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Should You Consider Only Premium Amount While Buying Employee Health Insurance?

Team AckoJan 17, 2024

There are two ways to offer Group Health Insurance to your employees. The first is a traditional approach that involves striking a balance between the premium and the coverage. The second is to go beyond the traditional approach and pick a cover that offers value for money in terms of the coverage as well as the overall services, including hassle-free claim settlement. The second approach has become more important due to the COVID-19 pandemic. A modern Group Insurance Policy is comprehensive, customisable, and utility-based, and the decision to buy such a plan should not be based solely on the premium. Read ahead for more information on this topic.




Is Employee Health Insurance Premium the Only Point to be Considered While Buying the Policy?

If you want to buy a cover that the employees will appreciate, offer great value, and increase productivity, then the answer is ‘no’. Several factors need to be considered before purchasing Employer-provided Health Insurance. Yes, the insurance premium paid to buy the policy is an important factor. But it is not the only factor. You need to check if the features of the policy and services provided by the insurer are up to the mark.

How is Group Health Insurance Premium Calculated?

Group Health Insurance Premium calculation depends upon the following factors.

  • The average age of the employees to be covered. (Higher age = higher premium)

  • Type of job performed by the employees. (Higher risk = higher premium)

  • The number of people covered under the policy, including employees’ family. (More people = higher premium)

  • Offered sum insured. (Higher sum insured = higher premium)

  • Included add-on covers. (Inclusion of add-on covers = higher premium)

  • Claim history of the organisation for policy renewal. (More claims = higher premium)

Factors to Consider While Buying Group Medical Insurance

There is no disputing that the policy’s premium is a vital part of the decision-making process when it comes to buying Corporate Health Insurance Plans. However, there are several other important factors that determine whether a cover is good or not. Here’s an overview of those factors.

1. Coverage

Low-cost policies can compromise the coverage offered. Make sure you have adequate policy coverage before purchasing the policy. For example, Group Health Covers often come without any waiting periods for pre-existing diseases. They also offer maternity coverage. Check whether such covers are included in your policy or are excluded to accommodate low premiums.

2. Flexibility

As an employer or a Human Resource (HR) executive, you need to have the flexibility to modify the Group Health Cover as per your needs at a policy level. This means you should be able to increase the sum insured, enhance the coverage, etc. Also, the cover must be flexible enough to accommodate the immediate family members of your employees.

3. Customization

While flexibility is at a policy level, customisation is at an individual level. For example, ACKO’s Group Medical Cover (GMC) does not follow the traditional one-size-fits-all approach. And individual employees can customise the cover as per their liking by paying extra as per the policy’s terms and conditions. Such customisation makes the cover comprehensive.

4. Beyond Insurance

Gone are the days when Employee Health Insurance only used to cover hospitalisation costs and offer free annual preventive health check-ups as benefits. Digital insurance goes beyond the traditional offerings. For example, ACKO’s GMC includes free teleconsultations with doctors, discounts on medicine and lab tests, and fitness rewards via the ACKO app.

5. Smooth Claim Settlement

Nowadays, policyholders/employees expect the claims to be settled smoothly, quickly, and easily. This can be achieved if the insurer offering the policy has a tie-up with a wide network of hospitals to process cashless claims and offers hassle-free claim settlement via a mobile app. For example, ACKO has a network of more than 6,500 multi-speciality hospitals for cashless claims that can be settled swiftly via the ACKO app.

Employee-Friendly Group Health Insurance

You as an employer might be placing yourself at the centre by considering only the payable premium while buying an Employee Health Scheme. As the insurance cover is for your employees, they need to be at the centre while making the buying decision. Of course, there needs to be a balance between the services and the features offered by the policy, and the premium charged for them. This is where ACKO’s GMC positions itself as the ideal insurance partner for people-first organisations.

ACKO’s GMC offers value for money for the employers, caters to the insurance needs of those employees who raise a claim, and offers holistic wellness benefits to the covered employees (and their family members). These wellness benefits are offered in the form of fitness rewards, discounts (lab tests and health check-ups), and free teleconsultations with doctors.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

Frequently Asked Questions (FAQ)

Here are some common questions and answers about Group Health Insurance offered by employers to the employees.

What is Group Health Insurance Premium for employees, and who has to pay it?


In Employer-offered Group health Insurance, the premium is the amount paid by the employer to the insurer to insure the company’s employees. This amount is usually paid by the employer as Group Health Insurance is offered as a job benefit to the employees. In some cases, the responsibility of paying the premium can be shared between the employer and the employee.

How much do I have to pay to insure my 100-member team of employees?


The answer depends upon several factors; primarily the chosen coverage and the services and features offered by the policy. In addition, the average age of the employees and risks associated with the employees also play a key role in determining the payable premium.

Do insurers offer a renewal discount for a Group Health Cover?


Insurers can offer a renewal discount for a Group health Cover if fewer claims are raised during the previous policy period. Discounts also depend on several other factors such as changes in coverage, team size, etc.

How can the insured employees raise a claim if they visit a hospital that is not a part of the network hospitals?


Insured employees can raise a reimbursement claim if they visit a hospital for treatment that is not listed as a network hospital. For example, a reimbursement claim can be raised easily via the ACKO app, where the insured employee is required to upload relevant documents (such as hospital bills) to receive the claim amount in the linked bank account.

Is Corporate Health Insurance and Group Mediclaim Policy the same as Group Medical Cover?


A Group Health Insurance Policy offered by the employer to the employees is known as Corporate Health Insurance. This plan goes by several other names such as Employee Group Insurance Scheme, Employer-Employee Insurance, etc.

Explore more on Group Health Insurance



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