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What a GMC and GPA Health Insurance Policies?

  • Author :
  • TATA AIG Team
  • Published on :
  • 03/06/2022

Employee satisfaction, especially the physical and mental well-being in current times - is a key component in determining the success and employability of an organisation. As a result, every organisation tries to ensure a safe and beneficial working environment for their employees.

Employee benefits may include a well-defined and fair compensation structure, equal pay and opportunities, maternity and paternity leaves, a safe working environment, clearly defined working hours, etc. One such important employee benefit offered is an insurance policy - life insurance and health insurance.

Under health insurance, employers may offer two types of plans - a Group Medical Coverage or GMC Policy and a Group Personal Accident or GPA Policy - to help employees take care of defined medical expenses. So, what are GMC and GPA policies? Let’s find out.

What is GMC Policy?

GMC full form in insurance is Group Medical Coverage. GMC in insurance is a group coverage plan that covers a set of people, commonly a group of employees belonging to one organisation.

Under the plan, the entire set of people gets health insurance coverage. GMC is customisable, and the extent of coverage will depend on the type of GMC policy chosen by the employee, the number of employees covered, income and age of the employees, the domain/industry of the organisation and so on.

As the risk of insuring is divided between a large number of people, GMC policies are cheaper than separate individual policies. The premium is either entirely borne by the employer or is divided amongst the employees in proportion to the coverage opted for. The employees can choose to pay the premium by direct GMC deduction in the salary.

GMC in insurance can either be a standalone policy or offer optional riders/add-ons for enhanced coverage.

What are the Benefits of GMC Policy?

Now that we have seen what GMC policy is, let us understand some benefits of GMC in insurance:

  • Hospitalisation cover, including pre-hospitalisation and post-hospitalisation cover for diagnostic tests and cost of medicine
  • Expenses incurred for daycare procedures that do not require overnight hospitalisation
  • Female employees can avail of maternity cover
  • Some GPA policies extend coverage to the spouse and children of the employees, including maternity cover for the wife and infant cover for newborn children
  • Insured employees can also avail cashless treatment facilities at network hospitals.

What is GPA Insurance Policy?

GPA insurance full form is Group Personal Accident. A GPA policy is a personal accident cover collectively provided for a group of employees and offers predetermined financial support in case of accidental injury, disability caused by an accident or death resulting from an accident.

GPA insurance is not highly customisable and offers a predefined set of features and benefits for all the covered employees. Due to distributed risk of coverage, the premium for GPA policies is lower than standalone personal accident covers.

The premium for a GPA policy will either be covered by the employer or paid for by the employees as part of their salary deductions.

A GPA insurance plan offers personal accident cover to their employees not only on the office grounds and during working hours but also outside of work, off-duty and when travelling outside the city or country.

What are the Benefits of GPA Insurance?

Now that we have seen what GPA insurance is, let us look at the benefits of a GPA policy:

  • In the event of the unfortunate death of the insured employee caused by accident, the family will be paid a predetermined amount as a death benefit.
  • If an accident leads to a temporary or permanent partial/total disability, the insured employee will receive a predetermined payout.
  • Ambulance charges are covered under GPA insurance.
  • Some GPA policies also cover the transportation costs of carrying the deceased individual as well as the funeral charges.
  • Some GPA insurance plans will cover the education costs of up to two dependent children in case of the insured employee’s accidental death.

Difference Between a GPA Policy and a GMC Policy

Points of Differentiation GMC Policy GPA Insurance
Scope of Coverage Group Medical Coverage or group health plans offer health insurance coverage, including hospitalisation, diagnosis, medicine, OPD, and maternity expenses for a group of employees. Group Personal Accident plans cover accident-related eventualities, such as accidental death, accidental total/partial disability, etc., for a group of employees.
Type of Coverage GMC policies are indemnity-based plans. This implies that the policy will pay out the amount equivalent to the exact expenses incurred by the employee, subject to the sum assured limits. GPA insurance is fixed-benefit. That means the policy pays out a lump sum amount as determined under the policy wordings. For instance, if the policy pays out 50% of the sum assured for partial disability, then it will pay out the entire 50% irrespective of the expenses incurred.
Coverage For GMC policies cover the employees as well as their spouse and dependent children. GPA policies only cover the insured employee.
Customisation GMC policies offer a wide scope for customisation based on the number of employees, industry/domain of the employer, type of occupation, etc. Being fixed benefit plans, GPA policies do not offer any major customisations.
Ideal For GMC policies are basically group mediclaim plans and can be bought by any employee-employer group for group health insurance coverage. GPA insurance is ideal for risk-prone, accident-prone industries, such as mining, construction, etc.
Range of Cover GMC policies have a wider range of coverage than GPA insurance as they offer comprehensive health insurance coverage. Additionally, a personal accident cover can be added as a rider to a GMC policy. Due to coverage for only accident-related eventualities, GPA insurance has a narrower range of coverage.

Conclusion

Group Medical Coverage or GMC policies and Group Personal Accident or GPA policies are two commonly bought health covers by employers for their set of employees. The choice between GMC or GPA insurance will depend on the scope of coverage required by the organisation. Generally, most organisations buy a Group Medical Coverage with a personal accident add-on. High-risk industries, such as construction or mining, may buy a separate GPA policy for the all-around protection of their employees.

No matter which type of health insurance your employer provides, it is advisable to get a separate health insurance plan for you and your family from Tata AIG. Individual medical insurance plans are generally more comprehensive and offer extensive coverage. Additionally, you can choose the required features and benefits of health insurance - either targeted or comprehensive - based on your and your family’s unique insurance requirements.

Thus, it is critical to know the details of your employer-provided health insurance, and it is equally important to buy a separate health insurance plan for a more comprehensive cover.

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