Group Personal Health

Group Health Insurance: Overview

Group Health Insurance (GHI) is a single, centralized health insurance policy provided by an employer or organization to its members. It's an indispensable component of an employee benefits package, offering financial protection against medical emergencies and promoting workforce well-being. By covering a group, it simplifies management and significantly reduces individual premium costs.

Key Features of GHI

• Zero Waiting Period for Pre-existing Diseases: Unlike individual plans, GHI often covers existing illnesses from the first day.
• Maternity & Newborn Coverage: Most plans include comprehensive coverage for maternity expenses and the newborn baby.
• No Mandatory Medical Tests: Employees and their dependents usually don't need to undergo medical screening.
• Cashless Hospitalization: Access to a wide network of hospitals for treatment without upfront payments.
• Family Coverage Option: The policy can be extended to cover the employee's spouse, children, and parents.

What the Policy Covers

• In-Patient Hospitalization: Covers room rent, doctor fees, nursing expenses for more than 24 hours of hospitalization.
• Pre & Post Hospitalization: Medical expenses incurred immediately before and after discharge (typically 30/60 days).
• Daycare Procedures: Expenses for treatments that require less than 24 hours of hospitalization due to advanced technology.
• Ambulance Charges: Costs related to emergency transportation.
• Optional OPD Cover: Coverage for outpatient department consultations and expenses (can be added).

Benefits to Employers

• Attract & Retain Talent: A top-tier benefit that makes the company competitive in the job market.
• Tax Advantages: Premiums paid by the employer are treated as a business expense, offering tax deductions under Section 37(1).
• Improved Productivity: Reduces employee financial stress and minimizes absenteeism due to health-related issues.
• Cost-Effectiveness: Lower per-person premium compared to individual policies, maximizing budget impact.

Who Can Offer GHI?

• Corporates and MSMEs (typically minimum 5 to 7 employees required)
• Startups looking for cost-effective employee benefits
• Cooperative Societies and Trade Unions
• Professional Associations or Groups with an affinity to a common field

Customizable Add-ons

• Voluntary Top-up (Super Top-up) for higher cover
• Corporate Wellness Programs
• OPD (Outpatient Department) Expenses Cover
• Global/International Coverage Extension
• Critical Illness Rider