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Group Insurance

Group Insurance

Group insurance policies provide insurance solutions, including life and retirement, to a group of people under one policy. It provides the same level of insurance coverage to all the members of the group eliminating the need for buying individual policies for each member. All these members are covered under the same risk. This policy is provided by organisations as part of their welfare program for the group members.

A group insurance policy offers coverage to a defined group of people. This could include members of an association, club, co-operative society, professional organisation, banks, companies etc. This allows employers, financial institutions and affinity groups to offer the best to the employees, creditors, customers or other individuals who can be identified as group members.

Group Term Life

Group Term Life Insurance Plans offer life insurance to a group of people under a single policy. A group term life insurance policy for employees assures financial assistance and independence to the beneficiaries of the concerned employee, in the event of his or her death. It offers multifarious benefits, from uniform cover to all, to ranked covers to various grades of members. Some group insurance schemes also provide covers for outstanding loans to a group of borrowers, while some come with critical illness and disability benefits.

Features

Master Contract

In a group insurance policy, an employer will purchase a master contract from an insurance company. The premium will be based on the number of members and the amount of coverage offered. If there is an increase in the number of members, the premium will increase proportionately. Similarly, the excess premium will be returned by the insurance company if there is a drop in the number of employees. The insurer will account for the group’s collective health, but members will not be required to undergo any medical tests.

Affordable

Group insurance policies are not as expensive as individual insurance policies. This is because the large number of insured under one policy allows the insurer to club together various kinds of expenses such as administration, operation and renewal.

Contributory

If the plan is sponsored by the employer, there is no financial burden on the employee. On the other hand, the employee should partake in the premium by paying a nominal amount which comes under a contributory life insurance plan.

Benefits

The benefits of a Group Term Life Insurance plans to employers as well as employees are as follows:

1. Coverage by Default

It provides insurance cover to members by simply being part of the group. It ensures basic insurance to cover those who do not have a personal life insurance policy.

2. Gratuity Funding

Employers are aided with a systematic method of building up funds for their future gratuity liability towards the employees. A group insurance policy assists the employers with the same, along with providing life insurance cover to employees, with greater ease.

3. Tax Benefits

Group Term Life Insurance plans offer tax benefits to both employers and employees. As per prevailing Tax Laws, Death benefits are exempt from tax under Section 10(10D) of the Income Tax Act, 1961. Moreover, group insurance plans are doubly effective - in employee welfare as well as retention.

4. Customizable to suit employee needs

Group insurance policy coverage can be extended with add-ons like education allowance, repatriation allowance, accidental death and more, thus covering a multitude of benefits along with the base cover.

5. No medical check-ups

Employees are relieved from the hassle of going through medical check-ups under Group Term Insurance Plans.

6. Cost-Effective

Since a group plan entails insurance cover for many people, its premium is much lower as compared to individual policies.

Limitations

The group life insurance premium is very low and very affordable. However, the cover is also limited so you should buy an additional insurance plan. By choosing the most suitable individual insurance plan, you can make the most of your investment. The group life insurance plan offered by the employer may not cover your spouse and children. Hence, you should reassess your insurance needs and choose the best coverage as per them.

Group Health Insurance

Group Health Insurance is a type of health insurance plan that covers for a group of people who work under the same organization. This is often offered as a valuable benefit for employees as the premium for the same is borne by the employer. The group health insurance coverage can be extended to the family members of the employees in some cases. This insurance plan is also referred to as corporate health insurance or employee health insurance.

Features and Benefits

A group health insurance policy has benefits for both the employer and employees as follows:

FOR EMPLOYERS

  • Boost Employee Retention - People value jobs that give them a sense of security. A group health insurance will not only give your employees and their families enough financial security, but an overall sense of satisfaction that their employer actually cares about them.

  • Strengthen Employee Motivation - Happy employees make happy workspaces and evidently successful companies! It’s no surprise that the safer and satisfied employees feel, the happier and more motivated they’re likely to be!

  • Tax Benefits - The employer also gets tax benefits for providing such policies to its employees.

  • Lower Cost - Health insurance for employees provides benefits at comparatively lower cost than individual health insurance policy. 

FOR EMPLOYEES

  • Coverage for pre-existing diseases - Unlike any individual health plan, a group health insurance policy starts covering pre-existing diseases from the day an employee joins the organization. In this way, there is no waiting period for any pre-existing disease.

  • Extensive range of coverage with no limit on diseases - Apart from covering pre-existing diseases, a group health insurance plan for employees provides a wider coverage with no limit on diseases.

  • Wider Maternity Cover - Most of these plans provide coverage for both C-section and normal deliveries. Some plans as well cover the newborn babies without a standard 90 days of maternity cover.

Coverage

The following eventualities are generally covered: 

  • Pre-existing diseases

  • Maternity cover is provided in all the group health insurance plans; however, some have a waiting period of 9 months whereas some do not.

  • The infant is covered from the day of his/her delivery.

  • Some plans also cover ambulance charges 

  • Pre and post-hospitalization expenses

  • Domiciliary and daycare expenses

  • Fees of a medical practitioner and specialists

  • Room rent and nursing charges

  • Anesthesia, oxygen, blood, OT charges, medicines, drugs, and cost of diagnostic such as x-ray, etc.

  • Some plans also cover radiotherapy, chemotherapy, pacemaker cost, etc.

Exclusions

The following eventualities are generally not covered: 

  • Some policies may not cover the employee’s parents

  • Non-allopathic treatments like homeopathy, Ayurveda, etc. 

  • The validity of a corporate health insurance policy for employees is always limited and is valid only until the employee works with the organization

  • Congenital diseases 

  • Expenses incurred in the treatment of AIDS and other related alignments

  • Alignment or complications arising out of the use or abuse of alcohol or drugs

  • Any non-medical expenses e.g registration fees, admission fees, charges for medical records, cafeteria charges, telephone charges, etc

  • Cost of spectacles, contact lenses

  • Any cosmetic or plastic surgery except for correction of injury

  • Hospitalization for diagnostic tests only

  • Vitamins and tonics unless used for treatment of injury or disease

  • Infertility treatment

  • Voluntary termination of pregnancy during first 12 weeks (MTP

Group Personal Accident

PAccidents can create serious financial issues for the injured and their dependents. Group Personal Accident is a type of group insurance policy that covers the group members in case an accident leads to their death or causes disability. This policy provides complete cover in the event of death or permanent total/ partial disability as well as in the case of temporary total disability.

Features & Benefits

  • Aids the insured member or his family in covering the large expenses incurred due to death or disability.

  • Several insurers offer this plan with worldwide cover.

  • Benefits of add-on covers, such as medical expenses, transportation of mortal remains, children’s education allowance, etc.

  • Many insurance providers provide the option of choosing either on-duty or off-duty cover under a group insurance scheme.

Coverage

The policy covers the following eventualities:

  1. Accidental Death: Death due to Accident

  2. Dismemberment: This would mean loss of limbs, loss of eyesight, loss of hearing, etc.

  3. Permanent Total Disability : If injury leads to permanent disability

  4. Permanent Partial Disability : If injury leads to partial permanent disability

  5. Weekly Benefit : Entitles insured for loss of Pay on temporary basis due to an accident

  6. Accident Medical Expenses Reimbursement : Entitles insured to claim both OPD and In patient expenses

Add-On Covers

  • Education Allowance

  • Family Transportation

  • Modification Allowance

  • Funeral expenses 

Exclusions

The following eventualities are not covered:

  • Pre-existing conditions 

  • Suicide

  • Military Service or operations

  • war, illegal act

  • bacterial infections

  • AIDS

  • dangerous sports

  • pregnancy or anything related to childbirth

Group Travel Insurance

Group travel insurance is meant for employers/groups for their employees/ members frequently visit overseas, they can buy a policy that will cover a group of people, you might be traveling for a business meeting, conference, training program’s or to take part in activities overseas with your club, either way, using travel insurance for groups, rather than everyone buying their policy, is likely to save you money. Group Multi-Trip travel policy provides coverage that protects group travelers against unexpected events such as trip cancellation, trip interruption, emergency medical situations, and terrorism in departure and destination cities. Group Multi-Trip travel policy has also been specifically designed for frequent travelers in groups.

Key Benefits

  • Low Premium: Premiums are relatively lower in group travel insurance plans as compared to individual policies for individual members. This makes them more affordable and worth buying, so they deal with the financial burden brought about by travel contingencies.

  • Peace of Mind: A group travel policy offers exhaustive coverage, bringing in a great peace of mind for one and all of the travelling group.

  • Convenience: Sudden emergencies can disrupt the trip for the entire group traveling together. In such cases, the financial burden is taken care of by a comprehensive group travel policy, sparing the group head and or the members of the ensuing financial hassles.

Coverage

  • Health Cover

  • Medical Expenses

  • Dental treatment

  • Transportation

  • Hospital Daily Allowance

  • Total Loss of Baggage Including Delay of Baggage

  • Hijack Distress Allowance

  • Loss of Passport

  • Financial Emergency Assistance Cover

  • Personal Liability

  • Personal Accident

  • Countries covered

  • Trip cancellation, trip curtailment, and trip delay

  • Political Risk and Catastrophe Evacuation

  • Emergency Travel Expenses - Replacement of colleague abroad

  • International Driving License Loss

  • Natural Disaster

  • Incidental Home Country Coverage

  • Acts of Terrorism

  • Sports and Adventure Activities

Exclusion

  • Any treatment that might be the reason for overseas travel.

  • Any treatment that can be delayed, according to the attending doctor and the overseas administrator, till the policyholder returns to India.

  • War (including the war that has not officially been declared), invasion, civil war, an act of foreign enemies; insurrection, rebellion, mutiny or revolution; usurped power (military or otherwise), capture, seizure, restraint, arrest, or detainment; nationalization, confiscation or requisition; or damage caused by or due to the order of any public local authority or government; and acts of terrorism, except Hijack Relief.

  • Any reckless, intentional or criminal activity, use or abuse of alcohol and/or drugs, or attempted suicide.

  • Participation in air force, military or naval operations, either as a military exercise or as war games, or actual engagement with a foreign or domestic enemy.

  • Losses are caused by attempted or actual commission or participation by the policyholder in illegal activities or attempted or actual violation of the law, including resisting arrest.

  • HIV/AIDS and all concomitant health conditions.

  • Loss or damage to the insured's passport as a result of the confiscation or detention by customs, police, or any other authority.

  • A loss which is not reported to the appropriate police authority within 24 hours of the discovery of the loss, and in respect of which an official report has not been obtained.

  • Loss caused by the insured's failure to take reasonable steps to guard against the loss of passport.

Group Gratuity

Gratuity is a statutory benefit to be provided to an employee as per the Payment of Gratuity Act, 1972 or as per own scheme of an organization if offering higher benefits. It is a lump sum amount paid out to an employee, upon his exit from employment and fulfilling the criteria prescribed in the Gratuity Act/the Scheme framed.

These statutory payments to employees create a gratuity liability for an employer. As an employer, one of your paramount concerns will be availability of sufficient funds to meet your company's obligation for these gratuity payments when needed. This can be best achieved by opting to contribute to the Insurance co. Group Gratuity Plan, which helps employers meet their statutory liability.

Process

As an employer, you can choose to invest a certain amount of money in order to meet your future gratuity liability. The amount set aside by you is invested in a range of equity and debt funds to provide returns over a long term. The kitty created under this plan is then used to make claim payments for gratuity when employees exit.

Features

  • The fund accrues interest from day one with maximum yield

  • For claiming IT rebate, valuation done by Insurance Company would be sufficient.

  • No certificate from an outside actuary is required.

  • Earning of the Trust is tax free.

Future Gratuity Cover

In the event of premature death often employee ,the sum payable as gratuity can be equal to the gratuity payable for the entire service (actual service + anticipated service ) under Insurance Company's Scheme, on opting for such cover at a nominal cost.

Tax Benefits

As an employer, annual contribution is allowed as expenditure/deduction in computing taxable income. However, maximum contribution cannot exceed 8.33% of an employee's salary each year.

Gratuity received by the employee is tax-free up to the limit specified and subject to conditions under Section 10(10).*

Employees Deposit linked Insurance

Employees Deposit linked Insurance is provided by the Employee Provident Fund Organisation (EPFO) department for private salaried employees is a special way of extending an enhanced life insurance cover to your employees, while reducing cost. The scheme offers a higher life cover to your employees without linking to PF balance. For the same cost as incurred while depositing with PF Authorities, insurers offer much higher sum insured.

EDLI is mandatory for all organisations which are registered under the Employees Provident Fund and Miscellaneous Provisions Act, 1952. The government has made it compulsory for such organisations to subscribe under this scheme so as to give the benefit of life insurance to its employees. This scheme works alongside EPF and EPS. The benefit under the scheme depends on the remuneration paid to the employee.

Features

Following are the key features of EDLI policy:

  • EDLI applies to all employees with a basic salary under Rs. 15,000/- per month. If the basic salary goes above Rs. 15,000 per month, the maximum benefit is capped at Rs. 6,00,000/-. With effect from 28.04.2021, the EPFO has increased the maximum benefit to Rs.7 lakh.

  • There is no need for the employees to contribute to EDLI. Their contribution is required only for EPF.

  • There is a bonus of Rs. 1,50,000/- available under the EDLI. With effect from 28.04.2021, the bonus is increased to Rs.2.5 lakh.

  • The Ministry had increased the minimum amount of benefit to Rs.2.5 lakh in Feb 2018, which was valid for two years. The EPFO has extended this minimum amount of Rs.2.5 lakh with retrospective effect from 15th Feb 2020.

  • Any organisation that has more than 20 employees needs to register for EPF. Therefore, any employee who has an EPF account automatically becomes eligible for the EDLI scheme.

  • As per the provisions of the EDLI, the contribution of an employer must be 0.5% of the basic salary or a maximum of Rs. 75 per employee per month. If there is no other group insurance scheme, the maximum contribution is capped at Rs. 15,000/- per month.

Benefits

  • Higher sum insured

  • Income Tax benefits

  • Lesser premium

  • Employees can get faster claim settlement 

Claims Documents

The following documents are to be submitted by the claimant:

  • Duly completed Form 5 IF

  • Death Certificate of the insured person.

  • Succession Certificate in case the legal heir files the claim.

  • Guardianship Certificate if the claim is filed on behalf of a minor by a person other than the natural guardian.

  • Copy of cancelled cheque for the account in which the payment is to be received.

Group Superannuation Scheme

Superannuation also called Pension benefit is one of the most important benefits for employees. This is a retirement benefit plan offered to employees to help them save a portion of their incomes during their tenure of employment, so as to secure their financial future post retirement.

The savings made over the years are grown by investing into superannuation plans and help to build a corpus to purchase an annuity on retirement, which will take care of their financial requirements, be it their medical needs or taking care of their loved ones.

Types

There are two types of scheme wherein the product allows for the contribution either from Employer (non Contributory) or from both the Employer and Employees (Contributory):

  • Defined Benefit Scheme: Under this scheme the amount of Pension and other benefits are defined in advance in the rules of the scheme.

  • Defined Contribution Scheme: Under this scheme the rate of contributions or the amount of contributions are defined in the rules of the scheme.

Features

The main features of a superannuation scheme are as follows: 

  • Employer can initiate superannuation scheme at any approved agency

  • The scheme is transferable – in event of employer leaving the organization

  • As part of Superannuation contribution, the company pays up to 15% of basic wages

  • In most companies, the scheme is offered to employee at nominal premium rate or free of any charges

Benefits

For Employers: 

  • The annual contribution under superannuation scheme benefit, is seen as a business expense

  • A superannuation scheme helps in retaining valuable employees

  • Group superannuation scheme can play a big role in attracting talented resources to the company

For Employees: 

  • A fixed source of Income (post-retirement)

  • In most cases the income remains fixed & is not influenced by market risks

  • An efficient tax saving plan

  • Multiple annuity options

Group Leave Encashment

It is a type of group insurance plan specifically designed for companies that offer Leave Encashment Benefit to their employees. The Leave Encashment Group Plan is designed to cater to the needs of Employee’s Leave Encashment liabilities increasing over the period of time. This product is designed to reduce the financial strain on the employer by helping them fund their Leave Encashment liabilities payable to employees. This will also help the employee fund for the leave encashment benefit systematically & effectively and release resources for your core business activities.

Eligibility

  • Group - Employer Employee Groups

  • Group Size – Minimum : 10 employees ; Maximum : No Limit

  • Entry Age (as on last birthday) – Minimum. : 18 years ; Maximum. : As per scheme rules (sub. to max. of 74 years)

  • Maximum Age at Maturity (as on last birthday) : As per scheme rules, sub. to max. of 75 years

Coverage

Death benefit

In case a member enrolled under the policy dies while in service, the sum assured along with the leave encashment benefit are paid to the nominee. The leave encashment benefit is determined based on the scheme rules. However, the benefit payable is limited to the remaining policy account value in the policy account.

Retirement/Leaving service benefit

On retirement of a member, who is enrolled under the policy, the leave encashment benefit is provided as per the scheme rules. The benefit is limited to the policy account value remaining in the account.

Benefits

  • A platform of a large pooled fund providing smooth returns and safety through diversification backed by our in-house investment expertise of the insurer. 

  • Flexibility in payment of contribution: you can pay annual contributions yearly, half-yearly or quarterly.

  • The plan has a uniform life cover of Rs 5000 per member

  • Tax Benefits as per the applicable tax laws. 

Group Credit Term Plan

Group Credit Term plan provides a life cover to the group of borrowers of credit institutions (banks,retail finance providers Etc.) with the life assured being the borrower and the credit institution being the beneficiary (only to the extent of the outstanding loan; the rest of the amount is paid to the nominee of the life assured). It is a solution for financial institutions who want to lighten the loan repayment burden of the borrower's family- in case of death or illness.

Features

  • Eliminates risk of loan default in the event of death

  • Financial relief to the family

  • Facilitate competitive pricing for lender

  • Cost-effective plan

  • Hassle free process to join - simple to administer

  • Choice of covers

Coverage

This is a group life insurance plan where the financial institute is the Master Policy Holder and all its customers become Insured Members by opting membership under this scheme for insurance cover.

The following death benefit options are available for master policy holder to choose from basis the loan/asset investment structure:

  • Flat Sum Assured: The Sum Assured will remain flat during the term of the policy.

  • Reducing Sum Assured: The Sum Assured will reduce on monthly basis as per the loan schedule annexed with the ‘Certificate of Insurance (COI)’. 

  • Reducing Sum Assured with Flat Cover during the Moratorium Period: During the moratorium period, the Sum Assured will remain as a flat cover and once the moratorium period is over, the Sum Assured will reduce on monthly basis as per the loan schedule annexed with the ‘Certificate of Insurance (COI)’. 

  • Reducing Sum Assured with Increasing Cover during the Moratorium Period: During the moratorium period, the Sum Assured will increase with respect to the outstanding interest and once the moratorium period is over, the Sum Assured will start reducing on monthly basis as per the loan schedule annexed with the ‘Certificate of Insurance (COI)’ for the member. 

The loan/repayment schedule of a member will depend on the interest rate & moratorium period opted for & agreed with the master policy holder. This loan/repayment schedule will define the benefit under this group insurance plan for cover under reducing Sum Assured.

Exclusion

  • Attempted suicide or self-inflicted injuries while sane or insane, or whilst the insured member is under the influence of any narcotic substance or drug or intoxicating liquor; or 

  • Engaging in aerial flights (including parachuting and skydiving) other than as a fare paying passenger on a licensed passenger carrying Commercial aircraft operating on a regular scheduled route; or committing any breach of law with criminal intent

  • war, whether declared or not or civil commotion; or taking part in any strike, industrial dispute, riot, etc. or 

  • Engaging in hazardous sports or pastimes, e.g. taking part in (or Practicing for) boxing, caving, climbing, horse racing, jet skiing, martial arts, mountaineering, o pastel skiing, potholing, powerboat racing, underwater diving, yacht racing or any race, trial or timed motor sport. or 

  • Nuclear reaction, radiation or nuclear or chemical contamination.

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