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

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.

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