the hospital. The policyholder does not have to pay the bills from their pocket for the covered expenses.

• Reimbursement/Compensation Claim- Here the policyholder gets the treatment first and then applies for a reimbursement of the expenses with the insurer.

A Group health insurance is a type of health insurance designed to cover the members and employees of an organisation. This policy protects the insured from financial expenses paid for medical emergencies and the treatment of health issues.

It makes it easier for employees to get sufficient financial coverage at an affordable rate as Group health insurance divides the risk among a large number of people.

At Tata AIG, we offer all-in-one SME insurance policies, like Group health insurance, that provide excellent benefits to the company as well as its employees.

Our group insurance plans offer compensation for in-patient treatment and pre- and post-hospitalisation expenses paid, and they also cover expenses related to surgeries like organ transplants.

Is group insurance mandatory?

After facing the severe consequences of a disease like COVID-19, IRDAI (Insurance Regulatory and Development Authority of India) has made it mandatory for all companies to provide their employees with Group Health Insurance.

What is the grace period in group health insurance?

The grace period for health insurance ranges between 15-30 days.

What is the time limit for health insurance claims?

If you want to raise a cashless health insurance claim, you have to notify the insurance company 48 hours before, in case of pre-planned hospitalisation. However, in case of a medical emergency, you have to notify the insurer within 48 hours of hospitalisation.

If you want to raise a claim for reimbursement, you have to notify the insurance company within 48 hours of hospitalisation.

Is abortion covered under the Group Health policy?

In general, a Group Health Insurance policy does not cover abortion. But, if you have opted for maternity coverage add-on in your group health insurance, you will receive reimbursement for the cost of abortion you paid from your pocket.