Health Insurance ( Mediclaim ) - Policy Design,
Hr Business Partner
#AnonymousDear HR Seniors,
Does anyone in your company has provided Group Medical Insurance? If yes, pls share details like how you give this benefit? Do you deduct from employee's gross or company pays premium amount? What kind of challenges have you faced in implementing this? I know in group medical insurance staff dont get a tax benefit, so what can we do to provide benefit as well as tax benefit.
My situation - Our HQ has approved this benefit but they want to pay only 80% of premium and the rest 20% to be deducted from staff's payroll. Some of them are not happy with this as its a deduction from their gross without any tax benefit! What can i do to minimize the loss?
What kind of setup do you have in your respective companies? Pls share and advise.
1st September 2016 From India, Delhi
We just incorporated Group Medical coverage in our organization from June 2016. I'm summarizing the policy and plan of action for you.
1) Entire premium amount is being funded by the organization as it's a benefit being provided to all the employees. (Deducting a part of premium from employee's salary isn't a good idea)
2) As and when an employee joins/ exits our organization, the HR informs the insurance provider to either add/delete their name from the GMC policy.
3) Scope of Coverage:- Covering hospitalization expenses in India for illness/disease contracted or injury sustained during the period of insurance subject to the limit of Sum Insured, where hospitalization is more than 24 hrs.
4) Sum Insured- Family Floater Rs. 3lacs
5) Family Definition:- Self+Spouse+2 Dependent Children up to 23 years of age
6) Pre-existing Diseases- Covered from day 1
7) Maternity :- Not Covered
Honestly, I haven't faced any problems as we haven't filed any claim till date.
Thanks and wish you all the best!
1st September 2016 From India, Mumbai
Goupe Mediclaim policy you can offer to your employees on below terms & conditions
1-Sum insured as you decided for it starts form 1 lac to your ..limit
2-Family:- Employe+ spouse & two childrens up to 21 yrs, female child waived after her marriage if she marries before 21.
3-instead of 20% You may go for 10 % co payment , at the time of billing of hospital , employees has to apy this amount
4- Instead of cashless you may keep reimbursement ,it helps to control the yearly premium
5-Company can get the benefit of service tax ,applicable on premium.
If you need any information you may call+91 9923359609
6th September 2016 From India, Pune
Group health insurance can be partly funded by the employee and partly by the organisation. The amount funded by the employee will be declared in Form 16 and for that amount the employee can claim tax benefits under section 80 D.
Do note this link for more information on how to structure group health insurance benefits for a new health insurance cover. Link Here
In case you want further information on the premiums typically charged in this, please visit -
6th September 2016 From India, New Delhi