If you are in a salaried job, and your employer has provided you with a health insurance cover, it is always advisable to get a standalone health insurance cover for your family, including your aged parents, and for good reason.
A whopping 75 per cent of organisations do not extend benefits to their employees’ parents and a huge 30 per cent do not extend the benefits to their employees’ families, according to The State of Employee Benefits 2023 report by Plum, an employee health insurance platform.
For the report, Plum modelled data from 2,500-plus policies to arrive at the insights and assumptions to reflect the state of employee benefits in India.
The findings revealed that early-stage companies, i.e., those with maximum of 200 employees, majorly extend benefits to employees. Only 26 per cent of such companies extend benefits to parents, and 44 per cent of them extend benefits to employees and children. A huge 30 per cent of them extend the benefits only to employees.
In comparison, only 9 per cent of mature companies (750-plus employees) extend benefits solely to employees. About 49 and 42 per cent of them extend benefits to parents and family, respectively.
The number for the growth stage, i.e., those with employees between 200 and 750 employees, are 50 per cent (parents), 39 per cent (employee and children) and 11 per cent (employee).
Cutting Cost
Employers, especially the early stage ones, also seem to be cutting cost when it comes to providing adequate health coverage to their employees, according to the report.
The median sum insured offered by the companies is around Rs 3 lakh, which is about 40 per cent lesser than the recommended sum insured of Rs 5 lakh.
For the growth stage and mature companies, the median sum insured comes to Rs 4 lakh and Rs 5 lakh, respectively, which is also less than the recommended sum insured of Rs 5 lakh-10 lakh.
Maternity Benefits
When it comes to extending maternity benefits, the figures are even dismal. On an average, only 56 per cent of companies offer maternity benefits to their employees.
The median maternity cover for normal delivery is around Rs 52,000 and for caesarean delivery is Rs 55,000.
Incidentally, the cost of C-section in private hospitals comes to around Rs 70,000 to Rs 2 lakh, while the average cost of childbirth in tier-1 and metro cities come to around Rs 45,000 to Rs 50,000 in private hospitals, the report said.
Among early stage companies, only 53 per cent offer maternity benefits and only 10 per cent offer maternity benefits exceeding Rs 50,000.
The growth stage and mature companies are more employee-friendly in this regard, with 88 per cent and 93 per cent of them extending benefits, respectively. About 40 per cent and 50 per cent, extend maternity benefits exceeding Rs 50,000.
OPD Benefits
According to the report, 65 per cent of India’s out-of-pocket expenditure comes from OPD spending. That said, a huge 98 per cent of Indian companies don’t offer OPD coverage with insurance, and about 58 per cent do not offer telehealth consultations on top of their group medical cover. Also, 90 per cent do not offer health check-ups to their team.
Life Policy
According to the report, 95 per cent of companies do not offer term life insurance to their employees and 77 per cent of companies fail to offer group personal accident and disability cover in addition to health insurance. This is despite the fact 43 accidents occur every hour in India, the report said.
Recommendations
Plum said in its report that in terms of hospitalisation companies should provide a basic comprehensive coverage of Rs 5 lakh, including maternity and modern treatment expenses up to Rs 1 lakh.
Companies which want to go beyond this limit can extend the coverage to include parents and increase the sum insured to Rs 10 lakh, with the maternity and modern expenses limit set to Rs 1.5 lakh.
The accident and life coverage should be set at minimum three times the annual earnings and up to five times the annual earnings with lump sum payout for critical illness.
In terms of primary healthcare and wellness, the basic comprehensive coverage should include facilities for teleconsultation for primary healthcare needs. Companies that want to go further in genuinely ensuring the mental and physical well-being of their employees can invest in full suite preventive programmes encompassing mental and physical wellness, nutrition, gym membership and outpatient department (OPD) facilities, including in-person doctor consultations, pharmacy and diagnostics expenses.
