Understanding the Graded Cover in Group Health Insurance

The insurance premium is generally linked to the cost-to-company (CTC) of an employee. It is paid by the employer on the basis of the salaries of the employee. The graded cover in group health insurance offers several sums assured to different employees. The benefits of such insurance are based on the group grades.

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
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

Graded Cover in Group Health Insurance

Many employees do not pay any heed to the graded cover in group health insurance. Insurance companies offer different benefits to employees based on their criteria. Therefore, the employees must understand the eligibility criteria for high coverage. Further, they must verify or check if the eligibility criteria are correctly applied.

Let us discuss the graded cover in group health insurance on the following basis.

  1. Designation

    The insurance benefits are generally differentiated based on the designation of the employee. The criteria of designation are applied for health, accident and life insurance policies. Therefore, the sum is assured based on the designation level. Further, the designation is categorised into three or four groups. The sum assured is determined for each group.


    • The employees working on the field level or low level can be offered health insurance or the sum assured of INR 3 lakh. Therefore, during the medical expenses, INR 3 lakh shall be reimbursed to such employees.
    • The graded cover in group health insurance for the middle or supervisory level of employees can be determined as INR 5 lakh. Therefore, an amount of up to INR 5 lakh shall be reimbursed to the employees in case of a medical emergency.
    • The employees placed on the top level of management are entitled to higher sum assured. So, they may obtain a sum assured of INR 10 lakh. Therefore, such employees shall be paid up to INR 10 lakh during a medical emergency.
  2. Salary

    The insurance benefits can also be based on the salaries of employees. The CTC of the employees has a crucial role to play in order to determine the group insurance benefits.

    It is common to link the salaries of employees to insurance coverage. The insurer may make it obligatory to offer coverage that should not exceed 10 times the salary or CTC of employees.


    • An employee earning INR 2 lakhs per annum can be assured of coverage of up to INR 5 lakh in case of a medical emergency.
    • In addition, an employee with a CTC of INR 10 lakh can be guaranteed medical coverage of up to INR 15 lakh for medical expenses.

    The employees must contact HR to verify if the sum assured is updated upon an increment in the salary. The nominee may find difficulties while claiming the appropriate coverage if the salary is not updated to the coverage.

  3. Family Size

    The family size is another option to differentiate the benefits of a group health insurance policy. It is generally applicable in healthcare insurance when the family has also been added to the group health insurance scheme.


    • A company may provide INR 2 lakh health coverage to an unmarried employee.
    • Further, the company may offer INR 5 lakh healthcare coverage to a married employee but no child.
    • Furthermore, the company may offer coverage of INR 10 lakh to a married employee with two children.


The employee must keep his current designation, CTC and family status updated to the group insurance coverage. In addition, the employee must understand the basic of the sum assured to comprehend the coverage.

Written By: PolicyBazaar - Updated: 19 April 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 14637 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 7579 Views
A group medical insurance scheme offers many benefits in addition to providing financial support during medical...Read more
08 Feb 2023 by Policybazaar 6988 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 6537 Views
Adequate health insurance forms an important component in a sound and practical personal financial plan. Its...Read more
21 Sep 2022 by Policybazaar 6782 Views
Nonprofit organisations are crucial in bringing about social...Read more
27 Feb 2024 by Policybazaar 30 Views
In today's fast-paced and competitive world, mental health...Read more
23 Feb 2024 by Policybazaar 54 Views
In today's fast-paced and competitive world, the importance of...Read more
22 Feb 2024 by Policybazaar 49 Views
Group health insurance for high-risk occupations (GHI) plays a...Read more
13 Feb 2024 by Policybazaar 95 Views
Providing health insurance coverage to employees is a gesture of...Read more
08 Feb 2024 by Policybazaar 95 Views
Policybazaar for Business - Group Health Insurance - Customer Reviews
View all
Based on 189 reviews
out of 5
Based on 189 reviews
38 users
136 users
15 users
0 users
0 users
3.8 April 09, 2023
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.
4.3 April 01, 2023
Necessary Investment
It is a good and necessary investment. Thanks PB.
4.3 March 24, 2023
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.
3.8 March 16, 2023
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.
4.3 March 15, 2023
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.
3.8 March 02, 2023
Great Experience
I got great deals on PolicyBazaar website. Highly recommend.
4.3 February 17, 2023
Excellent Purchase
It was a excellent purchase at PolicyBazaaar. Thankyou team.
4.3 February 04, 2023
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
4.3 January 22, 2023
Budget Friendly Purchase
Thankyou PolicyBazaar for providing such a great plan at affordable premium rates. It was a budget-freindly purchase.
4.3 January 09, 2023
Multiple Range Of Benefits
I purchased Group health Insurance which offered me plans with affordable rates Thankyou PB.