Pension is our Profeesional Right : Observing Black Badge Days from 2nd to 7th November 2009

Govt proposes New Health Insurance Scheme in lieu of CGHS

With an effort to introduce Central Government Employees & Pensioners Health Insurance Scheme (CGEPHIS) recommended by Sixth Central Pay Commission, Ministry of Health & Family Welfare, invites Expressions of Interest from Insurers and Health Insurance consultants for the proposed scheme.

As per the document known as Expression of Interest published the CGHS website in this regard, Government of India proposes to provide inpatient health care services to the following personnel of the Central Government .

Beneficiaries

• All personnel of the Central Government including All India Service officers, serving, newly recruited, retired and retiring and others who are covered under the existing CGHS(Central Government Health Services) and under CS (MA) [Central Services (Medical Attendance) Rules] Rules shall be offered Health Insurance Scheme on voluntary or on compulsorily basis . This could be:
• CGEPHIS shall be compulsory to new Central Government Employees who would be joining service after the introduction of the health Insurance Scheme.
• CGEPHIS shall be compulsory to new Central Government retirees who would be retiring from the service after the introduction of the Insurance Scheme.
• CGEPHIS would be available on voluntary basis for the existing Central Government Employees and pensioners serving in CGHS area/ covered by CGHS. In this case such serving Central Government Employees and Central Government existing Pensioners shall have to opt out of CGHS scheme. They will also have the option of choosing both CGHS and Insurance policy. In such case the total premium has to be born by the beneficiary.
• CGEPHIS would also be available on voluntary basis for the existing serving employees and pensioners in non-CGHS areas not covered by CGHS. In this case such serving Central Government Employees and existing Pensioners (who have opted for CGHS facility) shall have to opt out of CGHS scheme. They will also have the option of choosing both CGHS and Insurance policy. In such case the total premium has to be born by the beneficiary.

The proposals relating to sum assured/policy limits, family size, age limit, Insurance coverage are as follows

Sums Insured / Policy Limits

The scheme shall provide coverage for meeting all expenses relating to hospitalization of beneficiary members up to Rs. 500,000/- per family per year subject to stated limits on cashless basis through smart cards. The benefit shall be available to each and every member of the family on floater basis i.e. the total reimbursement of Rs. 5 .00 lac can be availed by one individual or all members of the family. The document also says the Government has proposed to restrict the benefit in respect of Domiciliary hospitalization and Maternity to Rs.50,000/- for each admission

Family Size / Age Limit

• Serving Employees: Self, spouse, two dependent children and dependent parents (New born shall be considered insured from day one).
• Retired Employees: Self, spouse and one dependent child.
• Additional dependent family member can be covered under the scheme by paying the fixed percentage of premium per additional dependent family member. The premium shall be borne by the beneficiary.
• All beneficiaries shall be insured till survival.
• The definition of dependent shall be as per guidelines issued by Central Government.

Insurance Coverage

In addition to the coverage afforded under a standard medical insurance policy, the following shall also be covered under CGEPHIS:

• Pre-existing diseases
• Maternity benefit
• Day-one Coverage for all diseases
• New-born babies
• Pre and Post hospitalization cover of 30 days and 60 days respectively
• Domiciliary Hospitalization

All AINVSA Office Bearers Kindly represent before the anomaly Committee as Per Govt.Of India Notification Below

NO.11/2/2008-JCA
Government of India
Ministry of Personnel, Public Grievances and Pensions
Department of Personnel & Training
JCA Section
*****************
North Block New Delhi
Dated the 4th February, 2009.
Anomaly Committee of the National Council (JCM) to settle the
anomalies arising out of the implementation of the Sixth Pay
Commission's recommendations
In accordance with the instructions contained in this Department's OM
of even number dated 12th January 2009, it has been decided to set up, as indicated
below, the Anomaly Committee of the National Council (JCM) consisting of
representatives of the Official Side and the Staff Side to settle any anomalies
arising out of the implementation of the Sixth Pay Commission's
recommendations: -
OFFICIAL SIDE STAFF SIDE
1 Secretary, .............. Chairman 1. Shri U.M. Purohit
Deptt. ofPers. & Training. 2. Shri M.Raghavaiah
2 Member (Staff) 3. Shri Rakhal Das Gupta
Railway Board. 4. Shri RP.Bhatnagar
3 Secretary 5, Shri Guman Singh
Deptt.ofTelecommunication. 6. Shri C.Srikumar
4 Secretary 7. Shri S.K Vyas
Department of Posts. 8. Shri Ch.Sankara Rao
5 Financial Adviser (Defence) 9. Shri K S.Murty
Ministry of Defence. 10. Shri RSrinivasan
6 Joint Secretary (Pers) 11. Shri KKN. Kutty
Ministry of Finance. 12. Shri S.G. Mishra
7 Joint Secretary (E)
Deptt. of Personnel & Training.
8 Deputy Secretary (JCA)
Deptt. of Personnel & Training
Member-Secretary.
2. The working of the Committee would be in terms of the conditions laid
down in this Department's OM dated 12th January 2009 mentioned above.
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Deputy Secretary to the Government of India
1. All Ministries/Departments of the Govt. of India.
2. UPSC/CVClLok Sabha Sectt.IPresident Sectt./ PM's Office
3. All Attachedl subordinate offices of Ministry of Personnel, P.G. and
Pensions.
4. Secretary (Staff Side), National Council (JCM), 13-C Ferozeshah Road,
New Delhi (10 copies). Proposed items may please be sent to Deputy
Secretary (JCA) with a brief in triplicate.
5. All Staff members of the National Council (JCM) (as per list attached). Any
item for the proposed committee may please be sent through the Secretary
(Staff Side), National Council (JCM).
6. All Official Side members of National Council.
7. Copy to NIC, Room No. ll-A, North Block, New Delhi with the request
that a copy of the OM may be posted on the Net.~~.
Copy for information to:
1. PS to Cabinet Secretary
2. PS to Secretary (P)