Mumbai: Employers are expanding employee health benefits beyond traditional group medical insurance as companies seek protection against diseases that can quickly overwhelm standard health cover. Reflecting this shift, AstraZeneca Pharma India has become the first company in India to purchase a group cancer care policy, on top of its existing group health insurance, which covers approximately 25,000 employees and their family members.This policy, which is structured by Howden India Insurance Brokers with a private insurer, supplements rather than replaces the employer’s base group medical cover.Most companies buy group medical insurance with a sum insured of Rs 3 lakh to Rs 5 lakh, but cancer treatment often costs many times more. The additional cover is designed to meet expenses after the underlying group health policy ends and also pays for certain cancer-related treatments that may not be covered under the basic policy.“This was a basic need that we identified, and we have been working on it for about a year to basically take out the edges of this product,” Howden India CEO Amit Agarwal told TOI. “Although cancer-related treatment is covered under your GMC policy, the insurance limit is quite low. On an average, Indian corporates buy anywhere between Rs 3 lakh to Rs 5 lakh. God forbid, if one actually faces a challenge like cancer. These policy limits were not sufficient.” He said discussions with another 10-12 employers are in the pipeline.
“When group health started, it was taken up by corporates as a retention tool. Today, most of these policies have become a standard inclusion in your package,” he said. “Now, what we are seeing is that there is a huge trend towards out-patient (OPD) and wellness. If you have 100 employees, only 9 or 10 will use this medical facility. Whereas OPD will actually be used by 50-60% of your population in a year. Many of these companies are investing heavily in OPD.“Howden spent about a year developing cancer care products with insurers before placing the first policy. Under the structure, companies continue to purchase their regular group health policy while deciding how much additional cancer cover they want. Agarwal said the product is different from retail cancer insurance because it is designed for employer-sponsored health plans and covers employees with pre-existing conditions.“Most of the cancer products available on the market were available on an individual basis,” he said. “Because we’ve built it into corporate manufacturing, even if you have a pre-existing condition, it’s taken care of.” He added that while the base group medical policy excludes some cancer treatments, “this policy will also go down and cover you from the beginning.”“This is the first product of its kind in the Indian market. This product was never introduced in the Indian market before,” Agarwal said.He said at least 100 corporate policies and 12 to 24 months of claims experience would be required before pricing and long-term pricing of the product could be determined.
