How to get a comprehensive Corporate Health Insurance that voids your need for a Private Insurance

Corporate health insurance simply is a single health policy, wherein the employees of an organization are covered with a health insurance and can also cover employee families. The premium cost under group health insurance could be as low as 50% of the cost of retail health policies. There are also other benefits under group insurance that include day 1 coverage of maternity and diseases, no pre-policy checks and simpler claim settlement as there are no issues with respect to claim rejection on grounds of pre-existing diseases and limited exclusions.

How does a corporate insurance differ from a personal insurance?

The sum insured is the maximum amount that an insurance company is liable for. Under corporate insurance, this number depends on the plan that the corporate opts for. Compared to personal insurance, this generally would be as low as Rs 50,000 to as high as Rs 10 lakhs and averaging around Rs 2 or 3 lakhs for a typical corporate. The employee will also stop getting covered under a corporate insurance, the moment they leave the organization and would need to depend on their personal insurance. Also, corporates can also change the health plans according to their budgets. As this is not mandated by government, corporates can choose to withdraw some critical benefits or withdraw health insurance altogether.

What should be included in a corporate health cover to make it comprehensive?

Day 1 PED/SD coverage - 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. Having zero waiting periods ensures that Pre-existing diseases (PEDs) such as diabetes, thyroid etc and specific diseases (SDs) like cataract, hernia etc are covered from

Day 1 unlike personal insurance plans.

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 1.5 Lacs. With the rising cost of maternity related expenses, it is critical to have this cover in your group health insurance, especially if the organization has the appropriate demographics.

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.
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 a parent coverage should be an important feature to include in the policy. Most employees in India are concerned about their parent healthcare and including a comprehensive cover for parents is a great way to provide employee satisfaction and give them financial relief at the time of medical emergencies.

Pre / Post Hospitalization - Pre-hospitalization expenses are medical costs incurred by theinsured before getting admitted in a hospital. Post-hospitalization expenses are medical costs incurred after discharge from the hospital. The period of coverage under this benefit ranges 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.

Corporate Buffer - Sometimes, employees will have medical expenses over and above their corporate health cover. 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. Critical illnesses can generally lead to these covers getting consumed easily and as a result these corporate buffers help in managing expenses.
Super Top-Ups - Using the corporate cover as a base, employees should avail the option of super top-ups that lets the employee get additional high value covers at only a nominal premium. Some super top-ups also let you continue with the base cover and super top-up sum insured post-employment.

The corporate health plan is not a lifelong plan. However, with careful planning, an organization as well as the employee can maximize benefits for their health insurance.

(The author, Sanil Basutkar is Co-founder, Healthysure)