If you have health insurance for yourself, it will help you protect and safeguard the money you earned by putting in your blood and sweat at the time of medical emergencies. The criteria is such that a premium cost is required to be borne by the policyholder. This premium can be a monthly, quarterly, or annual payment depending on the flexibility offered by the plan. If the policyholder is hospitalized, then the charges are paid off by the health insurer.
Now, you must be wondering if there is any possibility to avail these benefits for free. Well, looks like your wish has been long granted! With group health insurance, which is a type of cover offered by the employer to their employees, you can rest assured!
Quite recently, owing to the difficulties faced by the citizens during the pandemic due to the surge in medical costs and lack of health coverage, the government has made group health insurance mandatory in the country. Read ahead to learn more about the subject. 🔝
Is Group Health Insurance Compulsory in India?
The answer is plain and simple—yes! Employees are eligible to be protected by a group medical insurance in India. This has come into place after the nation-wide lockdown due to the pandemic. Before we dive deeper into the topic, let us briefly understand the meaning of the various medical policies. ⏰
- Individual Health Insurance refers to a policy that an individual purchases for themselves.
- Family Health Cover indicates a policy that an applicant buys for themselves and their family.
- Group Insurance Scheme is nothing but a policy plan which covers an individual and other members of the group.
- However, in case an employer applies for Group Medical Insurance to insure the employees of their organization, it is known as insurance for employees.
Learning About the Basics 💭
When the employer offers a group insurance policy to its employees, the entire cost of the policy’s premium is borne by them, and every employee is eligible to enjoy the benefits free of cost. The group plan will provide coverage to the extent of hospitalization expenses. In some plans, the hospitalization expenses of the employee’s family members are also covered up to a certain limit. Hence, it is advised that the terms and conditions be read carefully and due attention be provided to detail.
Recent Updates 💡
The Insurance Regulatory and Development Authority of India (IRDAI) issued a circular on 1st April 2020, in which it stated that medical insurance will be made compulsory.
It was after the lockdown that the government asked the organizations to follow a basic common procedure known as the Standard Operating Procedure to return to work and ensure that due insurance was offered as a part of compensation to the entire workforce. The employees, right from the lower level to the top level of management, are thereafter being covered under the medical insurance.
The IRDAI issued the circular to the insurance agencies, keeping in mind that the decisions of the Ministry of Home Affairs are fulfilled and implemented at the ground level.
Since the coverage has been made mandatory to all levels of workers – the policies are expected to be exhaustive, affordable, and worded simply so that it will be understandable.
People being employed for any kind of job for the company will be eligible to avail benefits as a part of the group medical insurance.
Discovering the Difference Between the Employee State Insurance (ESI) and Group Medical Cover (GMC) 📃
The Employee State Insurance Act, 1948 provides employees of the organized sector with medical insurance. All the employees earning a minimum monthly income of equal to or less than Rs. 21,000 can avail the facilities of medical insurance from ESI. 👀
The employee’s identity and employment proof has to be provided, and contribution in this case will be made by both—the employer as well as the employee. At the time of need, the employee is eligible to avail the benefits from the company under the Employee State Insurance Corporation (ESIC).
The key difference that needs to be understood here is that for employees with income below Rs. 21,000, ESI will be applicable. For all employees above the income range of Rs. 21,000, the group cover will be effective.
For more details, the employees can get in touch with the concerned employer or HR department. In this way, all types of employees will be covered under the program. One need not worry that the insurance will be job specific.
What are the Advantages of Group Medical Insurance for Employees of an Organization? 💯
Here are some of the top benefits of an employer-offered medical insurance policy for their employees.
- No Cost Health Cover
Employers take care of the premium cost, and employees just have to focus on doing their job. Amidst the rising medical and treatment costs, it is a boon for employees to avail benefits of such comprehensive coverage, which also provides some benefits to their family members.
Comprehensive Coverage ➕
The high quality features of the policy may include and are not limited to the below:
- Medical coverage for pre- and post-hospitalization expenses
- Absence of waiting period
- Treatment for COVID-19 is offered
- On-call consultations with medical practitioners
Companies have encouraged employees to focus on their health and exercise regimen. They have set weekly goals and even provide rewards to those who manage to achieve it. Hence, group health insurance is a necessity for organizations to cater to the individual needs and requirements of their employees.
Employees, on the other hand, are free to enjoy the benefits. They do not have to stress about whether they would be eligible just on the basis of their job description! ✔