Nasscom Health Insurance Plan

Nasscom, the premier industry body for IT and ITeS Companies in India, has recently announced a Health Insurance program for its member companies, in association with Medimanage. Medimanage would work as the advisory and service partner to all member companies with respect to the program.

Here are the details of the program.

Overview:

The IT-BPO industry in India is estimated to be a USD 75 billion sector providing direct employment to over 2.5 million employees. The unique value proposition that has enabled this sector to grow has been its ability to hire, retain and retrain the skilled technology and knowledge worker in the country. The industry today is ranked as the largest job creator in the economy and the most attractive workplace for the youth.

Employee health and wellness is a key priority for the industry – driven through various programs, work environment as well as providing health insurance to the employee and his / her dependents.

Healthcare insurance in the past two years has witnessed a steep increase driven by rising claims and increased regulatory environment.

NASSCOM with the support of its member companies is pleased to announce a unique initiative `Technology / Knowledge Worker Health Plan’ wherein aggregation of collective needs of small and medium NASSCOM members will be enabled to offer a cost effective health insurance plan for employees.

Contact:

For specific details, queries and your interest to join this program, we would request you to fill up the basic details in the form given below.

The Need:

A vibrant and growing SME sector is vital for the development for any sector. The IT-BPO industry today accounts for a large number of SMEs. NASSCOM data indicates that out of the 5,000 companies in India, almost 85% are SMEs. NASSCOM membership of 1250 companies includes over 700 SMEs.

The need to attract and retain high caliber talent is critical for SMEs to grow and an effective health insurance plan is an important priority for them. However, current cost structures have created an environment wherein:

• Small and medium-sized companies either can’t get coverage or are priced out completely
• Healthcare costs are rising by the minute at every level of care
• Urban tech companies have very high utilization rates compared to other types of companies
• Access to knowledgeable, effective intermediaries is very difficult for SMEs
• Support for claims and dispute settlement is nearly non-existent for smaller employee groups
• Insurers have no qualms increasing premia for smaller companies

This Technology / Knowledge Worker Health Plan has been created after widespread consultation with NASSCOM members on their need, challenges and interest to join an initiative like this.

Program Objectives:

The key objectives of the plan include:

• To provide a comprehensive, flexible and affordable health insurance covers for employees of NASSCOM member companies, particularly for small and medium companies.
• Bring technology into the domain of health insurance management empowering the customer to make informed choices and to enable efficient delivery of health insurance administration services.
• Provide a “single window” approach such that all the operations are seamlessly and empathetically taken care of with minimum intervention by the HR.

The Plan:

This Technology / Knowledge Worker Health Plan has been devised to provide multiple options coupled with flexibility to enable companies to make an informed choice on what plan would best suit their specific needs.

E- Employee; S-Spouse; C- Children; P – Parents; PIL – Parents in law

Unique Features of this Plan

1. Each company can select a plan from among 16 options!!!
2. Widest coverage provided at very reasonable prices.
3. Option of covering dependants left to employee.*
4. Pay for whom you cover.*
5. On-line payment facility available.
6. Policy serviced by Medimanage, a dedicated health insurance broking company.

Broad Details of this Plan

1. Sum insured on a floater basis.
2. Employee, spouse, first 2 children and parents/parents-in-law can enrol.
3. Coverage will be from policy inception or DOJ in case of new joiners.
4. Pre-existing ailments covered (4.1, 4.2, 4.3 clauses deleted).
5. All covers from day 1.There will be no waiting periods.
6. Day care procedures are covered.
7. Room rent limits applicable.
8. Room rent linked charges (Doctor fees, Surgeon fees etc).
9. Maternity is covered from day 1 for INR 50 K. 
10. Baby cover from day 1 in the main policy.
11. Pre & Post hospitalization covered (30 days & 60 days).
12. Cashless facility available.
13. Co-pay of 10% on parent claims. No co-pay for employee, spouse and kids.
14. 2 children upto 21 years can be covered.
15. Parents covered upto 80 years.
16. Terrorism covered.
17. Additions & deletion on pro-rata basis.
18. Limits on 6 procedures per life per year.
19. Non tertiary care procedures carried out in tertiary care centres will have a 10% co-pay.
20. Flexibility to cover spouse midterm in case of marriage.
21. Claims to be submitted within 30 days from the date of discharge.
22. Availability of a corporate buffer.
23. Claim intimation time of 48 hours.
24. 30 days allotted for enrolment.
25. Domiciliary care is excluded.

For details, please write to techiehealth@medimanage.com. You will receive a call/communication from the Medimanage relationships executive who will explain the policy in detail.

Benefits

This is a program meant exclusively for NASSCOM members. The advantages include – cost reduction, flexibility, access to healthcare insurance for employees and a one stop interface for all queries / issues and support.

Additional benefits include:

1. Better benefits
   • Large group benefits structure
   • Pre-existing ailments cover from day 1 (parents included).
   • Maternity cover upto 50,000
   • Parents cover from day 1.
2. Greater flexibility
   • Selection of sum insured.
   • Selection of dependents.
3. Lower premiums
   • Large group premium rating.
   • Option of selecting members lowers the premium by 30%.
4. Better predictability
   • Allows losses to be spread over large numbers keeping it in reasonable limits.
5. End to end support
   • “One stop shop” for all queries & facilitation
   • Web interface for all administration
   • Enrolment communication & enrolment
   • Query management
   • Re-imbursement claims facilitation
   • Cashless co-ordination

Join Now!

• NASSCOM will circulate the program highlights along with the enrolment form to all its members. Details will also be available on the NASSCOM site.
• Member companies fill up the enrolment form and send the communication to techiehealth@medimanage.com
• Medimanage gets in touch with the contact person within 12 working hours.
• Medimanage executive explains policy details.
• Plan selection by company.
• Company sends employee / dependent data as per format.
• Medimanage provides premium computation based on the data received along with written policy conditions.
• Company confirms the intent for coverage with effective date.
• Medimanage collects the premium cheque & commences the cover for the members.
• Medimanage embeds list in the software and structures the plan.
• Medimanage sends enrollment communication to all employees for the optional covers.
• Employees enroll members for optional covers through mPower (Medimanage enrolment portal)
• Premium for optional covers to be paid by employee by net banking / credit card / debit card. This premium will be paid directly to the insurer.
• In case a company wishes to pay for the optional covers and recover the amounts from the employees it is also permitted.
• Queries regarding enrollment addressed by Medimanage support service – on-line / over phone.