Group &amp Employee Insurance

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GROUP & EMPLOYEE

INSURANCE

By
SHABIR HAMEED
FN-34
 Group Insurance is that which covers a group
of people, usually who are the members of
societies, or professionals in a common
group.
 Employee Insurance specifies the
organization where the employees belong.
 The basic concept of insurance, i.e., risk
sharing is more evident here.
Features

 Employee insurance gets big business for an


insurance company with minimum operational
expenses (under one master policy issued to an
employer, union or any recognised group), it is
usually less expensive than individual policies.
 They are usually provided to permanent
employees and not to temporary, contract
employees or trainee interns.
 Employers voluntarily provide a variety of
benefits as a part of incentives which also
doubles as a form of motivation.
Types of Plans based on contribution

 If employees are made to pay a part of their


salary for the insurance, it is called
contributory plan
 If the company directly pays the premium
without any salary deduction, it is called non-
contributory plan
Types of Employee Benefits

 Medical Insurance
 Retirement Plan
 Life Insurance
 Short-term Disability Insurance
 Long-term Disability Insurance
 Dental Insurance
Advantages
 Improve productivity
 Reduction in employee turnover
 Cost effective
 Administrative cost
 Underwriting cost
 Billing
 Premium collection
 Total cost of designing benefits
Disadvantages

 Limited opportunities for employees to


choose their level of coverage
Fee-for-service

 Coverage for specific medical expenses


 Coverage for dependents with substantial
discretion
 Two methods for arranging Fee-for-service
 Basic coverage with supplementary major
medical insurance
 Comprehensive major medical insurance without
separate benefits
Moral Hazard with Fee-for-service

 Premium contributions of employees not


related to claim costs; as a result, they act
riskier
 Excessive utilization of health care; demand
for health care with hi-tech facilities even for
small illness.
Reduction in Moral Hazard under Fee-
for-service
 Increasing deductibles; hi-tech health care,
higher deduction for salary
 Tie-up of organization with certain specific
health care centres
 Close watch by the insurer
 Health Care Organization (HMO)
 Merging of care and insurance functions
Different Plans

 Coverage for dependents


 Cross subsidies among employees that are
inherent in group coverage; same
contribution, different level of risk
 Govt. mandated benefits
THANK YOU . . .

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