Group Health Insurance

Group Health Insurance

Hong Kong business owners who are risking their capital and their valuable time to build a successful organization should consider offering group health insurance for not only the health of their employees but also the health of their business.

Studies have shown that employees who have access to great health care benefits through the workplace will typically show more loyalty and are less likely to leave for an increase in compensation. Offering group health benefits can provide a hedge around your business that can ward off recruiters and headhunters. There are many types of group and company health plans available with many options but to get the best return on investment for your organization, consider offering a plan that provides comprehensive levels of benefits.

Inpatient Group Health Insurance

Depending on your provider, inpatient cover will help pay expenses for the following:

• Hospital Room – semi-private or private
• Intensive care room
• Medications while hospitalized
• Surgery and anaesthetist fees
• Diagnostic testing
• Surgical appliances – prosthetics
• Transplants
• Emergency and non-emergency transportation

Outpatient Group Health Insurance

• Doctor visits – general practitioner and specialists
• Prescription medications and vaccinations
• Diagnostic tests
• Outpatient surgery
• Home nursing
• Alternative therapies

Maternity Group Health Insurance

(Conception must be after the policy is issued)

• Pre and postnatal expenses
• Normal delivery expenses
• Complicated delivery expenses
• Hospital or home delivery expenses

Alternative Therapy Group Health Insurance

Alternative therapy programs are becoming popular in Hong Kong and Traditional Chinese Practitioner clinics are readily available for people seeking less invasive health care alternatives.

• Traditional Chinese Medicine
• Acupuncture
• Osteopathy
• Chiropractic Treatment
• Homeopathy

Dental Group Health Insurance

Dental expenses in Hong Kong can be very expensive and some plans are careful about what covers they are willing to provide. Most companies will offer a selection of two dental cover plans:

Routine Treatment: The routine level of cover is focused on preventative services such as annual checkups and cleanings. This plan typically offers basic dental treatment for simple fillings, root canal, and emergency treatment.

Major Treatment: The major treatment level offers cover for virtually any dental service including periodontitis and gingivitis treatment, bridgework, crowns, and gold jackets.

Medical History Disregarded Group Health Insurance (MHD)

One of the biggest advantages of offering group health insurance is that pre-existing conditions can be covered . Typically this benefit can be utilised with 10 or more employees. The larger the group of employees , the insurers may also offer the removal of waiting periods for select benefits.

Today, employees are unlikely to only consider compensation when it comes to making employment decisions. Knowing the exorbitant cost of health and dental care, employees now consider a benefits package as important or even more important than compensation. If you want to staff your business with loyal employees who will become assets for the long term, reward them with great health benefits that show your organization is sincerely concerned about their health and wellbeing.

Speak to your Trusted Union insurance adviser about your group health insurance risks to get the information you need to make a smart and informed decision.

Group Health Insurance FAQ

What does group insurance mean?

Group insurance means health insurance for a group - usually a business. This is different from individual health insurance which only covers a single individual. Group insurance premiums are paid for by the employer and can be tailored to a business’ specific needs.

There are different tiers of group insurance policy which offer different levels of coverage. It can cover everything from regular health insurance stuff like hospitalisation, outpatient expenses, dental and vision coverage to more exotic things like maternity insurance, long-term disability and critical illness, or life insurance.

Hong Kong business owners should consider purchasing group health insurance as an employee benefit to ensure you can attract and retain the best employees.

How do group health insurance plans work?

Group health insurance plans work in a very similar way to an individual healthcare plan. When purchasing the plan, you’re allowed to choose between different tiers of coverage and different coverage terms. Then it covers each employee enrolled in the plan like they have their own individual health insurance coverage.

Premiums are paid for by the employer and can be tailored by a group benefits professional to meet the specific needs of your business and its employees. But employees would still be responsible for paying their own deductibles or co-payments.

That said, because of the sheer number of employees being enrolled at policy inception, and as people get hired/fired as time goes on, the enrollment process for each employee is not as strict. While there may be a medical questionnaire given to each new enrollee, they will likely not require a thorough medical exam.

Another important caveat is that unlike individual health insurance, a group health insurance policy does not travel with you. If you leave your job or switch to a new company, you could be left with no coverage. This can be especially onerous if you’re taking chronic medications that are currently being covered by your group policy.

What is the difference between group health insurance and individual?

Individual health insurance and group health insurance in Hong Kong don’t differ much. You’re still eligible for the same types of coverage options and roughly the same terms and conditions.

The only real difference is that a group health insurance plan insures multiple people (an entire business) whereas an individual policy insures an individual only. In most cases, a

There are also family health insurance policies available which works much like a group policy but for an individual and their immediate family members.

Can I get group health insurance?

If you’re an employee of a company, you may need to speak with your HR person, boss, or manager about getting group health insurance as it’s up to them.

But if you’re a business owner with more than 1 employee (that is not you or a partner/owner) you would be able to get group health insurance.

Group health insurance has many benefits helping you with employee retention and attracting the best talent to your organization. Many studies have shown that employees who are healthy are more productive; and employees that are well cared for will feel a sense of loyalty to your business and would not be as easily convinced to go work for a competitor lured by the possibility to higher compensation.

Who is covered under a group insurance plan?

When a business owner or the HR/benefits manager at a company decides to purchase a group health insurance policy in Hong Kong, they can also choose who to enroll in it. Unlike Employees’ Compensation insurance, a group health insurance plan is not mandatory for businesses.

In most cases, businesses will extend coverage to allow all full-time employees to be enrolled but some businesses may choose to reserve this privilege for senior staff members, executives, or other key personnel.

How much does group health insurance cost?

Like with individual health insurance, the answer is: it depends. Among other factors, it depends on your level of coverage selected, the number of employees being insured by this policy and the type of work your business does on a regular basis.

If you select a higher tier of coverage with lower waiting periods or deductibles, you can expect to pay more. Similarly, a business with 15 employees enrolled would pay significantly less than one that intends to enroll 1000 employees. Also, a business that is in the heavy industry sector has employees that are doing dangerous work and are more exposed to risk. In that case, insurance companies calculate that the claims costs for that company would be higher in general so they have to charge more to compensate.

What are the advantages of a group plan?

There are many advantages to purchasing a group health insurance plan as a business in Hong Kong.

The first is that it’s cheaper than purchasing individual health insurance for each of your employees. By bundling them all together in a group health insurance plan, you will save money on your annual premiums.

The other key advantages lie in HR. Studies have shown that employees who have access to great healthcare through work are more likely to show loyalty and be less likely to leave you for a competitor lured by higher compensation. A group health insurance plan acts as a moat surrounding your business and protecting it from predatory recruiters and headhunters trying to poach your top talent.

Another less appreciated factor is employee productivity. Many employees neglect to seek medical attention because of cost reasons. Although public hospitals offer nearly free medical care to all HK ID holders, they have long wait times that employees are not willing to wait in line for. With a group health insurance plan, employees will have access to funds or reimbursement so they would be more willing to see a doctor and have their health issues resolved before it begins to impact their productivity and performance at work.

How many employees do you need to qualify for group health insurance?

Different companies have different preferences as far as the number of people to be enrolled in the group health insurance plan but really any business with more than 1 employee would qualify.

Generally speaking, an insurer who prefers small groups would look at companies with between one and 50 employees. If you have more than 50 employees, then it would be considered a large group. If that’s what you need, we can help with that as well - just get in touch.

Can I still get coverage under a group health insurance plan if I have a pre-existing condition?

You might have heard that health insurance plans would not cover pre-existing conditions. While this is true, there are exceptions to that rule for group health insurance plans.

If the plan is insuring more than 5 employees, many insurers will offer a “medical history disregarded”. That means you would be covered even for pre-existing or chronic conditions.This exception exists because of the logistical complexity involved in getting medical histories and health exams for large groups of employees.

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