Highlights of Group Health Insurance Policy by AIGETOA

Highlights of Group Health Insurance Policy by AIGETOA

AIGETOA Launches Group Health Insurance Policy for w.e.f. 01.04.2021 in tie up with New India Assurance (NIA)

Thanks for showing overwhelming response for the proposed Group Health Insurance Policy being launched by AIGETOA. After receiving the actual data from all circles and after having extensive discussions with various agencies and getting Feedback from various corners, AIGETOA has finally decided to opt for the New India Assurance Health Insurance Scheme. We have finally sealed the proposal for around 4000 executives and their dependents group. The Final Premium price arrived is Rs. 6630 plus GST @ 18 percent for the coverage of Rs 5 Lakh for one family (Employee+Spouse+ Kids) with facilities from Day-1. Income Tax Benefit for individual optees under section 80 D will also be applicable. The number of Kids allowable as on date is three in the policy, however, in case of third kid born (Except Twins) after start of the policy, coverage for third child will not be applicable. The Policy is aimed to be started from 01.04.2021 and the payment will be started collecting by next week.

The salient features are as follows:

  • The annual health coverage will be Rs 5 Lakh for the family.
  • The Annual Premium will be 6630/- per family (Self with Spouse and Kids including 3rd child as on date).
  • Zone wise Policy so Best TPA In A Particular Zone Can Be Selected.
  • The Premium will be uniform across all age groups. However, it is worth to mention that premium amount of the policy envisaged by AIGETOA is less for even the age group of 21-25 years vis-à-vis other similar policies.
  • Instead of opting for a corporate buffer, additional Top-Up of Rs 5 Lakh will be available at a nominal premium amount for those interested to opt it to enhance the coverage.
  • The coverage of Parents can also be included in the Policy by paying additional amount.
  • Policy starts without any formalities except some basic details of the family and payment of premium amount.
  • Domiciliary treatment applicable as per norms
  • Psychiatric treatment and congenital diseases treatment covered as per norms.
  • The facilities will be covered from Day-1 of start of the policy.
  • Standard Policy document will be shared at the time of payment of Premium from next week.
  • Those having individual policy as on date can also be added in the policy either on Pro Rata basis where the policy will be applicable from the date of cessation of previous policy or they can opt for new parallel policy from the day one as additional coverage. The copy of previous policy shall be required to opt for this policy.
  • Facility to claim reimbursement of the balance amount not paid by BSNL subject to fulfillment of documentary requirements.
  • Softcopy of the original policy document along with list of applicants and their payments details shall be provided by the Insurance Agency for claiming Income Tax deduction under section 80D.
  • All Pre-Existing diseases covered from day one.
  • 1st, 2nd ,3rd and 4th Year waived off and no waiting period.
  • Aayush Hospitalization Expenses covered up to the extent of 25% of the sum assured as per norms of the standard policy.
  • In case of single employee, their spouses will be covered without any extra premium in case of marriage during the policy enforcement period. Mid Term inclusion of newly born kid also applicable without any extra premium during policy enforcement period.
  • Room Rent – 1 percent Sum Assured.
  • ICU Rent- 2 percent Sum Assured.
  • All benefits of the continuance shall be extended to the willing employees opting for individual policies post retirement/resignation from BSNL provided they are covered under the policy for the minimum stipulated period to be eligible for exemptions. We are also trying to include the policy in the name of nominee in the case of some misfortune occurs to the opted executive (Matter under deliberation with the agency).
  • Dental Treatment Covered in case of injury due to accident.
  • Covid-19 Hospitalization Treatment Covered.
  • Pre-Hospitalization and Post Hospitalization expenses covered as per standard policy.
  • In case of Non-Network Hospitals, Reimbursement allowed provided treatment is taken in a minimum 15 bedded hospital.
  • Advance medical treatment covered along with their sub limits as defined in the policy.
  • Day care procedures(pre-defined).
  • Cataract limit of 50K or the actual bill whichever is lower per eye, per policy year.
  • Hernia – ₹ 1,00,000/- , or the actual bill, whichever is lower.
  • Hysterectomy – ₹ 1,00,000/- or the actual bill, whichever is lower
  • Maternity benefit scheme not Covered under the policy.
  • Ambulance charges 1% of sum insured subject to maximum 2500/- provided patient is admitted to emergency ward.

All Circle Secretaries and OBs are requested to start awareness campaign about the policy which is a best priced group health policy for the capped amount with PAN India Roll Out. It’s voluntarily in nature but opting of the policy by more and more people will strengthen our claim to force the BSNL Management to extend this facility by employer to its employees. We once again reemphasize that this is a welfare measure taken based on the popular request and the difficulties faced by employees during this critical time.

Group Health Insurance Scheme For BSNL Employees Proposed By AIGETOA CHQ For PAN India Level

AIGETOA thanks one and all for the overwhelming response on the Group Health Insurance proposal. We are now into the process of Final Negotiation with the insurance agency and soon we will be publishing the final proposal which will be at the best rates and best services and benefits.

We are happy to note that employees of almost all cadres across the BSNL have shown their interest on this first Pan India health insurance scheme for BSNL working employees on association platform. This scheme will automatically pave the path to give an insight to management to make indoor treatment in the same manner and Premium to be paid By the employer as done with other corporate organizations.

As assured this scheme will be ready to start by April-2021. This will cover all the major hospitals in the districts across country with cashless claim facilities. Wherever such hospitals are absent, reimbursement shall be applicable provided treatment is taken in 15 or more than 15 bedded hospital. Those who have not submitted their willingness may do so when the link for Final Policy Which shall be opened by AIGETOA.

Group Health Insurance Scheme for BSNL Executives/Employees proposed by AIGETOA CHQ for PAN India level

Dear All,

Though, it is our considerate thought that providing Health Insurance is the duty of employer and we are already into discussion with BSNL Management for improving the medical coverage and facilities. However, CHQ is in receipt of request from many circles for AIGETOA entering into negotiation for a group health insurance for the executives. Based on the request received from many circles, AIGETOA CHQ has decided to get into tie up with Insurance Agency on PAN India Basis in order to ensure best possible quotes as many employees want to get individual health insurance and are facing many difficulties in getting the insurance due to riders associated with the individual policies. As a welfare activity for the BSNL Executives/Employees, AIGETOA is in negotiation with New India Assurance Company Ltd (A central PSU) and Star Health Insurance (The leading Health Insurance Provider in private sector) for a group Health Insurance Scheme.

Salient Features of the proposed Group Medical Health Insurance Policy by AIGETOA.

  1. Best policy conditions with most competitive Premium rates under direct tie up with the company, not through any agent.
  2. All Executives/Employees of BSNL working PAN India is eligible to join. Income Tax rebate will be applicable for the premium.
  3. The policy will be distributed into zones so best TPA in a particular zone can be selected. In case of star health, it will be handled directly by the company. The treatment will be cashless. BSNL is spread throughout the country. At few places cash less treatment may not be available,in that case treatment has to be taken in hospital with 15 or more beds, which will be reimbursed.
  4. Medical Coverage for parents/In-laws can also be added as optional benefits with some extra premium.
  5. Sum Assured i.e. claimable amount for the insurer employees family will be Rs Five Lakhs plus top up.
  6. The provision for extra Top Up amount shall be there in the form of either Corporate Buffer or individual family top up with nominal cost.
  7. Definition of Family shall be as per Govt of India norms.
  8. Coverage will start from day one of the commencement of the policy. No waiting period shall be there.
  9. Pre-existing diseases will also be covered including planned surgeries as added advantage.
  10. Advance Treatment is also applicable with some conditions.
  11. Hernia, Hysterectomy, Cataract etc covered from first day.

We are right now negotiating for around 5000 employees. The current premium quote is expected to be around Rs 6000-7000 annually for 5 lakhs coverage for Self, Spouse and two kids, which is being negotiated for lowering it further. The premium for covering parents shall be extra.

This tentative premium is expected to go further down to a very low premium if the number of optees for the scheme is very high. We are trying to get the policy at the as minimum rates as much as possible as there is no middleman involved and the policy is being negotiated with the company Directly.

In case of any queries and clarification one may contact our respective Circle Secretaries.

We are planning to launch the scheme in the month of March-2021 itself. Accordingly all interested persons are requested to fill up the form latest by 10.03.2021 by clicking the following link.

Click here for Group Medical Health Insurance Policy Online Form