Which is the Best Employee Medical Insurance Scheme?

Group health insurance schemes can be a powerful retention tool in the long run for organizations. It is a beneficial tool that organizations deploy to take care of employees and their families’ health, additionally guarding employees against unforeseen financial burdens. In the age of pandemics and polluted food chains, health insurance has become necessary. It is equally important for organizations to understand the parameters and nuances of medical insurance plans to obtain optimized benefits and faster tech-based support services.

Define your needs to discover the best group health insurance scheme!

People need insurance services, not just insurance! Every organization has unique needs that insurance firms cater to by providing them medical insurance benefits. A group medical insurance scheme that best meets those needs would be the one for that organization. Clarity on employee insurance needs is important, which can be gathered through structured feedback by its human resources department facilitated by the insurance vendor. The following are a few real-life examples of employees’ unique medical needs:

  • A divorced sister/father and/or mother-in-law should be included in the medical insurance scheme.
  • Traditional treatments like AYUSH should be included in the scheme.
  • Dental surgery/treatments should be covered under the chosen scheme.
  • There should be no waiting period. The policy should be applicable from day one of enrollment.
  • There should be an option to increase cover substantially for an additional premium.
  • There should be an option of continuity of policy for an employee in case they leave the organization.
  • There should be no hidden terms and conditions which could deprive any employee of his health cover.

A vendor with a flexible approach as well as one who is technologically capable and pays attention to service orientation may be considered by employers to meet their medical insurance needs.

Empower clients to design their group medical insurance scheme 😍

Empower your clients to design the insurance plans that are best for them. The insurance service providers should get more patient-centric in adopting technology.

The medical insurance providers should have a consultative approach for designing medical insurance plans for their clients as they also act as a retention tool for employers. A good insurance provider would leverage technology to create an easy claim process and flexibility in insurance offerings. These aspects help improve customer experience and speed up operations.

The client’s needs could be gauged to create a tailor-made insurance plan with the following attributes:

  • The client’s unique medical needs should be consulted upon and incorporated into the insurance plan.
  • A no-strings-attached plan can be designed without any hidden costs or terms.
  • Always opt for an insurance provider who can provide complete and seamless customization of insurance plans to cater to the future needs of employees and their dependents.
  • Organizations should opt for a group health insurance scheme with a lower cost with no cappings on certain critical treatments and hospital room rentals. This helps avoid last-minute surprises for an employee during medical emergencies.
  • Pre-existing diseases, new joiners, and newborn babies should be covered from day one of enrollment without any waiting period. Check for any capping for critical illnesses and ensure coverage at minimal or no cost.
  • Coverage of pre- and post-hospitalization should be included in the insurance scheme.
  • Consider an insurance firm with not only a high claim settlement process but also swift approval of medical cases. A check on the insurance provider’s client list will allow companies to connect with them and receive first-hand feedback on the claim settlement process.
  • Ensure inclusion of additional benefits, such as accidental cover, pre-existing diseases, etc., for employees with maximum cost optimization.
  • Explore additional options for important top-ups for the base plan, term life cover, and group personal accident cover to minimize risks to provide health security to employees.

The above attributes should be considered for shortlisting an insurance service provider. These features are provided by service providers like Loop Insurance and Plum Insurance with excellent insurance plan customization and a digital customer service experience.

Technology for transparency and speed 😇

It is now imperative for insurance providers to be transparent with their customers and embrace speed in operations. An organization can provide excellent medical insurance to its employees if its insurance service provider uses digital processes to create customer experiences. Using technology for digital processes helps radically improve insurance services and customer reach.

  • Online platform for swift and seamless digital processes;
  • Digital processes for quicker treatment cost approval and claim settlement to avoid delays during patient discharge;
  • App usage for easy access to scheme information, digital medical insurance IDs, claim initiation, guided reimbursement process, and service team connect—email, WhatsApp, phone;
  • Medical schemes should not contain any hidden conditions which may deprive any employee during a medical emergency. It may seriously hamper the client relationships and the employer-employee relationship.

Technology would help create a transparent process and bring clarity to the benefits available to insurance holders.

Benefits to the Employer

  • Employers can claim tax exemption for the premium paid and declare it as a business expense.
  • Insurance acts as a retention tool. Employees are less likely to leave for want of medical security and benefits packages.
    • Employees get to medically/financially secure their families.
    • In the case of group-term, life maturity proceeds are tax-free.


For more insights into group health insurance, click on the following links for Plum Insurance products and blog.

Leave a Reply

Your email address will not be published. Required fields are marked *