Is Group Health Insurance Policy Enough for You and Your Family?

Health insurance is no alien concept in 2021. With a pandemic taking the world by a storm, the awareness regarding a safety net for health has increased manifolds. In a corporate setting, employers offer additional health benefits over and above the salary compensation by way of a group insurance plans. With this additional perquisite, employers try to retain their talent and keep the attrition rate at minimum.

These group health insurance plans offer coverage to all the eligible employees along with coverage to their families. However, such additional cover for families comes at an additional cost which is deducted from their salary.

Some notable benefits of a group insurance plan include no waiting period for coverage, no requirement of a medical check-up, coverage for pre-existing ailments from day one and also extending the coverage to other family members. However, these benefits of health insurance plans not all. There are certain limitations to the policy coverage. These restrictions make it essential to consider whether such group insurance plan is enough for you or not. Here are some of those limitations that should be considered:

  1. Standard policy coverage

A group insurance policy has standard policy overage for all the subscribers to the plan. Hence, all employees are provided with the same insurance coverage. While it may not be a bad thing, individual health requirement differs, and the insurance coverage must accordingly be customised to fit them. With a policy that offers same coverage for all employees, it may not be of much use. For instance, an employee who policy includes senior citizens, but the coverage does not cater to age-related ailments specifically. Thus, reliance on such group insurance plan may not be a smart choice. Moreover, these plans generally do not offer customisation and hence you are stuck with a template policy coverage.*

  1. Limited amount of sum insured

Group insurance plans offers coverage which may either be low or an average amount. Not always such a sum insured may be sufficient considering the spike in medical inflation and the treatment cost. Moreover, some corporate insurance plans provide the sum insured based on the designation of the employee and hence employees who have just started out their careers may not benefit from such low sum assured.*

  1. Coverage is limited for dependents/family

Corporate health plans often are limited in its scope in some way or the other. These limitations are generally for the dependents and family members added. Some plans limit the number of dependents that can be added whereas other policies provide a standard coverage for these dependents with incremental premium for additional coverage. In some situations, both these limitations act in place thus, narrowing the policy scope. * Standard T&C Apply

  1. Co-pay requirement

Some group policies include a co-pay clause where the insurance company requires you to bear a certain percentage of the claim amount. This, in turn, has the effect of a higher out of pocket expense required at the time of claim. In case of large hospital bills, it may even hurt your personal savings.*

  1. Employment dependent

The coverage of group policies is dependent on your employment, i.e., linked to your job. The coverage ends the moment you resign or are terminated from employment. Thus, any change in employment will cease any benefits from your existing health insurance plan. In addition, the plans differ among different employers and hence can make it difficult for employees.*

* Standard T&C Apply

These are some of the concerns why you shouldn’t solely rely on a group insurance plan. While the benefits it offers are useful, the limitation weigh down these benefits. Hence, make sure to carry an individual health insurance renewal each period along with a group coverage. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.


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