RETIREE BANKERS HEALTH INSURANCE -
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No one should have to choose between medicine and other necessities. No one should have to use the emergency room every time a child gets sick. And no one should have to live in constant fear that a medical problem will become a financial crisis.
- Brad Henry
WHICH IS BETTER IBA GROUP POLICY OR AROGYA SANJEEVANI ?
FOR NEWS OF INTEREST TO BANKERS AND RETIREES , CLICK HERE
To know complete details of Arogya Sanjeevani Plan promoted by IRDAI , CLICK HERE
To know complete details of Arogya Sanjeevani Plan promoted by IRDAI , CLICK HERE
UPDATE DATED 23.09.2022 : Since National Insurance Company has relaxed certain conditions and revised the scheme for the year 2022-23
Synopsis :
IBA Group policy :
Indian Bankers Association ( IBA ) is arranging health insurance for the employees of the member banks as well as to their retirees every year . Present group policy , which is a family floater policy , is taken by the IBA with a public sector undertaking United India Insurance Co Limited ( UIIC ) which will expire on 30.09.2020 for employees and 31.10.2020 for the retirees .
Every year IBA calls for fresh quotations from insurance companies and finalizes with the company which offers best premium with favourable terms and conditions . Hence the retirees wait with anxiety about the renewal conditions and pricing without any assurance whether the policy would be renewed or not at an affordable price .
The renewal policy for the next year will be issued by National insurance company , another public sector undertaking . The premium in the new renewal is slightly lower than the current premium paid . While banks are meeting the cost of insurance premium for the employees , retirees are made to pay for themselves . As the cost of insurance was raising every year and many retirees had opted out of the scheme earlier as they found it not affordable . Now retirees who have opted out earlier is given one more chance to take up the group insurance from 01.11.2022 . Policy allows top-up for an additional premium . The policy can be taken now .
Updated 09.10.2020 : The updated terms and conditions for renewal of the group policy for the year 2020-21 ( cover commences from 01.11.2020 ) are as follows :
1. The retiree award staff can take insurance of basic cover with Rs 1.00 lakh , 2.00 lakh or 3.00 lakhs
2. The retiree bank officers / executives can take insurance of basic cover with Rs 1.00 lakh , 2.00 lakh , 3.00 lakhs or Rs 4.00 lakhs
3. super top cover between Rs 1 , 2 , 3 , or 4 lakhs will be available only for policies with basic cover of Rs 3.00 lakhs
4. super top cover between Rs 1 , 2 , 3 , 4 or 5 lakhs will be available only for policies with basic cover of Rs 4.00 lakhs
5 Super top cover will not be available for policies with basic cover of Rs 1.00 lakh or RS 2 lakh .
6 . Retirees who have opted out of the scheme can join the scheme .
7 . Earlier who had not taken super top policy , now they can opt for it .
8. Irrespective of what policy taken earlier and the age of the retiree , retirees now can exercise fresh option .
9 . Room rent will be allowed maximum of Rs 1,500 per day for policies with base cover of Rs 1 lakh and ICU charges will be restricted to Rs 2,000 per day
10 . Room rent will be allowed maximum of Rs 3,000 per day for policies with base cover of Rs 1 lakh and ICU charges will be restricted to Rs 4,000 per day
11. However Room rent will continue to be maximum of Rs 5,000 per day for policies with base cover of Rs 3 lakhand Rs 4 lakhs and ICU charges will continue to be restricted to Rs 7,500 per day
12. Domiciliary coverage will be 10 % of the basic covered only
Arogya Sanjeevani plan :
Insurance Regulatory & Development Authority of India ( IRDAI ) had come out with a standard common health insurance policy to be mandatorily issued by all insurance companies licensed to issue health policies . The policy is called AROGYA SANJEEVANI POLICY . Though Plan will have common features , premiums can be decided by individual insurance companies . The policy is available for cover ranging from Rs 1.00 lakh to Rs 5.00 lakhs . Maximum entry age is 65 years and hence retirees up to the age of 65 years may have a look in to the plan .
We are comparing some of the features of the two policies below and check whether Arogya Sanjeevani policy can be used as an alternative by the retirees who want to opt out of the group scheme or who have already opted out .
We have compared premium charts of various insurance companies for Arogya Sanjeevani Plan . Hence we have taken the premium quoted by Universal Sompo Insurance company for comparison . Other insurance companies have also come out with their premium chart in . As Arogya Sanjeevani plan is portable , one can port the Arogya Sanjeevani insurance taken to any other insurance company if they find others are cheaper or more convenient . We have also have compared the premiums quoted by various insurance companies for Arogya Sanjeevani plans , which can be read here
IBA Group policy :
Indian Bankers Association ( IBA ) is arranging health insurance for the employees of the member banks as well as to their retirees every year . Present group policy , which is a family floater policy , is taken by the IBA with a public sector undertaking United India Insurance Co Limited ( UIIC ) which will expire on 30.09.2020 for employees and 31.10.2020 for the retirees .
Every year IBA calls for fresh quotations from insurance companies and finalizes with the company which offers best premium with favourable terms and conditions . Hence the retirees wait with anxiety about the renewal conditions and pricing without any assurance whether the policy would be renewed or not at an affordable price .
The renewal policy for the next year will be issued by National insurance company , another public sector undertaking . The premium in the new renewal is slightly lower than the current premium paid . While banks are meeting the cost of insurance premium for the employees , retirees are made to pay for themselves . As the cost of insurance was raising every year and many retirees had opted out of the scheme earlier as they found it not affordable . Now retirees who have opted out earlier is given one more chance to take up the group insurance from 01.11.2022 . Policy allows top-up for an additional premium . The policy can be taken now .
Updated 09.10.2020 : The updated terms and conditions for renewal of the group policy for the year 2020-21 ( cover commences from 01.11.2020 ) are as follows :
1. The retiree award staff can take insurance of basic cover with Rs 1.00 lakh , 2.00 lakh or 3.00 lakhs
2. The retiree bank officers / executives can take insurance of basic cover with Rs 1.00 lakh , 2.00 lakh , 3.00 lakhs or Rs 4.00 lakhs
3. super top cover between Rs 1 , 2 , 3 , or 4 lakhs will be available only for policies with basic cover of Rs 3.00 lakhs
4. super top cover between Rs 1 , 2 , 3 , 4 or 5 lakhs will be available only for policies with basic cover of Rs 4.00 lakhs
5 Super top cover will not be available for policies with basic cover of Rs 1.00 lakh or RS 2 lakh .
6 . Retirees who have opted out of the scheme can join the scheme .
7 . Earlier who had not taken super top policy , now they can opt for it .
8. Irrespective of what policy taken earlier and the age of the retiree , retirees now can exercise fresh option .
9 . Room rent will be allowed maximum of Rs 1,500 per day for policies with base cover of Rs 1 lakh and ICU charges will be restricted to Rs 2,000 per day
10 . Room rent will be allowed maximum of Rs 3,000 per day for policies with base cover of Rs 1 lakh and ICU charges will be restricted to Rs 4,000 per day
11. However Room rent will continue to be maximum of Rs 5,000 per day for policies with base cover of Rs 3 lakhand Rs 4 lakhs and ICU charges will continue to be restricted to Rs 7,500 per day
12. Domiciliary coverage will be 10 % of the basic covered only
Arogya Sanjeevani plan :
Insurance Regulatory & Development Authority of India ( IRDAI ) had come out with a standard common health insurance policy to be mandatorily issued by all insurance companies licensed to issue health policies . The policy is called AROGYA SANJEEVANI POLICY . Though Plan will have common features , premiums can be decided by individual insurance companies . The policy is available for cover ranging from Rs 1.00 lakh to Rs 5.00 lakhs . Maximum entry age is 65 years and hence retirees up to the age of 65 years may have a look in to the plan .
We are comparing some of the features of the two policies below and check whether Arogya Sanjeevani policy can be used as an alternative by the retirees who want to opt out of the group scheme or who have already opted out .
We have compared premium charts of various insurance companies for Arogya Sanjeevani Plan . Hence we have taken the premium quoted by Universal Sompo Insurance company for comparison . Other insurance companies have also come out with their premium chart in . As Arogya Sanjeevani plan is portable , one can port the Arogya Sanjeevani insurance taken to any other insurance company if they find others are cheaper or more convenient . We have also have compared the premiums quoted by various insurance companies for Arogya Sanjeevani plans , which can be read here
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KNOW ABOUT TAX ON RETIREMENT BENEFITS , CLICK HERE
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
PREMIUM CHART OF IBA GROUP INSURANCE POLICY
1. BASIC POLICY WITHOUT DOMICILIARY ( IN RUPEES AND PREMIUM INCLUDING GST )
BASIC POLICY WITHOUT DOMICILIARY :
1. For sum insured Rs 1,00,000 Premium is Rs 15,308 for self and spouse ( Rs 10,333 for self only )
2. For sum insured Rs 2,00,000 Premium is Rs 27,557 for self and spouse ( Rs 18,600 for self only )
3. For sum insured Rs 3,00,000 Premium is Rs 41,334 for self and spouse ( Rs 27,901 for self only )
4. For sum insured Rs 4,00,000 Premium is Rs 57,808 for self and spouse ( Rs 39,020 for self only )- ONLY FOR RETIRED OFFICERS
BASIC POLICY WITHOUT DOMICILIARY :
1. For sum insured Rs 1,00,000 Premium is Rs 15,308 for self and spouse ( Rs 10,333 for self only )
2. For sum insured Rs 2,00,000 Premium is Rs 27,557 for self and spouse ( Rs 18,600 for self only )
3. For sum insured Rs 3,00,000 Premium is Rs 41,334 for self and spouse ( Rs 27,901 for self only )
4. For sum insured Rs 4,00,000 Premium is Rs 57,808 for self and spouse ( Rs 39,020 for self only )- ONLY FOR RETIRED OFFICERS
2. BASIC POLICY WITH DOMICILIARY ( IN RUPEES AND PREMIUM INCLUDING GST )
BASIC POLICY WITH DOMICILIARY :
1. For sum insured Rs 1,00,000 Premium is Rs 25,520 for self and spouse ( Rs 17,226 for self only )
2. For sum insured Rs 2,00,000 Premium is Rs 51,047 for self and spouse ( Rs 34,457 for self only )
3. For sum insured Rs 3,00,000 Premium is Rs 77,920 for self and spouse ( Rs 52,596 for self only )
4. For sum insured Rs 4,00,000 Premium is Rs 97,776 for self and spouse ( Rs 65,999 for self only ) -ONLY FOR RETIRED OFFICERS
BASIC POLICY WITH DOMICILIARY :
1. For sum insured Rs 1,00,000 Premium is Rs 25,520 for self and spouse ( Rs 17,226 for self only )
2. For sum insured Rs 2,00,000 Premium is Rs 51,047 for self and spouse ( Rs 34,457 for self only )
3. For sum insured Rs 3,00,000 Premium is Rs 77,920 for self and spouse ( Rs 52,596 for self only )
4. For sum insured Rs 4,00,000 Premium is Rs 97,776 for self and spouse ( Rs 65,999 for self only ) -ONLY FOR RETIRED OFFICERS
3 SUPER TOP UP PLAN WITHOUT DOMICLIARY
KEY DIFFERENCES BETWEEN IBA GROUP INSURANCE POLICY AND AROGYA SANJEEVANI PLAN
KEY FEATURES |
IBA Group Policy |
Arogya Sanjeevani Plan of Universal Sompo General Insurance |
PORTABILITY |
NOT POSSIBLE |
Allowed among all insurers |
CO PAY |
NIL |
5 % |
DAILY LIMIT FOR BED RENT |
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RS 5,000 |
TOP UP |
AVAILABLE |
CAN BE TAKEN UP FOR HIGHER COVERS |
PRE- TEST |
NOT REQUIRED |
REQUIRED FOR PERSONS ABOVE 55 YEARS |
PRE -EXISTING MEDICAL CONDITIONS |
COVERED |
WAITING PERIOD as per Policy Plan |
PREMIUM FOR SELF FOR 3 LAKHS |
14,520 ( Including GST ) |
16,636 + GST AGE 61-65 Years |
PREMIUM FOR SELF + SPOUSE - FOR 3 LAKHS |
24,199 ( Including GST ) |
24,022 + GST AGE 61-65 Years |
PREMIUM FOR SELF - FOR 4 LAKHS |
19,358 ( Including GST ) |
18,761 + GST AGE 61-65 Years |
PREMIUM FOR SELF + SPOUSE - FOR 4 LAKHS |
57,808 ( Including GST ) |
27,040 + GST AGE 61-65 Years |
PREMIUM FREQUENCY |
ANNUAL |
MONTHLY / QUARTERLY / HALF YEARLY / ANNUAL |
ICU CHARGES PER DAY |
Rs 7,500 |
Rs 10,000 |
ELIGIBILITY |
ANY RETIRED BANKER CAN JOIN - NO AGE LIMIT |
PERSONS ABOVE 65 YEARS CANNOT JOIN |
OUR OBSERVATIONS :
(It is our opinion and the readers can have their own judgement of the situation )
(It is our opinion and the readers can have their own judgement of the situation )
ADVANTAGES OF RENEWING THE EXISTING POLICY WITH UIIC :
There are inherent advantages in renewing the policy with Group policy , compared to other plans :
1. Group policy provides 100 % cover and no co-pay is expected and there is no waiting period .
2. Pre- existing medical condition is accepted for the purpose of cover .
3. Same premium is quoted for retirees of all ages , while premiums vary according to age in Arogya Sanjeevani plans
NEGATIVES ABOUT THE GROUP INSURANCE POLICY
1. Policy is not portable . Hence retirees are forced to renew at the terms , conditions and premiums negotiated by IBA . If policy turns out unaffordable in future renewals , retirees will not be able to take fresh policies with others at their advanced ages . They will be left with no cover when they need it most .
2. Renewal of policy at reasonable escalation of premium is not assured . Domiciliary cover is made unaffordable by quoting premiums higher than the cover amount . Hence retirees lost the benefit of domiciliary cover .
There are inherent advantages in renewing the policy with Group policy , compared to other plans :
1. Group policy provides 100 % cover and no co-pay is expected and there is no waiting period .
2. Pre- existing medical condition is accepted for the purpose of cover .
3. Same premium is quoted for retirees of all ages , while premiums vary according to age in Arogya Sanjeevani plans
NEGATIVES ABOUT THE GROUP INSURANCE POLICY
1. Policy is not portable . Hence retirees are forced to renew at the terms , conditions and premiums negotiated by IBA . If policy turns out unaffordable in future renewals , retirees will not be able to take fresh policies with others at their advanced ages . They will be left with no cover when they need it most .
2. Renewal of policy at reasonable escalation of premium is not assured . Domiciliary cover is made unaffordable by quoting premiums higher than the cover amount . Hence retirees lost the benefit of domiciliary cover .
ADVANTAGES WITH AROGYA SANJEEVANI POLICY :
1. As plan is portable and available with all the health insurance companies , migration from one insurer to another insurer is easy and convenient . If services of an insurance company or its TPA is not satisfactory or renewal premiums are escalated , one will have always an option to migrate .
2. Premium is payable monthly also . Hence it can be integrated with pension payment
For complete terms , conditions , premium chart & prospectus of Arogya Sanjeevani policy of Universal Sompo General Insurance co Ltd , CLICK HERE
OUR SUGGESTION : IBA to take up with the insurance company for renewals for next 5 years with a pre-fixed escalation clause so that retirees can be well prepared for future hikes .
1. As plan is portable and available with all the health insurance companies , migration from one insurer to another insurer is easy and convenient . If services of an insurance company or its TPA is not satisfactory or renewal premiums are escalated , one will have always an option to migrate .
2. Premium is payable monthly also . Hence it can be integrated with pension payment
For complete terms , conditions , premium chart & prospectus of Arogya Sanjeevani policy of Universal Sompo General Insurance co Ltd , CLICK HERE
OUR SUGGESTION : IBA to take up with the insurance company for renewals for next 5 years with a pre-fixed escalation clause so that retirees can be well prepared for future hikes .
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BLOG ARTICLE ON
HEALTH INSURANCE OPTIONS FOR RETIRED BANKERS
The article explores the alternative avenues for existing health insurance group policy for Retired Bankers
TO READ THE ARTICLE CLICK HERE
HEALTH INSURANCE OPTIONS FOR RETIRED BANKERS
The article explores the alternative avenues for existing health insurance group policy for Retired Bankers
TO READ THE ARTICLE CLICK HERE
NEW ARTICLE PUBLISHED :
PLANNING FOR CONTINGENCIES
CLICK HERE TO READ
To know more about Health insurance , CLICK HERE .
TITBITS : From a recent report of Sample Survey Office , it is revealed that 80 percent of Indians , who mainly rely up on private health care , do not have any medical insurance . The government has brought only about 12 % of population under health protection schemes like Rashtriya Swasthya Bima Yojana . In the absence of health insurance , 75 % of Indians use their hard earned savings while 18% have to borrow . In order to escape from financial gloom in the events of medical emergencies , one has to definitely require some form of Health insurance .
HEALTH INSURANCE - Basics
A Health Insurance Policy would normally cover expenses incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured
a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
Sum Insured
The Sum Insured may have a maximum amount for each of the insured under the policy or cumulative for all the insured or a fixed amount to be paid out on particular type of disease or surgery needed or affixed amount per day for the period of hospitalization.
Pre and post hospitalization expenses
Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness.
Cashless Facility
Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
TO READ THE FULL ARTICLE ON HEALTH INSURANCE , CLICK HERE
A Health Insurance Policy would normally cover expenses incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured
a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
Sum Insured
The Sum Insured may have a maximum amount for each of the insured under the policy or cumulative for all the insured or a fixed amount to be paid out on particular type of disease or surgery needed or affixed amount per day for the period of hospitalization.
Pre and post hospitalization expenses
Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness.
Cashless Facility
Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
TO READ THE FULL ARTICLE ON HEALTH INSURANCE , CLICK HERE
READ OUR ARTICLES ON TOPICS IN HEALTH INSURANCE
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KNOW ABOUT TAX ON RETIREMENT BENEFITS , CLICK HERE
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
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FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
ARTICLES ON
SMALL FINANCE BANKS PAYMENT BANKS
UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
e-INSURANCE Account ( eIA )
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INSURANCE LIFE INSURANCE VEHICLE INSURANCE HOUSEHOLD INSURANCE
SMALL FINANCE BANKS PAYMENT BANKS UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
INSURANCE LIFE INSURANCE VEHICLE INSURANCE HOUSEHOLD INSURANCE
SMALL FINANCE BANKS PAYMENT BANKS UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR