Health Insurance - Govt rolls out Group Mediclaim Health Insurance Scheme
The Governor’s Administration on Thursday formally rolled out the
Group Mediclaim Health Insurance Scheme for employees, pensioners and
Accredited Journalists in the State.
Giving details of the scheme, Principal Secretary Finance Navin K
Choudhary said that the scheme is mandatory for government employees
including employees of PSUs, Autonomous Bodies and Universities while it
will be optional for Pensioners, AIS Officers, Adhoc, Contractual,
DRWs, Work Charged/ Contingent Paid Workers and Accredited Journalists.
The scheme, he said, shall come into effect from 1st October 2018,
for a period of one year and extendable annually for three years based
on satisfactory performance of the Insurer.
Navin said the policy has been tied up with M/S Reliance General
Insurance Company Ltd on annual premium of Rs 8777and Rs 22,229 (for
employees and pensioners respectively). The Policy will provide health
insurance coverage up to Rs 6 Iakh per employee/pensioner per annum
along with his/her five dependent family members on floater basis.
He said the Shri Mata Vaishno Devi Shrine Board, Shri Mata Vaishno
Devi University, Shri Amarnathji Shrine Board and the Accredited
Journalists of the State shall be also covered under the scheme. They
may do so provided the premium is collected in four quarterly
installments in advance and paid to the Insurance Agency on due dates by
the Agency concerned themselves.
He said the Medical Allowance in favor of all enrolled employees
shall be discontinued, drawn and credited to the M.H.8235 during the
currency of the policy on monthly basis.
Navin said the annual premium for the insurance cover of Rs 6 lakh
would be Rs 8777 and the same shall be deducted in four quarterly
installments of Rs 1295 on 1st October, 15th January, 15th April and the
last installment of Rs 1292on 1st July each year.
He said the M/S Reliance General Insurance Company will create a
corporate buffer of Rs 10 crores as part of Policy to meet the
expenditure incurred on the identified illness over and above the
insurance cover of Rs 6 lakh.
He said in case of both husband and wife or their any other family
member is/are Government Employee(s) or pensioner(s), the Premium shall
be payable by any one of them. The DDO shall obtain an authenticated
certificate in case the premium has been paid by any other family
member(s) of the employee and check/verify it from the concerned
Treasury Officer.
“If the parents or one of the parents of an employee, who are/is
pensioners/pensioner, fall within the employee plus dependent’s cap of
1+5, they are not required to pay the premium separately and take out a
separate policy. However, if the employee and his dependents, which
include his family plus his pensioner parents, exceed the above cap, one
of the pensioner parents can take out a separate policy for himself or
herself and his or her dependents,” he said and added that in case where
either husband or wife is a Central Government Employee and has opted
for the Mediclaim Insurance Policy launched by his/her employer, the
Group Mediclaim Insurance Policy shall be optional in the case of
his/her spouse, who is State Government Employee. However, the State
Government employee have to necessarily provide a certificate from the
DDO concerned of his/her spouse to the effect that the latter is covered
under the Insurance Policy of his/her employer and has paid the premium
for the said purpose.
He said the Government shall not refund any premium amount paid in
excess by any employee due to his/her own negligence or by the concerned
DDO. So, the instructions/ directions issued in this behalf are
required to be adhered to in letter and spirit. Any deviation will be
the personal responsibility of the concerned DDO.
He said the Drawing and Disbursing Officers (DDOs) shall deduct the
premium amount from the salaries of Employees and remit the same into
the concerned Government Treasuries under the General and Other Reserve
Funds Group Mediclaim insurance.
“The concerned DDOs shall thereafter furnish the details of total
number of employees and total amount deducted and remitted to the said
account to their concerned Treasury Officers who shall forward the same
to Director General, Accounts and Treasuries within two days,” he said
and added that the Director General Accounts and Treasuries shall
consolidate the information and forward the same to the Joint Director
(Resources)/Chief Accounts Officer, Finance Department on most immediate
basis.
Navin said that since the Policy is compulsory in nature, it shall be
the personal responsibility and liability of the DDOs to register every
employee under the scheme so that no employee is left out. AIS Officers
can opt out of the policy only if they are otherwise covered under a
separate Mediclaim Policy of the Central Government or have taken an
individual policy with any Insurance Company. In case, any employee
fails to have his premium deducted, the State Government shall not be in
a position to accept such a claim for medical reimbursement. All the
concerned shall in their own interest ensure that necessary premium is
deducted from their salaries.
The Principal Secretary Finance said that the Heads of PSUs/
Autonomous Bodies/ Universities, shall have the prescribed premium
including taxes deducted from the salaries of their employees and pay
the same to the concerned Insurance Company directly in the shape of
Bank Draft along with the list of enrolled employees against proper
receipt under an intimation to the Finance Department.
For a pensioner, he said, the annual premium for pensioner will be Rs
18629 which will be deducted in four quarterly installments of Rs 4657
on 1st October, 1st January, 1st April and the last installment of Rs
4658 on 1st July each year. The Medical Allowance in favor of all
enrolled pensioners who opt the policy shall be drawn and credited to
the concerned A/C NO with Moving Secretariat Branch of J&K Bank
during the currency of the policy on a monthly basis
He said all the pensioners who opt to be covered under the scheme
shall make an application to the concerned Treasury Officer/Branch Head
of J&K Bank for making a deduction of premium from their pension.
source : https://kashmirlife.net/govt-rolls-out-group-mediclaim-health-insurance-scheme-186525/