Group or corporate health insurance is provided to the employees of an organization as one of the employee benefits apart from the salary. The base health insurance policy is usually offered free to the employees because the employer pays the premium amount. The employer can also choose to pay the premium partly with the balance being paid by the employees. Group health insurance provides extra benefits if an additional premium is paid by an employer when required.
Group health insurance provides financial security in case of emergency hospitalization and as such becomes an important aspect to consider when switching jobs. Depending upon the plan, a group health insurance policy can cover pre and post-hospitalization expenses as well. Family members of the employees can also be included in group health insurance policies. There are many other coverage benefits.
Health insurance coverage needs to be considered while switching jobs. This is because once you leave a job, the group health insurance provided by your employer ceases to cover you. The group health insurance provided by a company is applicable to serving employees only.
Here are some points that should be kept in mind regarding group health insurance when switching jobs.
How does group health insurance work when switching jobs?
It is not advisable to be without health insurance coverage during the transition phase from one job to another. A medical emergency can happen at any time, forcing you to spend from your pocket. Thus, it is necessary to continue health insurance coverage when switching jobs.
As per IRDAI, an employee covered under a group health insurance policy can migrate to an individual health insurance policy if the employee switches to a new job or is terminated from the employer company. However, the right to accept or reject the request for porting to individual health insurance rests with the insurer. The insurer also has the right to determine the rules and regulations and the premium amount for the new individual health insurance policy.
You need to apply within 30 days before the termination of your services with the employer. Alternatively, you can apply within 5 days from the termination of your group health insurance policy. The request for porting to individual health insurance has to be made to the insurer.
To port your group health insurance coverage to individual health insurance, you may be required to submit a medical certificate and undergo a medical screening. However, these are not mandatory and depend upon the specific rules and regulations of the insurer.
Thus, when switching jobs, check with the insurer whether it offers the facility to port from group health insurance to individual health insurance.
When Switching Jobs, Remember
If you have a personal health insurance policy apart from group health insurance provided by your employer, ensure that it covers the period when you are switching jobs. If the policy has expired or will expire during the gap between the termination of an old job and the start of a new job, renew it before the gap period commences.
There are many short and long-term health insurance plans in the market. You can opt for a suitable plan as per your requirements to tide over the transition period from one job to another.
What kind of employee healthcare benefits should you look for?
When you are switching jobs, it is necessary to look at the benefits provided by the group health insurance policy of the new company you are slated to join. The fine print of the group health insurance policy provided by your current employer should also be compared with the healthcare benefits provided by your new employer.
The sum insured is a major consideration. Before switching jobs, check the sum insured provided by your new employer’s group health insurance policy. The sum insured should be greater or equal to the amount assured by your current group health insurance policy. It should be enough to cover your specific healthcare needs.
Group health insurance has the facility to include family members of the employees. At the time of switching jobs, check whether or not your new employer’s group health insurance plan covers family members as well. This is an important factor especially if your current group health insurance policy covers your family members. If your new employer’s group health insurance policy does not cover family members, determine the extra premium amount that needs to be paid to include family members.
Price Capping on Room Rent
Health insurance policies usually have price capping on room rent, ICU charges, medicines, etc. However, in the case of group health insurance, the capping amount is flexible. The employer can increase the capping amount or even waive off capping by paying more premium. Check the price capping, especially for room rent in your new employer’s group health insurance policy. Higher capping amounts or even no price capping are deemed suitable.
Group health insurance policies can carry a co-payment clause. Co-payment applies to specified medical conditions and hospital charges. Look for a co-payment clause in your new employer’s group health insurance policy. In case a co-payment clause is present, determine its magnitude. For instance, a 10% co-payment clause means you need to pay 10% of your hospital bill before the insurer pays the balance 90%. Low co-payment or absence of a co-payment clause is beneficial.
Extra Benefits or Add-Ons
Check the list of extra benefits or add-ons that can be availed by paying more premium under your new employer’s group health insurance policy. Common benefits include coverage for specific diseases, maternity coverage, etc. Decide whether you need any add-on benefits and whether you can pay the extra premium amount for add-ons.
Claim Settlement Ratio
Checking the claim settlement ratio of the insurer providing group health insurance to your new employer is important when switching jobs. A Claim Settlement Ratio of 90% or more is considered good.
Check the network hospitals of the group health insurance policy. Network hospitals provide cashless treatment. The network should be as wide enough as possible.
In a nutshell, it is important to continue to be covered under a health insurance policy when switching jobs, and equally important to consider the features of group health insurance provided by your new employer.
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