Sign In
For claim assistance in the cyclone affected areas of the EAST, please click here. Similarly, for assistance with claim related queries in the flood affected areas of Kerala and Himachal Pradesh please click here. To get assistance with claims for flood affected regions of Telangana and Andhra Pradesh, please click here.

What is Group Health Insurance?: Meaning, How It Works, Benefits

Is There a Car Insurance Claim Time Limit?

​Group health insurance is like a common umbrella that protects all the members of a group in the event of medical emergencies.

If you are an employer or administrator of any group or organisation, you can buy a group health insurance policy to offer financial coverage to your employees or group members during their health-related crises.

To learn more about what is group health insurance, how it works and what are its benefits, keep reading!

What is Group Health Insurance Policy?

Group health insurance is a type of insurance purchased by employers and organisation leaders to cover their employees for their medical expenses. It is usually given as a benefit for joining the organisation.

The main objective of group health insurance is to offer necessary financial support to all the insured members regardless of their age, gender, designation and income level. Not just the insured members; the coverage of group health insurance can also be extended to their spouses, parents and children.​

How Group Health Insurance Works?

The working of group health insurance is straightforward. An employer or group leader purchases a group health insurance policy based on the number of members and their coverage requirements.

Once policy is purchased, the employer pays a fixed percentage of its premium, while employees contribute towards the plan through regular deductions in their salaries. In some cases, the employer may pay the entire premium while the employees receive the covered benefits.

Features of Group Health Insurance Policy

Pre and Post Hospitalisation

Group health insurance plans in India offer pre and post hospitalisation coverage. This covers expenses related to diagnostic, tests, screenings, doctor consultation (pre-hospitalisation) and follow-ups, therapies, medication, recovery procedures, (post-hospitalisation).

Pre-Existing Disease Coverage

The best group insurance plans also offer coverage for pre-existing diseases of the insured members. However, beneficiaries are required to serve a fixed waiting period before claiming coverage for their pre-existing health ailments.

Cashless Hospitalisation

Cashless hospitalisation is one of the most attractive features of group health insurance.

It allows your employees to avail themselves of cashless hospitalisation across any registered healthcare facility in the country (as per the "cashless everywhere" clause of IRDAI).

For a fast and efficient cashless claims settlement, employees can get their treatment done at the insurance provider's network hospitals.

Inpatient Care

In-patient care refers to all the expenses incurred during hospitalisation. This includes room rent charges, surgeries, consultation fees and other related charges.

This is a crucial feature that ensures your employees receive the best treatment without worrying about the cost.

Extended Coverage for Family

Another appealing feature of group health insurance is that it allows your employees to cover their dependents under their policy. They can add their spouses, kids and even dependent parents under such schemes.

Inclusions and Exclusions of Group Health Insurance

Similar to other plans, the inclusions and exclusions of group health insurance vary based on the type of plan and insurance company. Let us discuss the common coverage areas and excluded events for Reliance Group Mediclaim Insurance.

Inclusions of Group Health Insurance

Pre and post-hospitalisation

  • Inpatient care

  • Pre-existing diseases

  • Maternity coverage

  • Room rent charges

  • Ambulance charges

  • Daycare procedures

Exclusions of Group Health Insurance

  • Domiciliary Treatments

  • Robotic surgery

  • Ozone therapy

  • Bone marrow transplant

  • Lasik surgery

  • Rejuvenation therapy

  • Cosmetic procedures

  • Septoplasty

  • C3R

  • Cochlear implants

Benefits of Group Health Insurance

Comprehensive Coverage

The primary benefit of group health insurance is that it offers financial coverage to all the insured members for expenses resulting from unforeseen hospitalisation or medical crisis.

As discussed above, group plans also offer extended coverage to the family members of insured individuals providing them with an all-round financial protection.

Affordable Premiums

As compared to other health insurance plans, group health insurance plans are affordable. They often feature low premium rates due to generalised coverage and low-risk exposure of the insured members.

In addition, you can get excellent discounts when buying your group health insurance plan online.

Helps in Employee Retention

By offering necessary financial coverage, you can instil a sense of loyalty and belongingness in your employees.

This gesture not only promotes a positive working environment but also helps you retain your existing employees and hire the best talents for your organisation.

Offers Tax Benefits

If you think that group health insurance is only beneficial for employees, you are wrong. A group health policy can help employers avail tax deductions on the premiums paid towards the plan.

Under Section 17 of the IT Act, 1961, you are eligible for tax deductions on premiums amounts under the clause "Profits in lieu of salary".

Types of Groups that Can Benefit from Group Health Insurance

Formal Groups

As the title suggests, a formal group refers to a group of professionals working for a company or organisation. In this scenario, the employer buys a group health insurance plan to cover all the employees for their unforeseen medical expenses.

Informal Groups

Informal groups are groups that do not share a professional relationship but are bound by a commonality. Some examples include people in a society, community, sports team, social group, etc.

Eligibility Criteria for Group Health Insurance

The eligibility criteria for buying group health insurance vary from one insurance company to another. In general, most plans come with an entry age of 18 years to 70 years.

In case of Reliance Group Mediclaim policy, you can extend the coverage to your spouse (18 to 70 years) as well as children (91 days to 25 years). Our plans also offer a Newborn Cover for children below 91 days of age.

Final Words

The main objective of issuing group health insurance plans is to retain their employees in the office, and it will also help the company's expansion and growth.

Usually, the majority of companies offer group health insurance plans to establish and offer protection to the employees suffering in the business organisation.

For employees, it is regarded as an essential requirement, which is also offered with more benefit to the employee.

So make an instant health insurance quote online & secure your staff members.

Buy Reliance Group Mediclaim Insurance

Purchasing group health insurance is the primary responsibility of an employer. By offering necessary financial coverage to your employees during their emergencies, you can ensure their good health and well-being.

Not to mention, your organisation will thrive when your employees are happy and satisfied. So, if you have not purchased group health insurance for your company yet, it is the right time to invest in a suitable health insurance policy.

With Reliance General Group Mediclaim Insurance policy, you can cover 7 to 1,000 employees with impressive sum insured options of ₹50,000 and ₹1,00,000 each.

In addition, we offer broad coverage with up to 100% claims settlement ratio and smooth claims processing so that you and your employees do not have to struggle to receive the benefits.

Looking for an individual/family health insurance policy instead? Check out our Health Infinity Insurance for comprehensive yet affordable coverage for you and your loved ones.

Frequently Asked Questions

Do employees need to undergo a medical test before buying group health insurance?

No. The employees are not required to undergo medical screenings in order to become a part of the group health insurance policy.

Does group health insurance offer maternity coverage?

Whether or not group health insurance offers maternity coverage depends on your plan. Some group plans offer coverage for maternity and childbirth-related expenses, such as hospitalisation, post-hospitalisation, diagnostic tests, vaccinations and so on. For more information, get in touch with your insurer.

What is the minimum number of people for the Reliance group health insurance plan?

With the Reliance General Group Mediclaim Insurance policy, you can cover a minimum of 7 to 1,000 members/employees of the same group/organisation.​