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Group Health Insurance for SME

Everything you need to know about Group Health Insurance for SMEs.

What is Group Health Insurance for SME?

Group health insurance for SMEs is a specific type of health insurance that covers small and medium businesses. It is designed to suit the needs of small businesses, giving business owners and employees more affordable health insurance rates. It is also a good way for small business owners to protect their employees against hefty medical expenses due to an illness or injury.

Key Points

  • As its name suggests, group health insurance for SMEs covers small and medium businesses.
  • Group health insurance for SMEs can benefit both the employer and the employees.
  • Full coverage for inpatient and day-patient treatments is one of the main features of group health insurance for SMEs.

Why Do Small Businesses Need Group Health Insurance?

Group health insurance for SMEs offers many benefits to employees as it gives them access to medical care when they need it the most. However, it also offers numerous benefits for employers. These include:

Improve Staff Loyalty and Retention
When you offer health insurance benefits to your employees, they will most likely feel valued and stay with your company longer. They will also become more motivated to perform better.

Gain a Competitive Edge
Your workplace will become more attractive to highly skilled job seekers if you look after your team. If you are a small business in a big players’ market, health insurance can be a reason for potential employees to choose your business over another. Thus, your business can recruit more talented people.

Increase Job Satisfaction and Morale
Health insurance for small businesses can help you build a stronger and more positive relationship with your employees. It may also build more trust in your organisation.

What Coverage Does Group Health Insurance for SMEs offer

Group health insurance for SMEs is flexible, so you can customize it to match your needs. You can opt for basic plans with essential benefits or more comprehensive plans with a range of features. In general, group health insurance for SMEs cover your employees for the following:

  • Full cover for day-patient and inpatient treatment.
  • Outpatient treatment, including specialist fees and diagnostic tests.
  • Accommodation in private hospital rooms.

Some policies may also offer accident coverage and maternity coverage as additional protection.

Health insurance for small businesses can help you build a stronger and more positive relationship with your employees.

What Is Not Covered Under Group Health Insurance For SMEs?

Keep in mind that there are several things you aren’t covered for. The exclusions vary depending on the type of policy and the specific insurer you choose. In most cases, the following things are not covered by group health insurance for SMEs:

  • Pre-existing conditions.
  • Chronic conditions.
  • Personal accident.
  • Cosmetic treatments.

Make sure to read your policy document carefully to see the full list of exclusions.

A successful business always start with happy employees.

Does Your Business Qualify For Group Health Insurance For SMEs?

There are certain requirements you need to meet to be able to apply for group health insurance for SMEs. Most insurers typically require your business to have at 3 to 50 employees, but some insurers only require you to have at least one employee. In most cases, your employees need to be between 15 and 60 years old.

How Do You Make a Group Health Insurance for SMEs Claim?

When you have a group health insurance plan for SME and need to file a claim, you have two options. The first is to claim for reimbursement, and the second is to make a cashless claim. A cashless claim can only be made if your employee gets their medical treatment in one of the network hospital affiliated with the insurance company. With a cashless claim, your employee doesn’t need to pay any amount in term of medical expenses as the insurer will pay for it right away.

However, if your employee gets their medical treatment elsewhere outside of the network hospitals, they can file reimbursement claims.

In order to make a claim, your employee will need to prepare some documents. These include:

  • Claim form.
  • Original medical expenses recipt.
  • Copy of ID card or passport.
  • Copy of insurance card.
  • The diagnosis of the condition treated that is certified by the hospital or doctor.

The claim process usually takes 15 days.

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