Group Health Insurance
comprehensive wellness benefits for your
employees and their families.
Empowering teams through comprehensive and affordable group coverage
With the government mandating health insurance for all employees across companies post-COVID, the demand for Group Health Insurance is on the rise. These plans often offer coverage not only for employees but also extend to their spouses and dependent children, ensuring comprehensive protection for families.
What is Group Health Insurance?
Group Health Insurance (GHI) is a type of health insurance policy that offers coverage to a group of people, typically employees of a company or members of an organisation. It is a cost-effective and convenient way for employers to provide health insurance benefits to their employees, as the risk is spread across a group of individuals.
Key features of Group Health Insurance
Here are some key features of Group Health Insurance in India:
HR friendly dashboard
Different plan options
Advantages of Group Health Insurance
Healthcare benefits can be highly valuable for both employers and employees. Here are some of the benefits of offering Group Health Insurance:
What’s covered in Group Health Insurance?
- Room charges: Depending on the plan, it may cover various room categories (single, twin, etc.)
- Doctor fees: Consultation charges by specialists and surgeons within network and non-network hospitals.
- Nursing care: Charges for nursing services during hospitalisation.
- Diagnostic tests: Coverage for necessary X-rays, blood tests, and other diagnostic procedures.
- Operation theatre charges: Costs associated with surgical procedures.
- Pre-hospitalisation: Diagnostic tests, consultations, and medications in a certain period before hospitalisation. Typically, this is covered as mentioned in the health insurance policy.
- Post-hospitalisation: Medications, physiotherapy sessions, and follow-up consultations for a specific period after discharge. Typically, this is covered for as mentioned in the health insurance policy.
- Day care procedures: Day care treatment refers to medical treatment, and/or surgical procedure which is undertaken under General or Local Anesthesia in a hospital/day care centre in less than 24 hrs.
- Ambulance cover: Transportation costs by ambulance to the hospital in case of emergencies may also be covered based on the policy terms and conditions.
- Pre-existing conditions: Depending on the plan, coverage for pre-existing conditions may be available.
- Psyciatric illnesses: Hospitalisation for treatment of psychiatric illnesses if necessitated is covered.
Additional inclusions (vary by plan):
- Maternity benefit: Covers prenatal, delivery, and postnatal care expenses.
- Newborn baby cover: Offers coverage for specific medical expenses of the newborn child generally up to 90 days.
- Organ donor cover: If you donate an organ, some plans cover your medical expenses.
- AYUSH treatment: Cover for traditional Indian medicine like Ayurveda, Yoga, Unani, Siddha and Homeopathy might be included in some plans.
What’s not covered in Group Health Insurance?
While Group Health Insurance offers valuable protection, it’s essential to understand what is not covered. Here are some common exclusions:
How to apply for a claim in Group Health Insurance?
Before raising a request for cashless, one needs to confirm the network status of the hospital. The same can be readily seen in the Onsurity Super App. Log on to the Onsurity Super App using the registered mobile number. Under ‘Health Insurance’ please go to ‘Hospitalisation Assistance’. Click on ‘View Hospitals’ which displays a page. One may enter the hospital name, city, or pin code and search for the hospital.
Planned Cashless Request
STEP 1: Log On
STEP 2: Pre-Authorisation Approval
STEP 3: Scrutiny by TPA/Insurer
STEP 4: Final bill and discharge summary
Emergency Cashless Request
In case of emergency, one is requested to reach the nearest hospital as it is the priority of the moment.
STEP 1: Submission
STEP 2: Processing
STEP 3: Final bill and discharge summary
2. Scrutiny by Good Doctors
3. Submission and Processing
4. Settlement or Rejection
Types of Group Insurance
Companies can offer various types of group insurance plans to their employees. Below are some of the most common types of group insurance plans available in India.
- Group Health Insurance:This covers the medical expenses of all employees in a company. Typically, the employer pays for the insurance, but the cost is often factored into the employee’s overall compensation or CTC (Cost-to-Company).
- Group Term Life Insurance:This policy pays a fixed sum assured to the nominee in case of the employee’s death. Employees can add the nominee at the time of onboarding.
- Group Personal Accident Insurance:This is a type of insurance that provides financial compensation in case of injury or death due to accident of the policyholder.