Many people like group health insurance because their employer pays for it. But when they leave the job, they often wonder if they can keep the benefits with an individual policy. They can.
Health insurance rules allow employees to switch to an individual plan and keep benefits like reduced waiting periods from the group policy.
This applies to everyone under a group insurance plan.
According to the regulations set by the Insurance Regulatory and Development Authority of India (Irdai), an employee covered by a company's health insurance plan can transition to an individual health insurance plan.
This option becomes available if the employee changes jobs or loses employment but wishes to maintain health insurance coverage.
What A Group Policy Includes:
A group insurance plan typically offers similar coverage and exclusions as an individual health insurance policy.
However, instead of individual policies for each employee, a single master policy is issued to the group's manager (employer). Individual employees receive ID cards detailing their coverage.
The policy lasts for one year and can be renewed with the same insurer or purchased anew from another insurer.
Having an individual policy alongside a group cover is beneficial. While migration is possible, it may bring up health concerns and encounter issues with new medical underwriting.
Those seeking increased coverage may contemplate migration, with the premium determined by the new insurer after policy underwriting.
Employees have the option to add family members like spouses, children, and even parents to the policy.
New additions can usually be made during the year, but typically only for spouses or children. While the specifics of coverage may vary among employers, in most cases, the employer covers the premium.
How To Make This Switch:
To make this switch, the individual must fulfil certain requirements outlined by the insurer and may also benefit from reduced waiting periods carried over from the previous employer's health insurance policy.
However, it's important to note that whether the conversion is accepted or not depends on the insurer. The insurance company retains the authority to establish the terms and conditions of the new health insurance plan, including the premium amount.
Usually, policyholders must first notify their current group insurance provider to start the conversion process. If they lose their job, they should reach out to the company's admin or HR department for details on how to port the policy.
The request to switch from a group health insurance plan to an individual one should ideally be made about 30 days before leaving the job.
According to the regulations, the insured employee should inform the insurer before their last day at the company.
Alternatively, they must do this within five days of the group policy termination to obtain a new individual health plan, covering the same amount, by paying the full premium.
The issuance of the new individual policy is subject to the insurer's underwriting requirements at the time of policy issuance. Sometimes, the insurer might request pre-medical checkup reports before issuing the policy.
Benefit Of Migration:
Migration from a group health insurance plan preserves benefits despite waiting periods.
According to regulations, individuals retain credit for years of continuous insurance coverage.
Under the new individual policy, waiting periods, including those for pre-existing conditions, factor in the duration of coverage under the group policy for both the primary insured and dependents.
