Full-time employment has countless benefits, but the one winner that rules them all is the eligibility for a group health insurance plan.
With the rising cost of healthcare and the need for quality care, which became apparent after the pandemic, corporate health cover is an increasingly valuable perk.
India's health insurance market reached ₹1.17 trillion in premiums in FY2023-24. Group health insurance now covers approximately 250 million lives through corporate policies. Yet only 7% of employees actually use their health insurance benefits. That's a gap worth paying attention to.
Medical inflation is running at 14%, the highest in Asia. What looked like adequate coverage three years ago might leave employees with significant out-of-pocket expenses today. A knee replacement that cost ₹1-1.5 lakh in 2018 now runs ₹2-3 lakh in 2024.
At Loop, we work as an employee health benefits provider for companies across India, helping them move beyond basic insurance to integrated healthcare. We've seen firsthand what separates policies that work from those that don't. This guide breaks down the features that actually matter when choosing group health insurance for your workforce.
Why Is Group Health Insurance Important?
The short answer is: healthcare is really expensive. In first-world countries like the United States, the expenses on healthcare increased steeply by close to $4.1 trillion in 2020. This has tripled from $1.4 trillion in 2000!
With respect to India, there was a 73 percent rise in costs from 2021 to 2022 to Rs 4.72 lakh crore from Rs 2.73 lakh crore in 2019 to 2020.
Enough with the statistics. Surely you get where this is headed.
With this in mind, individuals are increasingly looking to health insurance to help give them peace of mind should they find themselves ill or injured.
From a business point of view, it may seem going without healthcare can boost your bottom line. However, this thought can strangle your business's chances for long-term prosperity. Better be penny wise than pound-foolish, we say!
The positive side to this coin: offering the right group health insurance plan with added benefits will help jump-start business growth.
The instant you give your workforce the benefits they value, they have a higher commitment to meeting the company's goals, they’re less likely to quit, miss fewer workdays, are more productive, and they’re more satisfied.
No more is it just “nice to have” a group health insurance plan for your staff – it’s necessary!
Employee Wellness Handbook
A quick and easy-to-read guide for improving your employee wellbeing efforts
The 10 Features That Define Modern Group Health Insurance
1. Simplicity
Whether it’s something as simple as buying a phone or a washing machine, there are multiple brands and options out there. Besides online retailers, there are the official stores, partner stores, and more. The same goes for group mediclaim.
In general, the insurance space is very large and extensive. There are numerous players along with an abundance of intermediaries, like agents and brokers. Although they’re helpful, as an HR, you have to dip your hands into many processes and follow-ups. This is extremely time-consuming.
The simplicity comes in when you pick a reliable partner that handles all the tasks and ensures your plate is not full with work related to health benefits.
At Loop, from the start of the process, we simplify insurance for you and your organization.
With Loop, you can set up health insurance coverage in minutes, not days. Moving further along, whether it’s claims, endorsements, or customer support, everything is available on the go.
Plus, we handle all processes from start to finish. It’s almost like auto-piloting your health benefits process, so we reduce your workload while ensuring employees are healthy and happy!
Don’t believe us? See it for yourself! Check out How Livio's HR Saves 99% of Time on Health Benefits With Loop
2. Customization
From choosing your own pizza toppings to choosing the color of your iPhone, everything nowadays is customizable. This includes group mediclaim too!
In fact, it’s one of the key features that makes corporate insurance stand out.
As an organization, you can survey your employees, analyze your needs, and based on this, tailor make a plan designed specifically to meet your unique requirements.
Every policy comes with a base plan and sum insured in place, to which you can add what you desire. For instance, if your business is into manufacturing and your workforce comprises largely blue-collar workers, you can easily opt for a Group Medical Cover (GMC) with an add-on of Group Personal Accident (GPA) cover.
This GPA cover gives your staff additional protection and financial support for unexpected and unforeseen circumstances.
Read more: What Are GMC And GPA Insurance Plans and Top 7 Differences.
3. Medical coverage for family members and dependents
Managing health insurance policies, such as a family floater plan from different insurers, especially with large family members, is not easy! Each plan comes with different terms and conditions, claim processes, and additional requirements that can make the entire process a burden on top of the illness.
Managing multiple insurance policies gets complicated fast. One for yourself, another family floater for spouse and kids, a separate policy for parents. Different renewal dates, different claim processes, different network hospitals.
Group medical insurance puts everyone under one umbrella: employee, spouse, children, parents, and often in-laws. One policy, one network, one claims process.
4. Pre and Post-Hospitalization Coverage
Hospital bills are just the visible part of the iceberg. The real costs pile up in the weeks before and after admission: diagnostic tests, specialist consultations, medications, physiotherapy, follow-up visits.
Standard group health policies cover these expenses. Typically 30 days pre-hospitalization and 60 days post-hospitalization (varies by provider). The blood work, the scans, the specialist fees, and the recovery medications don't come out of pocket.
A single major surgery might involve ₹50,000+ in pre-operative tests and ₹30,000+ in post-discharge care, often covered for up to 60 days, but varies from provider to provider.
5. Zero Waiting Period (And Why It's Non-Negotiable)
With individual health insurance, you're looking at 3-4 years before coverage kicks in for pre-existing conditions. During that time, you're paying premiums but can't claim for the conditions that matter most.
Group health insurance flips this completely. Coverage starts from day one, no waiting for pre-existing conditions and no exclusions for critical illnesses.
This matters because your workforce isn't getting younger. Parents with diabetes, spouses with thyroid conditions, employees managing hypertension—these aren't edge cases. They're the norm. And when the average sum insured has risen from ₹5 lakh in 2020 to ₹7.5 lakh in 2023 (with ₹10 lakh+ now considered baseline adequate coverage for metro residents), you need that coverage accessible immediately.
Read more: What Is Waiting Period In Health Insurance: Full Guide
6. Coverage for pre existing diseases
Pre existing diseases are any conditions you suffer from and were diagnosed within the 4 years before you purchased health insurance. This can include medical coverage for anything like allergies, blood pressure, diabetes, cancer, etc.
When you purchase group medical insurance, you automatically get medical coverage for pre existing diseases. This means you can raise a claim for a pre existing disease almost instantly, as there’s no waiting period either.
This is especially good for policies that cover family members, as older individuals are at higher risk.
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7. No pre-medical screening
As a potential policyholder of an individual plan, one of the first things you must do is to undergo a pre-medical test. This test determines the status of your health and helps insurers determine a suitable plan.
Sometimes, the results lead to some individuals not getting covered due to previous conditions like cancer.
Fortunately, for those insured members covered by group medical insurance, this is not the case. Since the policy takes into account a large group, pre-medical screenings are waived off.
Irrespective of age, previous conditions, etc. you are assured of getting medical coverage for medical expenses.
8. Maternity cover
Yet another feature that makes group medical insurance a sought-after option is coverage for expenses related to maternity. Which is typically an additional coverage under a health insurance policy.
Maternity cover under group mediclaim primarily covers medical expenses related to delivery. Furthermore, the newborn baby is covered for up to 90 days. Post this 90-day period, you can add the child to the base plan too.
9. Hassle-free claims
With group mediclaim, especially with providers like Loop, there is no interference from intermediaries.
As the HR or the employee, you’re directly in contact with the claim assistance team at Loop who will help coordinate and settle the claims process. This way, the added follow-ups, lack of knowledge, etc. don’t come into play. Plus, with 24X7 claims support, you can reach the team at any time.
In essence, with a comprehensive group health plan, such facilities ensure that claims are settled quickly, saving you a ton of time, patience, and energy.
10. Customization and Flexibility
Not every organization has the same needs. A manufacturing company with largely blue-collar workers has different risk profiles than a tech startup with young developers. A company with an older average age needs different coverage than one with fresh graduates.
Modern group health insurance allows customization: adjustable sum insured levels, optional Group Personal Accident (GPA) coverage, add-ons for specific conditions, and increasingly, flexible benefits that let employees choose what matters to them.
With growing diversity in the workforce, one-size-fits-all coverage leaves gaps.
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Bonus: Added benefits
Group medical insurance is like a cake, it’s incomplete without the cherry on top - aka the added benefits.
Whether you talk about employees or HRs, Loop offers loads of benefits for both at no additional cost.
Some of the top benefits include:
- 24X7 claims support so employees can initiate and get support for claims directly from the Loop app, anytime, anywhere.
- A dedicated in-house medical team who are here to help your employees night and day and keep them healthy through an excellent preventive and primary care
- HR dashboard that’s like a control panel, so you always know what’s happening. You can see the latest data on claims and enrollment anytime
- Engaging wellness activities to keep your employees healthy and reduce the need for expensive care in the long run.
That’s not all! The Loop app makes it easy for your employees (and their families) to
- Get unlimited doctor consultations with specialists for Free
- Chat with a dedicated Medical Advisor (family doctor), and supports you in your healthcare journey
- Book discounted lab tests from home
- Access policy details, e-cards, and more anytime
- File cashless and reimbursement claims through in-app claims feature on the Loop app
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Beyond Insurance: Preventive Care and Wellness
This is where modern group health benefits diverge from traditional insurance. The best claim is the one that never happens.
Modern employee wellness benefits bundle insurance with primary care, unlimited doctor consultations, mental health support, wellness programs, diagnostic services, and health coaching.
An employee who catches pre-diabetes early and makes lifestyle changes costs far less than one who ends up hospitalized for diabetic complications. An employee with access to mental health support is less likely to burn out, go on extended medical leave, or quit.
74% of employers now incorporate mental health services in their wellness programs. The corporate wellness market, valued at $2.5 billion in 2024, is projected to reach $4.0 billion by 2033.
What Makes Group Health Insurance Different from Individual Coverage?
Group vs individual health insurance isn't just about who's paying the premium.
Cost: Group premiums are typically 40-50% lower than comparable individual coverage. Risk pooling across hundreds or thousands of employees gives insurers better predictability, which translates to lower per-person costs.
Underwriting: Individual policies assess you as a risk. Group policies assess the organization. Healthier employees effectively subsidize coverage for those with pre-existing conditions.
Flexibility: Individual policies lock you into fixed terms. Group policies can adapt, adding coverage levels, adjusting benefits, scaling with organizational growth.
Administration: The HR team manages enrollments, endorsements, and serves as the first point of contact. You don't have to become an insurance expert to access your benefits.
Eligibility: Who Can Get Group Health Insurance?
Per IRDAI regulations, a minimum of 7 employees is required to qualify for group health insurance. The business must be officially registered, and the employer-employee relationship must be genuine.
Beyond traditional employer-employee setups, professional associations, industry bodies, and other formal groups can also obtain group coverage.
For small vs large group coverage, smaller groups may face higher per-person premiums but can still access coverage far better than what individuals could obtain independently.
The HR Perspective: Why This Matters for Employers
- Retention: Companies with comprehensive health benefits see 35% lower likelihood of employee attrition. Some employees specifically choose jobs based on health benefits availability.
- Productivity: Employees who aren't worrying about healthcare costs or struggling to access care can focus on their jobs.
- Compliance: Recent labor code changes and mandatory health checkup requirements are making employer-provided health benefits legally necessary in many contexts.
- Administration: The right employee benefits partner makes health benefits largely self-managing. HR dashboards that integrate with existing HRMS systems, automated endorsements, real-time claims tracking.
Choosing the Right Group Health Insurance
Beyond the feature checklist, consider:
- Claims ratio and settlement time: How quickly does the insurer actually pay? Historical claims data tells you more than marketing materials.
- Network quality: Not just quantity of hospitals, but the quality of hospitals in locations where your employees live and work.
- Support infrastructure: Who do employees actually talk to when they have questions or need to file claims? Is it a dedicated team or a generic call center?
- Technology: Is there a mobile app that makes accessing benefits easy? Can employees find their e-cards, check network hospitals, and initiate claims without having to call anyone?
- Value-added services: Telemedicine, health checkups, wellness programs. What comes beyond basic coverage?
- Partner philosophy: Does the provider treat insurance as a claims-processing function, or as part of a broader health management approach?
What It Comes Down To
Group health insurance features on paper don't capture what actually matters: the experience when someone needs care.
The best coverage combines financial protection (adequate sum insured, minimal exclusions, zero waiting) with operational excellence (responsive claims support, broad networks, easy access) and proactive care (wellness programs, primary care access, preventive health management).
In a market where premiums are rising 25-50% annually and medical inflation continues at 14%, the quality of your health benefits is a business strategy question.
Loop closes the gap between having coverage and actually being cared for.
