NHIS for employees of Government Departments, Local Bodies, State Public Sector Undertakings, Statutory Boards and State Government Universities, etc., – Continuance beyond 30-06-2016
Government of Tamil Nadu
2016
MANUSCRIPT SERIES
FINANCE [Salaries] DEPARTMENT
G.O.No.169, Dated 9th June 2016.
(Thunmugi, Vaikasi-27, Thiruvalluvar Aandu-2047)
ABSTRACT
MEDICAL AID – NHIS for employees of Government Departments, Local Bodies, State Public Sector Undertakings, Statutory Boards and State Government Universities, etc., – Continuance beyond 30-06-2016 – Orders Issued.
Read :
1. G.O.Ms.No.430, Finance (Salaries) Department, dated 10.09.2007.
2. G.O.Ms.No.174, Finance (Salaries) Department, dated 28.04.2008.
3. G.O.Ms.No.139, Finance (Salaries) Department, dated 27.04.2012.
4. G.O.Ms.No.221, Finance (Salaries) Department, dated 20.06.2012.
5. G.O.Ms.No.243, Finance (Salaries) Department, dated 29.06.2012.
6. G.O.Rt.No.680, Finance (Salaries) Department, dated 29.07.2013.
7. G.O.Rt.No.456, Finance (Salaries) Department, dated 03.06.2016.
ORDER :
In the Government Order first read above, orders were issued to provide cashless health insurance cover to the employees of Government Departments, Local Bodies, State Public Sector Undertakings, Statutory Boards and State Government Universities and family members of such employees with a provision to avail assistance upto Rs.2.00 lakh in a block period of 4 years.
2. In the Government Order second read above, orders were issued to implement the scheme through the Star Health and Allied Insurance Company Limited with employee subscription of Rs.25/- per month and insurance premium of Rs.495/- per employee per annum excluding Service Tax. The scheme launched on 11.06.2008 was in operation till 10.06.2012.
3. In the Government Order third read above, orders were issued extending the New Health Insurance Scheme beyond 10.06.2012 and to implement New Health Insurance Scheme, 2012 with enhanced limit of assistance of Rs.4.00 lakh per family for a block of 4 years.
4. In the Government Order fourth read above, sanction was accorded for providing health care assistance by way of reimbursement to Government employees and their eligible Family Members during the period from 11-06-2012 to 30-06-2012.
5. In the Government Order fifth read above, orders were issued to implement the New Health Insurance Scheme 2012, through the United India Insurance Company Limited, with employee subscription of Rs.150/- per month and insurance premium of Rs.1860/- per employee per annum excluding Service Tax, in a block of four years from 01.07.2012 to 30.06.2016. The medical assistance was enhanced to cover 54 new medical treatments and 7 additional surgical procedures under the NHIS, 2012.
6. In the Government order sixth read above a Consolidated List of Hospitals covered under the NHIS, 2012 was notified. The Consolidated List of Hospitals was updated from time to time and last updation was ordered in the Government Order seventh read above.
7. The Government has examined the extension of New Health Insurance Scheme, 2012 beyond 30.06.2016 and decided to extend the same. Accordingly the Government direct that the Health Insurance Scheme, 2016 be implemented from 01.07.2016 as detailed below:-
(i) New Health Insurance Scheme 2016 shall be implemented with effect from 01.07.2016 for a further block period of four years;
(ii) A suitable Health Insurance Company shall be selected through National Competitive Bidding by restricting the Bidding to Public Sector Health Insurance Companies as was done in New Health Insurance Scheme, 2012;
(iii) The Insurance Premium for the above scheme shall be fixed on the basis of rate finalized through the abovesaid
competitive bidding;
(iv) The monthly subscription to be recovered from the employee shall also be fixed based on the insurance premium payable to the insurance company;
(v) The present limit of assistance of Rs.4.00 lakh for a block of 4 years per family shall be continued. However, the limit on assistance shall be enhanced to Rs.7.50 lakh for a block of 4 years per family for specified illnesses like cancer, liver and other transplantations, etc, to be specified in the covered illness list.
(vi) The list of hospitals, treatments/surgeries covered under NHIS, 2012 shall be continued under the NHIS, 2016 and additional hospitals and treatment / surgeries shall be included as and when necessity arises;
(vii) The orders on further modalities, terms and conditions for the implementation of New Health Insurance Scheme, 2016 shall be issued separately.
(BY ORDER OF THE GOVERNOR)
K.SHANMUGAM
ADDITIONAL CHIEF SECRETARY TO GOVERNMENT