What's a TPA (Third Party Administrator) In Health Insurance | Pazcare
TPA in health insurance, Advantages of TPA, Role of TPA, Top TPA companies
September 21, 2022
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As per Insurance Regulatory and Development Authority of India (IRDAI), a company with 7 or more lives is qualified to get group health insurance. However, it is up to the insurers to decide the minimum size they want to cater to. Commonly public insurers prefer offering group health insurance to companies with more than 100 lives and private insurers offer it to companies with more than 50 lives.
What’s the exception?
When you go to a wholesale shop and buy 200 notebooks, you can ask the shopkeeper for a discounted price. Let’s say 200 notebooks cost Rs 2000 and you get a discount of Rs 100. If you buy just 10 notebooks, then you will hardly get any discount. This is the same way group insurance work.
When you have a big employee strength, you can negotiate the price better. However, it is also important that with a bigger employee strength, comes a bigger claim dump. If many employees claim huge amounts in a year, then the next renewal might get a bit expensive as insurers would want to compensate for the money spent on settling claims.
Also read: Group health insurance premiums
What happens if the employee size goes lesser than the minimum size after group health insurance is issued?
The limit applies only at the time of issuance of a group medical insurance policy. If the number decreases after you get your group health insurance it won’t be a problem. However, when you go for renewal, which happens annually, you need to have the minimum size that your insurer dictates.