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Is Group Health Insurance Mandatory for Employees in India?

Team AckoJan 17, 2024

Health insurance assists in safeguarding your hard-earned money during health emergencies. You have to pay an annual premium to buy a policy and if you are hospitalised, your insurer steps in and helps to pay the bills. But, what if there’s a way to get this insurance coverage for free? Nope, this is not a fantasy; such a cover exists! It is called Employee Group Health Insurance. And recently, this Group Health Insurance has been made mandatory for employees. Read ahead to know more on this topic.

Contents

Is Company Health Insurance Compulsory in India?
- Understanding the Basic Coverage
- Recent Updates
Employer-sponsored Health Insurance: Employee State Insurance (ESI) vs Group Medical Cover (GMC)
Advantages of Group Medical Cover for Employees
Frequently Asked Questions

Is Company Health Insurance Compulsory in India?

Yes, medical insurance policy for employees is compulsory in India post the nation-wide COVID-19 lockdown in 2020. Before getting into the details, here’s a quick explanation of the Group Mediclaim Policy.

When you buy insurance for yourself, it is known as Individual Health Insurance.
When you buy insurance for your family, it is known as a Family Health Cover.
When insurance is bought for you and others in a group, it is known as a Group Insurance Scheme.
And when an employer buys Group Health Insurance Plan to insure the employees, it is known as Employee Group Health Insurance.

Understanding the Basic Coverage

A Group Insurance Policy for Employees can be availed free of cost as the policy premium is paid by the employer on behalf of the employee. This policy covers the hospitalisation expenses of the employee (and employee’s family in some cases) as per the prescribed limit.

Recent Updates

Before 2020, there was no specific rule mandating such a cover. However, after the pandemic-ridden past year, the authorities have introduced new regulations in this regard.

As per an April 1, 2020 circular issued by the Insurance Regulatory and Development Authority of India (IRDAI), medical insurance is to be made mandatory.
After the lockdown, corporations were asked to follow a Standard Operating Procedure for resuming work and offering insurance to the workforce was a part of it.
This circular was issued by the IRDAI to health insurance companies to implement directives of the Ministry of Home Affairs.
The IRDAI advised the non-life insurers to come up with comprehensive, affordable, and simple-worded policies.

Employer-sponsored Health Insurance: Employee State Insurance (ESI) vs Group Medical Cover (GMC)

Medical insurance is available for employees working in the organised sector in India. It is available under the Employee State Insurance Act, 1948. Employees earning a monthly wage of Rs. 21,000 or less can benefit from ESI. Both the employer and employee have to contribute to the Employee State Insurance Corporation (ESIC). When the time comes, the employee can avail of the benefits from the corporation.

One implication of the above-mentioned circular can be that the medical insurance needs of the employees below the wage limit of Rs. 21,000 shall be covered as per the ESI and of those above the wage limit of Rs. 21,000 shall be covered as per the GMC. Please speak with your employer/HR department for more clarity about employer-mandated health insurance.

Advantages of Group Medical Cover for Employees

Here are the top benefits of an employer-offered health insurance policy for the employees.

1) Free Health Insurance

Employees do not have to pay an insurance premium to receive the benefits of this plan. The premium is paid by the employer as a perquisite/benefit to the employee for being a part of the company. Such type of group coverage also includes your family members. And to receive this wide-ranging cover for free amidst rising healthcare costs is indeed a great advantage.

2) Top-notch Coverage

Even though a Group Medical Cover for Employees is available free of cost, it can be of a high quality. For example, ACKO’s Employee Health Policy comes with the following features:

Cover for hospitalisation expenses
No waiting period
COVID-19 cover
Out-patient Treatment (OPD) cover
Free tele consultations with medical experts
Facility to book lab tests

3) Preventive Health Care Benefits

Tracking your exercise regimen can help you to monitor your progress and achieve your fitness goals. Your group policy can help in this regard. For example, with ACKO’s Corporate Health Cover, you can track and monitor your fitness routine and get rewarded for achieving weekly/daily fitness goals.

Also, Read: Insurance for Bike

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

This section features common concerns about the Employer-Employee Insurance Policy.

FAQs

Q1. Since when is Medical Insurance made mandatory in India?

Medical coverage for employees has become mandatory in India post lifting of the nation-wide lockdown in 2020.

Q2. Is it possible to buy a Corporate Health Plan for a company with just 15 employees?

Yes, a 15-employee organisation can cover its employees under group insurance.

Q3. I am unemployed. Can I buy health insurance coverage for myself?

Yes, you can purchase Individual Health Insurance for yourself. You can buy the Arogya Sanjeevani Policy Health Insurance Policy offered by ACKO at just Rs. 2,399 per year.

Q4. Is it possible to add my spouse and parents to this Employee Policy even though they are not a part of the organisation I work at?

Adding family members to the employer-offered cover is one of the key features of the policy. This way, you can not only safeguard yourself against financial losses during uncertain emergencies but also have a cover for your close family members.