Companies in India are offering comprehensive health benefits to their employees, including parental cover, maternity benefits and OPD cover. However, experts advise employees not to rely solely on employer-sponsored insurance.
A recent study by Prudent Insurance Brokers has found that most companies in India offer their employees group health insurance of ₹5 lakh and maternity benefit of ₹50,000 as part of employer-funded corporate health plans. The study, based on a survey of over 10 lakh employees from 3,100 companies across 14 sectors, highlights emerging trends in employee benefits and healthcare, with an increased focus on coverage and cost management.
About 57 per cent of companies offer health insurance to employees’ parents. It accounts for 60 per cent of the total claims made under group health insurance policies. Although the frequency of medical expenses and claims related to older insured persons is higher, it has become a common part of corporate health policies. Some companies offer parental coverage under their basic policy.
While others include it as a voluntary benefit. Another notable trend is that nearly 40 per cent of companies offer family floater insurance cover of up to ₹4 lakh, while the top 10 per cent of companies offer more than ₹5 lakh, with maximum coverage reaching ₹10 lakh. Surinder Bhagat, Associate Vice President, Specialty Lines, explains that in recent years, 5 to 7 per cent of companies have turned to providing higher covers to manage more severe claims more effectively.
The study also reveals increasing coverage in health insurance policies. Companies are increasingly including siblings with disabilities and LGBT+ partners, reflecting more diverse family structures. This shift indicates a widespread effort by companies to create inclusive workplaces and provide equal benefits to all employees.
Maternity benefits are another area where most companies are consistent in their offerings. With nearly 95 per cent of companies offering maternity insurance to employees and their spouses, the average coverage for normal and C-section deliveries is ₹50,000. However, some industries such as banking, financial services, insurance (BFSI), e-commerce, retail and engineering offer higher maternity benefits.
In these sectors, the average coverage for C-section deliveries is ₹70,000, and the top percentage of companies offer up to ₹80,000 for normal deliveries and ₹1 lakh for C-sections. While medical costs have increased, companies are including parents and in-laws in the family definition under their group insurance plans. However, due to the rise in the proportion of claims from this group, employers are adopting strategies to make these plans more sustainable. Some common approaches include limiting the amount of insurance for parents, co-pay requirements for parental claims, and imposing strict room rent restrictions.
For example, employees may be required to contribute 5 to 15 per cent of the family floater insurance amount or a fixed contribution of ₹2,500 to ₹10,000 for parents’ coverage. Room rent sub-limits have become a standard cost-control measure in most companies.
About 95 per cent of companies impose room rent restrictions, usually at 2 per cent of the total insurance amount or a fixed limit of ₹7,500 to ₹8,000 per day. Higher management executives in many companies are also subject to these restrictions. Another emerging trend is the inclusion of outpatient department (OPD) benefits, especially since the COVID-19 pandemic. About 30 to 40 per cent of employers now include OPD cover in their health policies.
It provides coverage for health checkups, consultations, pharmacy, dental and vision services. The average OPD benefit is ₹10,000 for the family of the employee, spouse and children, although some employers extend this benefit to parents as well. Finally, the study emphasises the importance of employees securing independent health insurance in addition to their corporate group health plans.
Relying solely on employer-provided insurance is risky as coverage ends when the employee leaves the job or retires. Additionally, future employers may not provide the same level of coverage or may exclude parents from the policy. Premiums increase with age and pre-existing illnesses make it difficult to get coverage later, so it is wise to obtain individual health insurance early in life.
