All required procedures followed in Group Medical Insurance Scheme: JK Govt

Srinagar, Oct 6: Dispelling the rhetorical misgivings being created about the Group Medical Health Insurance Scheme rolled out by J&K Government recently, the State Government Saturday clairified that the scheme has been implemented after following all the required procedures in a fair and most transparent manner.
“The entire bidding process has been done in a competitive, clean and transparent manner in line with the Financial Rules and Regulations as well as CVC (Chief Vigilance Commissioner) guidelines,” said an official spokesman.
The spokesman said that the bidding process was monitored by a team of senior-most officers, well versed with the Financial Rules and Regulations, and was conducted through strict technical and financial evaluation.
“In the first round of bidding only one bid was submitted by a Public Sector Undertaking (PSU) and as the first round concluded with poor response it had to be terminated,” he said and added that thereafter, a pre-bid conference was organized, where both private and PSU companies participated and the tender was reissued with minor changes in technical parameters on their suggestion.
The spokesman said that all PSUs as well as top private insurance companies were contacted to participate in the bidding process as a result of which in the second round, 9 companies including Private and Public Sector Undertakings submitted their bids, out of which 5 qualified on technical evaluation criteria.
The financial bid of 5 qualified companies were opened and it emerged that Reliance General Insurance Company with a quoted premium of Rs 8776.84 was at L1, National Insurance Company Ltd with quoted premium of Rs 11918.00 at L2, ICICI Lombard with quoted premium of Rs 17691.74 at L3, Bajaj Allianz with quoted premium of Rs 23476.10 at L4 and United India Assurance Company with quoted premium of Rs 27225.00 at L5.
The spokesman said that the only PSU which participated in the first round and the bid of which was not opened due to poor response came second in the second round with a substantially higher premium quoted than L1. “Further, the gap between L1 and other bidders was substantial and, therefore, there was no question of lack of competition,” he said.
Enumerating further, the spokesman said it is important to point out that more than four years ago when ICICI Lombard was awarded the contract, the premium was Rs 6196 per annum. “However, coverage was much less than this time as the scheme was previously restricted to Gazetted employees only,” he said and added that although the earlier policy also covered employee plus 5 members of his family, the coverage was only for a sum up to Rs 5 lakh and between the age group of 3 months to 80 years.
He said the fresh scheme approved by the State Government for all employees, covers the employee plus 5 members of the family including new born babies and aged parents within the age group of zero to 100 years and that too for a coverage of Rs 6lakh with a premium of Rs 8877 per annum.
The spokesman said that on any criteria of coverage, number of hospitals where cashless service will be provided (more than 4700 hospitals across the country) and the prevalent market rates, the premium quoted by the successful bidder is extremely competitive. “It is also known that at the premium of Rs6196 five years back the then Company suffered losses, as the total amount paid out by them for treatment was higher than the premium collected,” he said and added that ICICI Lombard with whom the State Government had its last contract has quoted Rs17691.74 premium per annum under the fresh scheme.
The spokesman said only 3.5 lakh regular employees of the Government are expected to be covered under the scheme while for pensioners, All India Service Officers, Daily Wagers/Casual Labourers and those government employees who are already covered under a Health Insurance Scheme on their own, it will be optional. He said the expected outgo of the premium would be approximately Rs 310 crore per annum.
The spokesman said that the Group Medical Insurance Scheme with a very reasonable premium alongwith the coverage it provides, number of hospitals including all top hospitals of the country being empanelled, shall be extremely beneficial for the employees and the misleading information being spread is only aimed at creating doubts in the minds of the people.