Group mediclaim insurance policies or group health insurance plans are the health insurance covers provided to all the eligible members of a group. A group can be an organisation, company or employer. Generally, employers or organisations offer health insurance benefits to their eligible employees or members, and to their dependent family members in order to protect their well-being.
Basically, group health insurance policies are issued by insurance companies on the basis of common risk exposure with respect to the eligible members of the group. As the insurer’s risk is spread across the group among all the members, group health insurance plans are generally offered at a reduced cost.
When companies or organisations purchase group health insurance plans, the cost of the policy is either borne by the employer or by an insured employee or jointly by both. Whoever pays the cost of the policy, coverage is provided to the employee or member of the group against various health contingencies. There comes the general question – who is the policyholder in group health insurance policy?
Well, in an insurance contract there are various parties involved – the insurer (the insurance company that is providing the insurance coverage), the insured (the one who will receive the benefits of the policy) and the policyholder (the one who owns the policy). As a policy owner or policyholder may be the same as the insured. In a group health insurance contract that is offered by your employer, the policyholder or the policy owner is the organisation or the employer who offers you the chance to participate in the health insurance coverage. Employers or the organisation is referred to as “master policyholder” in any group insurance contract. However, employees who are insured and eligible to receive the policy benefits are referred to as “certificate holders”’.
Group health insurance policies work quite differently from individual health insurance policies. In case of group health insurance, the master policy is issued to the organisation or to the company offering coverage to each and every eligible employee or members registered under the policy for as long as the member or an employee is associated with that organisation or the company. That means the policyholder of any group health insurance policy is an employer only with the employee being the beneficiary till the date of his/her employment with the employer.