10th Bipartite Settlement/7th Joint Note signed between IBA representing the management of Banks and Workmen Unions/ Officers Associations on 25-5-2015 inter-alia provided for the introduction of Group Medical Insurance Scheme for employees and officers working in Banks covered by the Settlement (other than State Bank of India). The Scheme was also applicable to cover the existing retired Officers/employees of the Banks and dependent spouse subject to payment of stipulated premium by them.
In view of the increasing cost of premium payable by the retired employees/officers, the need has arisen to review the scheme as applicable to the retired employees and officers with a view to enable possible reduction in the premium payable by them.
With this in view, the issue was discussed between the parties and agreed as under:
- a)The scheme applicable to retired employees and officers will be a separate scheme
- b)Based on this a separate scheme worked out by and between the parties, the benefits of which would accrue accordingly for retired employees and officers.
- c)IBA would float tenders/RFP based on this separate revised scheme for the retired employees and officers
- d)The scheme and terms as applicable to in-service employees/officers will henceforth not be applicable to the retired employees and officers.
- e)Under this Scheme, the sum insured under the uniform base policy would be Rs. 2 lacs.
- f)Stand alone ceilings will not affect claims payable in other procedures covered under the policy.
- g)The bidder will also quote separate premium for those retirees, where the policy cover only one person
- h)The above separate scheme/Base Policy for the retired employees and officers would be based on the following :-
- 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 :
Treatment | Max. reimbursement |
|---|---|
High fever, typhoid, jaundice, other ailments, etc. requiring hospitalisation | Rs. 40,000 max. |
Coronary Angiogram | Rs.16,000 |
Angioplasty | Rs.1,00,000 |
CABG – bypass surgery | Rs.200,000 |
Open heart surgery for valve replacement | Rs.200,000 |
Cataract | Rs.30,000 |
Cost of intra-ocular lens | Rs.10,000 |
Knee Replacement | Rs.100,000 |
Lithotripsy – multi sitting - kidney stone removal | Rs.35,000 |
Hip replacement | Rs.100,000 |
Lasik surgery package per eye | Rs.15,000 |
Hernia | Rs.40,000 |
Hydrocele | Rs.20,000 |
Piles/hemorrhoidectomy | Rs.30,000 |
Appendicectomy | Rs.30,000 |
Cholecystectomy | Rs.40,000 |
Prostatectomy | Rs.40,000 |
FESS | Rs.30,000 |
Dialysis | Rs.2,000 |
Female Diseases/Surgery | |
Hysterectomy | Rs.40,000 |
Mastectomy | Rs.40,000 |
Cost of implants | Max. |
|---|---|
Temporary Pacemaker implantation | Rs.30,000 |
Permanent Pacemaker Implantation | Rs.40,000 |
Cost of Stent | Rs.30,000 |
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 | Ceiling |
Non-Cardiac | Rs.2,500/- |
Cardiac | Rs.5,000/- |
Other Charges :
Physician Consultation Charges per visit :
Specialist Consultation charges per visit :
Charges for Operations (maximum) :
Type | Surgeons Fee | Anesthesia | Theatre Charges |
|---|---|---|---|
Minor operation under LA | Rs.5,000/- | ||
Minor operation under GA | Rs. 5500/- | Rs. 2500/- | Rs. 3,000/- (fixed) |
Minor operations | Rs. 17,000/- | Rs. 7,000/- | Rs. 7,000/- (fixed) |
Supra Major Operations | Rs. 26,000/- | Rs. 9,000/- | Rs. 10,000/- (per hour) |
- -Option for Insurance coverage of single person to be provided.
- -All other terms and conditions of the Medical Insurance Scheme as mentioned in the 10th Bi-partite/7th Joint Note which is not explicitly mentioned in this amendment shall continue. Further, it is agreed that the coverages that have been added subsequently in the Scheme shall also continue, subject to the caps, if any, as mentioned herein.
- -Top ups facilities:- For additional insurance from one lac to Rs.10 Lacs, over and above the base policy to be offered, without above mentioned ceilings.
- -Pending formal amendment to the concerned provisions of Bipartite Settlement/Joint Note dt. 25-5-2015, the IBA may proceed with the revised scheme for the Base Policy of Rs. 2 lacs in order to complete the process of RFP, etc. and to finalise the scheme for implementation w.e.f. 1-11-2023.
Signed this day, the 19th July, 2023
INDIAN BANKS' ASSOCIATION
- Sd..M V Rao
- Sd.. Ashok Chandra
- Sd.. Rajeev Kumar
- Sd.. Lal Singh
- Sd.. Anupam
- Sd.. Gopal Murli Bhagat
- Sd.. Brajeshwar Sharma
WORKMEN UNIONS
- Sd.. AIBEA
- Sd.. NCBE
- Sd.. BEFI
- Sd.. NOBW
- Sd.. INBEF
OFFICERS' ASSOCIATIONS
Sd.. AIBOC
- …… AIBOA
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