According to the IRDA, every employer in India is compell to provide group health insurance coverage to their employees. This policy came about as a fallout of the 2020 COVID-19 global pandemic.
Group mediclaim policy ensures that employees’ health of an establishment is cover by their employers. Employers are require to cater to the medical bills of their workers in the event of any emergency health concern.
This post explains in detail what group health insurance entails. But first, you might want to know why this policy is different from other types of health insurance coverage in India.
How is group insurance for employees different from other health insurance coverage?
There are different types of health insurance plans available to Indians. If you venture to buy a mediclaim policy for yourself only, you will be subscribing to an ‘Individual Health Insurance Coverage’.
However, if you decide to purchase a health insurance policy for members of your immediate family, then you are taking up a ‘Family Health Insurance Plan’.
When insurance coverage is purchase for a group, it is refer to as a ‘Group Insurance Scheme’.
But if your employer purchases a Group Health Insurance Scheme for all the employees in the organisation, then this insurance coverage is refer to as a ‘Group Insurance Policy for Employees’.
What is the coverage under a group insurance policy for employees
Under a group medical insurance coverage, the premium is paid for by your employer. It enables you to receive medical assistance at a designate hospital or clinic without incurring any cost. Your employer covers your medical expenses, allowing you to receive free treatment.
You will not be require to commit any personal funds when receiving medical attention at a designate medical centre. Some Group Insurance Plans for Employees also cover the medical treatment of their immediate family members up to the prescribe insurance coverage limit.
Is group health insurance compulsory?
It is worth noting that before April 1, 2020, employers didn’t need to provide group insurance health coverage. However, the impact of COVID-19 on the workforce force the Insurance Regulatory and Development Authority of India (IRDAI) into taking action to protect workers by making the group mediclaim policy compulsory.
With the easing of the lockdown, employers are mandated to offer health insurance coverage to their employees as part of the condition for resuming operations. The IRDAI advised companies to provide comprehensive group health policies that are affordable with easy-to-understand terms and conditions.
Types of group insurance policies- ESI and GMC
ESI is an acronym for Employee State Insurance, while GMC is short for Group Medical Cover. It is a policy regulated by the Employee State Insurance Act, 1948, and it is available to employees working within the formal sector in India.
ESI is available to those workers earning a monthly salary of Rs. 21,000 or below. In this health scheme, employees and employers keep the policy active by contributing to the Employee State Insurance Corporation or ESIC.
Employees will derive the health benefits from this scheme directly from the ESIC and not from their employer.
However, in the case of GMC, the coverage is for those earning a monthly salary that is more than Rs. 21,000. With GMC, your employer caters to the prescribe premium payments under the coverage.
To know what compulsory group medical insurance plan you fall under, you are advise to liaise with your employer or the HR department in your place of employment.
Benefits of group medical insurance cover for employees
Some of the key benefits of a Group Medical Cover include:
- Free Medical Service: As an employee under a GMC, you are not require to use your personal funds to pay for hospitalisation and medical expenses. Your employer pays the premium according to the policy terms. Your immediate family members would also benefit from the free medical care available.
- Quality Medi-care: The free hospitalisation and medical expenses do not mean that the quality of medical care is below par. You and your family will receive top-quality healthcare, including lab testing, medical consultation services, zero waiting period, hospitalisation expenses, outpatient treatments, and even COVID-19 coverage.
In conclusion
Another benefit derive from GMC is preventive medicare, where your health and fitness are monitor regularly to ensure that you are treat early to prevent the emergence of ailments. The group mediclaim policy is a brilliant initiative by IRDAI that has compell employers to take the health of their employees seriously.
With plans such as ESI and GMC, employees can save rather than spend their life-long savings during a medical emergency. And so, the IRDA decision to make group health insurance covers mandatory for the employees is highly appreciate by the masses.
