In the case where the employee leaves a job or when the employer does not renew the group cover, all is not lost. Here's an option.
Having a health insurance policy for self and family members marks the beginning of a prudent financial plan. Those who have a group health insurance coverage either through their employer or as a bank savings account holder, it is often suggested by financial planners to keep separate health insurance. This is because the group health insurance policy may not get renewed and the risk of being without any insurance exists.
In a statement to PTI, Jet Airways which has already halted its operations had announced that the company has not renewed its Group Mediclaim Policy and that it has expired on April 30, 2019. This leaves those employees stranded without any medical cover who relied only on the employer-provided coverage.
Porting from a Group Cover
In the case where the employee leaves a job or when the employer does not renew the group cover, all is not lost and the employees may still opt to port the group cover to an individual cover, subject to certain conditions. The health insurance guidelines of IRDAI clearly state – “Individual members, including the family members covered under any group health insurance policy of a General Insurer or Health Insurer, shall have the right to migrate from such a group policy to an individual health insurance policy or a family floater policy with the same insurer.”
The process to port from a group cover should ideally begin much earlier before leaving an organization. However, in the case of Jet Airways as the employees are still part of the same company, the insurer of the erstwhile Group Mediclaim Policy and the management can find a way out. “As per IRDAI portability guidelines, one should apply for portability benefit 45 days prior to the expiry of your erstwhile group health cover. They can still port at a shorter notice, if the existing insurer allows porting, within the portability guidelines. If the existing insurer of their group mediclaim employee policy offers the individual policies, then under the provision of portability, these employees can get the continuity benefit for the period under group policy, or else the benefit of the continuous period of coverage get lost,” says Dr. Shreeraj Deshpande, Principal Officer and CEO (Officiating), Future Generali India Insurance.
Why to port a policy
Importantly, portability is allowed and it will be to the same insurer. So, if the Group Mediclaim is from insurer ABC, the employees can get an individual policy from ABC only. The reason why it is important to port is because of the benefit of waiting periods with respect to the pre-existing diseases as they are time-bound. Generally, insurers cover pre-existing ailments after 48 months of continuous coverage. So, by porting, this benefit is not lost as the waiting period already over is taken into account.
Even if one has a group health insurance cover, it’s better to hold an individual policy for every family member or a Family Floater that will help you build a decent track with the insurance company and ride out the waiting periods over the long term