Is Group Health Insurance Compulsory In India?

Group health insurance policy provides coverage to the insured employee in case of a medical emergency. It takes off the financial burden from the employee’s shoulder as the insurance company steps in to pay the hospital bills.Post Covid-19 lockdown, the Government of India made group health insurance mandatory for the employees which means that employees can get health insurance coverage for free.

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*Premium starting from ₹105/Employee/Month for ₹1 Lac Sum Insured covering Health & Wellness Needs (excluding GST)
#Premium may vary on the basis of coverage type & add-ons
**All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

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Disclaimer: The above plans and premiums are for 1 Lakh sum per life per month covering Health and Wellness needs of 7 Employees, 5 Spouse & 2 Kids below 35 years of age. The premium is inclusive of GST and do not cover PEDs & Maternity. Standard T&C Apply PolicyBazaar does not rate, endorse or recommend any particular insurer or insurance product offered by the insurer.

Why Group Health Insurance Compulsory?

Most of the employees in India do now no longer pass for clinical advantages because of loss of awareness. They have been wondering "Is worker coverage obligatory for our employees". However, there are numerous agencies that provide clinical advantages for employees in India.

Now a lot of employers are looking online for satisfactory institution medical health insurance plans to shield their employees now that the authorities have made it obligatory for employers to offer medical health insurance for employees in India.

Before this penitentiary choice via way of means of the authorities, health insurance advantages for employees in India weren’t obligatory for employers to offer coverage to their workforce. Although a few groups have been a step ahead & already blanketed their employee and their respective households thru institution medical health insurance plans.

Following the activities of 2020, new guidelines were installed place. These guidelines additionally awareness on employees who paintings past pinnacle metro towns and in smaller firms.

Should Every Employer Provide GHI?

Well yes, as part of the Revised Consolidated Guidelines for Resumption of Work Activities of the Ministry of Home Affairs, on 15 April 2020, the IRDAI of India issued an Order (403/2020 DMI (A)) which establishes that all industrial and commercial establishments, offices, workplaces, etc. they must follow a standard operating procedure.

The SOP includes workplaces, factories, social distancing for offices and establishments, medical insurance for workers is mandatory. In the circular, the regulator recommends that insurers offer comprehensive health insurance policies to individuals or groups.

IRDAI has also motivated insurance companies to design comprehensive health insurance products at a cost that organizations can afford. In this way, organizations can comply with current guidelines. He further stated that organizations should be able to continue medical insurance policies taken out by insurance companies not just for now, but for the rest of their lives. Employees who are below the salary limit of Rs.21,000 can obtain coverage in employees' public insurance (ESI) and the foregoing may seek coverage as part of the Group Medical Unit (GMC).

Benefits of Group Health Insurance For Employers

Here are several benefits of group health insurance for employers:

  • It is a more affordable option than retail health
  • Employers can take advantage of the many benefits of providing employee health
  • It is a good retention tool because employees know that employers take care of their
  • Increase employee morale and
  • Group health insurance can also cover spouses, children and family
  • Employers who provide health insurance to their employees may receive tax benefits in several sections of the Income Tax
  • It covers pre-existing conditions and illnesses and offers maternity coverage from day one that is not available with retail policies.

Benefits of Group Health Insurance For Employees

Here are some of the benefits of group health insurance for employees:

  • Employees do not have to pay for the group health insurance out of pocket.
  • Employees get medical coverage for their dependents as well.
  • The claim settlement process is more seamless in GHI than individual health insurance.
  • GHI also provides coverage for maternity as well as OPD benefits.
  • There is no waiting period in the group health insurance policy.
  • Under group health insurance, employees can raise a claim for pre-existing diseases.

Recent Updates in GHI Coverage

Here are some updates in Group health insurance coverage:

  • According to a circular dated April 1, 2020, issued by the Insurance Regulatory and Development Authority of India (IRDAI), medical insurance is to be made
  • Updates Prior to2020 there were no specific rules requiring such However, after the pandemic last year, the authorities introduced new regulations in this regard.
  • This circular was issued by IRDAI to the health insurance fund to implement the directives of the Ministry of the Interior. 
  • Post-lockdown, businesses were asked to follow a standard operating procedure to return to work, and offering workforce insurance was one of
  • IRDAI advised non-life insurers to develop comprehensive, affordable, and simple

Conclusion

Health insurance coverage has become a necessity. If you are employed then you do not even have to purchase it because after the Covid-19 lockdown and witnessing the wrath of Covid-19 the Government of India made it mandatory for all employers to provide group health insurance. You can always go to your HR manager to ask them about the group health plan and the kind of coverage it provides along with the sum insured amount. Better be sure than sorry.

Written By: PolicyBazaar - Updated: 10 March 2022
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