Buying Group Health Insurance

7 Questions HRs Should Ask Before Buying Group Health Insurance for Their Team

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Group health insurance is one of the main employees benefits companies and organizations provide. Rising medical inflation has necessitated coverage by health insurance even more. Thus, companies look to safeguard the health and wellbeing of their employees and protect them financially in the event of medical emergencies. 

Buying group health insurance might be confusing for HRs and owners of companies due to the abundance of plans having different features and benefits. There is no dearth of employee group health insurance plans, but the key is to select a plan that suits the employees’ needs and does not become a financial burden for the company.

HRs and owners must consider the following questions before buying group health insurance.

Who can be included in this policy?

The basic question to ask when buying group health insurance is who would be the beneficiaries of a particular plan. There are 3 types of group health insurance plans based on who can be covered by the policy.

The employee-only policy is the fundamental kind of group health insurance. The main purpose of group health insurance is to cover the employees and this policy covers the employees only. No one else except the employees can be included in this policy.

The employee, spouse, and children policy cover the employee, employee’s spouse, and two children of the employee. Such a policy automatically covers two children. However, more than two children can also be added to the policy on payment of an extra premium amount. 

Employee, spouse, children, and parents policy allows two parents or in-laws of the employee to be included in addition to spouse and children. This policy can either cover the parents or in-laws of the employee, but not both sets of people. Thus, the employee needs to decide whether to include parents or in-laws in the policy for any one of them can be included.

From the point of view of HRs and employers, the most economical option is the employee-only policy. This is because including the family members of the employees in the policy results in an increase in the premium amount. However, if the employer wants to cover the family members of the employees as well and can afford higher premium amounts, then the other two types of policies are suitable.

What does the plan cover?

Scope of coverage is another important factor to consider when buying group health insurance. Many plans also cover pre and post-hospitalization expenses apart from hospitalization expenses. Charges incurred within 30 days before hospitalization, such as diagnostic tests or visits to doctors, are covered under pre-hospitalization expenses. Charges incurred for up to 60 days after discharge from the hospital such as tests or medicines are covered under post-hospitalization expenses. It is up to the HR or the employer to decide whether to stick to in-hospitalization coverage only or extend pre and post-hospitalization expenses coverage as well to the employees.

Coverage of the room rent provided by a particular group health insurance plan must be checked. The main point to check is whether there is a capping on room rent or not. Capping means the policy limits the room rent that it would cover. For example, if the room rent capping is 2% of the sum insured of Rs. 5 lakhs, the maximum room

rent it would cover is Rs. 10,000. It is beneficial to ensure that the room rent capping amount is either high or there is no capping at all. 

There are many add-on benefits as well, such as maternity cover, critical illness cover, ancillary expenses cover, and more. Whether to opt for any add-on or not has to be made before making a purchase.

What are the details required when buying group health insurance?

Is important to understand the details that the company needs to provide to the insurer for buying group health insurance. Usually, the employee code, name, age, gender, and family and parents data( in case family/parents are included) are required by insurers. However, the insurer can ask for extra details per its rules and regulations. 

How much will group health insurance cost?

The premium amount is a crucial consideration when buying group health insurance. The cost of group health insurance depends on the coverage benefits, type of plan, and the insurer. More benefits translate into more premiums. The cost also increases if the family members of the employees are also included in the policy. The cost of the same kind of policy may also differ from one insurer to another.

Ultimately, the premium amount that the company is willing to shell out depends upon the kinds of benefits it wants to provide to its employees and whether their family members are to be covered or not.

Is claim support provided?

The process of raising claims must be easy and smooth. Thus, the details of the claim support provided by the insurer must be sought before buying group health insurance. The insurer should have a 24/7 helpline number to assist in the event of any difficulty faced during the process of raising a claim. The insurer should also have a dedicated email address for complaints and queries.

What is the process of renewal?

The process of renewing the policy should be understood prior to buying group health insurance. Insurance companies usually require the number of claims raised during the policy term along with the same employee data provided when renewing a policy.

However, any other kind of specific data required by the insurer for renewing the policy must be ascertained beforehand.

Where can the employee insurance data be checked?

The way to check employee insurance data in possession of the insurer must be determined prior to buy group health insurance. The ideal way is a digital dashboard provided by the insurer, which is integrated with the company’s IT infrastructure. 

Conclusion

At the time of buying group health insurance, it must be ensured that the coverage is in accordance with the needs of the employees without putting a drain on the company’s finances. The employees can also be given the facility to opt for extra benefits on their own by paying more premiums.

Are you thinking of buying group health insurance or thinking of porting out from your existing provider? If you are, then make sure that you opt for a better health cover with Vital for we offer a host of unparalleled benefits such as annual full-body health checkups, unlimited doctor consultations, and home delivery of medicines with discounts of up to 25 percent to name a few. 

So, what are you waiting for? Check out Vital at www.getvital.in/business or call us at 011-41171787 today.

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