A company’s group health insurance cover ceases to exist once an employee retires or resigns from the organisation. However, the employee including family members can migrate to an individual or family floater health insurance policy with the same insurer if he acts in time. For this, the insured employee has to intimate the insurer prior to leaving the employer or within five days of the date of cessation of group membership to issue a new retail health insurance policy for himself and his dependents (who were named as insured persons in the earlier policy) for cover up to his sum insured under the policy, on payment of premium in full for the new policy. After the migration, the insured can even opt for portability with any other general or standalone health insurer if needed.
Conditions for migrating
At the time of porting the group health insurance to an individual policy, the insured can even increase the sum insured according to his needs as most often employers offer a limited sum insured. Also, all the benefits accrued in the group policy will get transferred to the new individual policy.
In group health insurance portability, the waiting period typically ranges from 30 to 90 days. However, the waiting period for a certain disease under an individual or family floater policy ranges between two to four years. Brij Sharma, founder and chairman, MDIndia Insurance TPA, says an employee about to leave an organisation has the right to migrate from a group cover to an individual or a family floater health insurance plan of the same insurer.
Careful review
It is important to review the terms and conditions of the new policy such as premium, waiting period or exclusions before migrating from a group policy.
When migrating from a group insurance policy to an individual or family cover, the insurer will adjust the premium based on several factors such as the individual’s age, overall health, and any pre-existing conditions. Underwriting will involve a medical examination and if the individual is considered higher risk, a loading may be added to the standard premium. So, review these factors with the insurer to determine the precise premium amount when making the switch.
Comprehensive cover
While insurers allow migrating a group health insurance policy to an individual policy, it is better to have comprehensive health insurance even if one is covered under a company’s group insurance. Moreover, the premium of an individual policy taken at a young age will be cheaper than a cover after migration.
“Migrating is beneficial for job flexibility and customisation, while opting early makes sense for long-term coverage and lower premiums, especially when starting at a younger age. The choice should align with one’s specific needs and future plans,” says Rakesh Goyal, director, Probus Insurance Broker.
REMAIN ALWAYS UNDER COVER
- All the benefits accrued in the group policy will get transferred to the new individual policy on migration
- You can even increase the sum insured according to your needs or opt for portability with another insurer later
- It is always better to have comprehensive health insurance even if you have a company’s group insurance cover