Free tool · Instant score, no sign-up
Group Health Cover Grader: score your employee plan out of 100
Answer six quick questions and get an instant grade across four things that actually matter — coverage adequacy, cost efficiency, wellness & OPD, and claims support — with a red/amber/green breakdown benchmarked against typical Indian SME ranges. Your score is free and shown on the spot.
Grade my cover
Four things a good group plan gets right
Most group plans are sold on a single headline number. This grader looks past the headline at the four dimensions that decide whether cover actually helps your team when they need it.
Coverage adequacy
Is the sum insured high enough to survive a real hospitalisation, with maternity and no hidden room-rent cap?
Cost efficiency
Does the per-employee premium sit in the efficient band for the cover you get — not built down to a price?
Wellness & OPD inclusion
Does the plan reach everyday care — OPD, mental-health support and health checks — or only hospitalisation?
Claims support
When an employee is in hospital, do they get guided, cashless help — or paperwork and reimbursement waits?
Grade your cover
Pick the closest answer to each question. Your grade updates live — no email needed to see it. When you have answered them all, you can have the detailed improvement plan emailed to you as a PDF.
Your cover grade
Answered 0 of 5 + benefits. Complete every question to unlock your improvement plan.
What best-in-class looks like
Each bar above is graded against the shape of a strong SME group plan — using the indicative benchmark bands from our India group health insurance statistics (IRDAI Annual Report 2024-25 and market data). These are ranges, not a valuation of your specific policy.
Coverage adequacy
GapBest-in-class
A ₹4,00,000–₹5,00,000+ sum insured per employee, maternity included, and no room-rent cap.
How to close the gap
Lift sum insured toward ₹4,00,000–₹5,00,000 per employee and add maternity. A single ICU stay can exhaust a ₹2,00,000 cover, and maternity is one of the most-used group benefits.
Cost efficiency
GapBest-in-class
₹10,000–₹25,000 per employee per year buys comprehensive cover; employers typically fund 60–70%.
How to close the gap
Benchmark your premium against the ₹10,000–₹25,000 comprehensive band. Paying well above it — or a very low figure for thin cover — usually signals a plan built to a price, not to your team.
Wellness & OPD inclusion
GapBest-in-class
OPD, mental-health support and annual health checks bundled in — not hospitalisation alone.
How to close the gap
Bundle OPD, mental-health support and wellness / health checks. Hospitalisation-only cover misses the everyday care employees actually use, which is what makes a benefit feel real.
Claims support
GapBest-in-class
A dedicated claims concierge plus cashless at 10,000+ network hospitals; ~4-day settlement.
How to close the gap
Move toward guided, cashless claims. A dedicated concierge and cashless at a wide network spare employees large upfront outlays and weeks of reimbursement paperwork during a medical emergency.
Group premium typically runs ₹5,000–₹30,000 per employee a year, with ₹10,000–₹25,000 the most common band.
This is an indicative grade
The grade is an indicative benchmark of a policy’s structure — not a quote, an offer, or financial advice. It cannot account for every clause, sub-limit or exclusion in your policy wording. Actual cover and premium depend on your headcount, age mix, location, industry and claims history, and the insurer’s terms. Use it to spot gaps worth discussing, then confirm the details against your policy schedule and an exact quote.
Frequently asked questions
Your six answers are scored across four dimensions — coverage adequacy, cost efficiency, wellness/OPD inclusion and claims support — each out of 100. Sum insured and maternity drive coverage; your per-employee premium drives cost efficiency; OPD, mental-health and wellness toggles drive the wellness score; and your claims-support answer drives the last one. The four are averaged into an overall grade out of 100, with a red/amber/green band on each.
No. The score, the four-dimension breakdown and the red/amber/green bars are all shown instantly, with no email required. Only the detailed, board-ready improvement plan (PDF) asks for your name and work email so we can send it to you.
The indicative SME ranges published on our India group health insurance statistics page — drawn from the IRDAI Annual Report 2024-25 and market data. For example, ₹10,000–₹25,000 per employee per year is the most common comprehensive-cover band, and ₹4,00,000–₹5,00,000+ is a strong sum insured. These are ranges, not a valuation of your specific policy.
No. This is an indicative benchmarking tool, not a quote, offer or financial advice. It grades the structure of a plan, not its exact price. Real pricing depends on your headcount, age mix, location, industry and claims history. For exact numbers, request a quote.
Treat the red and amber bars as a prioritised to-do list. The improvement plan spells out the biggest, most fixable gaps first — usually sum insured, OPD/wellness inclusion or claims support — and gives you the exact questions to put to your broker or insurer before your next renewal.
Ready to close the gaps?
Get an exact group health quote built around your headcount and budget — with the sum insured, wellness benefits and cashless network your grade flagged, on a monthly subscription rather than an annual lump sum.
Get a benchmarked quote