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Showing posts with label Health Insurance. Show all posts
Showing posts with label Health Insurance. Show all posts

Thursday, 27 September 2018

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07:44

Free Benefits to Unorganized Workers by newly Launched 'Atal Bimit Vyakti Kalyan Yojna'

Free Benefits to Unorganized Workers by newly Launched 'Atal Bimit Vyakti Kalyan Yojna'
Newly Launched Atal Bimit Vyakti Kalyan Yojna to Benefit More Than 3 Crore Insured Persons 
Around 3.2 crore Insured Persons (IPs) will benefit from newly launched scheme of ESIC ‘Atal Bimit Vyakti Kalyan Yojna’. The ESI Corporation has approved ‘ATAL BIMIT VYAKTI KALYAN YOJNA’ for Insured Persons (IP) covered under the Employees’ State Insurance Act, 1948. This scheme is a relief payable in cash directly to the Bank Account in case of unemployment and while they search for new engagement. The cash benefit given to the unemployed persons searching for new employment will be 25 percent of his average earning of 90 days. Shri Gangwar was addressing on the occasion of 7th National Conference on Security and Safety at Workplace and distribution of Safety Systems Excellence Awards in New Delhi today.
Addressing the function, the Minister added that there are around six crores of workers in organized sector who are getting benefits of EPFO, ESIC and Social Security Schemes. The Union Government has taken many steps to enhance their working conditions, safety and social security in order to improve their standard of living. Present government is continuously making efforts to improve life conditions of around 40 crore workers of the unorganized sector also. In last two years nearly one crore workers have been linked with ESIC benefits and more than one crore have been brought in the fold of EPFO. Pradhan Mantri Jeewan Jyoti Beema Yojna and Pradhan Mantri Suraksha Beema Yojna  are totally free for unorganized workers. He further said that nearly 3 crore workers are benefitting from these Social Security Schemes.
The honorarium of 14 Lakh Aanganwadi workers have been increased from Rs. 3,000 per month to Rs. 4,500 per month. Likewise, honorarium of Aanganwadi helpers has also been increased from Rs. 1,500 to Rs. 2,250 per month. The incentive of AASHA workers has also been doubled, he added.
Shri Gangwar further said that the Ministry is making efforts to increase employment opportunities through Pradhan Manrti Rojgar Protsahan Yojana. Twelve per cent of the Employees’ Provident Fund (EPF) contribution of new employees is being given by government so that employers may not have to bear this cost. The government has spent Rs. 1,744 crores for this EPF contribution for around 72 Lakh employees of nearly 87,000 organizations in last two years.
The Minister congratulated all the winners of Safety Systems Excellence Awards and expressed hope that all the participants of this conference will gain from the ideas discussed on this forum.

Source:PIBNEWS

           
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Sunday, 23 September 2018

07:57

Agenda of Universal Health Coverage -Ayushman Bharat Pradhan Mantri Jan aarogya Yojana

Agenda of Universal Health Coverage -Ayushman Bharat Pradhan Mantri Jan aarogya Yojana
Ayushman Bharat –Pradhan Mantri Jan AarogyaYojana (AB-PMJAY) to be launched by Prime Minister Shri Narendra Modi in Ranchi, Jharkahnd on September 23, 2018 
India takes a giant leap towards providing accessible and affordable healthcare to the common man with the launch of Ayushman Bharat – Pradhan Mantri Jan AarogyaYojana (AB-PMJAY) by the Prime Minister, Shri Narendra Modi on 23rd September, 2018 at Ranchi, Jharkhand. Under the vision of Ayushman Bharat, Pradhan Mantri Jan AarogyaYojana (AB-PMJAY) shall be implemented so that each and every citizen receives his due share of health care. With Ayushman Bharat – Pradhan Mantri Jan AarogyaYojana, the government is taking healthcare protection to a new aspirational level. This is the “world’s largest government funded healthcare program” targeting more than 50 crore beneficiaries. 
BENEFITS UNDER THE SCHEME: 
Ayushman Bharat- Pradhan Mantri Jan ArogyaYojana (PMJAY) will provide a cover of up to Rs. 5 lakhs per family per year, for secondary and tertiary care hospitalization. 
  • Over 10.74 crore vulnerable entitled families (approximately 50 crore beneficiaries) will be eligible for these benefits. 
  • PMJAY will provide cashless and paperless access to services for the beneficiary at the point of service. 
  • PMJAY will help reduce catastrophic expenditure for hospitalizations, which impoverishes people and will help mitigate the financial risk arising out of catastrophic health episodes. 
  • Entitled families will be able to use the quality health services they need without facing financial hardships. 
  • When fully implemented, PMJAY will become the world’s largest fully government-financed health protection scheme. It is a visionary step towards advancing the agenda of Universal Health Coverage (UHC). 
FEATURES OF THE SCHEME 
Ayushman Bharat is a progression towards promotive, preventive, curative, palliative and rehabilitative aspects of Universal Healthcare through access of Health and Wellness Centers (HWCs) at the primary level and provision of financial protection for accessing curative care at the secondary and tertiary levels through engagement with both public and private sector. 
It adopts a continuum of care approach, comprising of two inter-related components: Creation of 1,50,000 Health and Wellness Centres which will bring health care closer to the homes of the people. 
These centres will provide Comprehensive Primary Health Care (CPHC), covering both maternal and child health services and non-communicable diseases, including free essential drugs and diagnostic services. The first Health and Wellness Centre was launched by the Prime Minister at Jangla, Bijapur, Chhatisgarh on 14th April 2018. 
The second component is the Pradhan Mantri Jan ArogyaYojana (PMJAY) which provides health protection cover to poor and vulnerable families for secondary and tertiary care. 
The Health and Wellness Centres will play a critical role in creating awareness about PMJAY, screening for non-communicable diseases, follow-up of hospitalization cases among others. The features of the scheme are as follows. 
Pradhan Mantri Jan ArogyaYojana: Financial protection from catastrophic expenditure:
  • 71st Round of National Sample Survey Organization (NSSO) has found 85.9% of rural households and 82% of urban households have no access to healthcare insurance/assurance. More than 17% of Indian population spend at least 10% of household budgets for health services. Catastrophic healthcare related expenditure pushes families into debt, with more than 24% households in rural India and 18% population in urban area have met their healthcare expenses through some sort of borrowings. 
  • PMJAY primarily targets the poor, deprived rural families and identified occupational category of urban workers’ families as per the latest Socio-Economic Caste Census (SECC) data for both rural and urban areas as well as the active families under the RashtriyaSwasthyaBimaYojana (RSBY). 
  • Approximately 10.74 crore identified families (approximately 50 crore beneficiaries) will be entitled to get the benefits. There is no cap on family size and age as well as restriction on pre-existing conditions.
Pradhan Mantri Jan ArogyaYojana: Hospitalization cover from inpatient care to post hospitalisation care: 
  • The objectives of the Yojana are to reduce out of pocket hospitalisation expenses, fulfil unmet needs and improve access of identified families to quality inpatient care and day care surgeries. 
  • The Yojana will provide a coverage up to Rs. 5,00,000 per family per year, for secondary and tertiary care hospitalization through a network of Empanelled Health Care Providers (EHCP). 
  • The EHCP network will provide cashless and paperless access to services for the beneficiaries at the both public and private hospitals. 
  • The services will include 1350 procedures covering pre and post hospitalization, diagnostics, medicines etc. 
  • The Yojana beneficiaries will be able to move across borders and access services across the country through the provider network seamlessly. 
Pradhan Mantri Jan ArogyaYojana in alliance with the States: 
  • The scheme architecture and formulation has undergone a truly federal process, with stakeholder inputs taken from all States and UTs through the national conclaves, sectoral working groups, intensive field exercises and piloting of key modules. 
  • The Scheme is principle based rather than rule based, allowing States enough flexibility in terms of packages, procedures, scheme design, entitlements as well as other guidelines while ensuring that key benefits of portability and fraud detection are ensured at a national level. 
  • States have the option to use an existing Trust/Society or set up a new Trust/Society to implement the Scheme as State Health Agency and will be free to choose the modalities for implementation. 
  • States can implement the Scheme through an insurance company or directly through the Trust/Society/Implementation Support Agency or a mixed approach. 
PROGRESS OF THE SCHEME:
MOUs with the states: 30 states and UTs have signed the MoU and have started working on implementation of the mission. Maharashtra has joined on 14th August 2018. MoU has been signed with Tamil Nadu on 11th September 2018. 
Pilot launch of PMJAY: 
Pilot launch of the scheme has started. The focus of the pilot launch of the mission is to test and enhance the developed IT systems and streamline the state preparedness for a comprehensive launch. 
The pilot been done in around 22 States / UTs (Arunachal Pradesh, Chandigarh, Chhattisgarh, Dadar Nagar & Haveli, Daman & Diu, Haryana, Himachal Pradesh, Madhya Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Uttarakhand, West Bengal, Uttar Pradesh, Jammu & Kashmir, Goa, Maharashtra among others). 
The pilot launch is taking place in specific hospitals to test the Beneficiary Identification System (BIS) and Transaction Management System (TMS) systems.
 The pilot launch involves over 1280 hospitals. 
Pradhan MantriAarogyaMitra (PMAM): 
  • The scheme is creating a cadre of certified frontline health service professionals called Pradhan MantriAarogyaMitras (PMAMs) who will be primary point of facilitation for the beneficiaries to avail treatment at the hospital and thus, act as a support system to streamline health service delivery. 
  • MoU was signed between National Health Agency and Ministry of Skills Development & Entrepreneurship (MSDE) on 27th August 2018 in New Delhi. 
  • AarogyaMitras training is being conducted in collaboration with National Skill Development Corporation (NSDC) and Ministry of Skill Development to strengthen implementation and operational preparedness. 
  • Training has already been conducted in across 20 states and around 3519 AarogyaMitras have been trained so far. Training programs for State, District and PMAMs have been conducted in 27 states. 
  • A total of around 3936 personnel have been trained at state, district and PMAM levels.
Hospital Empanelment: 
So far 15,686 applications for hospital empanelment have been received. 
 Fraud detection and Data privacy: 
  • Detailed guidelines have been prepared to address the issues around potential fraudulent activities that could be committed by any individual or organization. 
  • Anti-fraud cells will be established at the national and state level, and strong IT tools will be deployed to prevent and detect fraud. 
  • NHA Information Security Policy & Data Privacy Policy are being institutionalized to provide adequate guidance and set of controls on the secure handling of Beneficiaries Personal Data & Sensitive Personal Data in compliance with all laws and regulations applicable. International standards/regulation, like ISO 27001, National Institute of Standards & Technology (NIST), Health Insurance Portability and Accountability Act (HIPAA), General Data Protection Regulation (GDPR); and Indian regulations such as Aadhaar Act 2016, Indian IT Act 2000, IT (amendment) Act, 2008 and Personal Data Protection Bill by former judge BN Sri Krishnan (Yet to be enacted) are referenced while drafting these policies. 
IT systems update:                                                                    
  • Beneficiary Identification System (BIS) has been developed to identify and verify the beneficiaries at CSCs and point of care. 
  • NHA has tested the software in 80 districts across 10 states and further enhanced the system based on feedback. 
  • Hospital empanelment module has been active from 4th July and has already received empanelment requests from over 7,857 hospitals across 354 districts in 22 States / UTs. A comprehensive 
  • Transaction Management System (TMS) has been developed to facilitate transactions from hospitals (such as filing pre-authorization requests and claims submission). 
  • There have been trainings across the state concerning the operability of IT systems to enhance the state preparedness and receive feedback on the IT systems. 
  • Focused workshops have been organized to train the state level officials in operating the developed IT systems. 
  • Robust measures are being put in place in the IT platform to ensure privacy and security of the data. 
Beneficiary related: 
  • MoU has been signed with Common Service Centre (CSC) for Beneficiary Identification and will utilize the over 3 lakh village level entrepreneurs for identifying beneficiaries. 
  • Personalized Letters with unique family code are in the process of being sent to the identified families in the Additional Data Collection Data (ADCD) drive. This will drive awareness among the beneficiaries and further ease the identification process when they visit points of care or CSC centres. 
Ayushman Bharat – Pradhan Mantri Jan AarogyaYojana (AB-PMJAY) is a paradigm shift from sectorial, segmented and fragmented approach of service delivery through various national and State schemes to a bigger, more comprehensive and better converged and need based service delivery of secondary and tertiary care.

 Source:PIBNews
Details of Speech by Prime Minister On 23.09.2018



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Friday, 7 April 2017

08:19

Simplification of procedure for payment of Central Government Employees Group Insurance Scheme (CGEGIS) dues- regarding

Simplification of procedure for payment of Central Government Employees Group Insurance Scheme (CGEGIS) dues- regarding

Sub:- Simplification of procedure for payment of Central Government Employees Group Insurance Scheme (CGEGIS) dues- regarding.

Ministry of Finance vide their O . M. No. 7(1)/EV/2016 dated 17th March, 2017 issued instructions that in order to ease the process of payment of savings fund on account orf CGEGIS at the time retirement of a Central Government employee, In all cases where the service of the retiring Central Government employee has been verified, payment of the accumulation under Savings Fund of CGEGIS be made without awaiting confirmation of deduction of each monthly subscription of CGEGIS, as service verification is carried out……






Source:AIRF

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Tuesday, 4 April 2017

05:35

Kerala PKMM School introduces healthcare scheme

Kerala PKMM School introduces healthcare scheme

PKMM Higher Secondary School, Edarikode, one of the largest schools in the State, has introduced a healthcare scheme for its students and parents in association with Aster Mims, Kottakkal.

More than 7,000 children and their parents will benefit from the Arogya Sparsham scheme, by which Aster Mims will offer its healthcare facilities at reduced rates.

Aster Mims chief executive officer V.P. Jasir inaugurated the scheme at a function held at the school. He said the scheme would be introduced in other schools in the district.

Former Education Minister P.K. Abdu Rabb inaugurated the distribution of Arogya Sparsham health cards. Hari P.S., Aster Mims medical service deputy chief, explained the benefits of healthcare scheme.

School manager P.K. Mohammed Basheer, Principal Mohammed Shafi, Headmaster Kuriakose, and parent-teacher association president Jaleel Manammal spoke.

Source:The Hindu 
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Thursday, 27 October 2016

19:08

ESIC Scheme Updates:Workers can soon choose insurance plans other than ESI

ESIC Scheme Updates:Workers can soon choose insurance plans other than ESI 

NEW DELHI: Over 2 crore formal sector workers will soon have an option to choose health insurance products available in the market in lieu of the mandatory scheme run by the Employees State Insurance Corp (ESIC). 

At present, formal sector workers with monthly wages of up to Rs 21,000 per month are mandatorily covered under the health insurance scheme run by the ESIC. 

"The Labour Ministry will soon send a bill to the Union Cabinet to amend the Employees' State Insurance Act 1948, to facilitate the beneficiaries of ESIC scheme to opt for health insurance products available in the market," a source said. 

"The Ministry will push the bill for passage in the forthcoming Winter Session of Parliament beginning November 16," the source added. 


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Wednesday, 21 October 2015

08:59

7th Pay Commission – Advantages to Government or Employees?

7th Pay Commission – Advantages to Government or Employees? 

The Central Government employees are scheduled to get salary hikes on the basis of the recommendations by January 1, 2016. According to sources, the house rent allowance too would see an increase by 20 per cent. But the most significant recommendation is that 5 to 6 per cent of the annual increment would be performance-based. There is also likely to be a provision of retiring under-performing employees by the age of 55 or 30 years of service, whichever is more.

The Finance ministry has already opened its stand saying, the Seventh Pay Commission will be mindful of the fiscal concerns of the government while giving its report on new pay scales and remunerations for central government employees and pensioners.

So the question which arises in everybody’s mind is, for whom the 7th Pay Commission is for? Is it for the Central Government employees or for the Government? For Whose benefit is it working?

For example there is a rumour floating around that the CGHS facility is going to take its last breath after 7th CPC. The Seventh Pay commission is planning to propose health insurance scheme to replace Central Government Health Scheme (CGHS) at highly subsidized rates.

The pay panel will ask the central government to urge the insurance industry to come up with feasible health insurance solution for the central government employees and pensioners. The IRDA, the insurance regulatory body of India, will be compelled to ask the health insurance companies to offer a basic insurance to every central government employee and pensioner, regardless of age or medical condition and will not be allowed to make a profit of this basic insurance.

Health insurance would be available for central government employees and pensioners till death, the insured employees and pensioners will have to pay 50% of the premium from their salaries and pensions and the remaining 50% premium may be paid by the central government.

The CGHS is financed mainly through the Centre’s tax revenues. Though beneficiaries do contribute a share of their wages towards premium, ranging from Rs 600 to Rs 6,000 a year depending on their pay scale, this accounts for just about 5 per cent of the total expenditure. The government shells out the remaining 95 per cent.

However, now the Government is looking for ways to end the CGHS in its current form and to move to an insurance based health scheme to cut costs.

Recently, the CG Employee’s Welfare Ministry released an announcement which has created confusion and fury among the CG employees.

In the announcement it has been said that the senior officials have to analyse the service record and decide whether employees who have completed thirty years of service or reached their 50th year should continue their service or be advised to leave service after three months notice.

Does it take a management to learn that an official or an employee is unfit to continue in service when he has reached his 50th year? Does it take thirty years of continuous service to assess the efficiency of an employee?

Then what is the need for a probation period? After serving the Government for 30 years or till his 50th year, if somebody is asked to quit just like that, giving some damn reason when he is old, appears rather inhumane.

Unlike in the private sector, the pay hike in government is a once-in-10-years-affair. The Government need not and should not compare the Government employees with the private sector. The private sector works on profit mode, but the government organisations work in the service mode.

The NJCA at the Meeting of the Confederation held at Hyderabad on 09th October 2015 while endorsing the decision of the National Joint Council of Action (Railway, Defence & Confederation) to organize massive protest dharna at Jantar Mantar, New Delhi on 19th November 2015 and also Nationwide Protest Demonstration in front of all works spot & offices, has decided to further intensify the protest action against the negative attitude of the Government for the Unwarranted intervention of the Finance Ministry in the independent functioning of the Pay Commission by issuing a statement asking the 7th CPC to factor into its report the fiscal concern of the government and thereby to pressurize the commission not to recommend wage rise on the basis of a sound and scientific formulation and Causing engineered delay by the Government in the submission of 7th CPC report by granting four months extension upto 31st December 2015, even when the Pay Commission was ready to submit its report within the stipulated time i.e. 28th August 2015.


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Sunday, 2 August 2015

17:11

Mediclaim Policy for Bank Employees Through IBA by this Month End

Mediclaim Policy for Bank Employees Through IBA by this Month End

All state-run general insurers are likely to issue a master mediclaim policy for bank employees through Indian Banks Association (IBA) by this month end. 

As per the new wage agreement reached between bank unions and the IBA on May 25, employees of all the 43 member banks are to be provided with a health insurance cover by their respective banks. 

"Our discussions are on with the IBA on the health insurance cover for bank employees as part of the wage pact," New India Assurance chairman and managing director and chairman of General Insurers (Public Sector) Association (GIPSA) chairman G Srinivasan told PTI. 

However, he refused more details saying "things are still on the drawing board." 

"This is for the first time a proper health insurance policy is being worked out by banks for their employees," he added.

The IBA comprises 25 state-owned banks, 11 old-generation private sector banks and seven foreign banks which employ 10 lakh employees apart from 3 lakh retirees. 

"The master policy to be issued for employees,officers and

retirees of member banks, by month-end will cover the domissory treatment, minor and major surgeries," an IBA official said. 

Chennai-based United India Insurance is the lead insurer for the scheme. 

"We have made United India Insurance as the lead insurer while the other three will act as co-insurers in this case and we have decided to provide health insurance cover with a ceiling of Rs 3 lakh in case of workmen and Rs 4 lakh in case of bank officers," the IBA official said. 

"The premium to be paid by banks will be around Rs 6,000 per annum in case of officers and Rs 5,000 in case of employees," he added. 

The 10th bipartite wage agreement agreed to introduce a social security scheme in the form of reimbursement of hospitalisation expenses up to Rs 5 lakh, which include all dependent and family members of the bank employee. 

Already medical aid is covered in the 15 per cent wage hike, and the new health scheme will ensure 100 per cent reimbursement in case of hospitalisation.

Source :Business Standard.
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