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Managing Your Group Health Insurance Benefits: Tips for Maximising Coverage

Posted on 13 Feb, 2024
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The word “medical expenses” refers to one of those expenditures that has the potential to deplete a person’s life savings. If you get a mild ailment, like the common flu, and go to a hospital to be treated, the medical bill can run into thousands of rupees. Now, consider treating a chronic condition.

Organisations provide their employees with free group health insurance to alleviate the financial burden of medical emergencies. It is worth mentioning that in light of the havoc caused by COVID-19, the IRDAI made this insurance mandatory for all organisations.

While group health insurance is useful to employees, it increases the cost of the company in question. However, there are ways by which an entity might maximise insurance coverage while keeping the premium under check.

group health insurance

Features of Group Health Insurance Benefits

Before learning how to maximise group insurance coverage, you should understand the policy features.

  • Customisation

    You can customise your plan based on your needs. For example, if you are in the mining industry, you may want to tailor the plan by selecting the group personal accident rider.

  • Extensive Coverage

    Group health insurance policies allow you to cover not just your employees but also their spouses, children, and parents.

  • Waiting Period

    This term refers to the time during which one cannot utilise his/her insurance to pay for treatment expenditures. However, there is no waiting period clause for group coverage insurance.

  • No Screening Required

    Your employees do not need to undergo any medical screenings to be eligible for this insurance. That means that, even if they have a pre-existing health condition, they will receive the same coverage as others, with no changes to the policy terms and conditions.

Tips to Maximise Group Health Insurance Benefits

You can maximise group policy insurance benefits as an employer by implementing the following strategies.

1. Expand Your Workforce

Expanding the workforce comes with a cost. You must pay your staff a salary, incentivise them for good performance, and invest in their training. However, hiring new employees becomes critical if you are contemplating an expansion.

In group medical coverage, insurance firms spread the risks among all employees. That is, the larger the number of employees, the lower the insurer’s risk, and the smaller the risk, the greater the probability of receiving coverage at a reduced premium cost.

2. Go for Young Talents

Young people are less susceptible to chronic ailments. The craze of going to the gym and remaining active and healthy helps to keep ailments at bay. However, as one’s age and responsibilities increase, whether at work or in personal life, stress and a sedentary lifestyle take over, making the body vulnerable to a variety of health concerns, particularly heart disease and diabetes.

The healthier your workforce is, the fewer claims there are. This results in a lower insurance utilisation rate and a lesser load on the insurer in terms of claim settlement, resulting in a reduction in premium payments.

3. Organising Wellness Programs

The healthier the workforce, the higher the productivity. Thus, you must organise wellness programs and implement processes to monitor your employees’ health and urge them to stay healthy.

You can try the following:

  • Organising free medical screenings at office premises

  • Vaccinations against common ailments

  • Make your workplace a no-smoking zone and enforce a punishment if you catch someone doing so

  • Set up a modest gym on the workplace campus

  • Instal open channels of communication for discussing mental health over the telephone

These steps may also help lower the utilisation rate of the group policy insurance and, at the same time, premiums.

4. Reduce Optional Add-On Covers

Not all insurance riders are appropriate for your company. Let us illustrate this with an example.

You run a chartered accounting firm and hire interns aged 21-25 years. In this case, adding critical illness coverage to the policy is pointless because, as previously said, young individuals are less susceptible to illnesses.

Similarly, purchasing group personal accident coverage is pointless if your organisation hires for a white-collar job that solely requires desk work.

5. Accept Out-of-pocket Costs

To reduce the insurance burden on your revenue, choose a plan that requires most of the out-of-pocket expenses to be borne by the employees at the time of treatment. For example, you can choose group medical insurance with no coverage for ambulance charges or with a considerable cap on room rent and a higher deductible.

Conclusion

Group health insurance is a valuable tool for both employees and companies. Employees benefit from comprehensive coverage and peace of mind. On the other hand, employers can use it to keep skilled workers on staff. However, because group medical coverage is a cost to the organisation, it is critical to follow the above suggestions to maximise policy benefits.

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This contains only an indication of the cover offered. For complete details on risk factors, terms, conditions, coverages and exclusions, please read the sales brochure carefully before concluding a sale.ICICI trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license and Lombard logo belongs to ICICI Lombard GIC Ltd. ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025. . IRDA Reg.No.115. Toll Free 1800 2666. Fax No – 022 61961323. CIN (L67200MH2000PLC129408). customersupport@iciclombard.com. www.icicilombard.com. (Group Health Insurance, 4010 , IRDAN115P0010V01200607)