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Group health insurance covers provided by employers are a big source of comfort for millions of employees. Such schemes typically pick up the hospital bills for employees and their family members, their utility being the highest for the employees' elderly parents or in-laws. Most health insurers hesitate while extending covers to senior citizens as the likelihood of individual claims is quite high in this category. Even when they do, the premiums charged are extremely high. Little wonder then that employers' group health covers are treated as a godsend.

However, last year, some insurers decided to impose ceilings on the benefits in order to control mounting losses in their portfolios. In most cases, this was done by introducing the co-pay clause. A few organisations completely excluded the cover for parents, while others transferred the cost (premium for parents' covers) to employees.

"Last year, some companies had capped the benefits provided to employees in terms of parental coverage and this trend continues this year as well," says Sanjay Datta, head, health insurance, ICICI Lombard. Adds Damien Marmion, CEO, Max Bupa: "Organisations are looking at managing their costs better. One way to do this is to maintain the same costs but revise their service offering. Limiting the coverage to just the employee, introducing co-pay, etc, are some of the changes that are being made." Some companies are also offering employees the option of paying an additional premium for extending the cover to their families or increasing the cover amount.

"As the claim ratios have been unhealthy in the parents' segment, insurers have either hiked the premium by 30-100% or added new restrictions, such as co-pay, deductibles, treatment sub-limits and so on," says Mahavir Chopra, head, e-business, medimanage.com, an insurance broking portal. The changed scenario means that whether your organisation tightens its belt or not, you need to be prepared for the possibility that your parents could be left out of the group cover.

SITUATION 1

If parental cover is scrapped: It could be a major setback, but companies seldom take such a drastic measure. In any case, you will be better off reducing your reliance on your company's largesse. "Employees should stop depending only on the employer-enabled parental coverage and start evaluating a good health insurance product, preferably offering a lifetime coverage. As parents get older, the chances of getting a good health plan with wider coverage decreases substantially," says Chopra. If your parents are above 60 years, you could look at senior citizen health policies offered by health insurers. Opt for the largest possible cover.

Source : ET Bureau