January 31, 2024

Group Insurance for Employees: Get The Best Plan Without Breaking Your 2024 Budget

In this post, I'll show you exactly how to secure the best, most cost-effective group insurance for your employees, to ensure you get the maximum value out of your investment.

Whether you're a large corporation or a small business, you will learn something valuable and actionable here today.

You will also find the most comprehensive comparison of group insurance plans offered by different insurance companies in Malaysia.

(Psst... You won't find this☝️anywhere else on the internet!)

Let's dive right in.

Common myth: It's "just a medical card" for employees.

While a group medical plan is the most popular type of group insurance, in total there are 9 types of group insurance you can get for your employees:

  • Group Term Life
    coverage typically includes disabilities, terminal illnesses and repatriation of mortal remains
  • Group Personal Accident
  • Group Additional Critical Illness
  • Group Advanced Pay Critical Illness
  • Group Hospitalisation & Surgical (GHS)
    also known as "group medical plan"
  • Outpatient General Practitioner & Specialist Care
    enables employees’ cashless panel clinic visits
  • Maternity Benefits
  • Dental Care
  • Optical Care

To tailor an effective package for your staff, it can be incredibly worthwhile to understand the various types of coverage and, in turn, determine what is necessary and what is not.

So first, let's be clear on the purpose of a group insurance and how it all works — typical structures of these insurance plans, how they pay out when you make a claim, the requirements to get one, etc.

Why get a group insurance policy?

In the context of the workplace today, a group insurance is an important part of employee benefits offered by an employer to a group of employees.

In fact, according to JobStreet, 70% of managers consider group life and medical coverage a "must" and is also their major deciding factor in joining a company.

Different types of group insurance can cover different aspects of an employee's health, e.g. injuries from an accident, common and critical illnesses, disabilities and even death.

However, as crucial as it may be to employees, it is not mandatory for employers in Malaysia to provide group insurance as a benefit.

With that said, both big and small companies still frequently and strategically use tailored group insurance plans to support their hiring efforts and retain high-value employees.

What are the requirements for getting a group insurance?

If you had thought you couldn't get group insurance without a big team, well, here's some good news:

As soon as you have 3 people working in your company, including yourself, you can get group insurance!

The rest of the requirements are fairly straightforward and easy to fulfill:

Each headcount has to be a full-time employee of the company who is between 16 and 64 years old.

Basic requirements for getting group insurance:

  • You have 3 or more employees to insure.
  • They are full-time employees.
  • They are 16 years old or older but not over 64 years old.

There are certain benefits to having more headcounts

Having more employees does have its advantages when getting a group insurance:

As your team grows to 5, 10, 20 employees or more, you'll have more plans and insurance companies to choose from.

Every insurer has slightly different T&Cs around this, but, typically, once you have 11 employees, you can skip the underwriting process with most insurance companies.

No underwriting means no employee medical checkups will be required. And there’s no need to declare each employee’s health status too. This makes things faster and easier for everyone.

As your team continues to grow, reaching over 100 people, you'll start to see more significant advantages kick in — you'll have more leverage when negotiating prices, exemptions of waiting periods, and other terms and conditions.

Whether you're a lean team or a big one, group insurance offers valuable advantages for your business. So, no matter the size, you'll discover significant benefits when exploring group insurance.

Make employee benefits a breeze.

Get clarity on group insurance with true experts.

✨ Talk to one true expert  (instead of 10 reps...!!)

✨ Done-For-You comparison  (For easy decision-making!)

✨ Gain access to 10+ top insurers in Malaysia  (No gatekeeping!)

Understanding Group Insurance purchasing

What are the market prices?

A comprehensive group insurance package — one that enables your employees to go see doctors and specialists without worrying about the costs, get admitted to the hospital when necessary, and receive RM50,000 if they ever become disabled — only costs about RM110 per person per month.

For a simpler plan, the minimum monthly cost is RM40 per person, while premium packages befitting a CEO, VP or director can reach anywhere between RM500 to RM800 per month.

Know your employee count and budget

Constraints create clarity! Determine your two basic requirements before anything else — who do you want to cover (and how many of them) within what budget range .

Next, consider your team's demographics, company goals, and culture.

Do you mostly have mid-career employees with young families or highly focused singles? Do you have them working desk jobs, or out there in oil fields, or interacting daily with chemicals?

Tailor your plan accordingly for a happy, healthy, and motivated workforce.

Create tiers for different group insurance benefits

Benefits you give to your directors versus entry-level executives can be customised differently.

You can customise as many tiers as you need. This flexibility allows you to match your group insurance offerings to employees of varying seniority and contributions.

Consider multiple insurers

The insurance companies you know for personal coverage may or may not excel in group insurance!

Being open to different insurers can lead you to find plans that align more with your needs and potentially help you do a better job at staying within budget.

When in doubt, seek professional advice to navigate complex terms and conditions, special exclusions and limitations, and even negotiate with multiple insurers on your behalf! And we offer the perfect help on this.

constructing Group Insurance package

Select a base coverage

The components of any group insurance package start with one of these two base coverages:

  • Group term life plan (GTL)
  • or Group hospitalisation & surgical plan (GHS)  aka “group medical insurance”

Most group insurance plans available on the Malaysian market start with a minimal GTL plan, e.g. RM10-20k coverage for death or disabilities.

And then, an employer would typically attach a GHS plan (and anything else that they desire) to craft something more comprehensive than just the base coverage.

Attach additional riders

Other popular group coverages, such as the Outpatient GP and specialist plans (for cashless visits to a panel GP or specialist clinic), Group Critical Illness plans, Dental Care plans, etc…

They cannot be purchased separately; they must be attached to a base coverage.

This hierarchical bullet point structure below shows the bundled relationship between the base coverages and their riders.

Base coverages & their riders

  • Group Term Life (GTL)
    • Group Personal Accident
    • Group Additional Critical Illness
    • Group Advanced Pay Critical Illness
  • Group Hospitalisation & Surgical (GHS)

    • Maternity Benefits
    • Outpatient General Practitioner (GP) & Specialist Care

      • Dental Care
  • Optical Care

This means you can't attach a rider that complements a different base coverage.

For instance, you can't combine an Outpatient GP & Specialist plan with a GTL. To get the Outpatient plan, you need to have GHS as your base coverage, and you can optionally add GTL.

Dental Care has to be attached to an Outpatient plan with most insurance companies.

Optical Care is an exception. You can obtain it independently and directly from third-party administrators, who are commonly engaged by insurers to manage administrative processes.

This is because optical plans are essentially outsourced administrative tasks.

Extending coverage for spouses and kids

Two group insurance plans offer extensions for spouses and children:

  1. Group Hospitalisation & Surgical (GHS)
  2. Outpatient GP & Specialist Care

The requirements are simple: spouses must be 16-64 years old; and children included in the plan should be between 15 days and 23 years old, without gainful employment.

How do group insurances pay out?

When something bad happens, there are essentially three ways an insurance company will make a payout to an employee:

  • Insurance company makes a lump sum payment to the employee through the employer.
  • An employee utilises cashless healthcare services, then, insurance company settles the bill directly with a panel hospital or clinic.
  • An employee, for certain reasons, pays for healthcare services first, then, insurance company reimburses the employee directly.

An overview of different group coverages

Below, we’ll take a look at the various group insurance coverages, how they differ from each other, as well as a summary of typical plan structures and payout methods discussed above:

An overview of different group insurance types, including what they cover, when they trigger a payout and how they pay out (October 2023)

Group insurance type

What it covers

When it triggers a payout

How it pays out

Base coverage

Group term life

The event of a death, total and permanent disability (TPD), permanent partial disability (PPD) and terminal illness.

Some insurers also cover repatriation costs.

Upon an employee's death, TPD, PPD or diagnosis of a terminal illness.

Pays a lump sum

GTL rider

Group personal accident

The event of a death, TPD or PPD caused by an accident.

Upon an employee's accidental death, TPD or PPD.

Pays a lump sum

GTL rider

Group additional critical illness

Advanced stage of up to 43 critical illnesses, such as cancer, stroke, heart attack, etc.

Upon diagnosis of an advanced stage critical illness.

Pays a lump sum

GTL rider

Group advanced pay critical illness

Same as above. The difference between this and the plan above is that, in case of a critical illness claim, an employee can access the coverage amount of their Group Term Life, enhancing the total payout.

Upon diagnosis of an advanced stage critical illness.

Pays a lump sum

Base coverage

Group hospitalisation & surgical (GHS)

In case of hospitalisation, this plan covers an employee's hospital bills from treating any sickness or injury that is medically necessary.

Upon hospitalisation with a guarantee letter (GL); or insurer will reimburse through employer at a later date.

Cashless or reimbursement

Ghs rider

Outpatient general practitioner & specialist care

An employee's expenses when they visit a clinic to receive medical care.

The insurer pays a panel clinic directly. If the employee did pay out of pocket at any clinic, insurer will reimburse through employer.

Cashless or reimbursement

Ghs rider

Maternity benefits

Delivery costs, antenatal and postnatal care.

Insurer will reimburse through employer.

Reimbursement

outpatient rider

Dental care

Emergency dental treatment, extraction (anaesthesia included), x-ray, fillings, cleaning & polishing, etc.

Insurer will reimburse through employer.

Reimbursement

Optical care

Eye exam, prescription of glasses/contact lens, etc.

The third-party administrator (TPA) pays a panel service provider directly. If the employee pays out of pocket, they will be reimbursed by TPA.

Cashless or reimbursement

Which insurance companies in Malaysia offer employee benefits insurance plans?

There are about 10 options for group insurance for employees:

  • AIA
  • Allianz
  • AmMetLife
  • Etiqa
  • Great Eastern
  • Hong Leong Assurance
  • Prudential
  • Tokio Marine
  • Takaful Malaysia
  • Tune Protect Life

There are actually even more in the market but these are the main ones I usually consider for my corporate clients.

A couple more Takaful options not listed here are available as well for my Muslim clients who are strictly looking for Group Takaful only.

AIA, Allianz, AmMetLife, Etiqa, Great Eastern, Prudential, Tokio Marine, etc — How do they compare?

To the average consumer, getting details of group insurance plans has traditionally been a challenge, and comparing them is even more daunting.

Why? Because same things are named differently by each insurer, there are all kinds of coverage limits and varying details, and group plans are by nature highly customisable, adding to the complexity.

To simplify the early stage of your decision-making, we've created a cheat sheet that breaks down the most important features, requirements, and all the add-ons — giving you valuable insights at a glance to help you decide what your next step could be.

Now, let's dive into a comprehensive comparison of these 10 insurance companies and their group insurance offerings:

Comparison of Group Insurance for Employees Offered by 10 Insurance Companies in Malaysia (October 2023)


AIA

Allianz

AmMetLife

Etiqa

Great Eastern

Hong Leong Assurance

Prudential

Tokio Marine

Tune Protect Life

Takaful Malaysia

Requirements

Minimum headcount
with health declaration / underwriting required

5

No minimum headcount

5

3

No minimum headcount

11

5

5

5

10

Minimum headcount required to waive health declaration /underwriting
(Less paperwork, faster process!)

11

3

20

11

11

11

11

5

11

11

Maximum headcount

200

200

Unlimited

200

150

Unlimited

200

150

250

150

Group Hospitalisation & Surgical Plan (GHS)

Can be bought without Group Term Life (GTL) plan?

Must be bundled with GTL

Must be bundled with GTL

Must be bundled with GTL

Must be bundled with GTL

Must be bundled with GTL

Must be bundled with GTL

Annual limit

RM20k to RM400k

RM20k to RM300k

RM100k to RM200k

RM20k to RM200k

RM20k to RM300k

RM20k to RM200k

RM15k to RM200k

RM30k to RM200k

RM20k to RM200k

RM12k to RM100k

Hospital Room & Board

RM80 to RM600

RM90 to RM600

RM100 to RM300

up to RM500

RM150 to RM400

RM120 to RM400

RM80 to RM500

RM100 to RM500

RM90 to RM500

RM80 to RM350

Optional Add-on to GHS

Outpatient General Practitioner & Specialist Care

Covid-19 Hospitalisation

Can be extended to cover spouse and/or children

Group Term Life Plan (GTL)

Covered Event

MINIMUM Coverage Amount / Sum Assured

Death

RM20k

RM50k

RM10k

RM20k

RM20k

RM20k

RM20k

RM20k

RM25k

RM20k

Total permanent disability (TPD)

Partial permanent disability (PPD)

Terminal illness

RM20k

RM10k

RM20k

RM20k

Expenses for repatriating mortal remains

Optional Add-on to GTL

Critical Illness coverage

Accidental death

Make employee benefits a breeze.

Get clarity on group insurance with true experts.

✨ Talk to one true expert  (instead of 10 reps...!!)

✨ Done-For-You comparison  (For easy decision-making!)

✨ Gain access to 10+ top insurers in Malaysia  (No gatekeeping!)

take action today

It's easier than ever to get your group insurance costs under control!

The value of a well-crafted group insurance package is undeniable.

In today's landscape, it's almost fundamental.

As you navigate your group insurance options, remember that you don't have to go it alone.

Our dedicated team is here to offer the expertise, guidance, and support you need.

With our help, it's easier than ever to get the group insurance of your employees' dreams without breaking the company budget.

Instead of spending countless hours researching and comparing on your own, leverage our deep experience to customise a package that suits your industry, company culture and your team's unique needs while perfectly aligning with your business goals.


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