Keep These Points in Mind to Evaluate Group Medical Cover:
Renewal of group health policy takes place every year. But before you plan to renew your existing group cover, there are a few points to consider to evaluate group medical cover that offers your employees cost-effective and the best coverage.
Achieving the Objective
Whenever you plan to buy group medical cover for your employees, it aims to serve a broader objective. However, just setting up objectives isn’t enough. They need to be evaluated to find out whether the objectives have been met.
For instance, an employer may provide employee medical insurance to reduce sick leave or lower employee stress levels. So, at the time of renewal, the employer should evaluate if these objectives were met. If not, what steps could be taken to achieve them?
Sufficiency of the Coverage
Typically, a group health plan for employees is taken to reduce their financial burden at the time of a medical emergency. This can be achieved if there is sufficient and wide-range coverage for employees. Some features that group insurance should ideally possess may include a low or no co-payment clause, coverage for pre-hospitalization and post-hospitalization expenses, maternity cover, inclusion of dependents, etc.
Updated Features
Group health plans for employees have come a long way. From traditional offerings to being wellness-focused, these plans are now breaking the mold and are getting innovative and need-based. The employer can thus opt for such innovative products if the current plan does not cover these features.
Changes in Policy Terms
Insurance companies can change the policy’s terms and conditions after taking the required approval from the Insurance Regulatory and Development Authority of India (IRDAI). Also, they have to mandatorily inform the policyholder or the insured about the changes 90 days before the renewal. It is thus recommended to learn if there are any changes in the policy term or conditions before the renewal.
Changes in the Network of Hospitals
Sometimes, insurers may make changes to the existing list of the network of hospitals. It could be possible that this list might no longer include some hospitals that were convenient for a majority of your employees. Thus, evaluating this aspect of your group health plan is very important.
Pricing Factor
While evaluating group health plans for employees, the pricing factor cannot be ignored. Due to the myriad of offerings from insurance companies, the insurance market has become highly competitive even in terms of the premium price. There may be situations when the premium amount may rise at the time of renewal.
Hence, one should always analyze the additional cost and make an informed decision on incurring that extra cost. Often, this aspect is ignored by employers, and they end up paying relatively higher prices at the time of renewal.
Conclusion
Evaluating group health plan for employees has tremendous advantages both for the employer as well as for the employees. Products are now designed to cater to the needs of the employees. The employer thus has the privilege to choose a product that aligns with employee needs and is cost-effective.
