How Should HR and Admin Adapt When Introducing Mediclaim Benefits for Employees?

Hi, I am working as an HR Admin in an IT company. We are going to start providing mediclaim facilities to our employees. Please suggest what necessary changes have to be made when we start the mediclaim benefit for employees in the HR and Administrative departments. Thank you.

Hi, what do you mean by changes?

Mediclaim Policy Awareness

Have a Mediclaim Policy in place and circulate it among employees for awareness. Project free mediclaim benefit is being introduced as an employee welfare initiative.

Details of the Free Mediclaim Policy

The policy should brief about the free mediclaim policy for employees, including:

- Coverage limit per employee, say one/two/three Lakhs.
- Whether coverage is for the employee alone or family as well.
- Definition of family: Father and Mother covered for unmarried employees; spouse and 2 children for married employees.
- In case of resignation, the employee will not be able to use the Mediclaim benefit.
- Information about cashless and reimbursement options.
- Network and non-network hospitals.
- Any disease-wise capping, if any.
- Per day bed/ICU charges capping, if any.

For employees covered under ESI, this would be an additional benefit.

Hi Aditi, adding to Lakshminarayan,

Steps to Implement Mediclaim Facilities

First of all, you need to call various service providers/brokers and discuss with them the benefits available (inclusions and exclusions). Check the benefits that the peer group is providing, the settlement period for both cashless and reimbursement cases, any outpatient department (OPD) facility, and the costing as well. Once the policy is obtained, get the detailed policy copy from the insurer.

Employee Awareness and Risk Reduction

Ask the broker to provide a detailed awareness program either in person or virtually so that any doubts from the employees can be clarified between the employee and brokers, reducing HR risk. You can also ask for the Standard Operating Procedures (SOP) and escalation matrix for claim settlement and disputes, and much more.