07/12/2021
Employee Benefits
Local Group Health Insurance is one of the forms of Employee Benefits. The coverage is provided by Local Insurance to cover the treatment cost of company's employees and their families.
In accordance with the regulations in force in our country, each company must register its employees and family into the BPJS Kesehatan program.
As additional protection and also to provide comfort to your employees and their families at the time of receiving Health care, the company can also provide Health Insurance for their employees.
Group Health Insurance can usually be designed and tailored to the needs of the company, as well as the limits of its benefits. As an experienced consultant in this field, we will assist you in choosing, or determining the design, limitations and scope of the benefits as appropriate.
The policy usually provides Inpatient / Hospitalisation as the basic cover. The range of hospitalizaton benefits are determined by room and board per day. The limit of other benefits i.e. surgery, medicines, doctor's fee etc. will be aligned with the room and board chosen by client.
The Group Health Insurance also provides the following the additional optional cover:
1. Outpatient Treatment
2. Dental Treatment
3. Maternity
4. Glasses
5. Medical Check Up.
The availability of those additional optional covers is based on the size of group.
We usually are able to negotiate with the insurance company to delete some general exclusion, waiving waiting period, and cover pre-existing condition exclusions. The insurance companies' consideration is based on the size of group and the premium.
The premium will be determined by average of members' age, the level of benefits, the scope of coverage.
This program allows members to choose any doctor or hospital when ill. If member gets treatment at a provider doctor or hospital, then the members simply show the membership card to get cashless facility. However, if the cost of treatment is higher than member's benefit, then the member must pay the excess in the place of treatment.
If a member is treated in non-provider doctor or hospital, then the claim is processed by reimbursement system where the member pays the the treatment cost first, then submit the claim documents to the insurance company seeking for reimbursement.
One of the advantages for the company who provide Group Health Insurance for their employees, the company can have fix budget on their healthcare cost. Company pays fix annual premium to the insurance company and transfer the risk just in case the treatment cost beyond their budget.
Other benefits, company provides a sense of security because the health protection has been guaranteed. In urgent circumstances, members need not be bothered with the provision of medical funds, and they also do not need to borrow money from the company if at any time require medical expenses. Members also get easy access to wide hospital networks.
The program will be administered by professionals, so the company can concentrate more on the business they manage. Likewise, the Human Resources Department can focus on their task to develop their employees.
Please feel free to contact us for further information.