Companies provide several insurance benefits for employees. Under this scheme, the employer purchases group health insurance for the employees. Group health insurance costs less than individual health insurance and provides tax benefits to the employer. On the other hand, the employees get financial cover in the event of hospitalization. Thus, group health insurance is a win-win for both employers and employees.
The basic question is how to select the best health insurance for employees. Multiple insurers are offering group health insurance plans. The comparison can be made based on some main features which have been mentioned below –
Features of Best Health Insurance for Employees
The sum insured is the limit of the medical expenses borne by the insurer. The sum insured needs to be considered to select the best health insurance for employees. The medical inflation rate and the kind of hospital the employees are likely to opt for treatment must be considered when selecting the sum insured.
The minimum sum insured should be Rs. 3 lakhs for companies located in Metro or Tier-1 cities. If the family members of the employees are also included in the group health insurance, then the minimum sum insured should be Rs. 5 lakhs.
A comparison of the premiums of the high and low sum insured amounts to determine whether or not the additional amount for the higher sum insured is within the company’s budget is recommended.
Multiple Categories of Hospitalisation
The best health insurance for employees covers in-patient hospitalization, pre-hospitalization, and post-hospitalization expenses.
In-hospitalization expenses are incurred due to hospitalization to treat illnesses, injuries, or surgery. The group health insurance covers all the in-hospitalization expenses such as doctor’s fees, nursing expenses, costs of the medicines, operation theatre charges, room rent, plaster casts, anesthesia, and more. The policy covers the in-hospitalization expenses only if the insured is hospitalized for at least 24 hours.
Pre-hospitalization expenses are the expenses incurred 30 days before hospitalization. The expenses under this category include costs of medicines, doctor visits, diagnostic tests expenses, and more. The limit can vary from insurer to insurer.
Post-hospitalization expenses are incurred within 60 days after discharge from the hospital. Expenses include diagnostic tests, medical check-ups, and more.
Room Rent Limit
The room rent limit is the maximum room rent covered by the group health insurance. The room rent limit can be 1% of the sum insured or a single private room regardless of its category. Low room rent limit puts the employees at a disadvantage, particularly in Metro cities. This is because low room rent policies cannot fully cover the expensive room rents. For example, an insured employee has a room rent limit of Rs. 5000 would have to shell out money from his/her own pockets to stay in a private room having a rent of Rs. 10000.
In this scenario, the best health insurance for employees is the one that covers at least 1 private room, whatever may be the cost.
Less than 24 Hours of Hospitalization Expenses
Some group health insurance providers offer coverage for certain procedures that do not require even a full day of hospitalization. These include chemotherapy, eye surgery, tonsillectomy, and others. It’s up to the employer to decide whether or not the employees need this special kind of cover.
No Waiting Periods
The best health insurance for employees is one that does not have a waiting period. The waiting period is a certain time period after the purchase of the policy in which the policy is not active. The initial waiting period is of 30 days, during which the policy covers only hospitalization expenses for treating accident-related injuries and not diseases. The waiting period for specific diseases can be 1-2 years, while 3-4 years for pre-existing diseases.
It must be ensured that all kinds of waiting periods are waived off in the group health insurance policy.
Maternity Cover and New-Born Care
Companies employing young married professionals should consider maternity coverage and newborn care when looking for the best health insurance for employees. Maternity cover provided by group health insurance policies bears the expenses for both normal and C-section deliveries. Newborn baby care expenses are also covered for up to 90 days. The policy can also cover infertility treatment and legal abortion.
The best health insurance for employees covers the family members/dependents of the employee as well. Employees get maximum satisfaction when their family members are also covered under the group health insurance policy. However, such a group health insurance policy premium is twice more than an employee-only policy. Thus, it is for the company to decide whether to include the employees’ family members.
The best health insurance for employees provides coverage for domiciliary treatment. This means the policy pays for the expenses incurred by the insured for treatment at home on the advice of a qualified doctor. The reason for home treatment can be the unavailability of a bed at the hospital or the insured person’s inability to go to the hospital. The rules and regulations for domiciliary coverage vary from insurer to insurer.
Mental problems such as stress, anxiety, depression, and more are especially among working professionals. Thus, companies seeking the best health insurance for employees should look for psychiatric cover in the group health insurance plans.
Psychiatric cover pays for the expenses incurred on consultations with mental health professionals such as psychiatrists and psychologists.
Large Network of Hospitals
Cashless treatment means the insured is not required to pay anything, and the hospital bill is settled directly by the insurer with the hospital. However, this is possible only if the insured gets treatment in a network hospital of the insurer.
The best health insurance for employees is the one that has a large network of hospitals to provide cashless treatment. To this end, the employer must ensure that the insurer has many network hospitals, including the big hospitals where the employees live and work.
Finally, to sum up, the best health insurance for employees is a plan that fulfills all the employees’ requirements. So make sure that you choose your group health cover after conducting your research and ensuring that your requirements are fulfilled at the lowest possible price.
If you are confused about which health cover to opt for, then you must check out Vital at www.getvital.in/group-health-plan.