What is Employee Benefits Insurance?
Companies tend to offer some form of medical coverage for hospitalisation, outpatient general practitioner, outpatient specialist practitioner, and dental for employees. These are some of the most common Employee Benefits offered. An increasingly competitive employment market means that companies are forced to distinguish themselves by catering for employee needs outside of the workplace.
These benefits convey a message about what your company values and how involved it is with its employees. It can also aid in employee retention, which is more important than ever before. It reduces the learning curve and lost time training new employees.
Do I need to have Employee Benefits Insurance?
While not mandatory, most companies in Singapore do provide some form of Employee Benefits (also known as Group Health) Insurance to their employees, as they are an essential part of the overall compensation package offered to employees.
While the state has subsidised medical insurance provided for all citizens that have a CPF account; Medishield Life, most companies have an employee population comprised of mixed skillsets and nationalities. Every employee’s individual circumstances are different, and the company’s role is to provide for them while currently employed.
For foreign workers residing in Singapore on a work permit or S-Pass, Ministry of Manpower (MOM) regulations require the employer to buy and maintain medical insurance coverage of at least $15,000 per year for them.
What does Employee Benefits Insurance cover?
Hospitalisation and Surgical:
Covers Hospitalisation & Surgical Expenses
Outpatient Specialist:
Covers eligible expenses incurred at specialist clinics, inclusive of diagnostic scans
Group Personal Accident:
Covers loss of life, permanent disablement due to an accident
Group Critical Illness:
Covers 37 critical illnesses with lump-sum payout on diagnosis
Preventive Care:
Covers annual health check-up and other wellbeing benefits
Outpatient General Practitioner:
Covers eligible expenses incurred at a General Practitioner (GP)
Dental:
Covers eligible dental expenses
Group Term Life:
Covers death or total permanent disability
Maternity:
Covers delivery cost and pre & post-natal complications
Vision:
Covers routine eye check-ups, frames, and contact lenses
How much does Employee Benefits Insurance cost?
Underwriting is the process a health insurer uses to decide at what price and with what terms to offer its insurance plans, based on known or anticipated medical needs. People with pre-existing medical conditions present financial risk to the insurer because they are statistically more likely to make a claim. Health insurance is about hedging against unforeseen illness, not about providing cover for known medical conditions.
Factors that affect pricing
- Patient's historical claims for the last 3 years
- Any existing terminal illness (such as cancer), which represent potentially large claims
- Age distribution: older demographics represent a higher likelihood of claims
- Capping or exclusion of pre-existing conditions can help to bring down the premium
SME Employee Benefits Insurance packages
For SMEs, Packaged Plans seem to be the simple go-to solution as they are convenient and do not require any health declarations. On top of that, the prices are as seen on brochures which provide transparency to the audience and a good headstart for companies who are new to this, with the common coverages usually listed in the brochure.
In the event of a high-claims year, most SMEs naturally worry about potential rising costs of their medical insurance. In lieu of that, we are glad to announce that Packaged Plans are “portfolio-rated”. This means that the insurer will not increase the premium as a sole result of your claims. Instead, the insurer looks at the entire portfolio of companies as one entity and will adjust premiums accordingly.
Plans can start with as little as 2 employees and range up to 50. For companies beyond 50 employees, please contact us for further pricing information.
Work Injury Compensation Act (WICA) versus Employee Benefits Insurance
While there are situations where both Work Injury Compensation (WIC) Insurance and Employee Benefits Insurance can overlap, they are not substitutes for each other. Having one does not exempt your company from needing the other. Each caters to different needs. Work Injury Compensation Insurance will only cover work-related injuries or illnesses, while Employee Benefits Insurance will cover personal medical costs.
Important Note: For claims that fall under the Work Injury Compensation Act, they must be claimed under the Work Injury Compensation Insurance(WICI) first. Employee Benefits can cover both, but always claim WIC first.
Common exclusions
For Hospital and Surgical, all Pre-existing Conditions, unless the Insured Member has been insured continuously for 12 months under this policy, except for Pre-existing Renal Failure and Cancer which are permanently excluded under the Policy.
Kidney dialysis and Cancer treatment.
Routine or preventative physical examinations, investigation, medical check-up, vaccinations or treatments.
Vitamins, supplements or any Traditional Chinese Medicine whether prescribed or not.
Administrative expenses and non-medical personal service and other ineligible non-medical items.
Pregnancy, childbirth, abortion, miscarriage, infertility, pre-and-post natal care.
Sickness or disease directly or indirectly arising from sexually transmitted diseases.
Congenital conditions or genetic defects including hereditary conditions.
Frequently Asked Questions
About Employee Benefits Insurance In Singapore
- It's highly recommended to get a group medical insurance policy, as it allows your business to attract top talent. Group policies also protect your employees from financial burden as medical costs tend to run high.
- Mandatory or statutory benefits are entitlements that employers are legally obliged to give their employees. These can include paid annual leave, parental leave, paid sick leave, etc.
- In most cases, employees cannot choose their own insurance policy for group insurance plans. However, they may have the option to purchase additional coverage or opt out of the plan if they have their own insurance coverage.
- The continuation of employee benefits insurance coverage after leaving a job depends on the terms of the specific insurance policy and the employer's policies. Some insurance policies allow for continuation of coverage for a limited time, while others do not. In some cases, employees may have the option to purchase continuation coverage after leaving the company but at their own expense.
- The processing time for employee benefits insurance claims in Singapore can vary depending on the insurance provider and the specific circumstances of the claim. However, insurance providers are generally required to respond to a claim within 14 days of receiving all necessary documents and information.
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