Employee Benefits - Group Insurance FAQ


 Ø What is Group Insurance and why?

A group insurance plan insures a group of people under a single insurance contract and every individual member of the group enjoys a comparatively lower premium rate than insuring one person individually.


Ø What is the premium rate of the Group Insurance?

Premium will be determined based on the age, occupation and amount of insurance of all employees in a group. Proposal with the detail of benefit and premium will be submitted after receiving details of your employees from you.


Ø Why should an employer buy a Group Insurance?

·   Employees and their family would feel financially secure.

·   It helps increasing loyalty of employees towards their organization resulting in higher productivity of employees.

·   It safeguards the employer from paying huge amount in the event of adverse eventuality, like death, disability, injury & illness of employees.

·   Premium is lower in group Insurance.

·   It enables the organizations to plan and budget for the future accurately.


Ø Who is eligible to apply for this plan?

This plan is available to a group of 10 or more (for SMEs 5 or more) full time regular and salaried employees actively at work in the employer’s office in Nepal for at least 30 hours per week, under 65 years of age, in service on the policy effective date. Refers to an employee being actively at work on a full-time basis with the employer, and who is not disabled, granted a leave of absence, temporarily laid-off, or placed on part-time employment. The employer shall provide full details of employees to MetLife. Coverage shall commence on the employees subject to MetLife’s written confirmation.


Ø What type of groups can buy Employee Benefits Plan?

In order to be eligible for Group Insurance coverage, the group must be an employer- employee group and have been formed as a formal group for a reason other than to obtain insurance.


Ø Can we take the Group Insurance coverage on premium contribution basis?

Yes. If the insured group members are not required to contribute any part of the premium payment for the coverage where as employer pays full premium, the group insurance plan is a non-contributory plan. If the group members must contribute some or all of the premium payment in order to be covered under the group insurance policy, then the plan is a contributory plan. For Contributory Plans, participation must be at a minimum 75% of total eligible members of the Group.


Ø What happens if an insured employee leaves the organization due to retirement or termination?

His/her coverage is terminated from the day he/she leaves the organization. The unutilized premium is refunded or adjusted on a pro-rata basis against the premium for newly enrolled employees or the next renewal premium as per the preference of the Employer.


Ø What happens if a new employee joins the organization?

His/her coverage starts from his/her date of enrollment accepted by MetLife. We will charge only the pro-rated premium for the remaining period up to the renewal date or the Policy anniversary. If any unutilized premium is available, this amount can be credited towards the premium for new employees.  


Ø Are we covered at work, at home or during vacation and traveling?

Yes. This plan provides 24 hours a day and 365 days a year worldwide protection.


Ø How is coverage amount determined?

Coverage amount of each member can be determined in any of the following three (3) ways:

·   Flat Amount Plan: The amount of insurance is identical for all eligible employees.

·   Multiple of Earning Plan: The amount of insurance is determined by a multiple of the employees’ earning – be it 12 / 24 / 36 / 48 times of monthly gross or basic salary.

·   Class Plan: Amount of insurance varies according to the occupation or designation or salary level classification.


Ø Can we choose only certain coverage as we want to, on an optional basis?

Yes. We can customize the coverage package for your organization’s needs. However, Life and Accidental Death coverage are mandatory in order to qualify for other coverage.


Ø How do we make a claim?

You can call at our office for the assistance. Our friendly representatives will guide you on the claim process.