Are you worried about your Group Health Insurance plan lapsing when you leave your current employer? Know what you can do about your health insurance when you leave your job and whether it is possible to avoid the waiting period clauses that come with a new health insurance policy.
Group health insurance policies serve as a collective safety net, providing comprehensive coverage to employees. They are popular among salaried individuals in India, primarily due to their attractive feature of employer-funded premiums.
However, a common question arises when people leave their jobs: Does the group insurance coverage end too?
Fortunately, Indian health insurance rules provide a solution. Employees have the right to switch from a group policy to an individual health insurance plan. This allows them to transfer benefits and waiting periods. It also enables individuals to explore different insurance options and find coverage that suits their specific needs. Understanding this process is vital for maintaining uninterrupted best health insurance coverage during job transitions.
What are Group Health Insurance Policies?
1. Meaning
Group health insurance policies operate as collective coverage arrangements provided by employers to their employees.
Within a group policy, a master policy is issued in the organisation's name, while individual employees receive ID cards specifying their coverage details.
2. Coverage Period and Termination
The coverage period typically lasts one year and necessitates renewal with the same insurer or purchasing a new policy from a different insurer.
Coverage remains in effect under a group health insurance policy as long as the employee stays employed with the same company.
When the primary insured employee is no longer employed, coverage for both the member and their dependents ends immediately.
Leaving the job means losing the group health insurance coverage provided by the employer.
Portability Guidelines and Migration to Individual Policies
Fortunately, health insurance rules in India have provisions that allow employees to migrate from a group health insurance policy to an individual plan.
According to the Health Regulations 2016 and portability guidelines, individual members covered under any group health insurance policy have the right to migrate to an individual healthcare plan or a family floater policy with the same insurance provider.
They also have the option to exercise portability and transfer their coverage to another insurer.
During the migration process, individuals can transfer the benefits of any waiting period they have already availed of under the group policy. This ensures they do not lose out on the accrued benefits when transitioning to an individual policy.
It's important to note that the rules apply to members of any group insurance coverage, providing them with the flexibility to continue their health coverage in an individual capacity.
The Process: Migrating from Group Health Insurance to Individual Coverage
Individuals need to inform the group insurance company in advance to initiate the migration from a group health insurance coverage to an individual or family floater policy.
Doing so at least 30 days prior to the last employment date is advisable. However, if one hasn't done so, the person still has the option to apply within five days of leaving the employment.
The issuance of the new retail policy is contingent upon the insurer's underwriting requirements at the time of issuance.
You must submit certain documents to the insurance provider during the migration process. These typically include
Proposal Form
Portability Form
A copy of the resignation or retirement letter that's duly signed and stamped by the organisation's authorised person.
You must provide complete and accurate information to facilitate a smooth transition from the group policy to an individual health insurance plan.
Other important points
Migrating from a group policy to an individual policy allows for coverage transfer, but it may involve health concerns and fresh medical underwriting.
Those who want to increase their coverage amount can consider migration, with the premium determined by the new insurer after underwriting.
It's important to ensure that the policy document clearly shows the credit of waiting periods from the group cover to avoid any issues.
Individuals have the flexibility to switch to a different insurer approximately 45 days before the next renewal date, allowing them to choose the best insurance provider for their specific needs.
Benefits and Considerations of Migration
The benefit of migrating from a group health insurance policy is that individuals do not lose out on the advantages despite the presence of waiting periods.
Individuals are given credit for the number of years of continuous insurance coverage they had under the group policy.
When calculating waiting periods, including those for pre-existing diseases, the time spent by the primary insured and their dependents under the group policy gets considered under the new individual policy. This ensures that individuals can carry forward their previous coverage and not have to wait for the completion of waiting periods when migrating to an individual health insurance plan.
Conclusion
Comprehending the dynamics of group health insurance policies and exploring the options for migrating to individual policies is crucial for individuals in India seeking the best health insurance coverage. While group coverage ceases upon leaving a job, the portability guidelines and migration provisions enable a seamless transition to an individual policy. Individuals can ensure uninterrupted coverage, including Mediclaim and access to cashless health insurance facilities, by transferring benefits and waiting periods. It is vital to consider factors such as fresh medical underwriting and the flexibility to choose different insurers to find the best health insurance, providing comprehensive protection during medical emergencies.
