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Group Health Insurance should have at least 20 members: IRDAI

In an exposure draft on IRDAI (Health Regulation) Regulations, 2016, the regulator also proposed that the group members should have a relationship other than insurance with the group policy holder for their services

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Last Updated - May 15, 2023
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Insurance sector regulator – IRDAI (Insurance Regulatory and Development Authority of India)- has notified that in order to be eligible for a group health insurance, a group should have a minimum of 20 members. However, the group size for micro-insurance can be 5.

Also, In an exposure draft on IRDAI (Health Regulation) Regulations, 2016, the regulator proposed that the premiums filed shall ordinarily not be changed for a period of three years after a product has been cleared in accordance to the product filing guidelines specified by IRDA.

Thereafter, the insurer may vary the premium rates depending on the experience, such rate shall not be changed for a period of at least one year from the date of clearance IT. 

Changes in rates will be applicable from the date of approval by IRDA and will be applied only prospectively thereafter for new policies and at renewal. 

Also, the insurer shall not compel the insured to migrate to other health insurance products, if it is to the disadvantage of insured except if it is a case of migration from a withdrawn product in which case the insurer shall offer the policyholder an alternative available product subject to portability conditions.

The group policyholder shall clearly have other relationship than insurance, with the group members for their insurance. 

The group health insurance wouldn’t be available to the group which has been formed with the sole purpose of “availing itself of insurance”.

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