GROUP SCHEME

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• Group Term Insurance Scheme 

A) Nature of the Scheme:

Group (term) Insurance Scheme is meant to provide life insurance protection to groups of people. Administration of the scheme is on group basis and cost is  low. Under Group (Term) Insurance Scheme, life insurance cover is allowed to all the members of a group subject to some simple insurability conditions without insisting upon any medical evidence. Scheme offers covers only on death and there is no maturity value at the end of the term.


B) Premium Chargeable:

Group (Term) Insurance Scheme is at present offered under One Year Renewable Group term assurance plan (OYRGTA). Every year on Annual Renewal date LIC charges the premium depending upon the changes in size and age distribution of the age group.


C) Different Schemes:

Group (term) Insurance Scheme has a number of varieties . The Scheme may provide for a uniform cover to all members of the group or graded covers for different categories of members, cover for all amounts of outstanding housing loans or vehicle advances, or some other benefits (e.g., life cover to supplement pension or PF benefits in case of death). The schemes may have add-ons like Double Accident Benefit,Critical Illness Benefit, Disability benefit etc.


D) General Featues of various Group Insurance Schemes:

1. PREMIUM:
   The premium under such scheme may be wholly paid by the employer or the Nodal Agency. However, the scheme may be contributory i.e. the members may also contribute.
   
   
2. DOUBLE ACCIDENT BENEFIT:
   Double Accident Benefit, i.e. payment of double the sum assured on death due to accident (without permanent disability benefit), may be allowed under Group Insurance Schemes for an extra premium.
   
   
3. ELIGIBILITY:
   For Group Insurance Scheme in lieu of EDLIS the insurability condition is that should be a member of the Provident Fund Scheme of the employer. For other GI Schemes of employer-employee groups the insurability condition is that the member should not be absent on ground of sickness on the entry date. For all non-employer-employee Group Schemes the basic insurability condition is that the member should be in good health on the date of entry.
   
   
4. ADMINISTRATION OF THE SCHEME:
   At the commencement and thereafter on each Annual Renewal Date, the Group Policyholder will have to send all the member's data (and particulars of the new entrants from time to time) to the P & GS unit of LIC. Detailed OYRGTA premium calculation will be made on each Annual Renewal Date.
   
   

When a claim arises, the particulars of the respective member are to be intimated together with the claim form and death certificate.

Special Features of each Group Insurance Schemes can be obtained from the P&GS units of the Corporation.

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• Group Insurance Scheme in Lieu Of EDLI

What is EDLI?

All employees to whom the Employee's Provident Fund and Miscellaneous Provision Act , 1952 applies, have a Statutory liability to subscribe to Employee's Deposit Linked Insurance Scheme, 1976 to provide for the benefit of Life insurance to all their employees. Under the scheme as amended with effect from 24th June,2000 the insurance benefit is equal to the average balance to the credit of the deceased employee in the Provident Fund during the last 12 months, provided that where such balance exceeds Rs.35,000, insurance cover would be equal to Rs.35,000 plus 25% of the amount in excess of Rs.35,000 subject to a maximum of Rs.60,000. Thus if the lenth of service is not adequate and/ or the salary is low the average balance may be substantially less and such the benefit to the employee's family is either inadequate or non-existent.

The contribution @ 0.50% of each employee's salary is payable by the Employer to the Provident Fund Authorities.


THE BETTER ALTERNATIVE:

However, under Sec. 17(2A) of the act, the employer may be exempted from contributing  to this scheme, if he/she has provided for better insurance benefits through alternative scheme. LIC's Group Insurance Scheme in lieu of EDLI has been accepted as one such better alternative.


ADVANTAGES TO THE EMPLOYER :

1. The premium payable by the employer is usually less than the total contribution being paid by the employer to R.P.F.C; particularly when the salary level is high and average age of the group is low.
   
2. Settlement of claim is quicker, LIC requires only the death certificate and the Claim Form from the employer.
   
   
3. Premium paid by the employer is treated as normal business expenses for Income-Tax purpose.

ADVANTAGES TO THE EMPLOYEE:
Each employee is covered for a sum assured ranging between 5,000 to 2,00,000 depending upon the current salary and service put in from day one irrespective of the actual balance in the Provident Fund. Alternatively every employee/ worker can be covered for a  uniform sum assured which will be decided  depending upon the group size.


ACCIDENT BENEFIT:
Double accident benefit can be allowed to the extent of the Sum Assured for an extra Premium.


STEPS TO INTRODUCE THE SCHEME:

1. Put up notice for the knowledge of the employees that you are going in for LIC's Scheme in lieu of EDLI.
   
   
2. Apply to the Regional Provident Fund Commissioner under Sec.17 (2A) of the E.P.F. and M.P. Act 1952 to exempt you from EDLI Scheme. The application should be accompanied by the prescribed requirements including the Rules of the Proposed Group Insurance scheme. Central PF Commissioner, has authorized the R.P.F.C. to grant exemption from the 1st of the month in which the application for relaxation is submitted. LIC also offers necessary guidance to the employers for seeking relaxation.

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• Group Gratuity Scheme

Life Insurance Corporation of India offers its Group Gratuity Cash Accumulation scheme to enable employers to meet their gratuity liability in a very simple and efficient manner. The scheme is formulated in compliance with Part C of the IV schedule of Income Tax Act and tax benefits are available as provided in Income Tax rules

The gratuity arrangement with LIC provides the following services to the company

• Fund management under interest accumulation system
• Claim settlement on exit as per company rules/gratuity act
• Built in Insurance arrangement for the employees for future service
• MIS related to Income Tax and trusts accounts and Actuarial valuation

Fund management: Critical issues

Safety:           

Liability on account of gratuity experiences sharp increase every year due to its nature of its computation.  Apart from increase in service, increase in salary also contributes to increase in liability substantially as the benefits are payable on last drawn salary.  Hence funds have to be invested in a conservative way with a consistent growth and insulated from market risks

The unique advantage with LIC is the contributions made by the company and interests credited by LIC are irreversible. This ensures highest level of safety for the total corpus and consistency in future contributions. As the gratuity payments are statutory and LIC gratuity scheme being the only investment tool which enjoys sovereign guarantee, gives a greater comfort to employer.

Liquidity: Funds available with LIC is a single account for investment and claim settlement. Hence 100% liquidity is ensured for the purpose of claim settlement

Yield: LIC has been offering very competitive and consistent interest rates over the years. For the year 2009-10, LIC has offered 9.00% - 9.65% depending on fund size. The interest declared is net of administrative expenses incurred, hence no separate charges are charged after crediting the interest.

Interest rate offered by LIC is on daily balancing method. Hence, there is no idle time for earning interest, hence effective rate of interest is much higher. Another significant aspect is interest gets compounded annually, hence no reinvestment issues and no time lags.

No responsibility on trustees on Investment decisions: Trustees are free from all investment risks and hassles in cash accumulation system. Advantage of ‘real outsourcing’ can be derived by associating with LIC

No hidden charges: The scheme is focused on a long term association in compliance with investment regulations and statutory payment obligations and no charges are levied on the transactions for which the fund is meant for.

Funding can also be in a staggered pattern during the year, but no charges at entry level for any number of payments. No charges on withdrawals for resignation or retirement or death. Total corpus comprising of money contributed by the company and interest credited by LIC is available for claim settlement up to 100% subject to availability of funds.

Actuarial recommendations: On annual basis, LIC provides this information to the trustees and recommends the level of contributions.

Claim settlement: On the exit of an employee due to retirement / death/ resignation, trust may prefer a claim from LIC by sending a claim form.  Claim amount will be made available to trustees. Trustees can have the following options

• Preferring a claim from LIC and paying to employee
• Paying the money to employees and seek reimbursement
• Paying claims to employees at their end and seeking annual reimbursement

MIS: LIC provides statement of receipts and payments and actuarial valuation certificate and certificate of balance for the trust account.

Besides the above said advantages, the scheme also provides for employee welfare measures with built in insurance cover.

• Insurance cover for future service gratuity

 Another salient feature of the Gratuity Scheme with LIC is that it provides for insurance coverage to the employees to the tune of future service gratuity subject to certain limits.  The insurance cover can be flexible depending on the requirements of the Trust. The Group Insurance premium will be commensurate to the cover provided.

• Income Tax Benefit on Insurance Premium

The insurance premium paid towards the above said benefits is treated as deductible business expenses to the company.

The premium is not treated as perks in the hands of the employees

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• Group Super Annuation Scheme 

An organization today, has not only to man the various positions with competent and trained personnel but also has to create an environment wherein they can give their best and derive a sense of well-being, a sense of fulfillment and security and take pride in their continued association with the organization. Provision of pension may be an attraction for such persons to continue in the organization and give their best to the organization, as with continuous improvement in longevity a regular income even after retirement has become a necessity. To provide the pension benefits to employees, an employer has two alternatives under the provisions of Rule 89 of Income Tax Rules 1962.

1. Create a privately managed trust fund and as and when a member retires, purchase annuity from LIC to provide pension for such retiring member.
2. Entrust the Management of the Pension Fund to an Insurer by purchasing its Group Superannuation Scheme.

ADVANTAGES OF THE LIC MANAGED PENSION FUND:

The LIC managed Pension fund has the following added and distinct advantages:-

1. An attractive and competitive yield on the fund will be credited to Fund A/c.
   
   
2. The problem of liquidity gets automatically eliminated as soon as the fund is managed by LIC.
   
   
3. We conduct free actuarial valuations of the funds administered by us from time to time.
   
   
4. The Administration of the fund is carried out by us in a scientific manner and claims are promptly settled.
   
   
5. Group Insurance in conjunction with the Group Superannuation Scheme can be taken by an Organization to provide for an attractive lump sum payment on the unfortunate death of a member while in service, at very nominal cost.
   
   

Superannuation Scheme Provided by LIC:

The employer contributes a certain fixed percentage of salary of each member. Such Contributions are accumulated by LIC and the accumulated amount is utilized to provide various benefits as mentioned below.


BENEFITS:

1) ON RETIREMENT:
On Retirement of a member, the corpus (contributions plus interest) is utilized to provide the pension as per his choice.

2) ON DEATH:
The Pension is payable on the life of the beneficiary. Corpus is utilized towards the payment of pension of the type the beneficiary may opt and the benefit so received is tax free. A lump sum payable by way of death besides the pension, if the employer has taken Group Insurance Scheme in conjunction with the Group Superannuation Scheme.

3) ON WITHDRAWAL:

• He can get the equitable interest transferred to the Superannuation Scheme of the new employer or opt for immediate or deferred pension.

PENSION OPTIONS PROVIDED BY LIC:

1. Life Pension ceasing at death.
2. Life Pension with Return of Capital and Group Pension Terminal Bonus on death.
3. Life Pension guaranteed for 5,10,15 or 20 years and life thereafter.
4. Joint Life Pension payable on the last survivor of the employee and spouse.
5. Joint Life Pension payable to the last survivor of the employee and spouse with return of capital on the death of the last survivor. If desired , 1/3rd of the pension can be commuted at vesting.
   
   

ELIGIBILITY CONDITION:

It is not obligatory or statutory on the part of the employer to provide for pension to all employees. It is entirely upto him to decide to which class/ classes of employees he desires to extends the scheme. The eligibility conditions may be defined on the basis of designation or salary. (However, after the categories are specified, employer cannot discriminate between the employees and thus extends the scheme uniformly).

CONTRIBUTION:

The maximum annual contribution that an employer can make to the Pension Fund and Provident Fund is restricted by the Income Tax Provisions to 27% of the annual salary (basic plus D.A.) The annual contributions are treated as deductible business expenses.

WHO PAYS CONTRIBUTION?

Mostly the employer contributes, but is so desired, both the employer and the employees may contribute, in which case the scheme is called a Contributory Pension Fund Scheme.


TAX BENEFITS:

The provisions relating to the approved Superannuation Scheme are set out in Part 'B' of the Fourth Scheme of the Income-Tax Act, 1961 and Part XIII of the Income Tax Rules , 1962. The income tax concession will be available only if the scheme is approved by the CIT.

1. The annual contribution is treated as a deductible business expense in term of Section 36(1) (iv) of the I.T. Act.
2. In terms of a Notification issued by the Central Board of Direct Taxes .80% of the contribution (s) towards the past service liability are treated as deductible business expenses spread over in the subsequent years of payment.
3. The employee's contribution , in the case of the Contributions scheme qualifies for exemption under Section 80C of the Income-Tax Act.
   
   

GROUP INSURANCE SCHEME IN CONJUNCTION WITH SUPERANNUATION SCHEME:

The members of the Group Superannuation scheme can be covered under Group Insurance in conjunction with superannuation scheme so as to provide death risk cover while in service subject to certain conditions.

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• Group Savings Linked Insurance Scheme

The people working in the metropolitan cities, occupied as they are in their day to-day activities where inflation is inevitable, find difficult to provide adequate security for their families, Individual insurance with high premium in fact does not provide adequate insurance protection. Their need for insurance protection during service coupled with adequate savings for carefree retired life remains unfulfilled. Keeping this in mind, LIC has come out with an attractive insurance scheme viz. Group Savings Linked Insurance scheme at a very low cost. Central Government has a similar scheme with minor modifications. Semi-Government Organisations, Public Sector Organisations and also Large private business houses and industrial enterprises have introduced this scheme, the salient features of which are as under:


I) OBJECTIVES OF THE SCHEME:

• Protection at low cost without individual evidence of health.
  
  
• Attractive returns on savings to meet post retirement needs.
  
  
• Simple procedures for granting life cover to large groups under one umbrella.

II) INTRODUCTION OF THE SCHEME:

a) The Scheme can be introduced by employers provided certain percentage of employees is willing to join the Scheme.

b) For the new entrants to the Company, the membership of the Scheme is compulsory.

III) PREMIA:

It is decided on the basis of Group size and the occupation of the group.Premium has two components i.e. Risk Premium and Savings Premium.Risk Premium is utilized to offer life cover and the Savings Premium is accumulated in members account.


IV) ACCIDENT BENEFIT:

Double accident benefit can be allowed to the extent of the Sum Assured for an extra Premium.


V) INTEREST ON SAVINGS:

The present rate of interest allowed on saving portion of premium is 8% compounding yearly.


VI) ELIGIBILITY TO JOIN THE SCHEME:

Any employee irrespective of his present state of health is eligible to join the scheme subject to certain conditions. The only insurability condition is that the employee should not be absent on medical ground on the date of commencement of the scheme. All employees who have not crossed the retirement age are eligible to join the scheme. All future employees have to join the scheme compulsorily.


VII) TAX BENEFITS:
Employees' total contribution, savings as well as risk premium is entitled for income-tax rebate under Sec. 80C of the Income Tax Act. The entire claim amount including interest earned payable on retirement or leaving service or on death is free from income-tax. The premium paid by the employer towards insurance cover is treated as business expenses.

 

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• Group Leave Encashment Scheme

Many employers are providing Leave Encashment benefit in addition to other retirement benefits to their employees which is a lumpsum amount payable to the employees or their dependants on retirement, death, disablement, voluntary retirement etc.

Funding of leave encashment:

End-of-the-year leave encashment facility available to employees, can be a huge liability to the company. So can be Medical Leave Encashment, if provided for. To meet this need of entrepreneurs and businesses, LIC has introduced Group Leave Encashment Scheme. Just pay a yearly premium, fund your leave encashment liability and let LIC take care of your worries.

Nature of liability:
The amount depends upon the leave to the credit of the employee and his/ her salary at the time of exit. Liability is of increasing nature as it is linked with salary as well as leave position.

As per the amended section 209 (3) of the Company's Act 1956 and Accounting Standard (AS-15) dated January, 1995, the employers have to account for the liability in respect of leave encashment facility, if any, available to the employees and to provide for the same in their Annual Accounts. It is, therefore, necessary for the companies to ascertain liability in respect of Leave Encashment facilities, if any, available to the employees and provide for the same in the books of accounts every year. It helps the employers in ascertaining the true cost of their products and services.

The Features:
Group Leave Encashment Schemes (GLES) of LIC helps the employers in funding of their lave encashment liability. The salient features of the scheme are as follows:-

1. The Company will submit the employees' data and rules for Leave Encashment. LIC will make actuarial valuation and find out the funding requirements which shall be quoted to the company. The company will contribute as per the advice of LIC.
   
   
2. A uniform life cover per employee or graded cover will be provided under One Year Renewable Group Term Assurance Plan of LIC. A small term insurance premium will be charged in addition to contributions for funding.
   
   
3. A Running Account will be maintained under the scheme and the contributions (excluding term assurance premium) will be credited to this account and all claims except term assurance cover will be settled out of the Running Account. Interest at the rate declared by LIC from time to time will be credited to the Running Account at the end of the financial year.
   
   

Benefits:

1. On the exit of an employee or encashment of leaves during the service the Leave Encashment amount will be paid from the Fund of the scheme maintained with LIC.
   
   
2. On the death of an employee, in addition to his / her leave encashment benefit, his/her family will be entitled to the amount of Insurance Cover, which will be tax-free.
   
   
3. The Life Insurance Corporation of India will do the Actuarial Valuation and will provide necessary certificate as per AS-15.
   
   
4. The amount of Term Insurance Premium paid for Life Insurance Cover will be treated as business expenses.

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• Group Mortgage Redemption Assurance Scheme

Group Mortgage Redemption Assurance Scheme’, is a Group Insurance Scheme for the borrowers of Housing/Vehicle Loans from Financial Institutions where Loan is recovered under EMI. Under the Scheme, the premium is payable in a single installment covering a decreasing life cover. Insurance cover every year will be almost equal to the loan outstanding at the anniversary date of each borrower.

Under the scheme, the premium depends upon:

1. Age (nearer Birthday) at entry of the member into the Scheme.
   
   
2. Outstanding loan amount at entry date.
   
   
3. Term of loan.
   
   
4. Schedule of repayment.
   
   
5. Rate of interest with which the loan was availed.

Any borrower may become member of this scheme . The minimum term of assurance is 3 years. Existing Borrowers can join the scheme with certain conditions within 6 months of the commencement of scheme.

In case of death of the member during the coverage period ,life cover on the anniversary date preceding the date of death is payable .The claim proceeds are used to square off the outstanding loan.

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• Group Critical Illness Rider

Critical Illness product (accelerated benefit) is basically offered as an optional Rider benefit to all Employer-Employee group policyholders (both existing and new schemes) along with Group term insurance schemes i.e. OYRGTA ( One year renewal group term assurance ) type schemes. Schemes along with which the rider can be given shall include Group insurance, Group Gratuity (CA), Group Leave Encashment and Group insurance in conjunction with Superannuation. The Benefit will not be extended to spouses or dependants. Only full time permanent employees who are actively at work will be eligible for Critical Illness cover. The relevant premium is to be paid by the Group Policyholder.

FEATURES :

1. The Group critical illness rider benefit to employees is given as an add on benefit to the Group policy which has an element of life cover.
2. The Group Critical Illness rider allowable for each member shall be a minimum of 20 % of sum assured under the base plan and shall not exceed 100% of the sum assured under the base plan subject to minimum of Rs. 50 Thousands and maximum of Rs 20 lac per member.
3. All members of the attached policy should participate at inception and all eligible new members should compulsorily participate.
4. The diseases covered under the rider (subject to certain exclusions) are :

1. Cancer  2. Coronary Artery (Bye pass) Surgery  3. Heart attack (Myocardial infarction)  4. Stroke 
2. Kidney failure (End stage renal disease)  6. Aorta (Surgery of Aorta)  7. Heart valve replacement
3. Major Burns.

BENEFITS :

1. The Critical Illness Accelerated benefit is payable upon the first incidence of any of the 8 specified diseases and evidenced as per the diagnostic criteria specified. The rider shall terminate on payment of the Critical Illness benefit.
2. The Group Critical illness (Accelerated) Benefit pays a lump sum amount as a percentage of Sum assured out of the Sum assured under the life cover in the event of occurrence of 8 diseases covered under the rider.
3. No Critical Illness Benefit shall become payable to a member if the disease occurs within 90 days of the start of the coverage for that member of the scheme. This period of 90 days shall be called  “Waiting period”.
4. In case of death nothing is payable under this rider. However, under the base plan (i.e., the scheme on which the rider is opted for) benefits as under shall become payable :

1.     A benefit equal to base sum assured if no critical illness benefit is payable or has been paid  earlier.
2.    If critical illness benefit is payable or already paid, the benefit is reduced by the amount of critical illness benefit payable or already paid. In other words, the difference between the base sum assured and the critical illness benefit already paid is payable on death.

EXCLUSIONS:

1. Diseases in the presence of an HIV infection.
2. Diseases that have previously occurred in the life of the member of the scheme i.e. the benefit is payable only if the disease is a first incidence , regardless of whether the earlier incidence occurred before the individual was covered or whether the insured was covered by us or another insurer.
3. Any disease occurring within 90 days of the start of the coverage for each member of the scheme. (I.e. during the waiting period).
4. No payment will be made for any claim directly or indirectly caused by, based on, arising out of, or howsoever, to any Critical Illness for which care, treatment, or advice was recommended by or received from a Physician, or which first manifested itself or was contracted before the start of the policy period, or for which claim has or could have been made under any earlier policy.
5. Any congenital condition.
6. Alcohol or solvent abuse or taking of drugs, narcotics or psychotropic substances unless taken in accordance with the lawful directions and prescription of a registered medical practitioner.
7. Failure to seek or follow medical advice.
8. War, invasion, act of foreign enemy, hostilities(whether war be declared or not),armed or unarmed truce, civil war ,mutiny, rebellion, revolution, insurrection, military  or usurped power, riot or civil commotion, strikes.
9. Taking part in any naval, military or air force operation during peace time. 
10. Participation by the member of the scheme in any flying activity, except as a bona fide, fare-paying passenger of a recognised airline on regular routes and on a scheduled timetable.
11. Participation by the member of the scheme in a criminal or unlawful act.
12. Engaging or taking part in professional sport(s) or any hazardous pursuits, including but not limited to , diving or riding or any kind of race, underwater activities involving the use of breathing apparatus or not, hunting, mountaineering, parachuting , bungee-jumping.
13. Nuclear contamination, the radio active, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature.
14. Intentional self inflicted injury, suicide or attempted suicide, while sane or insane.
15. Existing diseases are not covered.

Additional exclusions may be disease-specific and would be incorporated into the definition of the disease.

TAX BENEFITS :

1. All benefits under the policy are also subject to the Tax Laws and other financial enactments as they exist from tome to time.
2. The premium payable are exempted under section 80D of Income Tax act.

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