Group health insurance
One health policy covering an employer's staff, or the members of a group, arranged and administered centrally, with cover that usually begins from a member's first day.
What it covers
Cover varies between insurers and plans. The policy wording is what decides whether a claim is payable, so read it before you buy.
- In-patient hospitalisation for every member of the insured group
- Cover for dependants, where the employer includes spouse, children or parents
- Pre-hospitalisation and post-hospitalisation expenses, day-care procedures and ambulance charges
- Maternity and newborn cover, where the employer opts for it
- Pre-existing conditions, which group policies often cover from inception, as the policy provides
- Cashless treatment at the insurer's or the administrator's hospital network
Key features
- Cover for a defined group, with joiners and leavers handled during the year by endorsement
- Standard waiting periods are often waived for the group, depending on what the employer buys
- Optional dependant cover, with the employer choosing who is included
- Optional voluntary top-up so employees can raise their own cover at their own cost
- Administered with the insurer or a TPA, with e-cards and a cashless hospital network: [NETWORK HOSPITALS]
- Minimum group size set by the insurer: [GROUP SIZE MINIMUM]
How to buy it
Four steps, with an advisor you can reach at any of them.
Tell us about the risk
Send us the member list with ages and dependants, the cover you want per member, and any claims history.
Underwriting details
An advisor collects the information insurers need to price the risk, and flags anything missing.
Compare quotes
We ask our partner insurers to quote, and put the cover, conditions and premium side by side.
Proposal & policy
Pick a quote, complete the proposal form and KYC, and the insurer issues the policy.
Group health insurance: FAQs
Does a group policy replace personal health insurance?
Not entirely. Group cover ends when you leave the employer, and the sum insured is chosen by the employer. Most people keep a personal policy as well, so their cover and the waiting periods they have served continue.
Are pre-existing conditions covered under a group policy?
Group health policies often cover them from inception, unlike retail policies, but it depends on what the employer has bought. The policy schedule and wording confirm what applies.
Can employees add family members?
Yes, where the employer's policy allows it. Dependants can be included in the base cover, or offered voluntarily with the employee paying that share of the premium.
What is a TPA?
A third-party administrator appointed by the insurer to issue cards, authorise cashless treatment and process claims. Your advisor deals with them alongside you when a claim needs following up.