Group Insurance
Estimate group health insurance cost and understand employer benefits.
Minimum group size is typically 7 members for most insurers. Premium improves significantly at 25, 50, and 100+ employee thresholds. Family floater top-ups can be offered at marginal extra cost.
Group health insurance is a single master policy taken by an employer (or association) covering all employees. Employees are listed as members; spouses, children, and parents can be added as dependents (usually at additional premium). No pre-policy medical tests for standard sum insured.
Tax Deduction — 80D
Employer's contribution is a business expense. Employees who contribute to premium can claim 80D deduction — ₹25,000 self/family, ₹50,000 for senior citizen parents.
No Waiting Period
Group policies cover pre-existing conditions from Day 1 — a key advantage over individual policies that have 24–48 month waiting periods.
Portability Caution
Coverage ends when employment ends. Employees should maintain a personal base health policy — group cover is a top-up, not a replacement.
Employee informs HR
Employee or family member calls the TPA/insurer helpline within 24 hours of hospitalisation.
Pre-authorisation for cashless
Hospital's insurance desk contacts TPA for cashless approval. Usually done within 1–4 hours.
Treatment proceeds cashlessly
Hospital bills the TPA directly. Employee pays only non-covered items (registration, food, non-medical).
Reimbursement path
For non-network hospitals: employee pays and submits bills + discharge summary to HR/TPA within 30 days.
Settlement
TPA settles with hospital directly (cashless) or with employee (reimbursement) within 7–15 working days.