Group Health Insurance

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Customising your group health insurance policy

To ensure the health of your business, it is necessary to take care of your employees’ health. By offering a group medical insurance policy, you can take care of your employees’ rising medical expenses that could otherwise be a major burden on their finances.

Often, organisations review the background of insurers and the policy but fail to customise policies. Most group health insurance policies offer basic coverage like pre- and post-hospitalisation medical expense cover, cashless hospitalisation, advanced technological surgery coverage, etc. However, there are other benefits you can discuss with your insurer and include in your corporate health insurance.

Additional Read: What are the benefits of group health insurance?

Extending the age limit for parents’ coverage

Many group mediclaim policies extend coverage to dependent parents of employees. However, such coverage often comes with an age limit of 65 years. You can customise this cover, increasing the age limit to at least 80 years.

Some health insurance companies might charge higher or extra premiums for this. In such cases, you can introduce co-payment or deductibles, which will allow you to share the cost with your employees. For employees, this will still be a better alternative than individually shouldering the rising healthcare costs that their parents may incur. It will also deter them from filing unnecessary claims.

Providing critical illness cover

Cancer killed 7.8 lakh people in India 2018. The sad part is that even youngsters now suffer from critical ailments like cancer, heart disease, kidney failure, etc. The treatment costs for such illnesses can be very high. For example, chemotherapy can cost Rs 10 to 20 lakh in some cases. The situation is worsened if the person contracting the illness is the family’s breadwinner and is unable to work. Thus, cover for the total treatment cost of critical ailments and cover for the loss of income incurred would offer considerable relief to employees.

You can structure a fixed benefit to be paid if an employee is detected with a specified critical illness. Some insurers will insure up to 30 different critical illnesses.

Reducing non-payable hospitalisation expenses

Expenses such as ICU charges, bed charge, etc. can be huge in case of a long-term illness requiring hospitalisation. Normally, a cap is prescribed on these in an employee insurance scheme. However, employers can have this cap removed to enable employees to avail the best facilities at network hospitals.

This cap has been an issue for Covid treatment. Many insurers will not pay for more than 2 or 3 PPE kits per day. The cost of devices such as oximeters that are a part of Covid care are not payable. In fact, we estimate that in Covid claims, insurance does not pay about 35% of hospital costs. You can reduce, if not eliminate, this by agreeing terms with the insurer.

Increasing the list of day-care treatments

Most day-care treatments can be expensive and might involve complicated procedures like eye surgery, angiography, and appendectomy. Employees might skimp on such procedures in the absence of necessary cover. As an employer, you can personalise your group mediclaim policy for employees by adding more day-care treatments; you can add well over 100 day-care procedures.

Covering maternity and baby care needs

The government recently decided to increase paid maternity leave for female employees from 12 weeks to 26 weeks. Similarly, you can help by covering maternity expenses and baby care expenses under a group health insurance policy. Though you might have to incur a slightly higher premium for providing maternity coverage, both female and male employees are likely to appreciate this move.

Adding accidental death riders

Employers can also choose to avail a personal accident cover as a rider to their group medical insurance policy. This will help employees in case they meet with an unfortunate mishap that leads to death or partial or total disability. You can also customise accident riders to include medical expenses arising from accidents. For example, fractures or burns that do not require hospitalisation can be paid for under an accident rider.

A policy that that does not suit the needs of your employees might not be very useful. Additionally, customisation helps provide extra provisions unavailable in the basic policy laid out by the insurer. These special provisions will depend on the size and type of your organisation, location (metro, tier 1 or tier 2 cities), preferences of employees, etc.

Additional Read: How Group health insurance plans can help small-and-medium-scale businesses

How can SecureNow help you in customising your group health insurance policy?

You can choose the right group medical insurance policy for your company with the help of SecureNow, a reliable insurance advisor. All you need to do is provide some basic details like the number of employees, riders, etc. We will then get you group health insurance premium quotes from leading insurers. Thereafter, we can help you compare these and chose the right one. If you would like, we can also help you in customizing your group health insurance plan.