Corporate Health Cover: 10 necessary add-ons

Now, even Indian insurers are open to the idea of covering LBGTQ and live in partners under a corporate cover. Companies are increasingly opting for these covers in line with growing expectations for inclusivity in the workplace. New age companies are increasingly adopting the cover and providing additional flexibility to the standard family coverage of spouse children and parents

By

Anuj Parekh

A corporate group health insurance cover offers health coverage to employees and can cover employee family members as well. The premium is paid by the organization and is generally cheaper than standard retail policies on an individual basis. Corporate Health Insurance gives a lot of flexibility to organizations to customize their health insurance plans for employees.

This flexibility is generally not seen in insurance plans offered to retail customers. As a result, organizations can buy a plan that suits the requirements of their employees as well as their budget.

We list out 10 major add-ons that corporates need to consider for their corporate group health insurance cover

1. Day 1 PED/SD coverage – This is generally a must have for corporate cover. Waiting period means that the insured has to wait for a specified period before they are able to make a claim related to that specific disease or condition. This ensures that Pre-existing diseases (PEDs) such as diabetes, hypertension, thyroid etc and specific diseases (SDs) like cataract, hernia etc which are subjected to waiting periods under retail plans are covered from Day 1. This often results in a smoother claims experience for employees as insurance companies can process claims without a lot of checks.
2. Maternity Cover – Maternity add-on covers maternity related expenses including pre and post-natal expenses. Many Insurance companies now offer an insurance cover upto Rs 1 Lacs. With the rising cost of maternity related expenses, it is critical to have this cover in your group health insurance, specially if the organization demographics indicate high healthcare costs towards maternity related expenses.
3. Day 1 Child coverage – Generally new borns have been covered only post 90 days of birth. But there can be covers that will include day 1 coverage. This means that all medical hospitalization expenses right from childbirth are covered under insurance.
4. LGBTQ and Live-in partners – Insurers are open to the idea of covering LBGTQ and live in partners under a corporate cover. Companies are increasingly opting for these covers in line with growing expectations for inclusivity in the workplace. New age companies are increasingly adopting the cover and providing additional flexibility to the standard family coverage of spouse children and parents.
5. Parents/Parents-in-law – Corporate health cover allows for coverage of both parents and parents-in-law. This generally tends to be a very expensive proposition, but if the organization has a high employee healthcare budget, then this should be an important aspect to include in the policy. Most employees in India are concerned about their parent healthcare. Including a comprehensive cover for parents is a great way to provide employee satisfaction and also give them financial relief at the time of medical emergencies.
6. Pre and Post Hospitalization – Pre-hospitalization expenses are medical costs incurred by the insured before getting admitted in a hospital. Post-hospitalization expenses are medical costs incurred after discharge from the hospital. Insurance policies offer extensive period of coverage under this benefit ranging from 30 / 60 days to 60 / 180 days of pre and post hospitalization coverage respectively. Higher the number of days covered will enable the employees to cover larger period of medical expenses.
7. Home Hospitalization – While domiciliary treatment is covered by majority of retail health insurance plans, it comes with its set of conditions with respect to unavailability of hospital room or inability of patient to taken to hospital. Certain. Illnesses such as dengue, pancreatitis, COPD management and many more can be treated from the comfort of home. Organizations can opt for home hospitalizations for certain conditions
8. Cashless OPD cover – Although OPD treatments are covered as part of pre and post hospitalization, customers are increasingly looking at standalone OPD benefits in an insurance. At present, majority of the OPD expenses in India are incurred out of pocket and not covered through insurance. Inclusion of OPD cover in the policy is an added benefit that an individual can get in select plans.
9. Corporate Buffer – Sometimes, employees exhaust their corporate health cover. In such a case, if an employee wants to make an additional claim, they will be unable to use their cover again. To help employees in this case, employees can opt for a corporate buffer that lets corporates give the benefit of additional coverage to employees who have their covers lapsed. Companies generally opt for a cover ranging from Rs 1 Lac to Rs 5 Lacs. Critical illnesses can generally lead to these covers getting consumed easily and as a result these corporate buffers do help in managing expenses.

Hospitalizations can become an expensive proposition for an individual, especially if they don’t have a cover or have an inadequate one.Organizations must assume a fiduciary responsibility to ensure that employees get health security as this ultimately helps the organization to have a protected workforce.

The team of experts at HealthySure, will provide the best advice in helping organizations select healthcare plans that work the best.

The Author is CEO & co-founder, HealthySure, an employee welfare platform and focussed on SMEs