The State Administrative Council (SAC) which met here under the chairmanship of Governor, Satya Pal Malik approved a Health Insurance scheme for J&K Government Employees and Pensioners based on ‘Trust Model’.
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 the 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 an appropriate insurance product and offer it to designated beneficiaries i.e State Government employees/pensioners. The administration of the scheme including a collection of premia, enrollment of the insured, settlement of claims will be with the said Trust. This measure will address the issue on a 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.