WHAT ARE GMC AND GPA INSURANCE POLICY

There is often a certain confusion among group health insurance policies like Group Medical Coverage (GMC) and Group Personal Accident (GPA). They seem similar but are definitely not. To make it easier and clear for you to choose the right policy for yourself, let us look at the detailed difference between these policies and understand their intricacies.

What is Group Medical Coverage insurance policy? (GMC)

Group Medical Coverage or GMC is a type of health insurance policy that provides coverage for a group of people like employees in a corporate insurance plan in case of hospitalisation due to any illness or medical issues.

What is Group Personal Accident insurance policy? (GPA)

Group Personal Accident or GPA is a type of health insurance policy that provides coverage for a group of people like employees in a corporate insurance plan in case of any disability due to an accident or even death.

Difference between GMC and GPA insurance policy

Factors	GMC	GPA
Also known as	Corporate Insurance, Employer-offered Insurance and Employer-employee Insurance	24-hour Worldwide Accident Policy and Personal Accident Cover for Employees
Capacity	This policy involves medical issues and emergencies of covered employees including pre-hospitalisation, post-hospitalisation expenses and day care treatments	This policy involves accidents of covered employees on duty or on duty + off duty depending upon the policy cover
Coverage	GMC plan coverage is calculated on indemnity basis. It means the covered employee’s expenses shall be settled under the sum insured limit only. For instance, if the policy’s sum insured is Rs. 3 lakhs and the hospital bill generated is Rs. 2 lakhs, the bill shall be covered entirely as it is within the sum insured limit	GPA plan coverage is calculated on benefit basis. It means the covered employee shall be provided with a lump sum amount for the injury as per the terms of the policy. For instance, if the policy’s sum insured is Rs. 60 lakhs and the accident results in permanent total disability for the covered employee; then they shall receive 100% of the sum insured amount
Extent	GMC covers the employee and, also dependent family members such as spouse, children, or parents	In case of GPA plan, only employees are covered, there is no extension for family members
Range	GMC having a wider coverage range can include GPA as an add-on in the policy	GPA has only a limited coverage towards accident scenarios for employees covered
Customization	The GMC insurance policy has aspects that can be customized by the employer	In case of GPA insurance policy there is no scope for customization
Premium	Generally, the premium for GMC policy is on the lower side	The premium for GPA policies is slightly on the higher range
Inclusions	The inclusions for a GMC policy are pre, during, and post hospitalisation expenses, Maternity cover, Day-care expenses, Out-patient Department (OPD) expenses, pre-existing diseases, critical illness cover, and regular health checkups	The inclusions of a GPA policy are accidental death, permanent partial disability, permanent total disability, temporary total disability, repatriation of mortal remains, child education cover, ambulance charges and hospitalization expenses like room rent in case of an accident
Exclusions	The exclusions for a GMC policy are drug and alcohol abuse and self-inflicted injuries	The exclusions of a GPA policy are attempted suicide, involvement in adventure sports, involvement in illegal activities
Best for	GMC policy is model for a wide variety of establishments	GPA policy is more suited for employees in industries that are exposed to risk of accidents such as construction, oil and gas or travel

Both the GMC and GPA insurance plans have their own benefits and now after knowing their particulars, depending on the nature of your industry, you can choose which suits best for your employee requirement.

FAQs – Frequently asked questions.

Q1: Does GPA policy have coverage on duty as well as off duty for employees?

Yes, in some cases GPA coverage can be extended from on duty to off duty as well. Under an on-duty cover, an employee shall be protected only in case of accidents encountered while being on duty. However, in an on-duty + off-duty cover, there is no such limit. The employee gets insured all the time as per the policy’s set terms and conditions.

Q2: Are part-time employees covered under GMC or GPA insurance policies?

No, typically only full-time employees are covered under GMC or GPA policies. However, they can be added if the employer wishes to provide coverage for such employees as well.

Q3: Is it compulsory to insure employees under a GPA insurance policy due to its nature and coverage?

No, it is not mandatory to cover employees under a GPA insurance policy. Though, a combination of a GMC policy with a GPA add-on is an ideal protection cover for the employees.

Q4: Is the payable premium for a GMC and GPA cover made by employers only?

No, the payable premium for GMC and GPA policies depends upon the chosen coverage which is generally paid by the employer. However, in certain cases the employees are asked to contribute in the premium payment. In case employees themselves choose to purchase add-ons on their policy then the premium for such enhancements is paid by the employees only.

Q5: Can family members be covered in a GMC policy?

Yes, under a GMC policy, all employees above 18 years and up to 70-95 years who are employed with an organization can be covered. Their spouse, parents, and dependent children aged between 3 months to 25 years can also be added in the plan depending on the employer’s choice of coverage.

Q6: Should you get a GMC policy for your employees if you have a company?

Yes, if your company has at least ten employees, it is advisable to get a group health insurance to protect them all. Depending on the nature of your industry and work you can choose between GMC and GPA policy.

Q7: If you are already protected under a GMC policy from your employer, should you get an individual health insurance policy too?

Yes, since the insurance plan is linked to your employment at the firm as you shall leave the coverage shall terminate. By opting for an additional individual health insurance plan, you can stay protected no matter where you work whether you are under a group insurance plan or not. You will also have the benefits of more coverage and personal tax savings.