How to Get Group Medical Insurance in Hong Kong

To get group medical insurance in Hong Kong, employers and directors need to first assess their company needs, then compare insurance providers and plans, and finally pick and customize a plan that will meet the needs of their company and stay within their budget.

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Are you the leader of an organization based in Hong Kong that needs to learn how to pick a group health insurance plan?

You’ve come to the right place! This Pacific Prime article will breakdown 8 simple steps you should take to secure a medical coverage plan for your company. We’ll also explain how you can save time and money by consulting an insurance broker when designing your employee benefits package.

You also won’t want to miss our webpages that explain how the healthcare system in Hong Kong works and what international health insurance options expats have there.

To find the best Hong Kong providers who offer group insurance plans, read our core article Group Medical Insurance in Hong Kong.

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Eight Steps to Get Health Insurance for a Group in Hong Kong

Image of Hong Kong City Skyline Spanning Water With Modern High-Rises with text overlay of "Eight Steps to Get Health Insurance for a Group"

These are the eight simple steps an employer or group leader should complete to pick the best group health insurance plan for their Hong Kong organization:

Assess Company Needs
Compare Insurance Providers
Request Quotes & Consultation
Customize the Plan
Review and Finalize Terms
Enroll Employees
Educate Employees
Manage and Renew the Plan

Let’s break down each step in greater detail.

Step One: Assess Company Needs

Step one for an employer in Hong Kong when securing a group health insurance plan is evaluating their company’s specific needs. Assessing your group’s demographics, size, health risks, and other factors ensures you choose a plan that provides adequate coverage while staying within your budget.

Here are several key factors every group should assess in Hong Kong:

Company Size & Employee Demographics: The number of employees and their age, health conditions, and family status (ex: single employees vs. those with dependents) influence the type of coverage required.
Industry-Specific Risks: Different industries have varying health risks. For example, companies in high-risk fields like construction or manufacturing may need plans with better accident and emergency coverage, while office-based businesses may focus more on outpatient and wellness benefits.
Budget & Cost Considerations: Employers must balance affordability with quality coverage. This includes evaluating the company’s budget for premiums, cost-sharing options, and potential long-term financial commitments.
Coverage Needs & Benefits: Employers must decide which essential benefits they need, such as inpatient coverage, outpatient care, dental and vision, maternity benefits, and/or wellness and preventive care.
Local vs. International Coverage: If the company has expatriates or employees who travel frequently, a global health plan with international coverage may be necessary instead of a local Hong Kong-only plan.
Regulatory & Compliance Requirements: While group health insurance is not mandatory in Hong Kong, some industries may have contractual obligations or employee expectations that make offering insurance essential. Employers should comply with labor laws and tax regulations regarding employee benefits.

Step Two: Compare Insurance Providers

Employers in Hong Kong will next be ready to identify and compare reputable insurers in Hong Kong. Some of the top group health providers include Allianz, April International, Bupa, Generali, and AXA.

Key factors group leaders should compare between insurance providers include:

Coverage Options: Employers should determine which providers offer their predetermined essential benefits. If the benefits they want aren’t included in a plan, can they be added?
Cost Comparison: Employers should evaluate premium affordability, cost-sharing with employees, and potential price increases upon renewal. Checking the claims process is also crucial, as faster reimbursement, direct billing at hospitals, and easy online claim submissions enhance employee experience.
Customer Support and Flexibility: Some insurers offer customizable plans, allowing different benefit levels for executives and junior staff. Additional perks, such as wellness programs, mental health support, and fitness incentives, can improve employee well-being.
Reputation and Reviews: Employers should also assess insurer reputation and reviews, considering client feedback, service ratings, and broker recommendations. Engaging an insurance broker can provide unbiased comparisons and negotiation support.

Step Three: Request Quotes & Consultation

Step three is for Hong Kong employers to request quotes and schedule consultations to compare options effectively. Don’t undervalue the benefits of consulting an international insurance broker who can offer a third party’s unbiased opinion on which provider best suits your group needs.

Here’s how a group manager may go about such consultations:

Gather Your Company Information: Insurers require details like company size, employee demographics, industry type, and preferred coverage options. Employers should prepare this information in advance to receive accurate quotes.
Contact Multiple Insurers & Brokers: Request quotes from different insurance providers, either directly or through brokers. Brokers can help negotiate better rates and offer expert insights on policy strengths and weaknesses.
Review Quote Details: Compare key aspects of your quotes, such as premium costs and payment terms, coverage limits and exclusions, employee contribution options (if applicable), and additional benefits like wellness programs or dental/vision coverage.
Ask About Customization & Flexibility: Some insurers allow businesses to tailor plans for different employee levels (e.g., executive vs. entry-level staff). Employers should clarify if adjustments are possible based on company needs.
Understand Claim Procedures & Support: During consultations, employers should ask about claim processing times, direct billing options, and customer service responsiveness to ensure employees receive seamless healthcare access.
Clarify Renewal Terms & Future Costs: Understanding how premiums may change upon renewal is essential to avoid unexpected cost hikes in the future.

Step Four: Customize the Plan

Step four entails working with your selected insurer to tailor your group health plan based on your company needs and budget. Employers will choose the coverage level of their plan, add additional benefits they need, lock in their cost-sharing, deductible, and premium fees, and finalize their plan.

Choose Coverage Levels: Employers can customize coverage for different employee tiers, such as executives receiving higher inpatient limits or additional wellness benefits.
Select Core Benefits: Decide on essential coverage like inpatient hospitalization, outpatient consultations, diagnostic tests, and specialist visits. Employers may also include maternity, dental, and vision coverage based on employee needs.
Add Optional Benefits: Some insurers offer mental health support, wellness programs, gym memberships, and alternative treatments (such as acupuncture or physiotherapy) to enhance employee well-being.
Define Cost-Sharing Arrangements: Employers must decide whether to fully cover premiums or have employees contribute a percentage. They can also offer voluntary add-ons for dependents, allowing employees to extend coverage to their families.
Customize Claim Limits & Deductibles: Adjusting deductibles (the amount employees pay before insurance kicks in) can help balance premium costs. Higher deductibles usually mean lower premiums but may increase out-of-pocket expenses.
Confirm Network & Direct Billing Options: Employers should ensure the plan covers top hospitals and clinics with direct billing to reduce employees’ financial burden.
Finalize Policy Terms: Review exclusions, waiting periods, and renewal conditions to avoid unexpected issues later.

Step Five: Review and Finalize Terms

Hong Kong employers shouldn’t sign any contract with an insurance company until they do a detailed review of the terms and conditions of the policy. Employers should review the coverage benefits, claims process, renewal and adjustment terms, their responsibilities and expectations, and more.

Since there are several factors to consider when finalizing the terms of an insurance plan, it’s important we break down this step from the previous section in a little more detail here.

Verify Coverage Details: Ensure all agreed-upon benefits, including inpatient, outpatient, maternity, dental, and wellness programs, are clearly listed in the policy. Check for any exclusions or waiting periods that may affect employees.
Confirm Premium Costs & Payment Terms: Review the final premium structure, payment schedule (monthly or annually), and any potential discounts for long-term commitments. Employers should also clarify how future premium adjustments will be handled.
Assess Claims Process & Turnaround Time: Understand how claims are submitted, whether direct billing is available, and the typical reimbursement timeline. A smooth claims process ensures employees can access healthcare without unnecessary delays.
Clarify Renewal & Adjustment Terms: Check how renewals are handled, including potential premium increases based on claims history. Employers should confirm whether they can modify the plan in future years to adapt to workforce changes.
Ensure Regulatory Compliance: The plan should comply with Hong Kong’s labor and insurance regulations, especially if it includes international coverage for expatriates.
Review Employer & Employee Responsibilities: Understand requirements such as minimum employee participation rates and notification procedures for new hires or terminations.

Step Six: Enroll Employees

Once the group health insurance plan is finalized, the next step for Hong Kong employers is to enroll their employees and ensure they understand their benefits. To do this, you will need your employee information and their insurance selections (if you’ve allowed them some choice of coverage).

Collect Employee Information: Employers must provide insurers with a list of enrolled employees, including full names, dates of birth, ID numbers, job titles, and dependent details if family coverage is included.
Explain Coverage Options: Clearly communicate what the insurance plan covers, including inpatient, outpatient, dental, maternity, and wellness benefits. Employees should also understand any cost-sharing requirements, such as premium contributions or deductibles.
Distribute Insurance Cards & Policy Documents: Once enrollment is complete, insurers issue digital or physical insurance cards and policy booklets outlining coverage details, claim procedures, and hospital networks to every employee.
Set Up an Enrollment Period: Some plans allow employees to opt into additional coverage or add dependents within a specific timeframe. Employers should ensure staff members complete the necessary paperwork within this period.
Ensure Employees Understand the Claims Process: Provide guidance on how to submit claims, use direct billing services, and contact customer support for assistance. Some insurers offer online portals or mobile apps for easy access.
Address Employee Questions & Concerns: Conduct information sessions or provide an FAQ document to ensure employees fully understand their benefits and how to use them.

Step Seven: Educate Employees

Once employees are enrolled in the group health insurance plan for their company in Hong Kong, it’s essential to educate them on how to use their benefits effectively. This is best achieved in an orientation meeting that explains the benefits, claims process, cost-sharing responsibilities and more.

Host an Orientation Session: Organize a meeting or webinar to explain coverage details, including inpatient, outpatient, dental, maternity, and wellness benefits. This ensures employees know what’s included and how to access care.
Provide Policy Documents & FAQs: Distribute digital or printed materials that outline plan benefits, exclusions, claim procedures, and contact details for customer support. A well-structured FAQ document can help address common concerns.
Explain the Claims Process: Educate employees on how to file claims, use direct billing, and access reimbursement. Demonstrating online portals or mobile apps can help streamline the process.
Highlight Network Hospitals & Clinics: Ensure employees know which hospitals, clinics, and specialists are within the insurer’s network to avoid unnecessary out-of-pocket expenses.
Clarify Cost-Sharing & Deductibles: If employees contribute to premiums or have co-payments, explain these costs clearly so there are no surprises when they seek medical treatment.
Encourage Preventive Care & Wellness Programs: If the plan includes health screenings, mental health support, or fitness programs, highlight these benefits to promote overall well-being.
Set Up Ongoing Support: Designate an HR representative or insurer contact to handle employee inquiries and assist with claim issues.

Step Eight: Manage and Renew the Plan

Leaders of organizations based in Hong Kong can manage and renew their group medical insurance plans by monitoring the claims and usages trends of their employees, gather employee feedback, and address issues with the insurer to make sure the plan meets employee needs and remains cost-effective.

Here are a few ways employers in Hong Kong can monitor their group health insurance package:

Monitor Claims & Usage Trends: Regularly review claim reports to track usage patterns. High claim rates may lead to premium increases, while underutilized benefits could indicate the need for plan adjustments.
Gather Employee Feedback: Conduct surveys or hold meetings to understand employee satisfaction with the plan. Identify any pain points, such as difficulty with claims processing or gaps in coverage.
Address Issues with the Insurer: If employees face claim denials or network limitations, work with the insurer to resolve issues and improve service. Maintaining open communication helps ensure smooth operations.
Review Plan Performance Annually: Before renewal, analyze whether the plan still meets company and employee needs. Compare alternative options and negotiate better terms with the insurer if necessary.
Plan for Cost Adjustments: Premiums may change based on claims history. Employers should budget for potential increases and explore cost-saving strategies, such as adjusting deductibles or modifying coverage tiers.
Renew or Modify the Plan: Decide whether to renew the existing plan, switch providers, or make adjustments. If making changes, ensure employees are informed well in advance.
Update Employee Enrollment: Add new hires, remove departing employees, and update dependent coverage as needed.

How a Broker Can Help Your Group Get Insurance in Hong Kong

Groups who purchase their insurance plans through a broker instead of directly from the insurance company can save time and money. Brokers save you time by aiding in the research and comparison process, and they save you money by using their market knowledge to find you the best deals available.

Here are some benefits groups get from using an insurance broker:

You get access to more insurance choices.
You get experienced insurance experts researching your situation for you.
You get access to the most cost-effective plans available.
You get assistance when submitting claims for reimbursement.
You get expert advice designed to help you find the right plan for you, not to be led to the plan an insurance agent wants you to choose.

There are many more benefits to using a broker, and Pacific Prime is your broker of choice. Let us help you find the right Hong Kong insurance plan for your budget and needs. Contact us to learn more!

If you’re not sure the difference between an insurance broker and an insurance agent, read our article that explains it.

Frequently Asked Questions

What are the requirements to get group medical insurance in Hong Kong?

To get a group health insurance plan in Hong Kong, employers need a registered business in Hong Kong and a minimum number of employees (often around 3–5+) to qualify. Insurers may require employee details like age, job roles, and whether dependents will be covered.

How much does group medical insurance cost in Hong Kong?

Costs vary for a group medical insurance plan in Hong Kong based on factors like company size, coverage level, and employee demographics. Basic plans may start at USD $128–$320 per employee annually, while more comprehensive plans that include maternity and dental can be higher.

Can group medical insurance plans be customized?

Employers can tailor group medical insurance plans by selecting different coverage levels for executives and staff, adding optional benefits (such as dental, vision or mental health), and adjusting deductibles or copays to balance cost and coverage.

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Conclusion

We’ve now reviewed in great detail how employers can get group medical insurance in Hong Kong for their company. You’ll likely now be ready to compare highly reputable group insurance providers that offer the best Hong Kong coverage.

We recommend beginning with Allianz and April International. If you’d like to see a list of the top 10 Hong Kong insurance providers, read this article.

To begin comparing health insurance plans side by side, check out our completely free insurance quote generator that contains over 50,000 insurance plans! You can also speak with one of our insurance brokers and get answers to all your questions.

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Author
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Serena Fung

Head of Content at Pacific Prime

Serena Fung is the Head of Content at Pacific Prime, a global insurance brokerage and employee specialist serving over 1.5 million clients in 15 offices across the world. With 6+ years of experience writing about the subject, she aims to demystify the world of insurance for readers with the latest updates, guides and articles on the blog.

Serena earned her Bachelor’s Degree in Psychology from the University of British Columbia, Canada. As such, she is an avid advocate of mental health and is fascinated by all things psychology (especially if it’s cognitive psychology!).

Her previous work experience includes teaching toddlers to read, writing for a travel/wellness online magazine, and then a business news blog. These combined experiences give her the skills and insights she needs to explain complex ideas in a succinct way. Being the daughter of an immigrant and a traveler herself, she is passionate about educating expats and digital nomads on travel and international health insurance.

How to Get Group Medical Insurance in Hong Kong

Discover the world's top health insurers.
Compare quotes with a click of the button.

Start by Comparing
Insurance Plans Online