A Group Health Protection scheme named “Swasthya Sathi” is announced by the Government of West Bengal vide notification no – 1104-F (P) dated 25th February 2016, which is implemented in the state for certain categories of employees/beneficiaries.




 

A Group Health Insurance scheme named “Swasthya Sathi” was announced by the Government of West Bengal vide Decision in Cabinet No – 2625 dated 17th February, 2016, and notification of Finance Department vide no – 1104-F (P) dated 25th February, 2016.

 

A State level Implementation Committee was formed under the chairmanship of the Chief Secretary to the Government of West Bengal to oversee the implementation of “Swasthya Sathi” vide notification no – HF/O/Swasthya Sathi/097/2016/4032 dated 2nd March, 2016.

 

The first meeting of State level Implementation Committee was held at Nabanna on 8th March, 2016 where it was resolved that The Scheme will have basic health coverage for Secondary and tertiary care up to Rs 1.5 lakhs per annum per family through Insurance Mode and up to 5 Lakhs for certain critical diseases like, cancer, Neuro-surgery, orthopedic and cardio logical diseases etc through assurance mode under the umbrella of Swasthyasathi samiti.. There will be no cap on the Family size and parents of both the spouses will be eligible under the scheme. All pre-existing diseases will be covered from the first day of the policy.

 

The second meeting of State level Implementation Committee was held at Nabanna on 5th July, 2016. State level Implementation Committee in its second meeting approved the administrative setup and proposed IT framework to make the scheme paperless, Cashless through use of Smart card.

 

     State level Swasthya Sathi Package Selection Committee was formed for selection of different packages, package rates and categories. More than 1900 packages have been approved for the said scheme.  

 

E - tender was introduced for selection of group health insurance provider for Swasthya Sathi scheme, vide memo no – HF/O/SS/ Tender _ INS/74 dated 9th September 2016. Only public sector Insurance Companies were allowed to participate in the e-tender. National Insurance Company (9 Districts) and United India Insurance Company (11 Districts) were selected as insurer for respective districts.  Offer letters were issued with the approval of Finance Department vide UO No 2096 dated 2.11.16. Total estimate approved by Finance Department is Rs 1363.72 Cr for 2016-17.

A Society named Swasthya Sathi Samiti  under the chairmanship of the Chief Secretary to the Government of west Bengal has been formed which has been registered, (No – S/M/4377 of 2016-2017 dated 15th November 2016) under Registration of Societies West Bengal Act XXVI 1961. First Meeting of the Governing Body of the Swasthyasathi Samiti was held on 8th December 2016.

 

All the district of West Bengal is covered up under the scheme and 45 Lakhs of families covering nearly 2.5 Crore population will be benefitted out of the scheme. Families of the Self Help Group Members, ICDS Workers &Helpers, ASHA Karmee, Civic Volunteer Force, Civil defence Volunteers and certain categories of contractual employees included under the scheme at present.

A 24X7 Call Centre support (Toll free number -1800-345-5384) for Swasthya Sathi and android based Mobile app have been introduced.

More than 500 Hospitals and Nursing Homes already registered under the scheme through online empanellement portal. Hospitals are graded according to the services available into three categories i.e. Grade-A , Grade-B  and Grade-C hospitals.

The Scheme has been inaugurated by the Hon’ble Chief Minister of West Bengal, Mamata Banerjee on 30th December 2016.

 

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