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Group Health Insurance: Compare, Buy, Renew, & Claim Online

Group Health Insurance is a simple way to provide health insurance to a group of people. On our website, you can easily compare different plans, buy the right policy, renew it effortlessly, and even make online claims.

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We simplify the entire process, making it hassle-free for you. With our simple platform, you can protect yourself and your loved ones. Explore now and make use of group health insurance to protect the health of your organization.

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Buying Group Health Insurance for the first time?

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Employee, Spouse & 2 Kids

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Employers' legal liability under the Workmen's Compensation Act of 1923 and the Fatal Accident Act of 1855 is covered by the Workmen's Compensation Insurance policy.

What is Group Health Insurance?

Group health insurance acts as a health shield for a large group of people. It is usually created by big companies to look after the well-being of their staff. But wait, this isn't just for them! Small businesses, labor unions, associations, and other groups can also get in on the health coverage action.

 

Benefits Of Group Health Insurance India

Advantages of Group Health Insurance for Employers:

  1. Improve employee retention
    When you provide health insurance to your employees and their families, it makes them feel more secure in the event of an unexpected medical problem. This increases their likelihood of staying with your organization for a long time because they know you care about their well-being.
  2. Support for mental well being
    Life can be unpredictable, which can be stressful for employees. Money troubles and health issues can bring them down. However, you can assist if you have group health insurance. They can talk to a mental health expert online to manage stress and feel better.
  3. Protect employees from severe health Issues
    If your workplace offers group health insurance in India, it might contain fun features like fitness tracking and doctor consultations as needed. You can even consult with nutritionists to keep healthy and avoid major health issues. These things enable you to live an active life.
  4. Provide Coverage for their families
    When you have Group Health Insurance, it helps pay for medical crises for both employees and their families. Depending on the rules, an employee can include family members in their coverage. In this manner, everyone gets assistance when they need it the most.
 

Why Should You Buy Group Health Insurance From Okbima?

Following the reasons to buy group health insurance from okbima are:

  1. Time-Saving
    Save time, and stress less! Purchasing group health insurance is now a breeze—no more agent visits or paperwork. Our online method is simple and quick, and you can buy coverage right away. Say hello to convenience and wave goodbye to wasted hours.
  2. Right Decision
    Unlock a wealth of knowledge! You can compare insurance policies from several firms using the wealth of information available on online sites. With ease, choose the best fit for your needs. Enjoy the independence of online insurance shopping and take advantage of the chance to make a well-informed decision.
  3. Transparency
    Embrace the convenience of the digital age! Now, you can say goodbye to agent scams and find everything you need online. Get instant access to insurance prices, discounts, terms and conditions, and more. A clear and reliable experience like never before is provided when purchasing health insurance online.
 

Key Features of Group Health Insurance

Some key features of Group Health Insurance are:

  1. No waiting Period
    The main benefit of group health insurance is that there is no waiting period for coverage. These plans do not have the waiting time that is required in other types of insurance coverage. The beneficiaries of such an insurance policy can avail of the coverage right from day one, including any ongoing medical conditions.
  2. Cashless Facility
    Some group health insurance firms have ties with specific hospitals. This is beneficial since it allows you to visit those hospitals without having to worry about paying the expenses yourself. When you are admitted, all you need to do is show your insurance card. So you don't have to deal with a lot of paperwork, the insurance company handles payment for treatments covered by your policy.
  3. Pre as well as Post Hospitalization Costs
    Your pre and post-hospitalization costs are both covered by the health insurance, group mediclaim policy for employees, which is an added benefit. This includes not only the hospitalization fee, but also all other expenses incurred, such as medical reports, X-rays, and so on. In addition, the cost of medications after being released from the hospital might be very expensive but is once again reimbursed.
  4. Cover for pre-existing ailments
    One of the highlight features of group health insurance includes coverage for pre-existing ailments. In the event that you have any illnesses, you need not be concerned about coverage being denied. Your group health insurance plan covers any pre-existing conditions, whether they are illnesses or other physical ailments. Some firms also provide coverage for severe illnesses, but it is best to understand these terms before purchasing one.
  5. Coverage for dependents
    A group policy covers not only the primary applicant for insurance but also their family members at a cheap cost. This means that the health insurance coverage given by your work can also be extended to your parents, spouse, and children.
 

What Is Covered Under Group Health Insurance Policy For Employees

The following benefits are often covered by group health insurance policies for employees:

Medical Expenses: The insurance plan pays for hospitalization, doctor visits, prescription drugs, and other healthcare costs.

Pre-existing Conditions: Employees with pre-existing medical issues are often covered, though there may be waiting periods before benefits start.

Maternity Benefits: A lot of policies cover prenatal, labor, and postpartum care.

Dental and vision care: A number of insurance plans cover the cost of corrective eyewear and dental procedures.

Preventive Care: Insurance coverage is often offered for services including immunizations, check-ups, and screenings.

Emergency Care: Employees are safeguarded in the event of unanticipated medical emergencies, including calls for ambulance services and trips to the emergency department.

Mental Health Support: Many insurance plans cover mental health treatments and counseling sessions.

Rehabilitation Services: Coverage may include rehabilitative services such as physiotherapy and occupational therapy.

 

Things To Consider While Buying Group Health Insurance Policy

Things to consider while buying group health insurance policy-

  1. Check your Employee's needs
    Group health insurance does not work the same way for every company. Each part has different requirements. Small businesses require accident coverage to protect their young, single, and often traveling employees. Mid-sized businesses need maternity benefits, and senior executives demand critical sickness coverage.
  2. Sum Insured
    Sum insured is the maximum coverage in a health insurance plan, which can be claimed yearly. Choose higher amounts insured for group health insurance to cater to rising medical expenditures and increased hospitalization bills due to the pandemic and medical inflation.
  3. List of network hospitals
    A list of network hospitals is provided by the insurer when you purchase health insurance. These hospitals have an agreement with the insurance to provide cashless hospitalization. It reduces the stress of making financial arrangements, especially in times of crisis like Covid-19. Employers should check the network hospital list in group health insurance plans.
  4. Claim Settlement Ratio
    The claim settlement ratio is the percentage of claims satisfied by the insurer out of the total received. A ratio of more than 90 is considered good. For your employees' convenience, it's important for the insurance carrier to have a quick claim settlement process.
  5. Wellness Benefits
    In the Covid era, mental health is important due to social distancing. Employers should select group health plans that include wellness factors. Insurers offer rewards for staying healthy, track wellness through wearables and apps, and give renewal discounts. However, few Indian corporations place a premium on wellness and prevention.
 

Documents Required For Claim Group Health Insurance

The following documents are required to make a claim for group health insurance

  1. Final Hospitalization Bill
    This can be a collection of many bills and receipts for various services or equipment received during hospitalization.
  2. Discharge Summary
    The doctor who treated the patient is responsible for writing the discharge summary. The doctor will provide information such as treatment details, post-hospitalization care, health status at the time of discharge, and more.
  3. Payment Receipt
    This is important in the event of a Group Health Insurance Plan reimbursement claim. Here, the insured will pay all outstanding debts before filing a claim against their health insurance.
  4. Details of the Patient
    To process a claim, identification information about the patient and their link to the employee is needed.
  5. Date of Admission and Discharge
    The duration of a patient's stay in the hospital affects a number of claim-related factors, including pre-and post-hospitalization coverage, room rent caps, non-payable medical charges, and more.
  6. Claim Amount
    The total (authorized) medical expenses incurred by an employee can be used to calculate the claim amount under a Group Health Insurance Plan.
 

Best Group Health Insurance Policy In India 2023

The best group health insurance plans are often chosen based on factors like coverage, cost, network hospitals, claim settlement ratio, and client feedback. As a result, the following group health insurance plans are common in India as of 2023:

 

How To Renewal Employee Group Health Insurance

Here are the steps to renew employee group health insurance

Step 1: Reassessment- With the start of every new plan year come revised requirements based on economic trends. The insurance carrier reevaluates your company to adjust premiums and terms based on factors like increased fees and risk levels. Group insurance costs are expected to rise unless cost-cutting measures are implemented.

Step 2: Screening- After reassessment, the insurance firm gives various group health insurance solutions. It's up to you to thoroughly consider each option and pick the one that best suits your needs.

Step 3: Selection- Choosing new health coverage involves considering your company's financial standing and employees' needs. Consult an insurance broker for assistance in screening several policies and selecting those that meet your needs and budget.

Step 4: Enrollment- Provide your employees with the selected group health plans for comparison. They can select the plan that best meets their needs, maximizing satisfaction.

Step 5: Renewing- Complete the renewal procedure by signing the relevant paperwork and making payments. The insurance company ensures that your employees have adequate coverage for the upcoming plan year.

 

How To File Group Health Insurance Claim?

To file a group health insurance policy, read below:

Step 1: Notify- Inform the insurance company as soon as possible after receiving medical treatment.

Step 2: Get Documents- Compile all the required paperwork, such as invoices, medications, and medical records.

Step 3: Complete the Claim Form- Complete the claim form thoroughly with all required information.

Step 4: Follow Procedures- Adhere to any specific claim submission procedures offered by the insurer.

Step 5: Cooperate- Be open and honest with the insurance provider as the claim is being processed.

Step 6: Await Reimbursement- Approval and reimbursement will be issued in accordance with the terms and conditions of the policy.

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FAQs About Group Health Insurance Policy

According to the Insurance Regulatory and Development Authority of India (IRDAI), a company must have at least 20 employees to be eligible for a group health insurance plan. However, there is a provision that allows for the issuing of microinsurance plans to organizations with at least five members.

Hospitalisation costs for infertility/pregnancy problems, such as abortions, are not covered by health insurance. These costs may be covered in some maternity health plans, but they are not in basic health plans.

A group health insurance plan is very beneficial to acquire the employee and his or her family a basic financial safety net against medical emergencies. The insured does not have to pay any premiums and can still enjoy the benefits of insurance coverage.

Yes, the government has made having health insurance a must. It is required that the employer you work for offer health insurance.

If the insured cancels the group health insurance policy within 90 days of the policy's start date, the insurer is required to issue a 100% reimbursement

Yes, you can purchase group health insurance policies online. However, it is recommended that you always buy it from reliable insurance companies or aggregators, like okbima.