Bankers Group Health Insurance Policy for 2024
IBA FINALIZES THE GROUP INSURANCE POLICY 2024
Dated 19.09.2024 : Indian Banks Association ( IBA ) had called , in the month of July 2024 , for Request for proposal ( RPF ) from the insurance companies for the common Group Insurance policy to be issued for both officers and staff including retirees with effective from 1st , November 2024 for a period of one year .
Total 6 bidders submitted technical bids on the last date of submission of technical bids i.e. 9" August, 2024. All such companies were asked to submit the commercial bids on 23rd August, 2024. Accordingly, out of 5 technically qualified insurance companies following 4 companies submitted their commercial bids.
a. National Insurance Co. Ltd. (NICL)
b. New India Assurance Co. Ltd. (NIA)
c. The Oriental Insurance Co. Ltd (OIC)
d. Go digit General Insurance Co. Ltd
8. In presence of Bank and IBA Officials, sealed envelopes containing commercial bids were opened. It was observed that National Insurance Co. Ltd. (NICL) emerged as L1 bidder, which was subsequently approved by the Managing Committee of IBA.
Medical Insurance Scheme Premium for Non -Domiciliary approved is as follows
Employees Retirees
Workmen / workmen retirees : SUM INSURED RS 3.00 LAKHS . PREMIUM : Rs 24,191 ( + GST RS 4,354 )
Officers / Officers retirees : SUM INSURED RS 4.00 LAKHS . PREMIUM : Rs 34,661 ( + GST RS 6,239 )
Arrangements will be made by the respective banks for issue of the policies and the terms and conditions of the policy will be as agreed between IBA and UFBU in the meeting held in July 2024
IBA CALLS FOR RPF FROM INSURANCE COMPANIES
Dated 24.07.2024 : Indian Banks Association ( IBA ) has called Request for proposal ( RPF ) from the insurance companies for the common Group Insurance policy to be issued for both officers and staff including retirees with effective from 1st , November 2024 for a period of one year .
The bidding process will have two parts - technical bid and commercial bid . Technical bids to be submitted on or before 11.00 a.m on 09.08.2024 and Technical bids will be opened on 9.8.2024 at 11.30 a.m. In case of retirees, the bidders will have to quote for single person policy in addition to policy for ex-employee and spouse.
Bidding insurance companies have to fulfil the following eligibility criteria :
1.The bidder should have been licensed for a minimum 5 years as of 31st March, 2024
2.The Bidder should have minimum Net worth of INR500Crs as of 31st March, 2024 .
3.The bidder should have Solvency Ratio of over1.50 as of 31stMarch, 2024 (Not applicable for Public Sector Insurers)
4. The Bidder should have collected Rs. 1000 Crore Gross Direct Premium of Health Insurance (within India) Business during the FY 2023-245.
5. Should have ICR 80% and above for FY 2023-24 .
In the second stage ,only those bidders, who have qualified on the basis of evaluation of their Technical Bids,will be allowed to participate in bidding process for financial bids
One may visit IBA website to go through all the terms and conditions of the bidding process
IBA AND UFBU SIGN AGREEMENT ON GROUP MEDICAL INSURANCE POLICY FOR 2024 -25 .
Dated 24.07.2024 : IBA and UFBU have come to an agreement with regard to issue of common medical policy for both serving employees and officers and retirees .
Salient features of the agreement is as follows ;
1. The common Policy will commence from 1-11-2024. (existing Policy of in-service employees will be extended up to 31-10-2024 and Banks will pay the pro-rata one month premium for the same.
2. Definition of family for the purpose of Serving employees and retired employees shall continue as hitherto as BP settlement.
Domiciliary benefit will continue to be extended to serving employees and families.
Employees will be permitted to update dependents during the currency of the insurance policy on account of Birth, Marriage of employee and Death of dependents. Substitution of dependent/s can be carried out by employees before commencement of Policy every year.
Critical illness benefits (Rs. 1 lac) as provided in BP settlement dated 25.05.2015 shall continue.
Corporate Buffer of Rs. 100 Crores which is available to serving employees as defined in BP settlement dated 25.05.2015 shall continue on the same terms as hitherto.
A Committee will be formed to participate in the process of selection/ allocation of TPAs by the Insurance company. This Committee will monitor performance of TPAs on regular basis and will recommend to delist hospitals/ medical units in the event of adverse feedbacks.
Since the Policy will be a combined one, there will be same premium for the retirees.
Medical Insurance cover would be Rs. 3 lacs for clerical/substaff retires and Rs. 4 lacs for officer retirees.
Top-up facility will be available on additional premium payment.
Those retirees who are not members of the IBA Policy will be given an opportunity to join the policy.
COMMON INSURANCE POLICY FOR WORKMEN AND RETIREES AGREED :
Dated 02.07.2024 : Indian Bankers Association ( IBA ) and UFBU constituents had a video conference today to discuss PLI and Medical insurance . The Team IBA was led by Shri. Rajneesh Karnatak, Chairman, Negotiating Committee and MD&CEO, Bank of India, Shri. S.L. Jain, MD&CEO Indian Bank, Shri. Nidhu Saxena, MD&CEO, Bank of Maharashtra, Shri. R.K. Sharma MD&CEO IDBI, Shri. B.K. Mishra DMD SBI, Shri. Gopal Murli Bhagat Dy. CEO IBA and Shri. Brajeshwar Sharma Senior Advisor (HR & IR) .
In the meeting , IBA informed that the Managing Committee of IBA has approved the revised parameters to decide the PLI as discussed in the earlier meeting held on 15th June 2024 and it is expected to issue an advisory to the Banks within couple of days.
GROUP INSURANCE FOR BANK EMPLOYEES AND RETREES : It is reported that IBA has agreed for the following :
1. IBA will call for the RFP from the Insurance companies with stipulation
[a] Combined policy for the workforce and the retirees
[b]. For the workforce covering Domiciliary treatment and for retirees Hospitalization alone;
[ c.] critical illness amount of Rs1 lacs (remain the same)
[d]. Syncronisation of the commencement of the policy for the workforce as well as for retirees. .
Residual Issues : Discussions held on 15th , June 2024
Dated 18.06.2024 : Indian Bankers Association ( IBA ) and UFBU constituents had negotiating committee meeting on the Saturday 15th June 2024 . The meeting was held in their Mumbai office of IBA . The representatives from both Officers Associations and Workmen Unions attended the meeting . Gist of the discussions held is as follows advised by AIBEA :
Extract from UFBU Circular dated 18.06.2024 :
Renewal of Group Medical Insurance Policy for 2024-25: Since the current Policy for retirees would end by 31-10-2024 and the Policy for the in-service employees/officers would end by 30-11-2024, there is need to renew the same. Hence the issue was discussed in this meeting. Having regard to the premium for the retirees which is increasing year after year, it was suggested that there can be a combined policy for retirees and in service employees/ officers with uniform coverage which would expectedly result in reduction in premium for the retirees.
We have further suggested that for the in-service employees/ officers, there can be additional coverage for treatment of critical illnesses. We have also suggested that the buffer coverage can be reviewed provided that any uncovered amount would be reimbursed by the managements of each Bank. Suggestions like reverting to reimbursement scheme and adopting SBI scheme, etc. would be taken up later as the same requires detailed study of cost benefit, etc.
IBA informed that they would take the views and opinion of the member banks in this regard, and further decisions can be taken in the next meeting. "
KM DASTUR LAUNCHES GROUP HEALTH POLICY FOR BANK RETIREES :
Dated 13.10.2023 : It is reported that M/S K.M Dastur Reinsurance Brokers Pvt Limited has launched a group health insurance policy for bank retirees in association with New India Assurance company for base cover and top up cover being provided by SBI General insurance limited .
The policy has been made more competitive with lower premium and better coverage than the IBA sponsored National insurance Policy .
It is also reported that following bank retiree associations have endorsed the policy .( We have not independently verified the claim )
1 All India Bank Retiree Welfare Association
2 All India Canara Bank Retirees Federation
3 All India Syndicate Bank Retirees Federation –
Maharashtra State Committee
4 All India Union Bank Retirees Federation
5 Andhra Bank Pensioners & Retirees Federation
6 Bank Of Baroda Retirees Association Maharashtra
7 Bank Of Baroda Retired Officers Welfare Association
8 Bank Of Baroda Staff Pensioners Association
9 Bank Of Maharashtra Retirees’ Association
10 Central Bank Retired Employees’ Association
11 Indian Bank Retirees’ Association
12 United Bank of India Retirees Welfare Association
13 United Forum of Bank Retirees
14 UCO Bank Retirees’ Association
15 Dena Bank Pensioners and Retirees Association
For all Retirees who are not a part of any association may pay through any association if they belong to any of the above banks. For those who are not represented by any of the above banks may either join through Central Bank Retired employees association or All India Union Bank Retirees Federation.
For details with the policy , one can contact the above retiree associations or K.M. Dastur Reinsurance Broker Private Limited .Their contact details are available in the Website: www.aicbrf.in.
PREMIUM CHART FOR IBA SPONSORED GROUP POLICY FOR 2023
IBA REVISES PREMIUM FOR TOP UP POLICIES WITH DOMCILIARY TREATMENT :
Dated 12.10.2023 : Indian Bankers Association ( IBA ) has now clarified that top up policy and super top up policy are one and the same . Retirees top up policy with domiciliary does not cover Domiciliary expenses ( Editor : We do not understand the logic of issuing such policy at a higher premium and the policy prima facie carries no meaning ) . They have also reworked the premium rates for top-up policies with domiciliary policies as follows :
PREMIUM CHART FOR TOP UP POLICIES WITH DOMICILIARY ( inclusive of GST ) :
A : Family policies :
1. Rs 1, 00,000 cover , premium is Rs 35,307 ( earlier Rs 52, 876 )
2. Rs 2, 00,000 cover , premium is Rs 66,196 ( earlier Rs 89, 798 )
3. Rs 3, 00,000 cover , premium is Rs 75,417 ( earlier Rs 146,851 )
4. Rs 4, 00,000 cover , premium is Rs 79,118 ( earlier Rs 195,644 )
5. Rs 5, 00,000 cover , premium is Rs 91,101 ( earlier Rs 231,457 )
6. Rs 6, 00,000 cover , premium is Rs 100,268 ( earlier Rs 258,998 )
7. Rs 7, 00,000 cover , premium is Rs 104,889 ( earlier Rs 287,708 )
8. Rs 8, 00,000 cover , premium is Rs 113,190 ( earlier Rs 319,945 )
9. Rs 9 , 00,000 cover , premium is Rs 121,493 ( earlier Rs 353, 351 )
10. Rs 10, 00,000 cover , premium is Rs 132,556 ( earlier Rs 365,505 )
B: Single policies :
1. Rs 1, 00,000 cover , premium is Rs 23 , 832 ( earlier Rs 35, 691 )
2. Rs 2, 00,000 cover , premium is Rs 44,683 ( earlier Rs 60,614 )
3. Rs 3, 00,000 cover , premium is Rs 50,908 ( earlier Rs 99,125 )
4. Rs 4, 00,000 cover , premium is Rs 53,406 ( earlier Rs 132,060 )
5. Rs 5, 00,000 cover , premium is Rs 61,493 ( earlier Rs 156,234 )
6. Rs 6, 00,000 cover , premium is Rs 67,681 ( earlier Rs 174,824 )
7. Rs 7, 00,000 cover , premium is Rs 70,801 ( earlier Rs 194, 203 )
8. Rs 8, 00,000 cover , premium is Rs 76,404 ( earlier Rs 215,964 )
9. Rs 9 , 00,000 cover , premium is Rs 82,008 ( earlier Rs 238,512 )
10. Rs 10, 00,000 cover , premium is Rs 89,476 ( earlier Rs 246,717 )
IBA has also clarified on single person policies as follows :
a. Single person premium is applicable when
1. Retiree has no surviving spouse .
2. Where retiree has passes away and spouse wants the cover
3. where retiree does nor require any cover for the spouse .
Bed charges limit : For policies with top up cover , limit for bed charges Is Rs 5,000 per day and ICU charges Rs 7,500 per day
Now all retirees will be eligible to exercise option for joining the scheme for base policy as well as top policy irrespective of the fact whether they were members of the scheme in previous years, as one time measure.
GROUP POLICY FOR RETIREE BANK EMPLOYEES / OFFICERS 2023 :
RENEWAL OF GROUP INSURANCE FOR BANK RETIREES FINALISED
Dated 19.09.2023 : Indian Bankers Association ( IBA ) has advised member banks that they have opted to continue renewal of the group insurance health policy for bank retirees with National Insurance Company , from 01.11.2023 for one year till 31.10.2023 . Individual retirees can approach their employer banks for making payments of the premium .
The new finalized arrangement for health insurance is significantly different than the arrears and has following features :
Retiree staff and officers can renew the group insurance policy , which will expire on 31.10.2023 at the following cost with the National insurance company as follows :
1. Retired bankers policy for a base policy with cover of Rs 2.00 lakhs without domiciliary at the premium of Rs 22,419 + GST
2. Retired bankers policy for a base policy with cover of Rs 2.00 lakhs with domiciliary at the premium of Rs 41,530 + GST )
Note : There is no distinction between officers and staff FOR THE TERMS , CONDITIONS AND PREMIUM
3. Top up policies are available over the base policy . The base policy has caps on bed room / room rent / ICU charges cost of implants and operations . If one opts for base policy + top up policy , the caps will be removed .
CAPS FOR BASE POLICY 2023 :
i) Bed Charge/room rent/Boarding expenses per day:
Metro/Urban centres Rs. 3000 Other centres Rs.2500
ii) ICU Charges per day:
Metro/urban centres Rs.6000 Other centres Rs.5000
iii) Standalone Ceiling/cap on treatments:
1. High fever, typhoid, jaundice, other ailments, etc. requiring. hospitalisation Rs 40,000 maximum
2. Coronary Angiogram Rs 16,000
3. Angioplasty Rs 1,00,000
4. CABG bypass surgery Rs.200,000
5. Open heart surgery for valve replacement Rs.200,000
6. Cataract Rs 30,000
7. Cost of intra-ocular lens Rs 10,000
8. Knee Replacement Rs. 100,000
9. Lithotripsy multi sitting -- kidney stone removal Rs.35,000
10. Hip replacement Rs. 100,000
11. Lasik surgery package per eye Rs.15,000
12. Hernia Rs.40,000
13. Hydrocele Rs.20,000
14. Piles/hemorrhoidectomy Rs.30,000
15. Appendicectomy Rs.30,000
16. Cholecystectomy Rs.40,000
17. Prostatectomy Rs.40,000
18. FESS Rs.30,000
19 . Dialysis Rs.2,000
Female Diseases/Surgery
Hysterectomy Rs.40,000
Mastectomy Rs.40,000
Cost of implants
Temporary Pacemaker implantation. Rs.30,000
Permanent Pacemaker Implantation Rs.40,000
Cost of Stent Rs.30,000
( Max. Reimbursable )
In case the patient is to be moved to a hospital/nursing home outside the urban agglomeration / municipal limits, then the expenses incurred on conveyance may be reimbursed at the following rates:
Ambulance Category
Non-Cardiac Ceiling Rs.2,500/-
Cardiac Ceiling Rs.5,000/
Other Charges:
Ventilator or respiratory charges Rs.5,000/- per day + oxygen charges
Oxygen charges Rs. 100/- per hour (Max. Rs. 1,000/- per day)
Physician Consultation Charges per visit:
Registration charges Rs.200/-
Consultation / routine visit Rs.400/-
Night visit/emergency visit - Rs.600/-
Specialist Consultation charges per visit:
Consultation / Routine day visit Rs.500/-
Consultation with ECG/Night visit / Emergency visit Rs.700/-
Physiotherapy charges Rs. 300
Charges for Operations (maximum):
1. Minor operations under LA : Rs 5,000
2. Minor operations under GA :
Surgeons Fee Rs 5,500 + Anesthesia Rs 2,500 + Theatre Charges Rs 3,000
3. Minor operations :
Surgeons Fee Rs 17,000 + Anesthesia Rs 7,000 + Theatre Charges Rs 7,000
2. Supra Major operations :
Surgeons Fee Rs 26,000 + Anesthesia Rs 9,000 + Theatre Charges Rs 10,000
HOW IBA CHOSE NATIONAL INSURANCE CO LTD ?
Group Medical Insurance scheme in-lieu of Reimbursement of Hospitalisation scheme was introduced as per 10th Bipartite Settlement / 7th Joint Note dated 25/05/2015. The said scheme was extended to retired employees and their spouse with a condition that the premium will be paid by them. The existing policy (2022-23) is covering 5,83,321 serving employees and 1,52,807 retired employees. As the premium of the retired employees' policy has been increasing disproportionally every year, a need was felt to revisit the terms of the settlement.
2. The parties to the Settlement/Joint Note met on 19/07/2023 and agreed to introduce concept of "Base Policy" with certain caps on room rent, consultation fees and a few procedures for the Retirees' Policy. It was agreed that the Top-Up options will also be made available as option for the amounts ranging from Rs. 1 lac to Rs. 10 lacs to those who opt for Base Policy.
3. Accordingly, to arrive at L1 bidder, with the approval of the Managing Committee of IBA an RFP was floated on 24.07.2023, duly incorporating the revised terms as mentioned in the agreement dated 19/07/2023. We called quotes from IRDA approved Insurance Companies for arranging Medical Insurance Policies for in-service employees and bank retirees.
4. The last date of submission of technical bids was on 7th August, 2023. Total 3 bidders. submitted Technical bids, namely:-
a. National Insurance Co. Ltd. (NICL) b. New India Assurance Co. Ltd. (NIA)
c. The Oriental Insurance Co. Ltd (OIC)
5. All of the above bidders were found technically qualified and therefore were asked to submit the commercial bids on 17th August, 2023. Accordingly, they submitted their bids and in the presence of Bank and IBA Officials, sealed envelopes containing bids were opened. It was observed that (NICL) emerged as L1 bidder, which was subsequently approved by the IBA