Group medical insurance for SMEs: how small groups are underwritten and what to compare
How do insurers look at a small group?
For small companies, insurers look at the number of employees, their ages, the industry, and any claims history. Some small-group plans apply a moratorium on pre-existing conditions for an initial period instead of medical questionnaires.
What should be compared?
Two plans at a similar premium can pay very differently.
| Feature | What to check |
|---|---|
| Inpatient limit | Per year and per disability |
| Ward entitlement | Public or private hospital, room type |
| Outpatient | Panel clinics, specialist referral, co-payment |
| Pre-existing conditions | Covered, excluded or moratorium |
| Dependants | Whether spouses and children can join |
| Claims | Cashless panel or reimbursement |
How often should the plan be reviewed?
At every renewal, against the current headcount and the claims the plan has paid. Headcount and age changes move the premium; plan design can be adjusted to keep the benefits that employees use.
Frequently asked questions
What is the minimum number of employees?
It depends on the insurer and plan. Several insurers accept groups of a handful of employees.
Can employees add family members?
Many plans allow dependants, at an additional premium.
Related cover
General information only, not advice on any particular policy. Cover depends on the policy wording and the insurer's terms.