What’s Copay in Employee Group Health Insurance?

An organization’s performance and success is always the result of the hard work of all its employees. As a result, the owner or the employer feels it is a moral duty to provide them with the best possible working conditions as well as security. In turn, a happy workforce proves to be more loyal towards the company and contributes more.

An essential step for any organization towards securing its employees is to buy an employment insurance plan. Having such a cover for employees greatly benefits them in meeting health challenges without facing any financial difficulties.

According to the Employee’s State Insurance Act, the employer of any establishment having more than ten workers needs to provide employment insurance to its workforce. Therefore, every employer needs to abide by the provisions of this act to avoid penalties.

If you have just started a company, and want to buy employment insurance, then you need to understand what copay is in employment insurance. To help you know the same, let’s dig deeper:

What is Copay?

Copay refers to a form of cost-sharing just as in other health insurance plans. Such cost-sharing between the insurer and the policyholder helps keep the premiums low. Understanding how the system works w.r.t copay is essential to make smart choices that suit both the healthcare needs of your employees and the budget of the company.

When, as an employer, you buy employment insurance, considering copay terms of any group health insurance plan is vital. It is because copay will have a bearing on your employees enrolled in the plan. They will need to pay a certain amount at the time of receiving medical care.

Copay is an insurance plan comes in three forms:

1. Copayment Fee – Some employment insurance plans come with a fixed fee for certain healthcare expenses like specific kinds of office visits, prescribed drugs, or other types of services. When you buy employment insurance, you get to know the terms related to a copay that help you understand how much the employees will owe from their pockets. If your policy lists a health insurance copayment of say Rs 500 for a doctor visit, the employees will have to pay that amount out of the total fees from their pocket when they see the doctor. The insurer will cover the rest of the amount.

2. Coinsurance Percentage – In this type of copay option, the group employment insurance states a percentage of the total cost for medical services instead of a fixed copayment fee. For instance, if the insurer owes a doctor Rs. 10,000 for your visit and your coinsurance percentage is 20 percent, you will need to pay Rs. 2,000 towards the cost. You can pay that amount either at the time of service or get a bill for the amount based on your coinsurance percentage.

3. Annual deductible – The insurer may have copay in the form of a yearly deductible that the insured employees may be required to pay towards covered medical services care in a single year. For example, if you have Rs. 5,000 annual deductible, you may need to pay that amount from your pocket towards the covered medical facilities before the insurer begins paying you for your claims.

It may also be the case that sometimes copay, coinsurance and deductibles apply toward the same medical service.

Some other points related to copay are as follows:

  • Usually, standard copay ranges from 10 to 20%.
  • Policies with copay mostly have lower premiums as employees need to pay a part of the claim from their pocket, which will result in less utilization of the sum insured.
  • Several corporates have a copay for claims related to parents to manage the costs.

Secure Your Employees the Right Way

As an employer, it is vital for you to offer health-related perks to your employees. More important than all of this is to secure your workforce with employment insurance. Group health insurance is an excellent way to provide a sense of security to your employees. You must also check the copay terms before buying any plan, keeping in mind both your budget and the employees’ needs in mind.

We, at SecureNow, simplify the process of purchasing group employment insurance for you. We bring together many insurers under one roof. Not only that, but we also help tailor the insurance policy as per your company’s needs.

Get the right employment insurance at the earliest and secure your workforce in the best way possible.

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