Employee benefits

A guide to group health insurance for employees in Hong Kong SMEs

Health insurance plans can be a confusing minefield for employers, and it is often difficult to know where to begin. To help, we've put together a mini guide to employees' health insurance plans for SMEs in Hong Kong. We'll cover the key considerations when choosing a group health insurance plan, and what to watch out for SMEs.


Participation Criteria


To begin, you must examine the participation criteria, which means there must be a minimum number of employees. In Hong Kong, the standard minimum number of employees to start a medical plan is between 3-5. If you have a smaller amount of employees, insurance plans will usually not cover any pre-existing health conditions and a health declaration will be required for underwriting.

doctor injecting vaccine
Area of Cover

Next, think about what area coverage you need for the team. Where are team members mostly based? All over the world? Are they frequent travellers? If so, insurance companies will most likely suggest worldwide coverage. Make sure Emergency Assistance Benefits are provided too, so your team can travel at ease.


Core Benefits

Hospital and surgical benefits are predominantly the basic benefit for most group health insurance plans, and are perceived as the essential requirement. Outpatient benefit might not be part of the core benefits, but employees view it as a basic requirement nowadays. According to a survey conducted by Mercer, among 913 companies that provide medical insurance in Hong Kong, the most prevalent benefits include:

  • Basic hospital (inpatient): up to 99% of companies

  • Outpatient: up to 89% of companies

Add-on Benefits

Apart from the most common outpatient doctor's consultation and medication, there is a vast range of outpatient benefits to choose from. Here are two increasingly popular ones among SME employees, as team members become increasingly more health conscious.

  • Dental

  • Chinese herbalist and bonesetter and acupuncture


Other benefits to consider would be maternity, and free or discounted body check-ups.

Medical Network

The size of medical network depends on the insurance company. The broader it is, the easier it is for employees to choose their preferred doctor within the network to visit when they are ill. By presenting the medical card provided by insurance companies for healthcare services within the insurer's medical network, you don't need the claim forms. It also means less guidance needed from HR managers too!

Seamless Experience
team having fun in outdoor area outside office

We crave for fast and seamless experience in everything we do today. This is especially true for startups and SMEs who work in an agile approach to accelerate business growth. Traditional insurance services may still heavily rely on agents to provide services to HR managers and employees, and require complicated paper processes for claims. Consider whether the group medical insurance plan comes with an online platform or mobile app to take care of your employees:

  • Network doctor search

It could be hard to perform doctor search from the physical booklet. Online or in-app search function based on the location and required specialty means the most suitable doctor can be located instantly.

  • Schedule doctor's appointment

Saves the long waiting time in clinic and makes better use of your employee's time.

  • e-Medical card

Convenient for the forgetful ones who may not carry the physical card with them everyday.

  • e-Claim

Employees may have preferred doctors who are outside of the medical network. In this case, e-Claim would be a handy feature to minimise the need for searching and filling claim forms.

StartupCare Hong Kong offers employee health benefits solution that takes a step further on health management. Apart from the above functions, employees can self-check symptoms through the in-app virtual health assistant, and track their daily step count to unlock rewards, encouraging a healthier lifestyle. Founders and HR managers can easily manage the onboarding and track health status of employees through a digital dashboard too.

Who to Pay?
In Hong Kong, it is a common practice among employers to cover 100% of the insurance premiums on behalf of their employees. Based on the managerial level of your employees, you may also choose different plans to form part of their employee benefits package.

Taking care of your employees' health will result in a healthier, happier and more productive team. Choose a group health insurance plan that best suits your needs as a SME.

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