Group Health Insurance glossary
Floater Sum Insured
A floater sum insured is a single cover amount shared across an employee and their covered dependents, instead of a separate amount per person. Any insured family member can draw from the common pool, and once it is used up for the policy year, the remaining balance is what is left for everyone.
Any covered member can draw from the single floater sum insured; once it is used for the year, the balance is what is left for everyone.
How a floater sum insured works in a group/employer plan
When you add family cover to a group plan, you choose between individual and floater structures. Under a floater, the policy sets one sum insured — say ₹5,00,000 — and the employee, spouse, children and any covered parents all share it. There is no per-person allocation; the pool simply depletes as claims are approved, whoever makes them.
Because the cover floats across the family, one member can use a large slice in a single hospitalisation while another uses none. The trade-off is exposure: a serious claim by one person reduces what remains for the rest of the family that year, until the sum insured resets at renewal — or refills earlier if the plan carries a restoration benefit.
Floaters are priced on the assumption that the whole family rarely claims heavily in the same year, so they usually cost less than giving each dependent a full individual sum insured. Any sub-limits in the policy still apply on top, capping specific treatments regardless of how much of the floater remains.
A worked example (₹5,00,000 floater)
An employee has a ₹5,00,000 floater shared with their spouse and one child. During the policy year the spouse is hospitalised for a claim of ₹3,20,000, and later the child has a day-care procedure costing ₹80,000.
Floater sum insured
Claims used (spouse + child)
Balance left for the family
Only ₹1,00,000 now remains for the employee and everyone else for the rest of the year. If the employee is then hospitalised for ₹2,50,000, the floater covers ₹1,00,000 and the family pays the ₹1,50,000 shortfall — unless a restoration benefit or super top-up refills the pool first.
Why a floater sum insured matters for employers
The floater is one of the biggest levers on both cost and employee experience in a family plan. It lets you extend cover to spouses, children and parents at a far lower premium than individual sums insured — which is often what makes dependent cover affordable for the whole workforce in the first place.
The flip side is shared exhaustion. A single large hospitalisation can drain most of the pool and leave the rest of the family thinly covered for the remainder of the year. For employees with older parents or higher health risk in the family, a bare floater can quietly become inadequate at exactly the wrong moment.
That is why the floater amount is a decision to make deliberately, not a default to accept. Sizing it correctly — and pairing it with a restoration benefit or a super top-up — is how you keep the premium efficient without leaving families exposed after one big claim.
How Onsurity handles the floater sum insured
Onsurity builds group plans so the floater is a clear, configurable choice rather than fine print. You set the shared sum insured for each employee-and-family band, and every member sees the exact floater amount and how much of it remains inside the Onsurity Super App — so no one discovers the pool is low only at the billing desk.
Claims settle cashless at 10,000+ network hospitals, drawing straight from the floater with no upfront outlay or reimbursement wait, and day-1 cover options mean the family pool is live from the joining date with no waiting period on eligible claims. Restoration and super top-up add-ons let you refill or extend the floater so one large claim does not strand the rest of the family.
HR tracks every plan's floater size, utilisation and claims status in one place on the TeamSure dashboard, while the Good Doctors claims concierge — real doctors — guides employees through pre-authorisation and discharge, so families understand exactly what their shared cover will pay before treatment begins.
Frequently asked questions
What is the difference between a floater and an individual sum insured?
An individual sum insured gives each member their own separate cover. A floater sum insured pools one shared amount across the employee and all covered dependents, so any member can draw from the full pool up to the point it is exhausted for that policy year.
Can the whole floater sum insured be used by one family member?
Yes. In a single policy year one member can use the entire floater — for example a ₹5,00,000 floater fully spent on one hospitalisation. The pool then stays reduced for the rest of the family until it resets at renewal, unless a restoration benefit refills it.
Is a floater cheaper than individual cover for the same employees?
Usually yes. Because a floater assumes not every family member claims heavily in the same year, the insurer prices it lower than giving each person a full individual sum insured. That makes it a common, budget-efficient default for employee dependent cover.
What happens to a floater if the sum insured runs out mid-year?
Once the shared pool is exhausted, further claims that year are paid by the family out of pocket unless the plan has a restoration or top-up benefit. This is why employers often pair a floater with a restoration benefit or a super top-up for large-claim protection.
How many dependents can share one floater sum insured?
It depends on the plan definition of family — commonly the employee, spouse and children, and sometimes parents. Every named dependent shares the same pool, so a wider family on one floater means the fixed amount is spread across more people.
Sizing the right floater for your team?
Get a group health quote and see exactly how the floater sum insured, family size and premium trade off for your headcount and budget.
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