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Group Health (Floater) Insurance

  • ghi image 1 Exclusively crafted health plans for your employees
  • Simple, affordable, and customized insurance
  • Always there for your employees' critical moments

Group Health(Floater) Insurance

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What is group health insurance?

Group Health (Floater) Insurance, as the name suggests, offers coverage to a group of people. It generally covers employees of a company or members. A group health insurance policy plays a vital role in ensuring employees' well-being by offering financial protection against medical expenses.

Affordability is a significant benefit of Group Health Insurance. The premium of group health insurance plans tends to be lower than individual health insurance plans. This makes it a cost-effective option for both employers and employees.

Group Health (Floater) Insurance plans generally offer extensive coverage for various medical expenses. This includes hospitalisation, surgeries,, medications, and even post-hospitalisation expenses upto 60 (sixty) days. Some add-on plans may also offer coverage for maternity expenses, pre-existing conditions, and outpatient treatments

Another advantage of Group health insurance is that it has no pre-existing condition exclusions. Unlike individual health plans that may impose waiting periods or exclusions for pre-existing conditions up to a certain number of years, group policies usually cover all employees regardless of their health history. With this, employees with pre-existing health ailments can have hassle-free access to the healthcare they need.

Many companies offer group health insurance as part of their employee benefits package. They bear the premium for this policy. This not only reduces the financial burden on employees but also demonstrates the employer's commitment to their well-being.

Employers buy group health insurance plans depending on the number of employees. At ICICI Lombard, we offer a simple, affordable, and customised group health insurance plan for your employees.

Why is group health insurance important for employers and employees?

Group health insurance offers various benefits to employers and employees.

  • For employers
  • For employees
  • Cost-effective coverage

    Corporate health insurance plans generally command lower premiums than individual plans. This is because risk is distributed across a broader pool of employees. This makes a group health insurance policy cost-effective for employers, especially for small and medium-sized companies.
  • Tax Benefits

    Contributions towards corporate health insurance premiums qualify for tax deduction under section 80D of the Income Tax Act. This results in a substantial reduction in your long-term tax liability.
  • Extensive Coverage

    Many group health insurance plans offer extensive coverage to you and your family. This ensures access to vital healthcare services without significant out-of-pocket expenses.
  • Coverage for Family at Zero Cost

    With a Group Health (Floater) Insurance policy, you can extend coverage to your entire family hassle-free. This weeds out the need to purchase separate policies for each family member, leading to significant cost savings.
  • No Waiting Period

    With corporate health insurance, there is no waiting period. The coverage starts as soon as you enrol. It ensures you do not have to bear hospitalisation expenses for certain conditions personally. Preventive Care Services.
  • Preventive Care Services

    Several group health insurance plans offer coverage for preventive care services at little to no cost. This encourages employees to actively maintain their health and well-being. It reduces the likelihood of more serious health ailments in the future.

Who should buy group health insurance?

Group Health (Floater) Insurance is vital for organisations of all sizes, ranging from small, medium-sized enterprises to large corporations.

Small businesses

Group Health (Floater) Insurance can offer multiple benefits for small businesses with approximately 20 to 50 employees. These companies often have limited resources. They may not have the financial flexibility to provide extensive health benefits to their employees Group Health (Floater) Insurance for small businesses allows them to offer cost-effective health solutions to their employees ... This helps them attract and retain the best talent by providing valuable healthcare benefits that go a long way in boosting employee satisfaction and loyalty. Read more..

Medium businesses

Medium-sized firms with around 250 employees also benefit significantly from corporate health insurance. While they generally have more resources than small businesses, they still face similar challenges when providing competitive benefits packages to employees. Group health insurance enables them to provide robust healthcare coverage without incurring high costs.

Large businesses

Large businesses with more than 250 employees can also buy corporate health insurance. Though they have greater financial muscle for employee benefits, group health insurance is an essential cog in the wheel of their benefits package. They often use it as part of their broader employee wellness initiatives to promote a healthy workforce... This policy goes a long way in helping them scale their business and evolve as a dominant player. After all, a healthy workforce is imperative for an organisation’s growth and sustainability. Read more..

Features of ICICI Lombard’s group health insurance policy

With ICICI Lombard's group health insurance policy, you get the following benefits:

6500 + network hospitals

We have 6500 + network hospitals across India where your employees can get cashless treatment. We have tied up with leading health institutions across India. Whether your employees reside in urban centres or remote locations, they are likely to find a network hospital near their homes. This reduces travel time and inconvenience during emergencies or even routine medical check-ups.

Teleconsultations

This is another significant benefit of our group health (floater) insurance policy. We offer unlimited general physical consultations for routine health issues by a qualified doctor. Your employees can avail of this facility by dialling 040-66274205. This feature goes a long way in offering holistic healthcare and maintaining overall well-being. It also brings down the chances of developing serious health issues in the future.

Health assistance services

Our group health (Floater) insurance policy goes beyond covering medical expenses by offering health assistance services. This service supports you in all your health-related needs. Whether searching for a specialist, scheduling an appointment with a doctor, seeking advice from a nutritionist, or requiring a second opinion, we have your employees covered.

In-house claims processing

One of the standout features of our group health (floater) insurance policy is the provision for cashless settlement. By seeking treatment at our network of hospitals, your employees can avail the necessary medical services without the hassle of out-of-pocket payment and then seeking reimbursement.

Wellness programmes

Our group health (floater) insurance policy allows your workforce to choose a range of wellness plans to suit their needs. These plans promote proactive health management and focus on preventive care and overall well-being. These programmes help foster a healthier workplace culture and boost the productivity and morale of your employees.

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What is covered under a group health insurance policy?

Our group health insurance provides coverage for the following.

1

Pre and post-hospitalisation

Our group health insurance policy covers pre and post-hospitalisation expenses. This means not only the costs of your hospital stay are covered, but also the expenses you bear before and after your hospital visit.

2

Pre-existing diseases

Group health insurance coverage for pre-existing diseases ensures your employees with prior health issues aren't left unprotected. It offers peace of mind and fosters a sense of security within the workforce. They feel reassured knowing their health needs are addressed despite pre-existing ailments.

3

Maternity expenses

Our group health insurance policy offers coverage for maternity expenses to your employees. This is a significant benefit for those planning to start or expand their families. It covers pre and post-natal expenses and offers coverage to the baby from day one. This not only offers access to quality healthcare services but also eases financial strain.

4

In-patient department expenses

Our group health insurance plan offers coverage for in-patient department expenses. These include room charges, doctor's fees, medical tests, surgical procedures, medications administered, etc., during hospital stay. It guards your employees against high costs associated with hospital stays.

5

Ambulance charges

Our policy covers ambulance charges that can be significantly high. These charges depend on various factors, including distance travelled, type of ambulance, and level of medical care provided. Coverage for ambulance charges ensures well-rounded financial protection.

6

Day care expenses

Day care expenses are those for which your employees need to stay in hospitals. They are done within a few hours or less than a day. Costs associated with such treatments can be pretty high, and coverage for them ensures peace of mind and holistic healthcare

Difference between group health insurance and individual health plan

Group medical insurance and individual health plans differ in several aspects.

Aspect Group Health Insurance Individual Health Plan
Meaning Covers a group of people Covers an individual
Who is insured? Employees and their family Only the individual
Purchaser and premium payment Employers Individual
Control over plan Limited control Full control
Coverage for pre-existing diseases From day one Usually after a few months or years
No claims bonus Not available Available
Coverage duration As long as you are employed with the company Needs to be renewed yearly

How to buy group health insurance policy from ICICI Lombard?

Follow these steps to buy group health insurance policy online:

  • Enter your corporate details here
  • Provide your mobile number, pin code, email ID and the name of your company
  • Click on 'Proceed To Buy'
  • Follow the instructions that appear to buy the policy
What are the benefits of renewing your Group Health insurance online?
Group Health insurance price

What is the claiming process for
a group health insurance policy?

The claim process from a group health medical insurance plan is simple. All you need to do is:

  • Inform the insurer promptly, usually within 24 hours. Use the various channels of communication. The earlier you inform, the better it is.
  • Submit the claim form and the necessary documents, including copies of reports, bills, and discharge summaries.
  • The insurance company will process the claim based on the claim form, documents provided, and the policy's terms and conditions

Ensure you know your insurer's claims process after you buy the policy.

Documents required for buying group health insurance policy

You need to provide certain basic and essential documents to buy a group health medical insurance.

  • Address and Identity proof, which could include your voter's card, Aadhaar card, passport, driving licence, etc.
  • PAN card copy
  • Income proof, including IT returns of your business
  • Copy of business registration
  • Recent photographs (passport or stamp size)
  • Employee details

Check with the insurer regarding any additional documents that you need to provide. Make sure you provide all the documents requested by your insurer. Failure to do so can result in application rejection. Also, ensure that the documents are in proper condition where everything is legible.

Car insurance price

Get answers to common questions about group health insurance policy

  • General
  • Cover
  • Premium
  • Claims
  • Policy

What is Group Health (Floater) Insurance?

Group health (Floater) insurance covers a group of peoples. It's typically offered by employers to their employees.

Which Group Health Insurance is the Best in India?

You need to consider various parameters before buying a group health insurance policy. Consider the insurer's claim settlement ratio, customisation options, sum insured offered, etc., before buying a plan.

Who Can Take Group Health (Floater) Insurance?

A business entity needs at least 10 employees to buy a group health (Floater) insurance plan.

What is the Maximum Age for Group Health (Floater) Insurance?

The maximum age differs across plans. Several health insurance companies offer plans up to the age of 65 years.

Is Covid 19 covered under ICICI Lombard’s Group Health Insurance policy?

Covid 19 is covered subject to minimum 24 hr of in-patient.

When should I get a group health insurance policy for my employees?

Employer can initiate a request for quotation of the Group Health Insurance policy for their employees at any point of time. The employer has to specify the coverage requirement and a quote shall be given to them.

Our workplace has only 10 to 15 members. Can I still buy a Group Health Insurance policy for them?

Minimum requirement for an employer to opt for Group Health Insurance is 10 employees or 25 total lives, below which we cannot provide Group health insurance.

Who all can be covered in a Group Health Insurance policy?

Group health insurance is categorized in 2 categories

  • Employer-employee - Employees along with their spouse, children and parents are covered
  • Non employer-employee – The enrolled are covered

How to get the Group Health Insurance for my small business?

Group Health Insurance can be bought through ICICI Lombard's Group health Insurance policy where we cover up to 500 lives. Premium is decided subject to coverage, demography and claim experience

Can I have a corporate health insurance and an individual health insurance policy both at same time?

Yes, you can you have corporate health insurance and individual health insurance at the same time.

What are the limitations of a Group Health Insurance?

Group Health Insurance policy is customized and tailor made and the policies are designed as per the client’s requirements. Therefore there are no limitations.

How is a Group Health Insurance different from an Individual Health Insurance?

Group Health Insurance is a collective insurance an organization buys for the benefit of its employees and employee’s dependents. The organization may tailor a plan or select a pre-planned insurance policy from an insurance company.

Individual health insurance is one that an individual purchases for himself or their dependents.

What employers should look for when buying a Group Health Insurance policy in India?

While buying the Group Health Insurance, the employer should take in consideration the coverage provided by the insurance company, the services offered and the company's claims process, this will make insurance policy buying more feasible and convenient.

Why should you take Group Health Insurance for your employees?

While buying Group Health Insurance, employer should see the coverages provided by insurance company, services offered and the company's claims process, this will make insurance policy buying more feasible and convenient.

Will I have to pay penalty if I don’t provide health insurance to my employees?

There is no penalty.

Can the policy be transferred from one insurance provider to another provider without losing the benefits?

Yes, at the time of renewal of the policy for next tenure.

What is the initial waiting period for ICICI Lombard Group Health Insurance?

No waiting period

What is a waiting period?

Expenses related to the treatment of any illness within 30 days from the first policy commencement date shall be excluded except claims arising due to an accident, provided the same are covered

What’s not covered in Group Health Insurance provided by ICICI Lombard?

Treatment on trial/experimental basis and any device/instrument/machine contributing/replacing the function of an organ; Holter Monitoring are outside the scope of the policy

What is covered in Group Health Insurance by ICICI Lombard?

BASIC COVERAGE- HOSPITALIZATION

  • Any illness which require minimum 24 hrs of hospitalization will be cover under GHI upto sum insured.
  • Apart from hospitalization, any day care procedure which do not require minimum 24 hours of hospitalization and are included in our standard Daycare list are covered. Refer to ICICI Lombard official website for day care list.
  • We have a sum insured range from 50,000 to 10 lacs.

ADD ON

  • Maternity expense- which include pre-post natal care of 30 and 60 days respectively and delivery expenses for 2 living children. Limit under maternity is customize as per customer requirement
  • Cost of Prescribed External Medical Aid- The Company will reimburse the charges incurred by the insured during the policy period on account of procuring medical prosthetic or artificial devices or any medical equipment including but not limited to hearing aids, spectacles, contact lenses.
  • Baby Day One- This add-on will cover medical expenses incurred on the “new born baby” only as an in-patient in hospital for a maximum period up to 91 days.
  • Critical illness cover-The Company will pay the sum insured for this add-on, in case Insured is diagnosed as suffering from one or more of the Critical Illnesses for the first time in life, during the Policy Period
  • Corporate floater- A floater of fix amount( 1L to 10L depending on customer requirements) will be provided to cover the medical expense over and above the SI
  • Ambulance Cover- Ambulance charges would include transportation cost to the nearest hospital in case of life threatening emergency conditions.
  • Health Check-up- The company by way of this add-on, will cover the cost of health check-up incurred by the Insured for medical examination undergone being a requirement from employer. Such medical examination is generally conducted to understand health status of the employee.
  • Disease sublimit- By way of this add-on, the company can introduce sub-limits on certain diseases based on the claim experience and the requirement of the Insured. The limit is customise with respect to customer requirement
  • Domiciliary Hospitalization- Due to unavailability of bed in nearby hospital or patient is not physically or medically fit to go to a hospital, can avail this add on for treatment at his home.
  • Room Rent, nursing charges, consultation fee, diagnostic fee etc- This add-on restricts the coverage for respective heads upto a specified amount. In cases, where the claim amount exceeds this amount, the entire admissible claim amount which includes various hospital bills etc, will be reduced in the proportion which the eligible room rent limit bears to the actual room rent.
  • Virtual OPD- Include Tele consultation and Video consultation
  • Wellness and Preventive care- By way of this add-on the insured can avail any or all of the below mentioned:
    1. Health Risk Assessment
    2. Health Check-up's (add-on of report evaluation service)
    3. Medical Centre Management
    4. Diet & Nutrition Plans
    5. Online Doctor Chat
    6. Health Camps - on campus
    7. Expert Sessions - on campus
    8. Second Opinions: Domestic and International markets
    9. Discounted offerings - on health and wellness services ( Eg Gyms, Diagnostic)
    10. Disease Management Programs: Eg Diabetes, Healthy Heart
    11. PHR - Personalized Health Records
    12. Health & Wellness Reminder Services
    13. Health Concierge Desk
    14. Others

The limit under Add on can be customized

What is room rent capping in Group Health Insurance (Group Mediclaim)?

Room rent can range from 1% of the sum insured to actuals for normal and ICU. The room rent charge depends on what the employee wants to opt for.

What is a pre-existing disease? Are pre-existing diseases covered in a standard health insurance?

Pre-existing disease is covered under the Group Health Insurance.. The term ‘Pre-existing Disease’ means any condition, ailment or injury or illness or related condition (s) for which the insured had developed signs or symptoms, and/or were diagnosed and/or received medical advice/treatment, within 48 months prior to the first Policy with the company.

What is “health check-up” facility?

Health check-up facility is provided from the vast network hospitals across multiple locations in India.

What is Maternity Benefit coverage under the Group Health Insurance?

Maternity Benefit covers the pre and post-natal expenses. It covers for the pre (30 days) and post (60 days) hospitalization and delivery expense. The monetary limit is customized depending on the requirement of the employer.

Is abortion covered under the Group Health policy?

Abortion is covered, subject to prescription from doctor & under a critical condition during pregnancy. Voluntary abortion is not covered under the policy.

Does the policy provide coverage to a new born baby under maternity coverage?

New born baby can be covered under the policy if the addon cover is opted for. This addon cover includes hospitalization expense of new born baby from day 1 upto full sum insured or maternity limit

Is congenital disease covered under the Group Health Insurance?

Internal congenital is covered under the policy. External congenital is covered only in life threatening situation subject to minimum of 24 hours of hospitalization.

Is treatment through AYUSH medicine covered under the policy?

Yes, subject to minimum 24 hours of hospitalization on in-patient (IPD) basis and is covered only in government recognized AYUSH hospital.

Do I have to undergo medical tests to avail this health cover?

Medical tests are not required to avail Group Health Insurance.

Is there any age limit?

Employee and spouse are covered upto age of 65 years, Children are covered upto 25 years of age and parents upto age limit of 80 years. Employee and spouse should be minimum 18 yrs.

What is Group Insurance Premium?

Group insurance premium is the money paid to the insurance company offering the group insurance plan.

Who Pays the Premium in a Group Health Plan?

It's the employer who pays the premium for a group health insurance plan.

How is the Group Insurance Premium Calculated?

Premiums aren't fixed and depend on several factors such as age, health conditions of members, number of members, job type, and sum insured, among others.

What happens to the policy coverage after a claim is filed?

Policy coverage will be extended up to expiry date of the policy subjected to availability of sum insured.

What is the maximum number of claims allowed over a year?

There is no limit on number of claim admissibility

How to avail cashless treatment?

Insured to get admitted in network hospital

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Hospital to send Cashless Request to ICICI Lombard Health Claims teams

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Process is done at ICICI Lombard Health Claims teams

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Decision to Approve/Query/Reject is taken

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Insured to pay non-payables & get discharge

  • Insured to submit Health Card Copy and Photo ID Proof at Hospital Insurance Desk.
  • Hospital will send the cashless request to ihealthcare through Web/email upon admission recommendation from Hospital Doctor. Insured needs to check the pre-authorization note and duly sign the same.
  • Post receipt of Cashless Request from Hospital, ihealthcare team to check the medical admissibility and accordingly Approve/Query/Reject the request.

Insured will be notified via SMS/email at all events of Cashless Hospitalization. A call will be made if the cashless request has been queried/rejected. (Subject to availability of insured/dependants contact details)

  • In case of planned admission insured/dependents can reach out to hospital for cashless approvals in advance
  • In case of emergency during admission insured/dependents can approach Hospital TPA desk for Cashless request.

Whom do I call at the time of emergency hospitalization?

You call our customer support number 1800 2666 (Available 24 x 7)

What to do if I am admitted to non-network hospitals?

Claim will be paid on reimbursement basis and below is the reimbursement process.

Insured Hospitalized in non-network hospital

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Payment to Hospital & collect original documents from hospitals

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Submit original document to ICICI Lombard Health Claims

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Claim process done by ICICI Lombard Health Claims

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Claim settled on reimbursement basis

Documents to be submitted for Reimbursement

  • Duly filled Claim form including NEFT form for Electronic Funds Transfer & Cancelled Cheque Copy
  • Discharge Summary (with details of complaints and treatment availed)
  • Final Hospital Bill (detailed break-up) along with interim bills & payment receipts
  • All investigation reports (Original Blood Reports, X-Ray Reports, Sonography, CT Scan, MRI etc
  • All Pharmacy bills supported by Doctor’s prescriptions
  • Implant Sticker / Invoice, if used (eg: Lens details in Cataract Case, Stent details in angioplasty)
  • Medico Legal Certificate (MLC) and or FIR for all accident cases

Claim Submission Process

  • Insured to collect all the claim documents during discharge.
  • Claim to be submitted within 30 days from date of discharge.
  • Claim form can be downloaded from our website www.icicilombard.com
  • Claim Status can be tracked Online or by sending an SMS to 575758

Insured need to dispatch the reimbursement claim documents to below mentioned address:

CLAIMS TEAM ICICI LOMBARD HEALTH CARE ICICI LOMBARD GIC LTD, ICIC BANK TOWER, PLOT NO:12 FINANCIAL DISTRICT, NANAKRAM GUDA, GACHIBOWLI, HYDERABAD. PIN CODE: 500032

  • In case of any claim related query, insured can write to us at ihealthcare@Icicilombard.com
  • Or can contact @ our Toll Free Number 1800 2 666 (In-house Call Centre)

What are the documents required for claiming?

Original bills for hospitalization, diagnostic, pharmacy, room rent and all the bills related to hospitalization duly signed by the employee and the hospital authority

How is the premium for Group Health Insurance policy calculated?

Premium is calculated based on employee’s demography, claim experience of past 2-3 years and coverage provided to the client

What are the advantages of Group Health Insurance?

Pre-existing disease (PED) is covered under Group Health Insurance, as compared to a waiting period which is applicable in individual health policies. Other coverages can be customized as per client requirement.

Are the dependents covered under ICICI Lombard’s Group Health Insurance?

The employees can avail the benefit of the coverage for his/her dependants under the Group Health Insurance. Dependants include spouse, children up to 25 years of age and parents up to 80 years of age.

Is policy valid Pan India?

The coverage of the policy is valid in India and employees, dependents can avail the facility of network hospitals.

Product Product Code UIN no.
Group Health (Floater)Insurance 4016 ICIHLGP24019V062324

Disclaimers:

Note: waiting period and pre-existing deceases shall be in exceptional cases as per the terms and conditioned mentioned in the policy wordings.
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Disclaimer : Any misinformation may result in policy cancellation