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Decision for employees Health Insurance scheme in limbo, decision taken a year back
Can JK’s bureaucracy trash past SAC decisions?
12/5/2019 8:39:11 AM

Jammu: Now when the Jammu and Kashmir government has announced that more than 3.5 lac of its employees will get the accidental insurance cover of 10 lac rupees, it has once again raised the long forgotten issues of the Health Insurance scheme under which the government workers were ought to get health insurance cover.
There has been no call made to review the status of the file and whether there should be any process initiated for the implementation of the SAC decision. “It is all mirror and smoke. Nothing concrete as of now has been done vis-a-vis implementing the decision of creating a Trust Model for the health insurance of the employees and pensioners. The fact is that the employees of the state at present are at the mercy of the situation- they aren’t covered under any health insurance policy,” said a senior official.
On January 28, this year, the State Administrative Council (SAC) under the chairmanship of then Governor, Satya Pal Malik approved a Health Insurance scheme for J&K Government Employees and Pensioners based on ‘Trust Model’.
The government while announcing the Trust based insurance scheme had stated that after the scrapping of previous Medical Claim Policy, State Government constituted a Committee of Officers headed by Principal Secretary, Health & Medical Education to examine the possibility of operating the Health Insurance Scheme through Third Party Administrator (TPA) by dispensing with the insurer and intermediary. The Committee was mandated to determine the contours of such scheme and a selection procedure.
The Committee after discussing and analyzing health insurance models of various states submitted its report along with three models.
The SAC considered the options/models suggested by the Committee of officers’ vis-a-vis advantages-disadvantages of each model.
After considering feasibility of various models and their merits, the SAC decided that ‘Trust Model’ may be implemented for the employee’s health insurance across the State for its added advantages
“Under this model, a Trust will be set up by the State Government. The Trust may design appropriate insurance product and offer it to designated beneficiaries i.e State Government employees/pensioners. The administration of the scheme including collection of premia, enrollment of the insured, settlement of claims will be with the said Trust. This measure will address the issue on long term basis and do away with issues of renewal and other issues which crop up every now and then. This will also ensure close monitoring. SAC directed the Health and Medical Education Department to take necessary measures in this regard,” reads the official handout dated 28 January, 2018.
As per the officials pricy to the development, there has been no forward movement witnessed vis-a-vis the implementation of that SAC decision. “One wonders how could that vital SAC decision be forgotten with such impunity with the power corridors of Jammu and Kashmir. It is ironic that nowhere from the directions were issued since then to take a final call over the implementation of Trust Model for the health insurance of the employees and pensioners. The proposal has been shelved as of now,” says an official.
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