Hospitalization is one of the most basic and expensive employee benefits that an employer can offer to its employees and the majority of employers fund the hospitalization through an insurance policy, which is primarily an indemnity policy!
The health coverage may cover just the employee or the spouse and children. Some firms cover the employee’s parents as well.
Self+ Spouse + Children
Self+ Spouse + Children+ parents ( or/and parents in laws)
While taking the policy one must ensure with its broker or insurer that the below covers are provided:
As with all things, Indian employer health benefit is shifting from that usual traditional all-expenses paid inpatient indemnity to other ways of risk or cost sharing, like high deductible plans or co-pay insurance plans.
The sum assured varies amongst employers but usually, a minimum sum assured is above Rs 200,000 for each employee. The average Sum Insured is 3,00,00 and a good sum insured means 5,00,000 per family.
Some corporations keep a provision for a corporate buffer amount for discretionary coverage if an employee exhausts the sum assured. The corporate buffer should not have any family incidence sub-limits.
Various combinations of benefit limits and privileges in room types are available at various levels of staff. You can also plan to offer a higher sum insured to employees completing certain years of service
Increasing medical inflation, improved access to healthcare, and extensive coverage in benefits have pushed claim costs steadily upward.
Many insurers have already begun putting limits on claim costs by conducting more investigations, restricting networks, and putting sublimits.
Employers must explore alternative strategies to avoid the sudden increase in insurance premiums that will be inevitable in the near future.
As a result, some companies began applying claim control measures to the policy and some companies started offering Group Health Insurance as a cost to the company rather than a benefit.
Flip side of applying these measures is if not communicated properly these changes in policy terms are perceived negatively by employees.
Consequently, many employers are simply bearing the cost of an increased premium year after year or face the risk of diminished employee satisfaction.
There is an urgent need to develop long-term measures and metrics which would help in containing costs and ensuring the effective management of health benefits
Companies should consider a flexible benefits strategy and the kind of structure that would be most appropriate in the context of employee satisfaction, expense control, and revenue growth.
Ethika has developed many tools and strategies that can help an employer overhaul their employee benefit program and align it with future needs.