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How to Select the Right Group Medical Coverage While Choosing a Group Health Insurance Company?

Team AckoNov 8, 2024

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Traditionally, choosing an Employee Health Insurance Policy is considered as a passive activity. In some cases, employers still continue to engage with a similar plan for years. This association is despite the availability of comparatively economical and comprehensive options. However, in a pandemic-affected era, partnering with a health insurance provider and picking Group Medical Coverage should be a proactive activity. Read ahead to know how to go about selecting the right medical coverage for the employees while partnering with a Group Health Insurance Company.

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How to Select Group Medical Coverage for Employees?

Gone are the days when it was common to offer a basic Mediclaim policy to the employees. Nowadays, both the need and the awareness of health insurance have increased, especially due to the uncertainties associated with the COVID-19 pandemic. In such a scenario, it is beneficial to insure the employees with Group Health Insurance that offers wide coverage, superior services, and hassle-free claim settlement. Here are three important points to keep in mind while selecting a Group Health Insurance Policy.

1) Flexible Plans

Group Health Insurance Plans should not be rigid. Employees should be allowed to modify them as per their needs. This can be in terms of adding their family members or increasing the coverage by contributing to the premium for the chosen top-up plans.

2) Beneficial Services

A holistic Group Insurance Policy offers a lot more than just insurance coverage. It also offers fitness and wellness benefits such as free teleconsultation with medical experts, discounts on buying medicines or booking lab tests, and rewards for maintaining an active lifestyle.

3) Smart Claim Settlement

Employees must have the opportunity to apply for a health insurance claim and receive the claim amount in a hassle-free manner. This is possible due to tech-based insurers who offer Smart Claim Settlement via their mobile apps and responsive websites.

Tips to Select Good Group Health Insurance Coverage:

Keep the following points in mind while selecting a Group Mediclaim Policy for the employees. As ACKO’s Group Health Insurance Policy is customisable, the points mentioned as ACKO Advantage are subject to the chosen policy’s cover, and terms and conditions.

1) High Sum Insured

The policy must have a sufficient Sum Insured considering medical inflation and cost of treatment. For example, a Sum Insured of Rs. 1 lakh is not going to be adequate, especially in tier 1 and metro cities.

ACKO Advantage: ACKO offers health insurance coverage of up to Rs 5 lakhs, which can be increased if needed via top-up plans.

2) COVID-19 Cover Inclusion

With the pandemic refusing to subside, it is of great importance to insure the employees with a COVID-19 cover.

ACKO Advantage: ACKO offers a COVID-19 cover to cover treatment costs.

3) Wide Network of Hospitals

Choose an insurer that has partnered with several top-ranking multispeciality hospitals in the city. Such hospitals ensure that the employees receive professional care and settle claims in a cashless manner.

ACKO Advantage: ACKO has partnered with more than 6,000 hospitals for easy access to good medical care.

4) No Waiting Period

Make sure that the policy does not have a waiting period for pre-existing diseases to raise a claim. If it does, then you will have to wait out the stated period before being eligible to raise a claim.

ACKO Advantage: ACKO’s group cover does not have any waiting period for pre-existing diseases, resulting in better coverage.

5) No Room Rent Limits

Room Rent Limits can be a dampener. This is because it is a slightly difficult concept to understand, which often leads to a lower claim amount while settling the claims. Ideally, pick a cover with no room rent limits and if it does, then make sure to read the policy details carefully.

ACKO Advantage: Depending on your requirements, ACKO’s Group Mediclaim Policy may or may not have a room rent limit.

Standard Coverage in Group Mediclaim Policy:

This section highlights the standard coverage in a Group Insurance Scheme offering insurance for employees. Do read the policy document for details as each policy can be different. For example, ACKO’s policy can be customised; thus, the inclusions and exclusions will change accordingly.

In-patient hospitalisation along with pre-hospitalisation and post-hospitalisation.

Out-patient treatments.

Maternity expenses and a cover for the newborn baby.

Cover for stated day-care procedures.

AYUSH treatment up to the specified limit.

Key Features of ACKO’s Group Medical Cover:

The Group Health Insurance Plan offered by ACKO offers wide-ranging coverage resulting in a Company Health Insurance plan that is affordable and convenient for the employer, and valuable and advantageous for the employees. Here are the top benefits of the cover.

Health cover of up to Rs. 5 lakhs for the employee including their family.

Free online consultations with doctors.

Facility to purchase medicines and book lab tests at a discount.

Rewards for completing fitness challenges.

Access the services of wellness experts such as mental health coaches and nutritionists.

Raise claims in a paperless manner from the mobile app.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

Frequently Asked Questions:

Here are some of the common doubts and their resolutions. Please feel free to send an email at [email protected] for specific queries.

Q1. Which are the major things to consider while selecting group insurance coverage?

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You need to look at the scope of the coverage, applicable terms and conditions, available add-ons, associated services, and the claim settlement process while selecting group insurance coverage.

Q2. Is there a limit in terms of the number of years of existence before buying health insurance for the company’s employees?

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No, even a new company can insure its employees with a health insurance policy.

Q3. Is it possible to buy this cover for a small-sized digital marketing company?

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Yes, even a small-sized company can buy this cover for the employees.

Q4. Which is the best Group Insurance Plan for a start-up?

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What works for one company might not work for another. Thus, there is no universal best plan. You can customise the policy as per your liking while buying from ACKO. This way, you get the opportunity to decide what’s best for your start-up and then purchase the cover accordingly.

Q5. Can the sum insured be increased to suit the health insurance requirements?

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Yes, the Sum Insured of the policy can be increased by purchasing top-up plans and paying the corresponding health insurance premium.

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