The Government of Jammu and Kashmir has decided to introduce the Health Insurance Scheme for its employees, pensioners and journalists (J&K Group Mediclaim Health Insurance Scheme for Employees, Pensioners & Journalists).
This government scheme has been launched in the state on the basis of a “trust model“. The Health Insurance Scheme for Employees, Pensioners, and Journalists (J&K Group Mediclaim Health Insurance Scheme for Employees, Pensioners & Journalists) has been approved in the State Administrative Council (SAC) meeting chaired by Governor Satyapal Malik.
In the health insurance scheme, the state government will provide a cover of up to 6 lakhs per year to the employees, pensioners, and journalists (Group Mediclaim Health Insurance Scheme for employees, pensioners, and accredited journalists). This means that employees, pensioners or journalists can avail up to 6 lakh healthcare services in a year (J&K Group Mediclaim Health Insurance Scheme). In addition, if there are five members in a family, they will also be covered under this scheme (J&K Group Mediclaim Health Insurance Scheme).
This health insurance scheme is compulsory for all government employees as well as employees who work in PSU or University are also eligible for this scheme.
Jammu Kashmir Group Mediclaim Health Insurance Scheme
The benefits that will be given to the employees, pensioners and journalists (J&K Group Mediclaim Health Insurance Scheme) in the Jammu and Kashmir Group Mediclaim Health Insurance Scheme can all be obtained from the state government listed hospitals:
- An official spokesperson said that under this model, a trust would be set up by the state government which would design the appropriate insurance product and provides it to the beneficiaries.
- The scheme will provide insurance coverage of up to Rs 6 lakh per employee or pensioner. Nominee employees, pensioners or journalists, along with their 5 dependent family members will also be included in the scheme on a floater basis.
- This policy has been made with Reliance General Insurance Company. Employees will have to pay a premium of Rs 8,777 and pensioners Rs 22,229 annually.
- Shri Mata Vaishno Devi Shrine Board, Shri Mata Vaishno Devi University, Shri Amarnathji Shrine Board and recognized journalists of the state will also be covered under Jammu and Kashmir Group Insurance Scheme.
- The annual premium will be deducted in four quarterly installments. These installments will be deducted on 1 October, 15 January, 15 April and the last installment on 1 July.
The committee, after discussing and analyzing the health insurance models of various states, submitted its report with three models. The SAC considered the options suggested by the committee. After considering the feasibility of various models and their features, SAC decided to implement the ‘Trust Model‘. This will include recovery of premium, registration of the insurer, medical claims settlement on behalf of the trust itself. The Trust will also take a decision on the renewal and other issues of the scheme. The SAC has directed the Health and Medical Education Department to take necessary measures in this regard.
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