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Group Mediclaim Insurance Policy

Benefits

​​
​₹50K & ₹1 Lac
of sum insured available
7 to 1000
workers can be covered
9,1​00​​​+
​cashless network hospitals

There’s more you can do for your employees than a salary. Taking care of their health with the help of a group health insurance plan can be the very thing they need. With Reliance General Insurance, you have a group mediclaim policy that’ll keep you and your employees happy.

What is Group Health Insurance? 

When a group of individuals, generally those working in the same organisation, are covered under a single health insurance policy, it is known as a group health insurance. 

Companies offer this as a perk to current and potential employees as a way to retain or attract them. 

A group health insurance policy is an economical and efficient way to offer health coverage to an organisation's employees. 

Benefits of Buying a Group Health Insurance Plan

Securing health insurance coverage for employees via a group mediclaim policy has several benefits. These benefits apply to both employees and employers alike. 

Take a look at the benefits of buying a group health insurance plan: 

1. Helps employers maintain their manpower

Offering health insurance coverage for its employees is one of the most attractive perks they can give. Employees would always look for this benefit when they're looking to switch or whether they're deciding to stay.

2. Tax benefits for employers

Under Section 17 of the Income Tax Act, 1961 employers get tax deductions for payment of premiums towards group health insurance. “Profits in lieu of salary" is the clause that states the tax deductions that employers receive.

3. Employees get free health coverage

Since the premiums are paid by the employers, it effectively means that employees get free health insurance for themselves and, depending on the company, their dependents.

4. Better job satisfaction

A perk through a group health insurance is the slight job satisfaction and mental well-being boost. It'll keep employees or attract them to your organisation. 

Group Health Insurance Plan from Reliance General Insurance

Every organisation needs a group mediclaim policy that will make the lives of both employers and employees better. 

At Reliance General Insurance, we have a comprehensive employee health insurance plan that will keep your team happy.

Reliance General Health Insurance Plan for Groups

Feature Benefit
Sum Insured₹50,000 & ₹1,00,000
Employees that can be covered7 to 1,000 employees
Number of Cashless Hospitals9,100+ Network Hospitals

 

Key Features

Here's what your employees get under a group health insurance plan: 

1. Inpatient care

This covers a variety of treatments that require at least overnight hospitalisation. Medical procedures like surgeries which require a prolonged stay at the hospital are covered under a group health insurance. 

2. Pre and post hospitalisation expenses

Any expenses incurred during any procedures before the actual hospitalisation and even those that are required after the treatment are covered under a group mediclaim policy. 

3. Pre-existing disease cover

Illnesses that an employee had before issuing the group health insurance are covered. These include diseases like heart problems, diabetes, blood pressure, etc. No waiting period is imposed on employees unlike an individual health plan. 

4. Cashless treatments

One of the primary benefits of an employee health insurance is the facility of cashless treatments. Cashless treatments can be availed at network hospitals where the medical bills are settled between the insurer and the hospital. Having cashless treatments eases the ordeal that an employee goes through in the unfortunate event of a hospitalisation.

5. Cover for family members

Some group health insurance plans offer the option to include spouses and children too. This is an additional benefit that will keep employees happy and relieved that their family is covered with a health insurance.

What is Covered in This Plan?

  • Individual cover for your worker
  • Pre-existing disease covered**
  • Workers aged 18-60 years can be covered
  • Maternity benefit**
  • Room rent charges covered#
  • Pre-30 days & post 60 days hospitalization
  • Road ambulance charges covered#
  • Day care procedure covered 

What is Excluded in This Plan?

  • Domiciliary hospitalisation
  • Robotic surgery/treatment done using this technology/robotically assisted surgery
  • Stem Cell Transplantation/bone marrow transplant
  • Septoplasty
  • Cochlear Implant or related aids
  • RFQMR - Rotational Field Quantum Magnetic Resonance Device - Cytotron
  • C3R
  • Balloon Sinuplasty
  • Bariatric surgery
  • Inj Avastin /Lucentis/Macugen
  • Ozone Therapy
  • Enhanced External Counter Pulsation Therapy (EECP)
  • Rejuvenation therapy
  • Lasik Surgery

Click here to know mor​e about the policy exclusions of the Group Mediclaim Policy.

T&C apply. Details mentioned here are for the product- Group Mediclaim Policy.
 ​
*As per the definition as given u/s 2(l) of The Factories Act 1948 as amended from time to time) mandated under clause no. 5 of Annexure-II of the Revised Guidelines issued by Ministry of Home Affairs, GOI vide order no. 40-3/2020-DM-I (A) dated 15th April, 2020.
**Available as add-on covers and not included in the base policy cover.
#Sub limits are applicable, please read the policy document for more details.

Eligibility Criteria For Group Health Insurance

Check out the criteria for a group mediclaim policy below:​​

Entry Age for Employee18 years to 70 years
Entry Age for Spouse18 years to 70 years
Entry Age for Dependent Children91 days to 25 years
Newborn CoverFrom birth till 90 days


How to File a Claim

Filing a claim is simple and quick today. Here's how you can file a claim with Reliance General Insurance:

Cashless Claim Reimbursement Claim

Step 1:

Inform the claims team. You can inform them by emailing, logging into the Self-i App or calling 022-48903009 (paid)

Step 1:

Inform the claims team. You can inform them by emailing, logging into the Self-i App or calling 022-48903009 (paid)

Step 2:

Submit details like type of treatment and all relevant documents

Step 2:

Submit details to the claims team and make the necessary payment at the hospital.

Step 3:

The claims team will settle the bill directly with the hospital

Step 3:

Scan and send your bill and other document to the claims team within 7 days of recharge to get reimbursed.


Why Every Organisation Should Buy a Group Medical Insurance?

As stated earlier, there are many benefits an employers can reap by purchasing a group mediclaim plan. This not only benefits employers but even employees benefit from it. 

Given the importance of a group health insurance, here are some advantages of buying one: 

1. Group health insurance is affordable

In today's day where almost every company is offering medical insurance coverage for its employees, you don't want to be left behind. Therefore, it is imperative that you find the most economical way to cover your employees. So rather than depending on individual policies, a group health insurance plan will prove more affordable than the former option. 

2. Extend coverage to family members

Employees can experience some kind of mental peace when they know that their family - be it a spouse, kids, or parents - are covered with health insurance. Depending on the group health insurance policy, employees can include their dependents too. 

3. PEDs are covered from day 1

Generally health insurance plans come with waiting periods ranging from the initial 30-day waiting period to the longer waiting period for pre-existing diseases. In a group health insurance plan, there are no waiting periods and even pre-existing diseases are covered from the day the policy is issued. 

4. Employees get free coverage

The primary benefit for employees is the benefit of free health coverage. Since all payment of premiums are borne by the organisation, employees can rest easy knowing they've got their health covered. 

5. It keeps employees happy

Ultimately, all the perks of an employee health insurance leads to this, that is, a sense of security in times of a medical crises. It'll keep them happy and motivated to continue.​

What Should an Organisation Consider Before Buying a Group Health Insurance Plan?

Before buying a group mediclaim policy, an employer should keep certain factors in mind. This will help them get an affordable health plan that will benefit employees the most. 

So, here are some factors to consider before buying a group health insurance plan: 

1. Useful Benefits

The most important part of selecting group health insurance is finding out whether it has benefits that will prove useful to the employees. Having such a health plan will bring that added delight to an organisation's employees. 

2. Coverage and Premium Amount

The best group mediclaim policy will offer valuable benefits while being economical at the same time. Therefore, an employer should consider premium amounts and how much the sum insured will be. 

3. Network Hospitals

One of the most vital deciding factors to selecting a group health insurance plan, or even an individual health insurance, is the number of network hospitals. More number of network hospitals means employees can avail cashless treatments easier. Thus, you can make it smoother for employees to deal with emergency treatments with a group health insurance that has more number of network hospitals. 

4. Service

Another deciding factor in buying a group health insurance policy is the service the insurer provides. Are they quick in providing resolutions? How is the claim process? Do they have a good track record in servicing its clients? Check online reviews of the insurer and its claim settlement ratios to understand how they deal with its customers. 

What is the Difference Between a Group Health Insurance Plan and an Individual Health Insurance Plan?

Health insurance plans for groups and individuals share some similarities while being vastly different in whom they serve. The primary purpose remains the same, however, that is to provide health coverage. 

Here are the main differences at a glance: 

Individual Health Insurance

An individual health insurance plan is a policy that is purchased by a person to insure themselves from paying high medical expenses and hospitalization bills. 

You can buy a health policy for yourself, or your spouse, or children, or even for your elderly parents. The premium rate is calculated based on policyholder's age, gender, medical history, and much more. You should know that premium paid in this type of health plan can be expensive. 

However, in such plans, you can get a more comprehensive cover that will target your personal needs. You can also avail add-ons to enhance your coverage. 

Group Health Insurance

As the name suggests, group health insurance plans are purchased when a group of people wants to get insured. These are more common in the corporate world where employers buy this plan for their staff. 

But social groups, sports teams, and joint families can also buy this health plan. The premium is calculated based on the size of the group, the industry the company operates in, demographics of the people involved, and much more. Buying a plan for a group will reduce the premium rates but it will also reduce some of the benefits that you would typicallly get in an individual health plan. 

Individual vs Group Health Insurance: Pros & Cons

Given below are the pros and cons of the individual and group health insurance plans:

Pros

Individual Health Insurance Group Health Insurance
More flexibility in the tailoring of coverageCheaper coverage for better conditions
You will have more control over co-pays, deductibles, and benefit limitsEven if you are suffering from a pre-existing condition, you will get the coverage without any test.
You can research and choose the insurance company that you likeSome brokers offer extra administration and claims support to corporate clients
You don't have to be employed with a company or be with a group to be eligible for the health plan.Lower premium rates

Cons

Individual Health Insurance Group Health Insurance
Higher premiumsYou won't be able to set coverage benefits and limits
Extra costs, or no coverage for pre-existing conditionsYou can only be insured under the plan as long as you're employed. Once the employment ceases, you will no longer be covered.
Lack of support for using the plan where some insurers and brokers are concernedYou don't have authority on the plan. 

Topics Related to Group Health Insurance​

Health Insurance | Health Insurance Plans for Family | Personal Accident Insurance | Medical Insurance | Mediclaim | Senior Citizens Health Insurance | Critical Illness Insurance | Health Insurance for Parents | Medical Insurance Plans | Health Insurance Tax Saving | Online Health Insurance | Compare Health Insurance Plans

Group Health Insurance FAQs 

1. Who all can be covered in a group health insurance policy?

Any individuals who are part of an organisation as employees can be covered under a group health insurance policy. In some case, even credit card companies offer health insurance to its customers, which is another form of group health insurance. 

2. Can I have a corporate health insurance and individual health insurance at the same time?

Yes, you can have both a corporate health insurance and an individual health policy at the same time. A corporate, or employee health insurance, is given at the sole discretion of the organisation as a perk. But buying an individual health insurance plan is completely dependent upon the individual. 

3. What are the limitations of a group health insurance?

A group health insurance policy, though very useful to employees, has certain limitations. The main limitation comes in the form of over dependence on an employee health insurance. However, this can easily be countered by taking an individual policy. Then there's the limitation of no tax benefits for employees, lack of customisation options, etc. 

4. How is a group health insurance different from an individual health insurance?

As the name suggests, the main difference lies in who is covered under the plan. An individual plan covers only the individual (plus any family if a family floater plan is taken). A group health insurance, on the other hand, covers a group of people, usually employees in an organisation. 

5. When should I get a group health insurance for my employees?

As of April 2020, the IRDAI mandated all “industrial and commercial establishments, work places, offices, etc." to provide health insurance for their employees. So, as an employer, you're required to offer health insurance coverage to all existing and new employees. 

6. Does a group health insurance plan offer maternity benefits?

There are some group medical insurance plans that offer maternity benefits. Maternity benefits may include coverage for childbirth, pre-hospitalisation and post-hospitalisation expenses, care for newborn, vaccination cover for newborn, etc. 

7. Do I have to undergo medical tests to be included in a group health insurance policy?

No, companies generally don't require you to undergo a medical test to be included in the employee health insurance. The process to add you in a group mediclaim policy begins from the day you join the organisation. 

8. Is there any age limit to be covered under a group health insurance plan?

There is an age limit for a group health insurance policy which generally starts from 18 years till the individual is with the company. For dependent children, coverage starts from 91 days till 25 years and newborns will be covered from birth till 90 days.​​​​​​