How to Evaluate your Group Medical Cover?

Group health insurance coverage is a policy offered by an employer or organisation to its employees or members. Unlike individual plans, it covers a group of people under a single policy. This type of insurance typically includes medical expenses, hospitalisation, cashless claims, pre & post-hospitalisation expenses, in-patient treatment, maternity cover, and more.

When selecting or renewing a group health insurance plan, consider the following factors to ensure comprehensive coverage for your employees.

Adequate Coverage

When purchasing a group medical cover, ensure that the coverage extends beyond hospitalisation expenses. The group plan should cover hospitalisation fees, pre-hospitalisation tests, post-discharge OPD expenses, prescriptions, and screenings. A broad coverage eases the financial burden on the employee. This support helps them focus on recovery and return to work sooner.

Also, the type of coverage to opt for depends on the employee composition and your budget. For example, if your majority workforce age is between 25-45 years, offering maternity insurance coverage can be beneficial. Now, if you are wondering about - how to calculate GMC premium? For this, you need to consider factors such as the number of employees, their age, location, and the coverage amount.

Network Hospitals

A wider network of hospitals is important when selecting a group health insurance policy. It ensures that employees have access to quality healthcare facilities, even when they are away from their usual location. Not only does a network hospital offer a cashless facility (like any other hospital), but it also requires minimum documentation and offers a faster claim settlement process. This comprehensive coverage provides employees with peace of mind and helps them focus on their health and work.

Sum Insured

The sum insured is another important aspect of group medical insurance plans for individuals. It determines the maximum amount that the insurer will pay for covered medical expenses. Choose a sum insured that adequately covers the healthcare needs of your employees. Also, consider factors like rising medical costs and inflation. A sufficient sum insured ensures that employees can access quality healthcare without worrying about financial constraints.

Flexibility

Choose a group health insurance coverage that offers flexibility in terms of customisation. Every organisation has unique healthcare needs. Flexible group medical insurance lets you customise coverage options to meet the specific needs of your workforce. It allows you to add new employees, adjust coverage for dependents, or incorporate new health services.

Waiting Period

The waiting period is an important factor when choosing a group health insurance plan. It refers to the time during which certain benefits are not available after the policy is purchased. Understanding the waiting period helps businesses to ensure that employees can access the necessary medical services when they need them. A shorter waiting period means quicker access to healthcare. It is beneficial for employees requiring immediate treatment.

Room Rent Limits

You must also consider room rent limits when choosing a group health insurance coverage. These limits determine the maximum amount the insurer will pay for room charges during hospitalisation. You must select a policy with room rent limits that align with the prevailing hospital charges. Choosing a policy with adequate room rent limits ensures that employees can avail of quality healthcare without incurring significant out-of-pocket expenses.

New Born Baby Cover from Day 1

Newborn baby cover from day one is an important feature to consider when choosing a group health insurance policy. It ensures that medical expenses for newborns, such as hospitalisation and vaccinations, are covered right from birth. This provides peace of mind to employees, as their newborns are protected from the very beginning. Also, it helps manage financial burdens associated with childbirth.

Settlement Process

The settlement process is a key factor to consider when choosing a group health insurance cover. A smooth and efficient settlement process ensures quick claim processing. It provides timely financial support to employees during medical emergencies. It is important to select an insurer with a reputation for prompt claim settlement, as this can significantly impact the overall experience of employees and their families during times of need.

Family Coverage

Family coverage is a critical factor when selecting a group health insurance policy. It extends the benefits of the policy to employees' family members, including spouses, children, and sometimes even parents. This comprehensive coverage ensures that employees' loved ones have access to quality healthcare without incurring additional costs. Family coverage also promotes employee loyalty and satisfaction, as it demonstrates the employer's commitment to the well-being of their family.

Choosing the right group health insurance policy for your SME is crucial for the well-being of your employees. Tata AIG offers various SME insurance plans like group health insurance policies, fire and burglary policies, etc.. The group mediclaim plans are designed to meet the unique needs of your workforce.

With Tata AIG group health insurance, you can ensure that your employees have access to quality healthcare. It includes coverage for pre-hospitalisation and post-discharge expenses, a wide network of hospitals, cashless treatment, and efficient claim settlement processes.

What is the average premium for group health insurance and how to calculate it?

The premiums for group health insurance vary. Different businesses have different requirements and you can customise the group medical insurance plan based on various factors. You can calculate the group health insurance amount by considering the following factors:

• Average Age of Employees

• Type of Job

• People Covered

• Gender

• Sum Insured

• Add-on Covers

• Medical History

• Policy Duration

• Claim History

How to compare group health insurance plans?

Before buying a group health insurance, compare plans to get the best deal. Consider factors like coverage benefits, network hospitals, premiums, claim settlement process, waiting periods, and additional features like maternity cover or wellness programs. Also, consider your employees' specific needs and the plan's affordability.