Tender Notice Dt - Department of Health , J&K
Tender Notice Dt - Department of Health , J&K Tender Notice Dt - Department of Health , J&K
PART I – INFORMATION TO THE BIDDER ABOUT THE SCHEME1. Name :RASHTRIYA SWASTHYA BIMA YOJANAIN THE STATE OF ___________J&KThe name of the scheme shall be “RASHTRIYA SWASTHYABIMA YOJANA”2. Objective :To improve access of identified families and other beneficiaries to qualitymedical care for treatment of diseases involving hospitalization and surgerythrough an identified network of health care providers.3. Beneficiaries:The scheme will be implemented throughout the State in 2 districts namelyJammu and Srinagar. Therefore, tenders are invited to cover an estimated67000 Rural and urban families of Jammu and Srinagar districts of theState. The families could be Below Poverty Line (BPL) or any other categoryas identified by the State Government/ State Nodal Agency. District wiseprofile of the BPL families is given below:Sl.No.Name ofDistrictsBPLFamiliesNo ofBlockNo ofG.PNo ofPHCsNo ofCHCsNo ofDistrictHospitalNo ofPrivateHospital1 2 3 4 5 6 7 8 91 Jammu 484682 Srinagar 18532Total 67000NOTE: In addition to the BPL Families, Central/ State Government mayadd other categories of Beneficiaries to the scheme in a way that allthe provisions of RSBY applicable to the BPL families are alsoapplicable to the added categories.5
4. Unit of Enrolment:4.1. The unit of enrolment for this scheme is family. Coverage under thescheme would be provided identified beneficiaries and their families[up to a unit of five).4.2. This would comprise the Household Head, spouse, and up to threedependents. The dependents would include such members who arelisted as part of the family in the BPL data base and database of otherbeneficiaries (if applicable).4.3. Head of the household will need to identify three members (In caseswhere spouse is not present in the family details, four members canbe identified) who will be enrolled in the scheme. If the spouse is partof the identified beneficiary family list then it would be mandatory toenroll the spouse.5. Benefits:5.1. The Benefits within this scheme, to be provided on a cashless basis tothe Beneficiaries up to the limit of their annual coverage, packagecharges on specific procedures and subject to other terms andconditions outlined herein, are the following:a) The scheme shall provide coverage for meeting expenses ofhospitalization for medical and/or surgical procedures includingmaternity benefits, to the enrolled families up to Rs.30,000 perfamily per year subject to limits, in any of the network hospitals.The benefit to the family will be on floater basis, i.e., the totalreimbursement of Rs.30,000 can be availed of individually orcollectively by members of the family per year.b) Pre-existing conditions/diseases are to be covered from day one,subject to the exclusions given in Annexure 8.c) Coverage of health services related to surgical nature shall also beprovided on a day care basis.The Insurance Company shall provide coverage for the following daycare treatments/ procedures:i) Haemo-Dialysisii) Parenteral Chemotherapyiii) Radiotherapy6
- Page 1 and 2: GOVERNMENT OF J&KDEPARTMENT OF HEAL
- Page 3 and 4: GOVERNMENT OF J&KDEPARTMENT OF HEAL
- Page 5: Table of ContentsPART I - INFORMATI
- Page 9 and 10: part of insured family member till
- Page 11 and 12: iii) Those facilities undertaking s
- Page 13 and 14: ased on basic quality criteria as g
- Page 15 and 16: Insurance Act 1938.2. Premium payme
- Page 17 and 18: (d)(e)(f)pre-defined fee.An enrollm
- Page 19 and 20: ) Beneficiary has balance in his/ h
- Page 21 and 22: intermediary institutions for the p
- Page 23 and 24: to as the “Call Centre Service”
- Page 25 and 26: The parties shall refer such disput
- Page 27 and 28: for the insurer to download.ii. Dis
- Page 29 and 30: esponsibility of the Insurer to ens
- Page 31 and 32: 36. Notification of Award And Signi
- Page 33 and 34: details of the scheme as mentioned
- Page 35 and 36: SECTION B - FINANCIAL PROPOSAL(KIND
- Page 37 and 38: SECTION D -DECLARATION BY THE BIDDE
- Page 39 and 40: Annexure - 3UNDERTAKING BY THE BIDD
- Page 41 and 42: Annexure 5Format for Providing Addi
- Page 43 and 44: O.T. Charges, Medicines and Drugs,
- Page 45 and 46: 34 FP00300010 J32 Ethmoidectomy - E
- Page 47 and 48: 123 FP00500048 Q43 Duplication of I
- Page 49 and 50: 212 FP00500137 K51 Ileostomy 7 17,5
- Page 51 and 52: 301 FP00600020 D27 Ovarectomy/Oophr
- Page 53 and 54: 390 FP00900048 K25 Vagotomy with Py
- Page 55 and 56: 477 FP01100044Closed Reduction and
PART I – INFORMATION TO THE BIDDER ABOUT THE SCHEME1. Name :RASHTRIYA SWASTHYA BIMA YOJANAIN THE STATE OF ___________J&KThe name <strong>of</strong> the scheme shall be “RASHTRIYA SWASTHYABIMA YOJANA”2. Objective :To improve access <strong>of</strong> identified families and other beneficiaries to qualitymedical care for treatment <strong>of</strong> diseases involving hospitalization and surgerythrough an identified network <strong>of</strong> health care providers.3. Beneficiaries:The scheme will be implemented throughout the State in 2 districts namelyJammu and Srinagar. Therefore, tenders are invited to cover an estimated67000 Rural and urban families <strong>of</strong> Jammu and Srinagar districts <strong>of</strong> theState. The families could be Below Poverty Line (BPL) or any other categoryas identified by the State Government/ State Nodal Agency. District wisepr<strong>of</strong>ile <strong>of</strong> the BPL families is given below:Sl.No.Name <strong>of</strong>DistrictsBPLFamiliesNo <strong>of</strong>BlockNo <strong>of</strong>G.PNo <strong>of</strong>PHCsNo <strong>of</strong>CHCsNo <strong>of</strong>DistrictHospitalNo <strong>of</strong>PrivateHospital1 2 3 4 5 6 7 8 91 Jammu 484682 Srinagar 18532Total 67000NOTE: In addition to the BPL Families, Central/ State Government mayadd other categories <strong>of</strong> Beneficiaries to the scheme in a way that allthe provisions <strong>of</strong> RSBY applicable to the BPL families are alsoapplicable to the added categories.5
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