A top-up insurance plan within group health insurance covers hospitalization costs. But, only after a threshold limit is crossed. This threshold limit is known as deductible i.e, a portion of the claim amount that is not covered by the insurer and has to be paid by the policyholder. Once the claim amount crosses the deductible […]
Disease-wise capping: How can it help GMC to manage price?
With disease-wise capping, an insurer can reduce claims out-go and hence its risk for the GMC. Though you can select the list of diseases and respective capping for a group policy insurers have pre-defined slabs of lower limits, default limits, and higher limits. Below is an illustration of these slabs – Disease-wise capping can be […]
Who is the right insurer for a start-up GMC?
When you are buying group insurance for the first time, you have to be extra cautious in your choice of service partner. There are 20+ general and health insurance companies in the market offering group health insurance services. Choosing among them can be a tough task. Below mentioned are a few parameters that can help […]
How can employees take advantage of group to individual portability?
As per Health Regulations 2016, portability guidelines, members covered under any group health insurance policy of a general/health insurer can port/migrate from a group policy to an individual policy with the same insurer. Though group health insurance schemes do not provide all the benefits which are available in an individual policy, they seem to be more relaxed. This guideline is extremely […]
What are the options for a company to buy insurance for expat employees?
Most companies now have global operations. The statutory laws of the foreign land may require them in order to provide coverage. To expat employees working in their respective geography. Since in most countries the local law regulates insurance while buying the for expat employees. It is important to ensure that the policy is admissible in […]
What are the limitations of a Group Health Insurance for an employee?
Though group health insurance policies are extremely flexible by design in terms of enrollment and operability, they come with their own set of limitations. Below we highlight a few limitations of the group health insurance program – The employee has little or no control over their individual coverage. Designed the benefit structure of the group […]
How can deductible and co-pay help in lowering the prices for Group Health Insurance?
How deductible & co-pay help keep Group Health insurance prices low? Group health insurance pricing is a function of claims record, number of lives covered with respective demography, and benefit structure of the policy. An increase or decrease in the benefit structure translates into a proportionate increase or decrease in projected claim costs and hence […]
How can a maternity claim be shared between 2 health insurance policies?
It is common for insurers to cover maternity-related expenses in a health insurance policy. However, since maternity claims are frequent, insurers cover them for a restricted policy sub-limit, which is commonly between INR 50K – INR 1L. Key Takeaways No “Double Benefits”: While you can use two policies, the total payout cannot exceed the actual […]
What are the key features that a startup should evaluate in a GMC Policy?
A Group Mediclaim (GMC) policy is the most common employee benefits policy for any company. It is a tailor-made program, i.e., it gives you complete choice in personalizing the benefits, terms, and conditions. Therefore, companies design policy benefits with features that appeal more to the target audience – the employees. Key Takeaways The “Day One” […]
Types of endorsement scales in group medical insurances
As an organization contemplating group medical coverage (GMC), you might have encountered different types of endorsement methods. This post helps to make sense of these endorsement methods. Key Takeaways Pro-Rata: The “Pay-as-you-go” Model: This is the most employee-friendly method. If a new hire joins on Day 180 of a 365-day policy, the company only pays […]