G.O.Ms.No.202, New Health Insurance Scheme, 2016
The Government of Tamil Nadu, Finance (Salaries) Department, issued G.O.Ms.No.202 dated 30 June 2016 to implement the New Health Insurance Scheme, 2016 through United India Insurance Company Limited, Chennai. It makes enrolment compulsory for covered employees and eligible family members, sets cashless medical assistance limits, and provides for salary deductions and payment of insurance premiums.
What the document governs
G.O.Ms.No.202 dated 30 June 2016 of the Government of Tamil Nadu, Finance (Salaries) Department, implements the New Health Insurance Scheme, 2016. It is a health insurance document, not a land use, property registration or planning order.
The scheme covers employees of Government Departments, State Public Sector Undertakings, Statutory Boards, Local Bodies, State Government Universities and eligible family members. Willing State Government organisations or institutions registered under the Tamil Nadu Registration of Societies Act, 1975 may also be enrolled if they can bear the employer share without liability falling on the State Budget.
Administration and insurance provider
The New Health Insurance Scheme, 2016 is implemented through United India Insurance Company Limited, Chennai. The Director of Treasuries and Accounts is the scheme administrator.
Key provisions include:
- Enrolment is compulsory for covered employees and their eligible family members.
- The coverage block runs from 1 July 2016 to 30 June 2020.
- Approved treatments and surgeries are generally provided through a cashless model at approved hospitals.
- Accident cases may receive medical assistance where approved treatment or surgery was obtained at a non-network hospital.
Medical assistance limits
The New Health Insurance Scheme, 2016 provides the following family limits for the four year block:
- Up to Rupees Four Lakh for approved treatments and surgeries listed in Annexure II.
- Up to Rupees Seven Lakh and Fifty Thousand for specified illnesses listed in Annexure II A.
- A maximum of Rs.25,000 per eye for cataract surgery.
- A maximum of Rs.45,000 for hysterectomy.
- An overall maximum of Rupees Seven Lakh and Fifty Thousand per family.
Where both legal spouses are covered employees, the family limits do not increase. Employee contribution is recovered only from the younger spouse.
Premium and employee contribution
The annual premium payable by the Government to United India Insurance Company Limited is Rs.2,100 per employee, plus applicable Service Tax. The employee contribution is Rs.180 per month, deducted from salary from July 2016. Any premium above the employee contribution is borne by the employer, with the Government bearing it for Government employees and employees of Government aided educational institutions.
Lists of approved hospitals, treatments, surgeries, district nodal officers and updates are to be hosted on the websites identified in the document.
This summary is generated from the source document to help you find what is relevant. The PDF above is authoritative. For advice on your own property, use LandLens One or speak to a qualified professional.
Common questions
Does G.O.Ms.No.202 affect the ownership or use of my property?
No property or land provision appears in the document. G.O.Ms.No.202 concerns health insurance for covered employees and eligible family members.
Is enrolment under the New Health Insurance Scheme, 2016 optional?
Enrolment is compulsory for the employees and eligible family members covered by the scheme. Certain willing State Government organisations or institutions may join subject to the stated conditions.
Can treatment at a non-network hospital be covered?
The document extends medical assistance to accident cases where the patient received approved treatment or underwent surgery at a non-network hospital.
What happens if both spouses are covered employees?
The family remains subject to the stated family assistance limits. The monthly employee contribution is recovered only from the younger of the two employees.
