Home / Group Health Insurance: Group Mediclaim Policy for Employees
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Only ~10% employees make an insurance claim in a year. Rest 90% never use the insurance policy and are indifferent to its features.
ACKO Health has something for everyone. Benefits like fitness tracking, medicine ordering, doctor consultations that keep 100% of your employee workforce engaged.
ACKO Health plans are customizable by each employee. They can choose whom to include in the policy, and also modify their coverage with Top Up and Add-on Covers.
All the health benefits are curated to keep employees physically and mentally healthy.
With In-App Enrolment and On-boarding. no more hassle on employee enrolment. We integrate with popular HRMS solutions so you don't have to worry about managing employee entry & exits. We also provide a paperless claims experience so you never have to worry about any paperwork either.
Our goal is to have Zero Administrative Overheads for you when it comes to managing Employee Health Insurance.
Our algorithm detects the right nudges to prevent employee hospitalization by keeping them healthy with preventive check-ups and doctor consultations.
You not only get good karma for keeping your employees healthy, but also lower your insurance claim costs that lead to savings for insurance premium next year.
ACKO Health has tons of healthcare benefits designed for modern healthcare needs of employees.
Connect with Google Fit/Apple Fitness and track your fitness activities on the mobile app.
Complete fitness challenges to get ACKO Coins. Redeem ACKO Coins against curated rewards.
Plan your diet by consulting a Nutritionist right from the app.
Never let a medical question go unanswered. Get unlimited free consultations with specialist doctors.
Get exclusive discounts on pharmacy when you order prescribed medicines.
Book diagnostic lab tests from the comfort of your home.
We have solved two main challenges for your employees - availability and quality of healthcare services.
A PAN India network of more than 6,300 multispeciality hospitals.
PAN India network of more than 4,500 labs for diagnostic tests.
More than 35,000 specialist doctors accessible for a virtual consultation.
Group Medical Coverage (GMC), also known as Group Mediclaim Policy or Group Health Insurance, provides coverage towards medical expenses arising out of hospitalisation to a group of employees/workers of a particular organisation. Employee health insurance provided by the employer offers coverage to the employee and sometimes his/her family members. This includes spouse and dependent children and in some cases even dependent parents/parents-in-law.
To combat COVID-19, the Indian Ministry of Home Affairs has mandated all industrial and commercial establishments, workplaces and offices to provide medical insurance to their employees before reopening the offices. This is as per Order No. 40-3/2020-DM-I (A) dated 15th April 2020 issued as part of the Consolidated Revised Guidelines for resuming workplace operations by Ministry of Home Affairs. Irrespective of the mandate, giving your employees health insurance in these times, is the right thing to do.
Employee first companies are picking ACKO Health plan for their employees. Here are some of the reasons why.
We get that administration of Group Health Insurance for employees is a hassle. Some employees leave, new ones get added and some get new dependents added. ACKO Health seamlessly integrates with popular HRMS solutions to provide easy administration of policy. Did we mention that enrolment to claims - everything gets handled on our App?
Insurance policies are used by only ~10% of your employees. While we take every measure to give the best claim experience to these employees, we have added a host of benefits for the rest 90% too. ACKO Health app gives easy access to high-quality primary care and wellness initiatives like Out Patient Department (OPD), free doctor tele consultations, discounted pharmacy & diagnostic lab tests, fitness challenges and a lot more!
If higher number of employees claim on insurance, premium for employers goes up next year. Using machine learning, ACKO Health keeps nudging your employees towards preventive care to help them stay healthy. Not only it is better for the health of your employees, it saves you extra premium expense during renewals.
No two employees are the same. Their health insurance should be the same either. With ACKO Health you can give your employees the freedom to customize their plans benefits and coverage. While you take care of the essentials, the employees can choose to pay for added benefits.
Nobody likes to push papers from one team to another. Which is why we have completely digitized our claims process. Just upload the required documents on our App and we'll take it from there. You can track your claim status on the App and there will be no need to submit any physical papers. Sounds easy, right?
Enrolment, Policy customization, end-to-end claims processing, OPD benefits, doctor consultations, diagnostic tests, fitness tracker and digital health cards - everything is available on one single App. Employees can use any and all features the way they see fit.
We expect you to do a through comparison of all available options before deciding on the right plan for your employees. Here's something to help you along the way.
Every company want's to lower the expense. Going for lower premiums is like second nature. But you should keep an eye on benefits as well. Often, a marginal increase in premium can turn a 'good' policy to a 'great' policy when it comes to benefits. A policy with poor coverage will only make your employees suffer later.
It's the hard truth that most employees don't even remember which insurance company they are covered from, because they never use the benefits outside of hospitalization claims. ACKO makes all the benefits easy to use via the app. There's no point you spending money for something nobody uses.
Insurance is used only by ~10% of the employees. You should compare what extra the plan is providing that can appeal to all your employees. You should also check if how easy it is to use those extra benefits by the employees. ACKO Health provides all the wellness and preventive care benefits stitched in one app.
It's a myth that insurance companies look for reasons to reject claims. Almost every time, there is a good and valid reason for declining a claim. As a buyer, you would want to check the claim settlement ratio of the insurer though. It is a good metric to have the comfort that your employees will be taken care off at the time of claims.
Arguably, the most important thing to check is how easy it is for your employees to register and track their claims. Everything else is an additional benefit. ACKO has digitized the entire process of claims to simplify the claims process.
You should compare the network of hospitals and clinics that are empanelled by the insurance company to ensure your employees get access to good healthcare services, no matter where they are.
The following are the differences between Group Health Insurance and Individual Health Insurance.
|Group Health Insurance||Individual Health Insurance|
|Usually, the employer pays the premium for the employee and their family.||The individual has to pay the premium for themselves as well as for their family|
|Lower premium||Higher premium|
|Only the employer has the right to cancel the policy.||Only the individual has the right to cancel the policy.|
|Insurance is valid until the employee is with the organisation post which ceases to be valid for the employee.||Insurance is valid for the entire policy period.|
|Dependent on the organisation’s financial health and employee strength.||Dependent on the age, health and medical history of the individual.|
|No need for medical check-ups.||Medical check-ups might be required to get a health insurance policy.|
The Insurance Regulatory and Development Authority of India (IRDAI) is the regulator of the insurance industry or sector in the country. The regulatory body forms rules and regulations on all types of insurance policies being sold in India. Here are a few things that the IRDAI says to be careful with while opting for group health insurance.
The master policy will bear the group or organisation’s name and be issued to the group’s manager.
A certificate of insurance is issued if you are part of a non-employer-employee group policy.
The certificate of insurance will contain the schedule of benefits, terms and conditions of the coverage and premium charged.
The cover will cease once the employee leaves the group.
The group’s manager should disclose the premium charged by the insurer and the terms of the policy, including any discounts, which should be passed on to employees or members.
The group’s manager should disclose any administrative charges that he/she has collected from employees or members over and above the premium rate charged by the insurer.
Health Insurance Policy is not complex if you understand and learn about the various terminologies and know the inclusions and exclusions of Group Health Insurance. Here are some of the commonly asked questions about GMC.
FAQs Related to Employers
Apart from valuable benefits, the best group health insurance should also provide excellent post-sales services such as servicing of claims and swift settlement. The support team should also provide hassle-free and paperless transactions, making it easier for employees to avail of insurance coverage for themselves and their families. Additionally, the insurance company should have a wide network of hospitals across the country to offer extensive coverage.How many members/employees can be covered under employee health insurance?
There's no lower or upper limit as such. Most insurance companies keep a lower limit of at least 10 employees for group health insurance coverage.Who can be covered under the group health insurance plan?
All employees of the organisation can be covered under the ACKO employee mediclaim insurance policy. As an employer, you can define employees or workers who are eligible for the corporate health insurance plan.How is the premium for the group health insurance policy calculated?
While calculating the group health insurance premium, ACKO will take into consideration factors such as the age and number of employees, the location of the organisation, and the number of dependents of the employees. Previous claims history is also taken into account. However, these are just the primary factors that ACKO will consider while calculating the premium. There are a lot more factors that go into pricing a policy.How to design group health insurance for employees?
While shopping for a group mediclaim policy for employees, you should focus on providing maximum coverage at a lower premium. Also, the insurance company should have the ability to service its employees during hospitalization concerning claims, redressal of grievances and other related services.
ACKO General Insurance Limited
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IRDAI Registration No: 157
Category: Non-Life Insurance
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