MEDICAL AID – New Health Insurance Scheme 2016, Extension for another one year period 01.07.2020 to 30.06.2021 – TN Govt.
Government of Tamil Nadu
2020
MANUSCRIPT SERIES
FINANCE [Salaries] DEPARTMENT
G.O.Ms.No.279, Dated 24th June 2020.
(Saarvari, Aani-10, Thiruvalluvar Aandu 2051)
ABSTRACT
MEDICAL AID – New Health Insurance Scheme, 2016 for employees which is to expire on 30-6-2020 – Extension for another one year period from 1-7-2020 to 30-6-2021 – Orders – Issued.
Read the following :-
1. G.O.(Ms).No.202, Finance (Salaries) Department, dated:30-06-2016.
2. G.O.(Ms).No.391, Finance (Salaries) Department, dated:10-12-2018.
3. Government Letter No.14973, Finance (Salaries) Department,
dated:10-06-2020.
4. Letter received from the United India Insurance Company
Limited, Chennai, dated:11-06-2020.
ORDER:
In the Government Order first read above, orders were issued for implementation of New Health Insurance Scheme, 2016 to provide health care assistance for employees and their eligible family members with a provision to avail assistance upto the limit of Rupees Four Lakh in a block period of four years (from 1-7-2016 to 30-6-2020) as a CASHLESS model for the approved treatments/surgeries (listed in the Annexure-II of the said order) in the network hospitals approved through the United India Insurance Company Limited which is a public sector company. However, the assistance shall be upto Rupees Seven Lakh and Fifty Thousand for illness listed in the Annexure-II-A of the said order. The coverage of medical assistance shall be extended to accident cases where patient got approved treatment/undergone surgeries in a non-network hospital. The annual premium payable by the Government to the United India Insurance Company Limited shall be Rs.2,100/- per employee, per annum for the block period of four year. The annual premium initially paid by the Government shall be recovered from the employee @ Rs.180/- per month by deduction in monthly salary.
2. In the Government Order second read above, orders were issued for extension of medical assistance in case of emergency care on reimbursement in non-network hospitals for the treatments/surgeries cover under New Health Insurance Scheme, 2016 for employees and their eligible family members subject to eligible medical expenses and ceiling criteria. An additional premium of Rs.50/- per employee, per annum is being paid to the
United India Insurance Company Limited.
3. The New Health Insurance Scheme, 2016 for employees is to expire on 30-6-2020. In order to ensure continuity of insurance coverage for employees and considering the outbreak of the COVID-19 pandemic, Finance Department proposed to extend the current contract with United India Insurance Company Limited with existing terms and conditions for a period of another one year, under Rule 14 (9) of Tamil Nadu Transparency in Tenders Rules, 2000.
4. In the reference third read above, the United India Insurance Company Limited was requested to convey their consent for extension of the New Health Insurance Scheme, 2016 for employees for a further period of one year w.e.f 1-7-2020 to 30-6-2021 with the same terms and conditions of agreement and with a cover of Rs.4 lakhs for families of all insured employees.
5. In the reference fourth read above, the United India Insurance Company Limited, has agreed to the extension of the New Health Insurance Scheme, 2016 for Employees for a further period of one year w.e.f. 1-7-2020 to 30-6-2021, with assistance capped at Rs.4 lakhs for each of the insured employees along with their eligible family members and Rs.7.5 lakhs for specified illnesses.
6. The Government after careful consideration, directs that the New Health Insurance Scheme, 2016 for employees, which is to expire on 30-6-2020, shall be extended for a period of another one year from 1-7-2020 to 30-6-2021, with assistance capped at Rs.4 lakhs for families of all insured employees and at Rs.7.5 lakhs for specified illnesses, as per existing terms and conditions of agreement made with the United India Insurance Company Limited.
7. The Commissioner of Treasuries and Accounts is directed to send necessary proposal to the Government for sanction of insurance premium as per the terms and conditions of the agreement.
(BY ORDER OF THE GOVERNOR)
S.KRISHNAN
ADDITIONAL CHIEF SECRETARY TO GOVERNMENT.