Re: Medical Insurance Scheme for employees- Benefits of using GIPSA Hospital Packages vs. Network Hospital vs. Non Network Hospital and also availing reimbursement route

[Vidhin Pandit]

I produce herewith news read from Bank of Baroda Staff facebook close group Posted by  Pension Dept. Head Sh. Rajni Jani:

Dear All, I have sent following mails to all branches.  Dear Sir/Madam  Re: Medical Insurance Scheme for employees- Benefits of using GIPSA Hospital Packages vs. Network Hospital vs. Non Network Hospital and also availing reimbursement route  As you are aware, policy commenced from 1-10-2015 expired on 30-09-2016 and we have now obtained the statistics of different types. During the year, we have come across various issues of deductions in claims on account of clause “Customary and Reasonable Charges” etc. In Banking, this was the first year of Group Insurance Policy:  On going through the statistics obtained, following data in respect of hospitalisation claims emerged.  (Amount in Rs.)  EXISTING EMPLOYEES Cashless Claims Reimbursement  Claims TOTAL  Average Payment per employee Average Payment per employee  Gipsa Network Hospital 51246 44764 49362  Non Gipsa Network Hospital 64631 80062 67940  RETIRED EMPLOYEES Cashless Claims Reimbursement  Claims TOTAL  Average Payment per employee Average Payment per employee  Gipsa Network Hospital 69846 70656 70036  Non Gipsa Network Hospital 87716 92304 88491  Here, it is essential that difference between GIPSA PPN (Preferred Provider Network) and non GIPSA is understood. GIPSA stands for General Insurers Public Sector Association. GIPSA Network hospitals provides treatment based on rate schedule separately contracted with all the insurance companies whereas NON GIPSA Network hospitals are though network hospitals do not follow the said rate schedule but are registered as Network Hospital to provide Cashless Treatment to Policy Holders.  Above analysis shows that it is always advisable to prefer GIPSA network hospital as less Insured amount gets exhausted vis a vis NON GIPSA Network Hospital. This will help employees to have more unutilised Insured amount in a year at their disposal as also it will keep CLAIM RATIO also under control and will not allow Insurance Company to raise the premium. Such savings will help bank to provide more amount towards other employee welfare benefits.  Therefore, we had requested for GIPSA NETWORK HOSPITALS list separately from Insurance Company and the said list is attached for ready reference. We have also advised the company to provide such list separately on their website. AS CAN BE OBSERVED, NO OF SUCH HOSPITALS IS ALSO MORE THAN 1000 ACROSS INDIA.  This is first of its type communication in the matter on one observation and some more observations will follow shortly.  We request you to bring this to the notice of staff members attached to your branch and retirees visiting your branch.

GIPSA ppn.xlsx

Vidhin Pandit