Insurance concepts, explained for employers
Buying cover for a team means meeting a lot of jargon — sum insured, co-pay, waiting periods, TPAs, GMC vs GPA vs GTL. This is the map: the definitions, comparisons and guides that explain how employee insurance actually works, each in plain language.
Explore group health insuranceCore concepts & definitions
Start with the terms that change what you pay and what your employees get. Each links to a plain-English explainer.
Sum Insured
The maximum a policy pays in a year — and how to size it for your team.
Read more →Co-payment
The share of a claim the employee pays while the insurer covers the rest.
Read more →Waiting Period
When pre-existing and specific conditions become claimable.
Read more →Room Rent Limit
The daily room-charge cap, and why it quietly scales every other bill.
Read more →Cashless Claim
How the insurer settles hospital bills directly at network hospitals.
Read more →Third-Party Administrator (TPA)
The intermediary that processes cashless approvals and claims.
Read more →Pre-Existing Disease (PED)
How conditions employees already have are covered in group plans.
Read more →Top-Up & Super Top-Up
Affordable extra cover stacked above a deductible threshold.
Read more →Section 80D Tax Benefit
The tax deduction on health-insurance premiums for company and staff.
Read more →Network Hospitals
Hospitals with cashless tie-ups — how they work for your team.
Read more →Browse the full libraries: Group health terms explained and the A–Z insurance glossary.
Compare the covers
The decisions employers actually weigh — which group covers you need, and how private cover sits alongside statutory schemes.
GMC vs GPA vs GTL
The three group covers a company needs — and what each one actually pays for.
Read more →ESI vs Group Health Insurance
What statutory ESI covers, and where a private GHI plan fits.
Read more →Group vs Individual Cover
Why group cover is cheaper, day-1 and no-medical-test versus a retail policy.
Read more →Employer guides
Decision-ready guides that turn the concepts into a plan you can buy and run.
Is Group Health Insurance Mandatory?
The 2026 legal position — ESI thresholds, IRDAI guidance and voluntary cover.
Read more →Riders & Add-ons
Maternity, OPD, top-up, critical illness — building a plan by stacking riders.
Read more →Super Top-Up for Employers
How a super top-up over a deductible affordably raises total cover.
Read more →Explainer articles
Longer reads that unpack a single concept end to end.
Individual vs Group Health Insurance
A side-by-side look at cost, eligibility and cover for the two models.
Read more →OPD vs IPD
Out-patient versus in-patient care, and how each is covered.
Read more →The Hospital TPA Desk
What the TPA desk does at admission, and how it unlocks cashless treatment.
Read more →Tax Benefits of Group Health Insurance
How group cover saves tax for your company and your employees.
Read more →Government Health Insurance Schemes
Ayushman Bharat, ESIC and state schemes — and where private cover complements them.
Read more →Frequently asked questions
What is the difference between GMC, GPA and GTL?
GMC (Group Medical Cover, also called group health insurance) pays for hospitalisation and medical treatment. GPA (Group Personal Accident) pays a lump sum for accidental death or disability. GTL (Group Term Life) pays the nominee a fixed sum assured if an employee dies from any cause. Most companies layer all three — see our GMC vs GPA vs GTL comparison for a side-by-side.
What does "sum insured" mean in a group health policy?
The sum insured is the maximum amount the policy will pay for covered claims in a policy year. In a floater plan it is shared across an employee and their dependents. Sizing it correctly — against local hospitalisation costs and your team profile — is one of the most important plan-design decisions.
Is a waiting period applicable to group health insurance?
Corporate group plans usually offer day-1 cover with no waiting period for hospitalisation and often waive pre-existing-disease and specific-illness waiting periods that apply to retail policies. The exact terms depend on your plan design, so confirm them before you buy.
Do employers get a tax benefit on group health insurance?
Yes. Premiums a company pays for group health insurance are generally treated as a business expense, and employee-paid premiums can qualify under Section 80D. Read our explainer on the tax benefits of group health insurance for the details.
Ready to put the right cover in place?
Now that the concepts are clear, get a personalised group health insurance quote for your team — starting ₹145 per employee per month.