Group Health Insurance

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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 few parameters that can help you in your decision of selecting the right insurer for a start-up GMC :


  1. Benefit structure: You should choose a partner which is flexible to offer you the benefit structure of your choice in your group health insurance plan. By far the benefit structure is the most important element of a group health insurance policy. All claims in the policy will be settled in adherence to the benefit structure defined in the policy. Hence if you have to decide between two providers, the first one offering you only restricted room-rent capping vs the second offering you room-rent capping of your choice, you should undoubtedly choose the latter one.


  1. Hospital Network: This is the second most important point to be considered in your choice of the right insurer. All health insurance policies offer cashless service to the insured within the insurer’s hospital network. You should choose an insurer that has a robust network of hospitals in your locality for your start-up GMC. Your employees will get access to high service quality levels within the insurer’s network enhancing their overall experience of the policy.


  1. Employee choice: Each employee is at a different career stage, has different aspirations and responsibilities. Hence it is impossible to design a health insurance benefit plan that suits everyone. This is where offering choice to the employee in terms of policy add-ons gets important. Your insurer should be able to offer add-ons to your employee for a subscription. Add-ons like sum insured top-ups paid to cover for dependents, health check-ups, etc. are commonly offered to the employee group for a voluntary subscription. These features help in enhancing the employee satisfaction levels and improving the relevancy of your employee benefits program.


  1. Claim settlement ratio: Claim settlement ratio for an insurer is the percentage of claims that they have settled out of total claims filed/intimated to them. It reflects the overall risk management ability of the insurer and the commitment it has towards customers. Customers show higher confidence in insurers with a higher claim settlement ratio. Since the claim settlement ratio is published every year by each insurer, use the most recent one for your decision-making for your start-up GMC.


  1. Minimum size: Each insurer has a minimum lives threshold to underwrite a group health insurance program. Though this no. is generally very small, ranging anywhere between 10 to 25 lives for an insurer, some start-ups might face a challenge in case the insurer’s minimum no. of lives criteria is not met. In this case, the insurers which have a lower threshold on the minimum no of lives will bid for the proposal.


Service orientation: The moment of truth for any insurer is at the time of servicing the policy. Competitive premium is only half-truth and if your decision is based only on that parameter alone, there is a high chance that it may go wrong. You should inquire in detail about the insurer’s goodwill, claim process, service levels, infrastructure, and financial standing for evaluating their market performance. Since group health insurance policies are common in the market it may be wise to spend some time taking service feedback on insurers from your professional network.

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