Learn How to Add or Remove Coverage from Your Policy with Ease
Are you tired of a one-size-fits-all approach to health insurance policies? Do you feel like you're paying for group health insurance coverage you don't really need, while still lacking coverage in certain areas that could drive employee happiness and well-being?
That's where a Flexi GMC policy comes in.
With Flexi GMC policies, both employers and employees have more control over their healthcare coverage, which can lead to greater satisfaction and peace of mind. It's a win-win situation!
In this blog post, we will discuss everything you need to know about Flexi GMC policy, its benefits, and how you can add or remove coverage per your healthcare needs.
What is a Flexi GMC policy?
A Flexi GMC policy is a health insurance policy that offers flexibility in terms of coverage and premiums, allowing you to customise the plan as per your requirements. With the option to add or remove coverage at any given point, you can ensure that your healthcare policy stays in sync with your healthcare needs.
- Customise your coverage amount
- Choose your deductible
- Personalise other parameters to make the policy affordable and suited to your requirements
- Add or remove coverage at any given point
One popular form of a Flexi GMC policy is where the employer provides a baseline coverage and the employees have the option to upgrade it at their own cost.
It's like a menu of benefits to choose from, and the employee can pick the ones that fit their healthcare needs. Once they've made their selection, the cost of those benefits is simply deducted from their payroll.
Another type of Flexi GMC policy allows employees to forego the baseline coverage altogether. Instead, they receive the corresponding cash value added to their monthly payroll or in the form of vouchers. This way, they can choose to use the cash towards healthcare expenses or for anything else they may need.
Looking for more information on Group Insurance Policies? Check out our blog on "What Your Group Accident Insurance Policy (GPA) Doesn't Cover: Critical Exclusions to Keep in Mind" to stay informed about your coverage.
Benefits of a Flexi GMC policy:
- Flexibility: As mentioned earlier, a Flexi GMC policy offers flexibility to your employees in terms of coverage and premiums. Your leadership team can choose the coverage amount, deductible, and other parameters based on your company’s healthcare needs and budget.
- Affordable: A Flexi GMC policy allows your company to choose a higher deductible*, which can significantly lower the premium. This makes it an affordable option for your company, especially if you want a good health insurance policy on a limited or specific budget.(*Higher deductibles mean that your company has to pay more out of its pocket before the plan actually starts to cover your employees’ health expenditure.)
- Tailored coverage: With a Flexi GMC policy, you can customise the coverage as per your employee healthcare needs. For example, if any of your employees have a pre-existing condition, you can opt for a policy that covers the treatment for them.
- Tax benefits: A Flexi GMC policy offers the same tax benefits as a GMC policy. The premium paid by any employer to insure their employees is termed as a ‘business expense’ for the company. This expense is shown in the employer’s profit and loss account and is eligible for tax benefits in accordance with the Indian Income Tax Act of 1961.
Who can buy the Flexi GMC policy?
If you're wondering who can buy the Flexi GMC policy, the answer is any organisation or business with over 7 employees! That's because the IRDAI regulations state that group healthcare plans are available to companies of this size or larger.
To purchase the group policy, you can choose to customise it by paying extra for added benefits.
This option is up to the employer and partly to the employees. Usually, employers opt for a Flexi plan when employees are willing to pay for the extra add-ons.
This means that if you're part of a company that meets the size requirement, you could consider getting a Flexi GMC policy and adding the benefits that suit your healthcare needs!
How to Add or Remove Coverage from Your GMC Policy
Making changes to your GMC policy is simple and hassle-free.
If you need to add coverage, you can reach out to an insurance broker like Nova Benefits and let them know what additional coverage you require. After understanding your needs, they will provide you with a quote for the new coverage, and upon agreeing to the terms and paying any additional premiums, the new coverage will be added to your policy.
Similarly, if you want to remove coverage, you can inform Team Nova about the coverage you wish to remove. We will work towards making the necessary changes to your policy after discussing the implications of removing the coverage with you.
It is important to keep in mind that adding or removing coverage can have an impact on your premiums and deductibles. Adding coverage will likely increase your premiums, while removing coverage may lower them. However, if you remove coverage, you may be left without protection in certain situations, so make sure you fully understand the implications before making any changes.
Important scenarios to consider under a Flexi GMC Policy
Scenario 1: If the Group Health Insurance (GHI) policy is cancelled by the company HR
When cancelling a Group Health Insurance policy, there are several important considerations to keep in mind. First and foremost, the policyholder, in this case, the company HR must provide notice to the insurer, and the length of the notice period can vary depending on the insurer. It's important to check your policy documents to confirm the notice period, but typically it is around 30 days.
During the notice period, it's important to note that employees will not be able to make claims under the policy. Additionally, if there have been no claims made under the policy by any of your employees, the insurer will cancel the policy and refund any unused premium. However, the amount of the refund will depend on the time since the policy was issued and its duration. It's also worth noting that if the policy is about to expire, you may not be entitled to any refund at all.
It's essential to keep in mind that once the policy is cancelled, your employees will lose access to its benefits. Therefore, it's crucial to have a replacement plan ready to go to ensure that your employees have continuous access to health insurance coverage.
Scenario 2: If the Group Health Insurance (GHI) policy is cancelled automatically
If a Group Health Insurance (GHI) policy is automatically cancelled, the policy coverage ends and a refund of the unused premium may be possible, subject to certain parameters. Automatic cancellation can occur due to various scenarios, including the death of the policyholder, which would result in a refund of the unused premium if no claims have been made by any employees. Other scenarios leading to automatic cancellation depend on the policy agreement, such as the dissolution of the business or other agreed-upon circumstances with the insurer and policyholder.
Schedule a free consultation call with Team Nova to learn more about making changes, adding, or deleting coverage for your upcoming GMC policy renewal.
Scenario 3: If the Group health insurance (GHI) policy is cancelled by the insurer
If the insurer cancels your Group Health Insurance policy, they are required to give you a 30-day notice (or as specified in the agreement) and refund any unused premium based on the same parameters as discussed earlier. However, the refund policy may not apply if there has been any dishonesty or misrepresentation of facts by the insured or anyone acting on their behalf.
How can Nova Benefits help you make the most of your Flexi Benefits policy?
Ready to take the confusion out of customised insurance coverage options for your employees?
Let Nova Benefits be your company’s health insurance expert.
We understand that finding the best coverage for your people can be confusing and overwhelming. That's why our team of experts is here to help you make informed decisions on Group Health Insurance. Get quotes from multiple insurance providers to make sure you're getting the best coverage at the best cost.
Simplify your employee healthcare experience today: Book your free consultation call
- Can I change my deductible or copay amount with a Flexi GMC policy?
Yes, you can change your deductible or copay amount with a Flexi GMC policy. This can be done by contacting your insurance provider and requesting the change.
- What happens if I need to add coverage for a pre-existing condition?
Adding coverage for a pre-existing condition may depend on your specific policy and the terms offered by your insurance provider. You may need to go through a waiting period before the coverage takes effect.
- Can I change my provider network with a Flexi GMC policy?
Yes, you can change your provider network with a Flexi GMC policy. This can be done by contacting your insurance provider and requesting the change.
- What happens if I need to add coverage for a new dependent?
Adding coverage for a new dependent may depend on your specific policy and the terms offered by your insurance provider. You may need to provide proof of eligibility for the dependent.
- Can I switch to a different insurance provider with a Flexi GMC policy?
Yes, you can switch to a different insurance provider with a Flexi GMC policy. However, you will need to cancel your current policy and apply for coverage with the new provider.
- Are there any downsides to a Flexi GMC policy?
A potential downside of a Flexi GMC policy is that the premium may be higher than a traditional policy. Additionally, adding or removing coverage may require additional paperwork and administrative tasks.
- Can I get a discount for bundling multiple policies with a Flexi GMC policy?
This will depend on your insurance provider and the policies you are bundling. Some providers may offer a discount for bundling multiple policies.
- Can I add coverage for alternative therapies with a Flexi GMC policy?
This will depend on your specific policy and the options offered by your insurance provider. You may need to add a rider or additional coverage to cover alternative therapies.
- Can I cancel my Flexi GMC policy at any time?
Yes, you can cancel your Flexi GMC policy at any time. However, you may be subject to cancellation fees or penalties depending on the terms of your specific policy.