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What Our Plans Cover
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Hospitalisation for employees and...
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Pre-existing conditions from incep...
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Maternity benefit
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Newborn cover from day one
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Day-care procedures and pre and po...
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Ambulance charges up to the scheme...
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Cashless access at network hospita...
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Optional out-patient and wellness...
Who Can Consider This Plan?
- A registered organisation with employees on its payroll
- A minimum group size, commonly seven to twenty depending on the cover
- Employees actively at work on the date cover commences
- Accurate census data — pricing follows the population profile
- Uniform benefit design within each defined grade
What May Not Be Covered?
- Any cover after the employee leaves the organisation
- Dependants not declared in the census
- Treatment outside India, unless specifically extended
- Cosmetic and elective procedures
- Non-medical consumables, unless the scheme covers them
Always check the policy wording before you commit.
Why Choose Wealth & Covers?
- Expert advice to choose the right plan
- Plans from leading insurance companies
- Hassle-free process and documentation
- End-to-end support, including claim assistance
- Dedicated relationship manager
Our Insurance Partners
- Star Health Insurance
- Care Health Insurance
- Niva Bupa Health Insurance
- HDFC ERGO
- ICICI Lombard
- Bajaj Allianz
We represent multiple providers to help you find the most suitable option at the best price.
- Expert Guidance Personalised advice from experienced insurance professionals.
- End-to-End Support From choosing the right plan to claim assistance, we are with you always.
- Claims Assistance Hassle-free claim support to ensure you get what you deserve.
- Transparent Process Clear information, easy documentation and a hassle-free experience.
Overview
Group health insurance covers a company's employees, and usually their dependants, for hospitalisation under a single master policy. Underwriting is on the group rather than the individual, which is what makes it possible to cover employees with existing conditions on standard terms.
That is its defining advantage. Pre-existing conditions are typically covered from day one, waiting periods are waived, and maternity is commonly included — none of which any retail policy offers a new buyer. For an employee with a chronic condition or a family planning a child, the group policy is worth considerably more than its cost.
Its defining limitation is equally simple: it ends with the employment. Employers who explain that clearly, and encourage staff to hold their own cover alongside, deliver a better benefit than those who let people believe they are permanently insured.
Who should consider it
Any employer above the minimum group size. It is consistently rated the most valued benefit after salary, and for smaller companies competing for talent it is often the most cost-effective differentiator available.
Benefits
- Pre-existing conditions covered from day one, with no waiting periods
- Maternity cover commonly included without the retail waiting period
- Employees with health issues covered on standard terms
- Dependants — spouse, children and often parents — can be included
- Cashless treatment across a national hospital network
- Premium generally deductible as a business expense
What is covered, and what is not
Read the right-hand column first. It is the one that decides whether a claim is paid.
Typically covered
- Hospitalisation for employees and declared dependants
- Pre-existing conditions from inception, with waiting periods waived
- Maternity benefit, where the scheme includes it
- Newborn cover from day one, where maternity is included
- Day-care procedures and pre and post-hospitalisation
- Ambulance charges up to the scheme limit
- Cashless access at network hospitals
- Optional out-patient and wellness extensions
Typically not covered
- Any cover after the employee leaves the organisation
- Dependants not declared in the census
- Treatment outside India, unless specifically extended
- Cosmetic and elective procedures
- Non-medical consumables, unless the scheme covers them
- Amounts above the sum insured, and any co-payment share
- Conditions excluded by name in the scheme design
Inclusions and exclusions vary between providers and between plans from the same provider. The wording in your own policy document is what governs — we will walk you through it before you buy.
How it works with us
- 1 We profile the workforce, not just the headcount Age bands, salary bands, locations and dependants. A scheme priced on headcount alone is priced on the wrong data.
- 2 Benefit design before market approach Sum insured basis, family definition, waiting periods and co-payment. These decide the premium far more than the choice of insurer.
- 3 Quotes compared on claims service as well as price A cheap scheme with a slow TPA costs you in employee goodwill every single month.
- 4 Onboarding and employee communication We run the enrolment, produce the cards and explain the scheme to your people. Benefits nobody understands are benefits nobody values.
- 5 Mid-term additions and an annual review Joiners and leavers handled by endorsement, and a renewal built on your actual claims data rather than a standard loading.
Important considerations
The things a brochure tends to leave out. Read these before you decide.
- Your claims ratio drives the renewal. A scheme running above about eighty per cent will see a loading, and the levers are benefit design and wellness rather than shopping the market.
- Decide on parents deliberately. Including employees' parents is the single largest cost driver in most schemes and also the most appreciated inclusion — price it as a separate option rather than folding it in.
- Tell employees the cover ends with employment. Encouraging them to hold personal cover alongside costs you nothing and prevents a genuinely bad outcome later.
- A co-payment or a room rent cap reduces premium substantially. Both are defensible design choices; both need explaining to staff before the first claim rather than after.
- Judge the TPA as carefully as the insurer. Slow pre-authorisation at the hospital counter is what employees actually experience, and it is what they will remember.
Documents required
- Company registration and GST details
- Employee census — age, gender, salary band and location
- Details of dependants where family cover is included
- Existing policy schedule and claims data, where renewing
- Organisation chart, where cover varies by grade
- Signed proposal form from an authorised signatory
Frequently Asked Questions
Are pre-existing conditions really covered from day one?
Yes, and that is the central advantage of group cover. Because the insurer underwrites the population rather than each individual, employees with existing conditions are covered on standard terms with waiting periods waived — something no retail policy offers a new buyer.
Should we include employees' parents?
It is the most appreciated inclusion and the largest cost driver, particularly where parents are elderly. Many employers offer it as a voluntary top-up the employee co-funds, which keeps the base premium manageable while still making the cover available.
What happens when an employee resigns?
Cover ends, usually on the last working day. Some insurers allow conversion to an individual policy carrying the served waiting periods. It is worth telling employees this at onboarding rather than at exit.
How is the renewal premium decided?
Principally on your own claims ratio for the expiring year, adjusted for changes in the population profile. A scheme running high will attract a loading, and the effective responses are benefit design changes and wellness measures rather than switching insurer.
Is maternity covered without a waiting period?
Commonly yes on group schemes, which is one of the most valued features for a young workforce. Sub-limits usually apply for normal and caesarean delivery, so check those figures against costs in your city.
Want a shortlist instead of a catalogue?
Tell us the situation and an advisor comes back with two or three options that actually fit — and names what each one gives up.