Importance of group medical insurance for employees

Group medical insurance, as the name suggests, covers medical expenses for a specific group of individuals. These types of insurance policies are purchased by employers for their employees. It not only provides coverage for employees, but also their family members or dependents (depending on the plan). That said, some group insurance companies allow covered employees to enhance their group plan coverage by paying an additional amount. The group plan is also very beneficial for employees who do not have other health plans and can therefore be an excellent financial aid, especially during the ongoing pandemic situation.

Here are some basic benefits of group medical insurance:

  • Claims can be made for home expenses.
  • They pay for medical expenses incurred as a result of illness, disease or accident.
  • It covers pre- and post-hospitalization costs according to the coverage of the contract.
  • offers cashless services in network hospitals as mentioned in the policy document.

The group insurance plan premium is sometimes deducted from the employee’s CTC, while in some cases employers offer it for free. Therefore, paying premiums is a quick and painless process as the minimum amount contributed to this scheme is deducted directly from salary either monthly or annually. This further eliminates the possibility of missing the premium payment deadline. Additionally, with comprehensive coverage, group health plans have become the most important deciding factor for employees when choosing an employer.

Group insurance plan provides coverage at affordable premium rates

Besides that, here are some of the main reasons you should consider when buying a group insurance policy:

To save money

The group plan offers coverage at an affordable premium rate, and it is very beneficial for those who do not have an existing health plan. The amount of the premium is established by the insurance companies according to the risk factor of the whole group. Premium payment can be made in two ways:

  • The organization or group owner who holds the insurance for the employees pays the premium amount in full.
  • The employer pays part of the premium, while the remaining premium is paid by the employees.

As a result, the arrangement is best for both parties.

Complaints are processed faster.

Claims for group health insurance plans are processed faster compared to other plans and hence the employee does not have to face any hassle. The third party administrator and the insurance company are primarily responsible for carrying out this process.

Maternity cover

While maternity and childbirth would be considered complementary features under some health insurance plans, this is not the case for a group health plan. All costs for both types of childbirth – normal and cesarean section – are covered by the employer’s insurance company. In addition, the baby is also covered by the plan up to 90 days after delivery.

No prior medical examination is necessary.

The majority of employee health insurance companies do not require employees to undergo a physical or medical exam before enrolling in the plan, which might otherwise be required for other health plans.

No wait times for pre-existing conditions (PED)

This is one of the most exciting benefits of having a group plan. Under a typical health plan, treatment for DEPs, such as diabetes, hypertension, etc., requires a waiting period before being covered by the plan. However, a group health insurance plan has no such limitations and covers these conditions from day one. Therefore, if an employee is covered by their health insurance plan, they don’t have to worry about the costs of treating pre-existing conditions.


Employee productivity plays an important role in the success of any business. When an organization has a group of motivated and productive employees, the result is always better. By including a group insurance plan in a benefits package, the employer is able to provide a safe work environment for its employees without having to worry about emergency medical expenses for themselves and their family.

In summary, a group insurance plan not only protects employees, but also protects employers’ funds at the most affordable rates. So it’s a win-win situation for both.

The author is the director of Probus Insurance

(Warning: The opinions expressed are those of the author and Outlook money does not necessarily subscribe to it. Outlook money will not be responsible for any damage caused to any person/organization directly or indirectly.)

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