What Is Group Health Insurance?

Compare group health plans from top insurers in India!

Group health insurance is a type of health insurance policy that covers a group of people. This group of people is from the same organisation, cooperative group, or member of some organisation. Group mediclaim insurance policy for employees or corporate health insurance is offered as an employee benefit. Usually, employers pay the entire premium for the whole group and receive tax benefits.

Group medical insurance plans in India provide benefits such as pre and post-hospitalisation coverage, free health checkups, daycare procedures, ambulance charges, etc. Not just that, many group policies allow insured members to add their partners and dependent children under the policy. These plans also offer maternity and newborn coverage benefits, making them comprehensive plans that come with affordable premiums and tax benefits.

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Group health insurance is a type of health insurance policy that covers a group of people. This group of people is from the same organisation, cooperative group, or member of some organisation. Group mediclaim insurance policy for employees or corporate health insurance is offered as an employee benefit. Usually, employers pay the entire premium for the whole group and receive tax benefits.

Group medical insurance plans in India provide benefits such as pre and post-hospitalisation coverage, free health checkups, daycare procedures, ambulance charges, etc. Not just that, many group policies allow insured members to add their partners and dependent children under the policy. These plans also offer maternity and newborn coverage benefits, making them comprehensive plans that come with affordable premiums and tax benefits.

Did You Know?

After the COVID-19 lockdown, the Indian government introduced a regulation stipulating that all industrial, commercial, and corporate offices must provide group health insurance coverage to their employees.

Bestselling Group Health Insurance Plans in India

Company Name Plan Name CSR Why Do We Recommend It? Sum Insured

Star Health Insurance
Star Group Health Insurance Plan 99.21% Covers newborn
Covers daycare treatment
Optional maternity cover
Upto 1 Crore

Care Health Insurance
Care Group Health Insurance Plan 100% Covers children and parents
Can make easy changes
Online health risk assessment

TATA AIG Health Insurance
TATA AIG Group Health Insurance 95.46% Lower premiums
Customisable policy
No waiting period

Aditya Birla Health Insurance
Aditya Birla Group Health Insurance 99.01% Draw and retain employees
Simple administration procedures
Riders benefits

Digit General Insurance
Digit Group Health Insurance 96.83% Covid-19 covered
Low-cost premium
Cashless claims

Niva Bupa Health Insurance
Niva Bupa Group Health Insurance 100% Coverage for parents
No pre-policy health checkup
Comprehensive coverage

ICICI Lombard General Insurance
ICICI Lombard Group Health Insurance 98.53% Maternity coverage
Critical Illness coverage
Dental expenses covered

BAJAJ Allianz General Insurance
BAJAJ Allianz Group Health Insurance 93.54% Ambulance charges covered
In-patient hospitalisation
Wellness benefits

SBI General Insurance
SBI Group Health 96.47% Wide coverage
Nursing expenses
No pre-medical check-up for 65 year
Upto 5 Lakh

ManipalCigna Health Insurance
ManipalCigna Pro Health Prime 99.96% Non-medical expenses covered
No room rent capping
Restoration benefit
Upto 1 Crore

Read our most trending article- Top 10 Health Insurance company in India and get to know about the best health insurance companies.

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Types of Group Health Insurance in India

In India, there are various types of group mediclaim policy available.

Corporate Mediclaim Cover

When an employer purchases group health insurance for their employees it is known as corporate mediclaim coverage. It is one of the most commonly purchased health insurance plans. You will get all the benefits including cashless treatment, hospitalisation, pre and post-hospitalisation and much more. Sometimes, these plans also cover family members of the employees, including spouses and dependent children.

Group Personal Accident Insurance

Group personal accident insurance is similar to individual personal accident insurance. Group personal accident insurance extends the benefits to a group of people, like employees or members of any association. This plan is offered by the employer or the association to provide financial protection against the expenses arising due to accidental injuries.

Why Group Health Insurance For Employees Is Important?

Group health insurance is solving numerous problems for the people working in a corporate set-up. Let us discuss a few of them.

Problem Solution
Team building is a major problem nowadays Group health insurance helps ensure the security of your team
Employee retention People will stay when they feel secure, even health-wise
Work-life balance With health insurance, you can make sure that your employees’ health is covered
Team security By providing health insurance, you can make sure that your teams will get adequate healthcare.

If your employees stay healthy, they will be able to work more efficiently. In short, it is a win-win situation for the company as a whole.

Benefits of Group Health Insurance

Group medical coverage offers valuable benefits for the employees as well as the employer.

  • Financial Protection

    Accidents, illnesses, and surgeries can lead to heavy medical expenses. Group health care plans help to cover these costs and protect you from financial strain.
  • Access to Quality Care

    The best group health insurance policy in India offer access to a large network of doctors, hospitals, and specialists. It makes sure that you will get the quality health care that you deserve.
  • Employee Satisfaction and Retention

    Offering group health insurance can attract and retain top talent, especially in competitive job markets. They will feel cared for and supported.
  • Tax Benefit

    According to the Income Tax Act, you as an employer can claim tax deductions for providing health insurance benefits to your employees. The amount of tax benefits depends upon the premiums paid.
  • Comprehensive Coverage

    Many group mediclaim insurance plans to cover a wide range of medical expenses, like hospitalisation, doctor’s visits and much more. Some also extend their coverage to the family members of the employees.

To know more about this, you can visit here- Benefits of health insurance .

Features of Group Health Insurance Plans in India

  • Comprehensive coverage
  • Cashless claims
  • Flexible terms and conditions
  • No waiting period
  • In-patient hospitalisation
  • Maternity expenses
  • Pre and post-natal care
  • Day care procedure
  • Ambulance charges
  • Domiciliary hospitalisation

Eligibility of Group Health Insurance

However, the eligibility criteria depend upon the employer's plan and criteria. Moreover, some general guidelines for eligibility are:

  • Your company must have a minimum of 7 employees.
  • Your new employee must have completed the minimum number of waiting periods which could be 30 to 90 days.
  • Children of the employees must be under the age of 26 years.
  • Dependent parents of the employees.

What’s Covered in Group Health Insurance Plans?

Inpatient Services

  • Hospitalization
  • Surgery
  • Room and board
  • Nursing care
  • Anesthesia
  • Laboratory and X-ray services

Outpatient Services

  • Doctor's visits
  • Specialist consultations
  • Preventive care (e.g., check-ups, screenings)
  • Emergency room visits
  • Mental health services

Other Optional Benefits

  • Dental coverage
  • Vision coverage
  • Maternity and newborn care
  • Rehabilitation services
  • Ambulance services

Prescription Drugs

  • Generic and brand-name medications

What is not included in a group health insurance plan?

  • Cosmetic Procedures
    Procedures such as plastic surgery or liposuction are primarily for aesthetic purposes.
  • Experimental Treatments
    Treatments not widely recognised and accepted by the medical community.
  • Pre-existing Conditions
    Some plans may have limitations or exclusions for pre-existing conditions, especially if they were diagnosed before you enrolled in the plan.
  • Self-Inflicted Injuries
    Injuries caused intentionally by the insured person.
  • War or Acts of Terrorism
    Coverage may be excluded for injuries or illnesses resulting from war or acts of terrorism.
  • Substance Abuse Treatment
    Treatment related to substance abuse may have limitations or exclusions.

Importance of Health Cards in Corporate Mediclaim Policy

A health card in group medical coverage acts as an identity card during hospitalisation. The insurer provides a digital health card that you need to show at the hospital during the billing process for claim settlement. You just need to download the card and show it to the third-party administrator located at the hospital.

How to Claim Group Health Insurance?

Follow these steps to intimate claims for a group health insurance policy:

  • Step-1

    Use your registered mobile number to log in to the PolicyX user account.

  • Step-2

    Click on ‘Claim corporate health policy”.

  • Step-3

    Enter the necessary details and submit a soft copy of the documents. Now, your claim will be submitted and the amount will be credited to your account.

There are two different types of group mediclaim policy claim processes. Read here about both the claims.

How to Buy a Group Health Insurance Policy?

To buy a group health insurance plan, you need to follow these steps

  • Step-1

    Visit the PolicyX health insurance page, and enter the details of your company and strength.

  • Step-2

    Click on 'Get free quotes' and compare Group health insurance plans as per your needs.

  • Step-3

    Select and pay premiums online for the purchased group health insurance plan of your choice.

  • Step-4

    Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your office health insurance plan.

What is the renewal process of a group health insurance policy?

  • Step-1

    Visit the PolicyX.com website.

  • Step-2

    Click on the ‘Renew’ tab

  • Step-3

    Mention your ‘Policy Number’ and 'Date Of Birth'

  • Step-4

    Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your group health insurance plan.

Connect with our insurance experts for your group health insurance policy renewal at 1800-4200-269

Documents Required To Buy Group Health Insurance

There are certain documents required for the claim settlement process of a group health insurance that are mentioned below:

  • Medical reports
  • Doctor’s prescription
  • Form filled with the doctor or hospital’s signature
  • Hospital bill
  • Police report in case of accident
  • Discharge report
  • Other necessary documents are required by the insurance provider.

Conclusion: Group Health Insurance For Employees

Group health insurance offers a win-win situation for both employers and employees. It makes work-life balance easy for the employees. And employers can be able to retain top talent. Also, the tax benefit is an add-on that employers get for paying the premiums.

So are you ready to explore corporate health insurance plans for your company? PolicyX can help you compare quotes, understand different features, and choose the best plan that fits your needs and budget.

Visit our website or contact our insurance experts for a free consultation.

Group Health Insurance: FAQ's

1. What is the age limit for group health insurance?

Employees and spouses are covered up to the age of 65 years, children are covered up to 25 years of age and parents up to the age limit of 80 years.

2. What is the minimum number of employees for group health insurance?

As per IRDAI, a business should have at least 7 employees to be eligible for a group health insurance plan.

3. How to claim group insurance?

You can either opt for a cashless claim or a reimbursement claim.

4. Does group health insurance offer maternity coverage?

You can get optional benefits for maternity in group health insurance.

5. Where can I compare group health insurance?

You can visit PolicyX.com to compare group health insurance plans and get exciting discounts for buying.

6. Is group health insurance policy compulsory in India?

Yes, after the COVID-19 pandemic, all companies must provide group health insurance to their employees.

7. Can I convert group health insurance to the individual?

Yes, you can but then your premiums will be changed. To convert your policy, you need to contact your insurer.

8. What is GMC in group health insurance?

GMC stands for Group Medical Cover. It is also known as corporate health insurance or employee medical health insurance.

9. How is the premium of a group health insurance calculated?

The premium of your group health insurance depends upon the number of employees, average age, number of dependents, and locations of your company.

10. Who pays the premium for the group mediclaim policy?

Most of the time, employers pay the premium for the group medical insurance policy. However, in some companies, the premium is paid on a sharing basis.

Health Insurance Companies

Explore top health insurance companies to buy the most suitable mediclaim policy for families.

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Simran saxena

Written By: Simran Saxena

An explorer and a curious person, Simran has worked in the field of insurance for more than 3 years. Travelling and writing are her only passion and hobby. Her main agenda is to transform insurance information into a piece that is easy to understand and seamlessly solves the reader’s query.