As employee expectations shift and workforce wellbeing becomes a strategic priority, group medical insurance is no longer just a checkbox on the HR benefits list. Employers in Sri Lanka are increasingly recognising the value of tailoring their group medical insurance policies—not just for cost control, but for talent retention, productivity, and brand equity.
But how do you balance affordability with meaningful protection? And how can brokers guide businesses toward innovative, sustainable group health plans?
Let’s explore how group medical insurance can be strategically customised to suit both employer goals and employee wellbeing.
Why Customisation Matters
One-size-fits-all group medical policies may be convenient, but they often fail to deliver real value. Different companies have different risk profiles, workforce demographics, and budget realities.
Customisation allows for:
- Better cost-to-coverage efficiency
- Higher employee satisfaction
- Better alignment with company values (e.g., mental health, wellness, family care)
Key Strategic Levers for Customisation
🔹 1. Demographics and Workforce Needs
Understanding the age, family status, and nature of employees’ jobs helps design the proper benefit structure.
- Younger workforces may value outpatient (OPD) benefits, dental, or wellness screenings.
- Older teams or those with family coverage may prioritise inpatient, maternity, or chronic disease management.
🔹 2. Policy Limits and Sub-Limits
Rather than opting for high flat limits across the board, employers can introduce tiers:
- Executive vs. general staff coverage
- Sub-limits for maternity, dental, spectacles, etc., to manage claim costs while offering relevant value.
🔹 3. Riders and Add-ons
Employers can enhance basic group medical policies by adding:
-
- Critical illness cover
- Hospital cash benefits
- Major Surgery Cover
- Telemedicine access
These boost perceived value without drastically increasing the premium.
Costing Considerations: Balancing Value and Budget
Group medical insurance is a recurring cost, but one that offers long-term ROI in employee morale, retention, and reduced absenteeism.
Key costing strategies include:
✅ Claims Experience Review
Past claim trends help set realistic limits and avoid over-insuring.
✅ Co-Pay Options
Introducing partial co-payment for OPD services or specialist consultations can lower premiums and encourage responsible usage.
✅ Voluntary Top-Ups
Allow employees to increase their coverage or include dependents by paying an additional premium, creating flexibility without placing a burden on the employer.
✅ Wellness Initiatives
Promoting fitness, preventive screenings, and mental health awareness can reduce claim ratios in the long term, and some insurers reward this with preferential pricing.
Enhancing Employee Value Perception
Offering a group medical policy is one thing; making sure employees see and appreciate its value is another.
Here’s how companies can bridge that gap:
- Onboarding and Benefits Orientation: Educate new hires on how to use their policy effectively.
- Dedicated Help Desks or Broker Support: Ensure smooth claims processing and clarity on entitlements.
- Feedback Loops: Regularly review usage patterns and satisfaction to adjust benefits accordingly.
The Broker’s Role in Group Medical Strategy
Insurance brokers are key partners in helping HR and finance teams:
- Navigate policy design options
- Benchmark pricing and benefits across insurers
- Interpret claims data to suggest improvements.
- Advocate during complex claims and renewals
Brokers who understand sector-specific risks and workforce nuances can add substantial value, not just by negotiating rates, but by crafting more innovative, people-centric solutions.
Final Thoughts
Group medical insurance isn’t just a cost centre—it’s a strategic tool for workforce care, brand loyalty, and risk management. With thoughtful customisation, transparent communication, and data-driven decision-making, companies can offer benefits that make a real difference.
In a competitive employment landscape, meaningful health coverage may be one of your best assets.
Leave A Reply