Can employees customise their coverage options within a group insurance scheme, including corporate health insurance?

A corporate health insurance policy is a simple, convenient, cost-effective and customisable way for companies to provide health insurance to their employees. While this means that a company can easily customise and build the right policy based on their particular needs with dozens of coverages or keeping affordability in mind, employees may have little say on the specifics of an individual policy. 

So, while it depends on the type of organisation you work at and the specific company, here is all you need to know about employees group insurance schemes, how much customisation is possible for group health plans, certain essential coverages to look out for, and whether you should consider getting an additional policy individually. 

What is employees group insurance scheme?

Employees group insurance schemes allow companies to provide health insurance coverage to all employees in a single unified policy regardless of age, gender, occupation, or socio-economic status. This makes it an excellent option for companies as the Indian government requires all professional organisations to provide health insurance to their employees. While this might have been difficult in the past, with the popularisation of ​​ group insurance plans, providing group health coverage is possible simply and cost-effectively.

How much is it possible to customise the coverage options within group health plans?

Depending on the specific insurance provider you approach, it is possible to fully customise group health plans based on the group's needs. While it is not possible to opt for coverage for certain permanent exclusions of the policy, it is possible to opt for a policy that even covers risks that were not originally covered as part of the plan. Whether it is coverage for pre-existing conditions, maternity and newborn expenses, coverage for dependents, or anything else, it is possible to build the best plan for the group's needs. 

For example, as the needs of employees sitting at their desks differ from those of employees working at an oil refinery using manual labour, a policy can be customised based on this. If your company is willing, it can customise the policy based on the employees' needs, providing coverage for relevant risks. Consult with an insurance agent to understand what is customisable and what is not. 

What are some coverages to look out for in group insurance plans?

There are several essential benefits of group health insurance which must be considered by both employees and companies opting to provide group health coverage to their employees. 

1. Coverage for both in-patient and out-patient medical expenses.

2. Coverage for occasional health check-ups with precautionary diagnostics and preventative healthcare.

3. Coverage for pre-existing conditions such as diabetes, hypertension, etc.

4. Coverage for maternity expenses.

5. Coverage for dependents, including spouses and children. 

6. Plans with zero waiting period for coverage.

7. No or low co-pay for coverage.

Should you get an individual health insurance plan over employee group insurance?

Providing employees with group insurance is highly beneficial for both the employees and the organisation. While it ensures financial security and peace of mind when dealing with medical risks to the employees, it also creates a safe and productive working environment in the company, boosts employee morale, and builds employee loyalty, all while attracting new talent. 

While it is highly beneficial for employees who get employer-sponsored health insurance plans with coverage for expected and unexpected medical risks, there might be additional needs for employees that must be addressed. Suppose your company does not address or consider these specifics. In that case, opting for an additional individual health insurance plan to supplement the gaps and get the best coverage for your needs might be beneficial.

Conclusion

So, while group health plans are highly customisable, allowing companies to build the best plan at the best price for their particular needs, it might not always be possible for a company to accommodate the specific needs of every individual. This is why, in certain circumstances, individuals might need to opt for an additional policy to supplement their needs and secure their financial and medical well-being and that of their loved ones.