How can Deductibles and Co-pay Help in Lowering the Prices for Group Health Insurance?

Nowadays, the insurer offers different options to the policyholder that helps the latter to deduct the premium cost. Deductible and Co-pay or Co-payment are the two terms which must be understood by a policy buyer. These factors lower the premium prices to some extent. However, both factors are somewhat contrasting and co-related to each other.

Read more
Personalised health plans that fit your organizations requirements & dedicated experts to help you choose.
Customized plans

Affordable prices

24X7 Support

Dedicated claims manager

Total Care

All round wellness benefits

Fast-track your search with instant quotes from top insurers
₹1 Lakh cover starting at
₹110/employee+
No medical test required
Zero waiting period
Paperless claims
secure-icon We don't spam
Get Updates on WhatsApp
By clicking on "View Plans Instantly" you agree to our Privacy Policy and Terms Of Use and also provide us a formal mandate to represent you to the insurer and communicate to you the grant of a cover.

Whom do you want to insure?

  • Employee, spouse & kids

  • Employee only

Role of Deductible in Lowering the Premium of Group Health Insurance

Deductible helps in lowering the premium of group health insurance. The deductible is the amount payable by the policyholder before the insurance company pays the claim amount. The insurer shall only pay the claim amount in case it exceeds the deductible amount.

Case Study

Let us understand how deductible helps in lowering the premium in group health insurance with a case study.

Mr. Mehta applied for subscribing group health policy for his employees for a claiming amount of Rs 1,00,000 per person. However, the employees were fit and not susceptible to health-related issues. Therefore, Mr. Mehta chose a deductible amount of Rs 10,000.

As per the deductible amount chosen by Mr. Mehta, the premium cost is likely to decrease. This is how deductible helps in lowering the premium in group health insurance. Now, if the claim exceeds Rs 10,000, then the insurance company shall pay the remaining amount.

For example, consider a claim is estimated at Rs 20,000. Under deductible terms mentioned in the insurance contract, MR. Mehta is likely to pay Rs 10,000. Another, Rs 10,000 is expected to be paid by the insurance company.

How Co-pay Helps in Lowering the Premium of Group Health Insurance?

Co-pay is the percentage of the claim which is likely to be borne by the policyholder under the group health policy. The policyholder under co-pay may opt for a specific percentage of the total claim payable by the insurance company. The percentage opted by the policyholder shall be borne by him.

The remaining percentage shall be payable by the insurance company. Since some percentage is payable by the policyholder, the insurance premium is likely to decrease. This way, the co-pay helps in lowering the premium of group health insurance.

Let us understand how co-pay helps in lowering the premium of group health insurance with the help of another case study.

Mr. Sharma is the owner of ABC Enterprise. He wished to subscribe to the group health insurance policy in order to indemnify his employees against unforeseeable events. He was offered the Co-pay by the insurance company in a range from 10% to 20%. He opted for 10% and purchased the insurance policy.

According to this, he is likely to bear 10% of the total claim arising from the medical bills of his employees. Since he has opted for co-pay, his insurance premium is likely to decrease. This is how co-pay helps in lowering the premium of the group health insurance.

Due to a health issue, one of his employees was admitted to the hospital. The employer filed the claim by filling out the claim form. The surveyor was appointed who estimated INR 1,00,000 as the total claim.

Out of the total sum, 10% is required to be paid by Mr. Sharma. He paid INR 10,000. The remaining amount was paid by the insurance company.

Difference between Co-pay and Deductible

Co-Pay Deductible
Co-pay is the fixed portion which is likely to be paid by the policyholder. A deductible is the fixed amount which is likely to be paid by the policyholder.
Co-pay is always in the form of a fixed percentage. A deductible is always in the form of a fixed sum.
Co-payment can opt only for a specific type of health insurance. Deductible can be opted for in most health care policies.

Conclusion

Co-pay and deductible help in lowering the premium for group health insurance. Some portion of the claim is paid by the insured. Therefore, it helps in lowering the prices of premiums of group insurance policy.

Written By: PolicyBazaar - Updated: 24 May 2023

Wait! Didn't find what you were looking for?

Our certified business insurance experts are just a call away.

Call scheduled successfully

Thank you
Our experts will provide you assistance with your
insurance coverage. Be assured, all your questions
will be answered

Customizable plans from top insurers

starting @ ₹110/employee*

View Quotes
Group Health Insurance Articles
GIPSA stands for General Insurance Public Sector Association.It is a group of four General insurance companies...Read more
28 Apr 2022 by Policybazaar 14525 Views
Employee welfare is one of the prime responsibilities of an employer. It helps in the smooth functioning of the...Read more
29 Nov 2022 by Policybazaar 7475 Views
When it comes to insurance, it's important to have a clear understanding of the available options. GPA (Group...Read more
01 Jun 2023 by Policybazaar 6439 Views
A group medical insurance scheme offers many benefits in addition to providing financial support during medical...Read more
08 Feb 2023 by Policybazaar 6903 Views
Adequate health insurance forms an important component in a sound and practical personal financial plan. Its...Read more
21 Sep 2022 by Policybazaar 6708 Views
In today's fast-paced and competitive world, mental health...Read more
23 Feb 2024 by Policybazaar 20 Views
In today's fast-paced and competitive world, the importance of...Read more
22 Feb 2024 by Policybazaar 18 Views
Group health insurance for high-risk occupations (GHI) plays a...Read more
13 Feb 2024 by Policybazaar 64 Views
Providing health insurance coverage to employees is a gesture of...Read more
08 Feb 2024 by Policybazaar 69 Views
In the corporate sector, the health and happiness of employees...Read more
14 Nov 2023 by Policybazaar 342 Views
Policybazaar for Business - Group Health Insurance - Customer Reviews
View all
4.4/5
Based on 189 reviews
4.4
out of 5
Based on 189 reviews
38 users
136 users
15 users
0 users
0 users
3.8 April 09, 2023
Mansi
Excellent Support
It was easy to buy insurance from PolicyBazaar website and customer support was also amazing to clear all the doubts.Thankyou. Highly worth it.
Dehradun
4.3 April 01, 2023
Mahesh
Necessary Investment
It is a good and necessary investment. Thanks PB.
Lucknow
4.3 March 24, 2023
Surya
Provides Satisfactory Results
I purchased Group health insurance at policybazaar recently and i am so much satisfied with the plan. The application process was smooth and efficient, making the typically tedious task of getting insurance surprisingly hassle-free.Thanks PB.
Bareilly
3.8 March 16, 2023
Naveen
Helpful In Making Decisions
When it came to selcting the right Group Health Insurance, Policybazaar offered an impressive range of options from reputable insurers. I appreciated the comprehensive details avalable for each policy which helped me to take the better decisions. Thankyou.
Delhi
4.3 March 15, 2023
Rajesh
Increases Clients Expectations
I recently had the pleasure of securing a Group Health Insurance policy throug PolicyBazaar and I must say the Entire process exceeded my expectations! From start to finish, their service werw great. Thankyou.
Delhi
3.8 March 02, 2023
Ravi
Great Experience
I got great deals on PolicyBazaar website. Highly recommend.
Pune
4.3 February 17, 2023
Diljeet
Excellent Purchase
It was a excellent purchase at PolicyBazaaar. Thankyou team.
Coimbatore
4.3 February 04, 2023
Satya
Prompt Services
Policybazaar's efficient claims process was impressive. In case of any medical emergencies, my employees were able to get their claims settled swiftly, allowing them to focus on their health and recovery without worrying about financial aspects.Thankyou
Chennai
4.3 January 22, 2023
Abhishek
Budget Friendly Purchase
Thankyou PolicyBazaar for providing such a great plan at affordable premium rates. It was a budget-freindly purchase.
Delhi
4.3 January 09, 2023
Abhash
Multiple Range Of Benefits
I purchased Group health Insurance which offered me plans with affordable rates Thankyou PB.
Pune