What Are GMC and GPA Health Insurance Policy?

Health insurance is one of the essential benefits employers could offer to their employees, as it protects and safeguards the interests of employees. When employees are cared for, it is more likely to increase their productivity as well as company profits. In the case of health insurance for employees, GMC and GPA are two options to choose from. GPA full form is Group Personal Accident, whereas, GMC full form is Group Medical Cover.

These policies pay for all costs incurred by employees due to unforeseen incidents or circumstances that might happen. In addition, both policies provide medical and financial protection for employees to protect them from financial and medical risks. Let us find more on what is GPA in India, what GMC policy is, and the difference between them?

What is a Group Medical Coverage Policy? 

The GMC’s full form in insurance is Group Medical Coverage. The Mediclaim Policy for employees offered by the employer can be called the group medical coverage policy. Under the plan, every employee gets access to the same kind of benefits without any difference. One of the most essential features of the GMC health Policy is that employers can customize the policies according to the needs of the company. In addition, since the risk is spread across multiple people or employees, the policies have a premium that is lower than individual Mediclaim policies available in the market.

Advantages of the GMC Insurance Policy

Let’s now have a look at the advantages of the group medical coverage policy:

• The policy provides coverage for all costs related to hospitalization.
• Employees are provided with maternity coverage.
• Daycare procedures are eligible for reimbursement.
• A number of companies offer GMC policies to family members of employees, including their spouse, parents, in-laws, as well as their dependents.
• Employees can make use of the cashless services available at network hospitals.

Coverage Under Group Medical Coverage (GMC) Policy

Any health insurance policy is considered worthy based on the coverage provided in the plan. GMC plans cover the following:

• Hospitalization expenses are covered for employees if the admission is for more than 24hrs.
• The costs that occur prior to and after hospitalization are covered, including the cost of diagnosis, the cost of medications, X-rays, etc.
• The Policy covers all pre-existing illnesses like hypertension, diabetes, etc., from day one. So, there isn’t any waiting time.
• Critical illnesses, such as cardiovascular diseases, cancer, etc., are covered under the Policy.
• Coverage for maternity expenses and newborns is also available.
• GMC provides an option to extend the coverage of the Policy through add-on covers such as Super Top-up, Personal Accident, etc.,
• Daycare procedures that don’t require in-patient or hospitalization are also covered by GMC policy.

What is GPA in India?

GPA full form in insurance is Group Personal Accident insurance, which is a general health insurance policy that provides employees with financial assistance in case of accidents that might result in injuries, disability, or sudden deaths.

If a particular employee encounters a fatal accident, the GPA policy will cover the entire cost of hospitalization. This is irrespective of the fact that the accident happens when they are on duty at the workplace or not and whether the incident occurs outside or inside the country).

Advantages of the GPA Insurance Policy

The most important benefits of the GPA Health insurance are:

• The insured person gets full compensation if they die due to an accident. 
• On becoming permanently disabled also compensation is paid. The only condition is that the accident must be the reason for causing injuries, such as impairment or dislocation or dismemberment of any part of the body.
• GPA Health Insurance provides coverage for ambulance expenses and also for the transportation of the body, after their death, for the funeral.
• In the event of death of the insured person, GPA Health Insurance provides an adequate amount of money to their children as educational assistance.
• Death claims resulting from accidents or sudden deaths or incidents are also insured.

Coverage Under Group Personal Accident (GPA) Policy

GPA also has specific inclusions and exclusions like any other personal accident policy. Here is the list of coverage items:

• In the event of an accident that causes either total or partial permanent impairments (like the loss of sight or legs), financial compensation is provided. If it involves death by accident, then suitable compensation is offered to the family members.
• The coverage is offered for ambulance expenses as well as transportation costs.
• It covers the in-patient hospital expenses as well as daycare procedures, room rent, etc., that might happen due to an accident.
• In the event of permanent disability or death of the policyholder, the Policy provides coverage for dependent children that can be utilized for their education, tuition, or wedding expenses.

Difference Between GMC and GPA Insurance Policies

For a clear understanding of how these two insurance policies differ from each other, let’s look at the differences between Group Medical Insurance and Group Personal Accident Cover:

1. Coverage

A group medical cover policy covers inpatient hospitalization, pre & post – hospitalization, pre-existing conditions, daycare treatments, maternity costs, newborn baby, etc.

A group personal accident cover policy offers financial compensation for the death or disability of the employee due to an accident.

2. Exclusions

In general, GMC policy does not cover medical expenses that might be due to self-injury, suicide, cosmetic treatments, alcohol/drug use, HIV/AIDS, etc.,

The GPA policy generally does not cover expenses that could happen due to natural deaths, involvement in criminal activities, self-injury suicide attempt, diseases that are pre-existing, and alcohol dependence.

3. Beneficiaries

Employees and their dependents, i.e., spouse, parents, children, and spouse are entitled to get cover under GMC policy.

A GPA policy applies only to employees of the company.

4. Choice

A GMC Policy offers the ability to customize the features of the plan by the employer based on the needs of employees.

No facility to customize the plan is provided under the GPA policy.

5. Ideal for

GMC policy is appropriate for all businesses.

Whereas GPA policy is ideal for companies that carry a risk of accidents, like travel, construction, manufacturing, mining businesses.

The Conclusion

The Group Medical Cover (GMC) and Group Personal Accident (GPA) Insurance policies can bring along a plethora of benefits to an organization by improving their employee satisfaction. In addition, it is also a great way to retain talent within the company. Therefore, it is crucial to understand the needs of the employees and make the best choice, not only for the betterment of the employees but also for the entire organization.