Employers prefer group healthcare plans as they protect their employees financially during any medical crisis.

Interestingly, group medical insurance offers benefits to employees as well as employers. Employees can work stress-free and let the insurance take care of their health expenses, whereas employers can gain the trust of their employees and save tax money.

The question is, does group health insurance cover pre-existing conditions along with the basic coverage? Let’s find out the answer and explore what benefits you can get from group medical insurance.

What is Group Health Insurance?

Group health insurance is a type of health insurance that offers coverage for members of a common group. It is usually purchased by employers, organisations and companies who want to offer financial protection to their employees during medical emergencies.

As per the Insurance Regulatory and Development Authority of India (IRDAI), an organisation should have at least 20 employees to opt for group health care plans. Though there are micro insurance plans for companies with less than 20 employees, irrespective of the number of employees, offering security to your employees is important.

Does it Cover Pre-Existing Conditions?

Yes. Group health insurance from reliable providers like Tata AIG offers coverage for pre-existing diseases.

Pre-existing diseases are nothing but health issues that existed before the start date of a health insurance policy. These can range from chronic conditions like diabetes, hypertension, and asthma to previous injuries or ongoing treatments for other medical issues. To cover this huge cost, it is important to get insurance coverage for pre-existing conditions.

Note that these can be covered from day one of the group insurance policy.

Companies can significantly change their reputation in the market by offering group health insurance for pre-existing conditions.

How Premiums are Calculated?

The Group health insurance premium is calculated based on the overall risk of the group of employees. It is not calculated as per an individual’s health risks of each member.

The type of industry, the demographics of the employees (such as age and gender), and the selected insurance benefits (such as scope of coverage) are some factors that influence the premium.

Benefits to Employers and Employees

Group health insurance and pre-existing conditions work hand in hand. Let’s explore some top benefits of these policies for employees, employers and the entire organisation.

Benefits of Group Health Insurance For Employers

Group medical insurance for pre-existing conditions not only helps employees but also contributes to the organisation’s welfare.

Attracting Talent

Offering complete health insurance to employees that includes coverage for pre-existing conditions can add value and uplift the company’s brand identity.

Reduced Absenteeism

Employees with access to health care for pre-existing conditions are likely to be healthier and more productive, as they can work stress-free.

Tax Benefits

Employers can claim tax deductions for the cost of premiums, which reduces the overall cost of providing benefits.

Benefits of Group Health Insurance for Employees

Though there are multiple benefits of group health care plans, it is primarily designed for employees and their well-being.

Security

Employees have the peace of mind of knowing that their health concerns are covered, including those diagnosed before the start of coverage.

No Medical Underwriting

Group plans typically do not require medical screening, which means employees with health issues are not penalised or excluded.

Family Coverage

Many group plans like Tata AIG’s plans offer the option to cover family members, providing comprehensive protection for the employee’s loved ones.

Group Medical Insurance Pre-existing Conditions: Challenges and Considerations

Cost

The cost of providing health insurance, especially in small companies or those with a high-risk group, can be significant.

Plan Limitations

Some plans may have limitations in terms of network hospitals or capped benefits for certain conditions.

Dependency on Employment

Coverage is typically linked to employment, meaning it can be lost if an employee changes jobs or the employer decides to change or drop the coverage.

Conclusion

Group health insurance plans are a valuable component of employee benefits, providing necessary coverage without the restrictions often imposed on individual plans.

Understanding how these plans handle pre-existing conditions, how premiums are calculated, and what both employers and employees stand to gain can help in making informed decisions about healthcare coverage in a corporate setting.

By offering group health insurance and pre-existing conditions coverage, employers not only comply with regulatory requirements but also enhance their appeal as favourable workplaces that care about the health and well-being of their employees.