Your employees are one of your organisation’s most valuable assets. A well-designed Group Health Insurance policy can provide employees and their families with financial protection against unexpected medical expenses while helping companies build a stronger employee benefits program.
At Insurance Man Consulting, we help corporates evaluate Group Health Insurance options based not only on premium, but also on coverage, limits, exclusions, waiting periods and claim conditions.
Group Health Insurance is a health insurance policy purchased by an organization for its employees. Depending on the policy structure, coverage can also be extended to eligible family members such as spouses, children and parents.
The employer chooses the coverage structure in consultation with the insurer and employees receive benefits under the group policy.
A properly structured Group Health Insurance plan can cover expenses such as:
* Hospitalization expenses
* Pre- and post-hospitalization expenses
* Day-care procedures
* Ambulance expenses
* Certain maternity-related expenses, where covered
* Coverage for eligible dependants( Spouse ,kids and parents)
* Other benefits depending on the policy and insurer
The actual coverage, limits, exclusions and conditions depend on the policy wording.
Group Health Insurance policies can look similar when compared only on their premium and sum insured. However, the differences often become apparent when an employee actually needs to make a claim.
Important areas to evaluate include:
At Insurance Man Consulting, we help organisations look beyond the headline benefits and understand the terms and conditions that can affect a claim.
To obtain an accurate Group Health Insurance quotation, insurers generally require the following information from the organisation:
1. Employee & Dependant Details
* Number of employees
* Employee age and gender
* Number of dependants to be covered
* Age and relationship of dependants
* Location of employees, where relevant
2. Coverage Requirements
* Required sum insured per employee/family
* Whether dependants should be covered
* Coverage for parents, if required
* Maternity coverage requirements
* Room rent and ICU preferences
* Desired additional benefits or top-up options
3. Existing Policy Details
If the company already has Group Health Insurance, it is useful to provide:
* Existing policy copy
* Current sum insured and benefits
* Current premium
* Renewal date
* Number of employees/dependants covered
* Previous claims experience
4. Claims Information
Insurers may require details of the organization’s previous claims experience( Claims Dump and Claims Analysis) and previous years policy copy, particularly when an existing policy is being renewed.
This can include:
* Number of claims
* Total claims amount
* Claims paid
* Claims outstanding
* Major claims, where applicable
* Claims experience for previous policy years
5. Company Details
* Company name and industry
* Number of employees
* Company location(s)
* Policy start/renewal date
* Contact details of the HR/authorised representative
For a Faster & More Accurate Quote
The more complete the information provided, the easier it is for insurers to assess the risk and provide an appropriate quotation
✔️ 20+ years of insurance and claims settlement experience
✔️ 1,000+ claims handled
✔️ Trusted by 100+ corporates
✔️ Options from leading insurance companies
✔️ Focus on coverage, exclusions and sub-limits—not just premium
✔️ Dedicated claims assistance
✔️ Corporate-focused, customised insurance solutions
Looking for Group Health Insurance for Your Employees?
Whether you are buying Group Health Insurance for the first time, reviewing your existing policy or approaching renewal, our team can help you evaluate your options and understand what you are actually buying.
Don’t choose a Group Health Insurance policy only because it is cheaper. Choose one that you understand.
1. What is Group Health Insurance( GHI) for employees?
Group Health Insurance is a health insurance policy purchased by an organization to provide medical insurance coverage to its employees. Depending on the number of employees , coverage may also be extended to eligible family members, especially dependent parents.
2.What is the Minimum number of employees required for GHI policy?
Min number of employee required for GHI are 7, this largely depends on the Insurer. Very Few Insurers cover less than 10 employees. Most Insurers cover 25 Plus employees.
2. Can family members be covered under Group Health Insurance?
Yes. Many group health policies allow employers to include dependants such as spouses, children and parents. The eligibility and additional premium depend on the number of employees,family structure choosen and finally the insurers existing terms and conditions.
3. What does Group Health Insurance generally cover?
Coverage includes 24 hr hospitalisation, Day Care treatments and surgeries, pre- and post-hospitalisation expenses, Maternity Coverages, Pre and post Maternity coverages,ambulance expenses and other benefits specified in the policy.
4. Does Group Health Insurance cover pre-existing diseases?
Most group policies provide coverage for pre-existing diseases from the beginning of the policy period, subject to the terms agreed with the insurer. This should always be confirmed in the policy wording.
5. Is maternity coverage available under Group Health Insurance?
Maternity coverage can be included in certain group health insurance policies. The applicable limits on the Maternity Coverages, waiting periods and other conditions vary depending on the Employer and the Insurer.
6. What are sub-limits in Group Health Insurance?
Sub-limits are specific limits imposed on certain medical expenses, such as room rent, ICU charges or particular treatments. A policy with a high sum insured may still have significant sub-limits, which is why these should be reviewed carefully. Sub limits bring down the policy premiums and can be used by the insurer at times of negotiation. Sublimit at times create confusion among employee and at times dissatisfaction too. The Coverages by two insurers may look the same, but one may have sub limits and the other may not have. its important to check the Sub limits when making a purchase decision.
7. How is the premium for Group Health Insurance determined?
Premiums can depend on factors such as the Employee number and age profile of employees, dependents to be covered, sum insured, demographic, floater or non floater benefits selected and the organization’s previous claims experience.
8. Can employees choose their own health insurance coverage?
No ,the health Insurance Coverage and the benefits are chosen by the employer basis the Industry standards and at times also after careful evaluation of the ongoing employee benefit trends. Some organizations provide a standard cover for everyone, while others may offer top up options where the employee is free to choose on the top up benefits.
Generally ,the flexibility to choose the benefits is proportional to the size of the employees in the organization.
9. Can new employees be added or deleted from the Group Health Insurance Policy(GHI)?
Yes employees can be added and deleted from the GHI policy. In such cases the premium is charged on a Prorate basis. The Insurer also shares a Premium register, where both the employer and the insurer can maintain a proper account of the additions and deletions.
10. How can Insurance Man Consulting help with Group Health Insurance?
We help corporates compare insurance options, understand coverage and policy limitations, evaluate exclusions and sub-limits, and provide claims assistance. Our recommendations are based on the organization’s requirements, our Claims settlement experience, this is in addition to providing Competitive Premiums .
11. Why should a company use an insurance consultant instead of buying directly?
A consultant can help the organization evaluate the fine print, coverage limitations, exclusions and claims implications before making a decision. At Insurance Man Consulting, our 20+ years of claims settlement experience helps us bring a practical claims perspective to insurance selection.
12. How do I get a Group Health Insurance quote for my company?
For First time GHI purchasers-The Insurer would require the details of the employees and dependents in a particular format, plus need the coverage and the benefits required details.For Renewals- Insurers would require Existing policy and claims details in addition to the above information.
