New Health Insurance Scheme for Tamilnadu Government Employees 2020

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

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

1. 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 from 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

Source :Tamilnadu G.O.Ms.No.279, Dated 24th June 2020

Government of Tamil Nadu
2021

FINANCE [Salaries] DEPARTMENT
G.O.(Rt) No.325, Dated 27th May 2021.
(Pilava, Vaikasi- 13, Thiruvalluvar Aandu-2052)

ABSTRACT

New Health Insurance Scheme, 2016 for the employees of Government Departments and other Organisations – Empanelment of Accredited Hospitals – Approval of 52 additional hospitals, inclusion of additional speciality for 1 hospital, for name change 1 hospital, and for deletion 5 hospitals based on the recommendations of the Accreditation Committee – Notified – Orders – Issued.

Read:-

1. G.O.(Ms).No.309, Finance (Salaries) Department, dated: 14-08-2012.
2. G.O.(Ms).No.169, Finance (Salaries) Department, dated: 09-06-2016.
3. G.O.(Ms).No.202, Finance (Salaries) Department, dated: 30-06-2016.
4. G.O.(Rt). No.199, Finance (Salaries) Department, dated: 21-03-2017.
5. G.O.(Rt).No.695, Finance (Salaries) Department, dated: 01-09-2017.
6. G.O.(Rt). No.589, Finance (Salaries) Department, dated: 12-07-2018.
7. G.O.(Ms).No.239, Finance (Salaries) Department, dated: 13-07-2018.
8. G.O.(Rt). No.12, Finance (Salaries) Department, dated: 02-01-2019.
9. G.O.(Rt).No.482, Finance (Salaries) Department, dated: 29-05-2019.
10. G.O.(Rt).No.712, Finance (Salaries) Department, dated: 11-11-2020.
11. G.O.(Ms).No.279, Finance (Salaries) Department, dated: 24-06-2020.
12. From the Principal Secretary / Commissioner of Treasuries and Accounts, Lr.Rc.No.3378/ 2020/NHIS- 2, dated: 23.03.2021.

ORDER:

In the Government Order first read above, Government have constituted an Accreditation Committee for empanelment of accredited hospitals and to monitor the quality of treatment consisting of the Commissioner of Treasuries and Accounts, the Director of Medical and Rural Health Services and a representative of the United India Insurance Company Limited.

2. In the Government Order second and third read above, orders have been issued for the implementation of New Health Insurance Scheme, 2016 to provide Health Care Assistance to the employees of Government Departments, Public Sector Undertakings, Statutory Boards, Local Bodies, State Government Universities, willing State Government Organisations / Institutions and their eligible family members with a provision to avail cashless assistance upto Rs.4.00 lakh (Rupees Four Lakh only) and an enhanced assistance of Rs.7.50 lakh has been allowed for specific illness like Cancer, for certain organ transplantations, etc., for a block of 4 years on selection of a suitable Public Sector Insurance Company through National competitive bidding.

3. In the Implementation procedures for New Health Insurance Scheme, 2016 included in the Annexure I to the Government Order third read above, it is provided for inclusion of additional list of approved hospitals and treatments / surgeries based on the report of the Accreditation Committee.

4. In the Government order fourth read above, orders have been issued to include 72 additional hospitals and additional specialties in 5 existing hospitals in the Approved List of Hospitals under New Health Insurance Scheme, 2016.

5. In the Government order fifth read above, orders have been issued to include 81 additional hospitals and inclusion of additional specialties in one existing hospital in the Approved List of Hospitals under New Health Insurance Scheme, 2016.

6. In the Government order sixth read above, orders have been issued to include 106 additional hospitals in the Approved List of Hospitals under New Health Insurance Scheme, 2016.

7. In the Government Order seventh read above, Government have constituted the Accreditation Committee for empanelment of accredited hospitals consisting of the Commissioner of Treasuries and Accounts as Head of the Committee, the Director of Medical and Rural Health Services and a representative of United India Insurance Company Limited as Members of the Committee for empanelment of accredited hospitals and also to monitor the quality of treatment for the employees of Government Department and other organizations covered under New Health Insurance Scheme. Further, Sub-Committees were constituted at District Level consisting of Joint Director, Medical and Rural Health Services, Treasury Officer and a representative of United India Insurance Company Limited to assist the Accreditation Committee for empanelment of private hospitals in various Districts across the State under New Health Insurance Scheme.

8. In the Government Order eighth read above, orders have been issued to include 74 additional hospitals, deletion of one hospital and inclusion of Additional Speciality in one hospital in the Approved List of Hospitals under New Health Insurance Scheme, 2016.

9. In the Government Order ninth read above, orders have been issued to include 3 additional hospitals under New Health Insurance Scheme, 2016.

10. In the Government Order tenth read above, orders have been issued to include 133 additional hospitals and inclusion of Additional Speciality in 29 hospitals in the Approved List of Hospitals under New Health Insurance Scheme, 2016.

11. The Principal Secretary / Commissioner of Treasuries and Accounts in his letter twelfth read above has submitted proposals to include 52 additional hospitals in approved network hospitals, inclusion of additional speciality for one (1) hospital, for name change 1 hospital and for deletion 5 hospitals under New Health Insurance Scheme, 2016 for employees of Government Departments and other organizations as recommended by the Accreditation committee.

12. The Government, after careful consideration of the recommendations of the Accreditation Committee, have decided to include 52 additional hospitals in the approved network hospitals, inclusion of additional specialty for 1 hospital, for name change 1 hospital and for deletion 5 hospitals under New Health Insurance Scheme, 2016 as detailed in the Annexures to this order and issue orders accordingly.

(BY ORDER OF THE GOVERNOR)

S.KRISHNAN
ADDITIONAL CHIEF SECRETARY TO GOVERNMENT.