How to Determine A Small Group & A Large Group
The number of employees working under you determines the small and large group. We live in the era of start-ups and when you start a company, the first and foremost thing you have to do is hire fresh talents that would help you in growing the company. However, as per the Insurance Regulatory & Development Authority of India, an employer must have at least 20 employees working in the company to be eligible to purchase a group health insurance policy.
But, insurance companies have divided group health insurance plans into two categories. One is a small group and the other is a large group. So, if a company has up to 50 employees then it will be considered a small group, and the company will have to opt for small group health insurance. Similarly, if a company has more than 50 employees then it will be considered a large group, and the company will have to opt for large group health insurance.
How to Qualify for Small Group Health Insurance?
In order to purchase a small group health insurance for your company. You need to qualify by fulfilling the below-mentioned requirements:
- As per IRDAI, the company must have at least 25 employees to purchase a group health insurance plan.
- The company must have more than 25 and up to 50 full-time employees to purchase a small group health insurance.
- Every insurance company has a different set of rules hence the requirements to purchase a small group health plan may vary from one insurer to another.
- If a company has part-time employees then they will have to turn them into full-timers and then go for the small group health insurance.
How to Qualify for Large Group Health Insurance?
In order to purchase a large group of health insurance, you will have to fulfill the below-mentioned requirements:
- The company must have more than 51 employees working full time.
- Every insurance company has different terms and conditions, if the terms and conditions are in your favor then you can purchase a large group plan.
- Every insurance company has different eligibility criteria and if you meet the specified eligibility criteria of your desired insurance company then you can purchase it.
Coverage Provided Under Small & Large Group Health Insurance
Coverage provided by insurance companies under small and large group health insurance plan varies from one insurer to another. However, here are some of the common coverage provided under these insurance plans:
- Lab tests
- Prescribed medicine
- Pre and post hospitalization charges
- Preventive health care
- Ambulatory services
Difference Between Small & Large Group Health Insurance
Both insurance plans have certain differences. One of the obvious differences is the kind of coverage these plans provide. Since a small group plan provides coverage to a small group of up o 50 employees whereas a large group plan provides coverage to more than 51 employees.
Apart from this, the premium amounts of both insurance plans are different. If you have a small group of employees then the premium could go higher however if you opt for a large group of health insurance then the premium amount would be lower. Again, it may vary from one insurer to another.
These are some of the primary reasons behind the difference between small group health insurance and large group health insurance. So while purchasing the insurance plan whether for a small group or large group do your research thoroughly, compare different plans, and do not settle for a lower coverage in order to pay a lower premium. Make sure that the insurance plan has some value for the employees.
Be it a small group or a large group, purchasing a group health insurance plan can be a hectic process. This is why it is advised to purchase the insurance plan online instead of offline. Also, the insurance policy you provide to your employees should serve some value and make sure it does not go in vain. You can make sure of it by educating your employees about the benefits of the insurance plan so that in case of a medical emergency they do not have to pay out of pocket.
Written By: PolicyBazaar - Updated: 26 April 2022