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Is Group Health Insurance Policy Compulsory in India?
Feb 21, 2023

Do Employees Need to Compulsorily Have a Group Health Insurance Policy in India?

Health insurance is a crucial tool for protecting your financial well-being in the face of unexpected medical emergencies. Typically, you have to pay an annual premium to purchase a policy that will cover your hospitalization expenses when you become sick or injured. Often, people avoid buying health insurance because it means they would have to bear an extra cost annually.  But there are different kinds of health coverage available for everybody. Believe it or not, there is a way to get health coverage for free. It's called employee group health insurance, and it's a type of insurance that is provided by an employer to its employees at no cost to the employee. Recently, this type of insurance has been made mandatory for employees in India due to the COVID-19 pandemic. In this article, we'll delve into the details of employee group health insurance and explore the benefits it offers to employees.

Is Company Health Insurance Compulsory in India?

Yes, coverage for employees, also known as group health insurance policy, is compulsory in India post COVID-19. Before getting into the details, here’s a quick explanation of the distinction between different Group Mediclaim Policies:
  1. When you get coverage for yourself, it is called Individual Health Insurance.
  2. When you get coverage for your family, it is called Family Health Cover.
  3. When you receive coverage with others as part of a group, it is called a Group Insurance Plan.
  4. When you receive health insurance coverage from your employer under a Group Health Insurance Plan, it is called Employee Group Health Insurance. *

Understanding the Basic Coverage

A Group Health 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 an employee’s family in some cases) as per the prescribed limit. *

Advantages of Group Medical Cover for Employees

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

1. Free health coverage

Employees do not have to pay a health insurance premium to receive the benefits of this plan. The premium is paid by the employer as a benefit to the employee for being a part of the company. Your immediate family including your spouse and dependent children are included in the coverage. Moreover, you can add other family members to this cover for a nominal payment. It is a major advantage to have such holistic coverage while healthcare costs skyrocket. *

2. Top-notch coverage

Even though a Group Medical Cover for Employees is available free of cost, it can be of high quality. Most employee health plans come with the following features:
  1. Cover for hospitalisation expenses
  2. No waiting period
  3. COVID-19 cover
  4. Teleconsultations with medical experts
  5. Facility to book lab tests*

Preventive Health Care Benefits

Many cashless health insurance providers appreciate when policyholders take steps to avoid major illness or injury. For example, if a policyholder takes regular health check-ups, they are considered favourable. Hence, insurers often promote the practice of preventive health check-ups. They offer these check-ups at affordable prices. Moreover, they can sometimes also include medical tests at reasonable prices through their various associations. *

Is Group Health Insurance enough?

Employee group health insurance is a useful facility for employees, offering free, high-quality coverage for hospitalization expenses, and potentially other benefits such as outpatient treatment and preventive care. However, it's important to note that group health insurance policies are not always the best option for everyone. * While group health insurance can be a great benefit for employees, it is important to consider the limitations of these policies. For example, the coverage of group health insurance policies depends on your employer. You will have to accept whatever coverage they offer you. Additionally, group health insurance policies are paid for by the employer, which means if you leave your job or lose your employer's coverage for any reason, you will also lose your health insurance coverage. * Given these limitations, it may be a good idea for employees to supplement their group health insurance with an individual health insurance policy. Individual health insurance policies allow you to choose your own coverage and customize it to meet your specific needs. They also offer more flexibility in terms of which hospitals and healthcare providers you can use. While individual health insurance policies may require you to pay a premium, they can provide a higher level of protection and peace of mind. * * Standard T&C Apply Overall, employee group health insurance can be a safety net for employees, but it is important to remember the limitations of these policies and consider purchasing an individual health insurance policy to provide additional protection. Additionally, you need to be smart with buying an individual policy. You need to buy the right coverage for the right price.  To help you with that, you can use a health insurance premium calculator.   Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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