Less than 5% Indian Companies Offer Comprehensive Insurance Coverage

Plum’s The State of Employee Benefits Report 2023

Bengaluru, March 16, 2023: Plum, an employee health insurance platform, has released its first edition of a benchmarking report titled, “The State of Employee Benefits 2023.” The report evaluated 2,500+ employer-sponsored health insurance plans across businesses of all sizes and inferred that Indian employers are falling short in offering comprehensive benefits; only 5% of Indian organisations offer comprehensive insurance coverage*: Health Insurance (GMC) + Accident and Disability Insurance (GPA) + Term Life Insurance and comprehensive telehealth consultations (GTL + Telehealth).

Plum evaluated the policies of organisations, categorising them as early stage start-ups (having an employee strength of less than 200 employees), high-growth businesses (having 201–750 employees) and mature stage companies (having an employee strength of 751 and above). Of the 2,500+ health insurance plans evaluated, it was observed that the median sum insured offered by India’s employers is INR 3L (startups), INR 4 lakh (high growth companies) and INR 5L (mature stage companies). Over 53% of organisations offer a sum insured of less than INR 5 lakh, 43% offer a sum insured of INR 5–10 lakh, and only 3% offer a sum insured of INR 10 lakh or greater.

The report reveals that a majority of companies, 64% provide additional health benefits beyond their health insurance plans, with telehealth consultation being the most popular at a 42% adoption rate. Despite the importance of term life insurance for employees’, less than 5% of companies offer it as an additional benefit. Additionally, the report reveals that while 65% of India’s out-of-pocket medical expenses come from OPD (outpatient department) spending, less than 2% of Indian companies offer OPD coverage with insurance.

It is alarming to see that women, who constitute a significant portion of the workforce, are not receiving adequate maternity benefits from their employers. In fact, only 56% of Indian organisations offer maternity benefits to their female employees, with just 14% of them having a maternity limit greater than INR 50K.

Abhishek Poddar, co-founder and CEO, Plum, said, “We launched the State of Employee Benefits report to shed light on the current state of employee health benefits in India, and the findings are concerning. At Plum, the belief is that it is crucial for all companies to holistically care for their employees and their families.”

“Amid the current environment of uncertainty, it is essential for companies to pay heed to their employees’ holistic health. The costs of healthcare in India are rising and a single illness can drain a family’s lifetime savings. Therefore, as employers, it is important to cover employees’ and their families’ healthcare costs and also any ancillary costs that can occur due to accidents or lifetime disabilities. Not only will this increase peace of mind at work, but also increase retention and create an environment of equitable benefits for all. If salaries are benchmarked, so should benefits be,” Abhishek added.

The report also highlights that 69% of all companies evaluated have extended coverage to employees’ families. What is concerning is that of these companies, only 25% cover parents, followed by 44% offering an employee-spouse-children (ESC) plan, and lastly, 30% offering an employee-only plan. An extensive family coverage also helps safeguard employees’ financial well-being and makes health insurance accessible to the “missing middle” of India.

Plum recommends that holistic health covers the following:

“The way organisations and employees view insurance is changing. It is no longer a basic benefit, but one that helps with talent management and retention. Further, at Plum we advise our customers to design covers based on employee demographics and demand. Covid was the UPI moment for insurance and we have come a long way in making insurance new age and modern,” said Aditya Bagarka Head of Strategy and Innovation at Plum. Aditya recommends what the ideal basic comprehensive coverage should be (left). He also recommends what companies that want to go above and beyond with modern coverage should provide.

Benefits

Basic comprehensive coverage (irrespective of size)

For companies that want to go above and beyond…

Hospitalisation Expenses

Sum insured of 5 lakhs including maternity and modern treatment expenses upto 1 lakh covering employees their partners & children

Sum insured of 10 lakhs including maternity and modern treatment expenses upto 1.5 lakh covering employees their partners, children & parents

Accident & life

3 times their annual earnings to help the family recoup in case of an unfortunate loss

5 times of annual earnings and lump sum payout for Critical Illness to help the family recoup in case of an unfortunate loss

Primary Healthcare & Wellness

Avenues to consult doctors for primary healthcare needs – this is possible via teleconsultation today

Invest in full-suite preventive programs:

● Mental and physical wellness

● Nutrition

● Gym memberships and

● OPD including in-person doctor consultations, pharmacy and diagnostics expenses.