Salient features in the modified policy are as under
1. Top up and Super top-up is one and the same:
2. As per the expiring terms and conditions, domiciliary treatment will remain 10% of Base policy Sum Insured opted even for those who opted Single Person rate.
3. Domiciliary treatment is not covered under Top up policy, as per the conditions of previous years’ policies.
4. As per request received from IBA, separate rates were given for Single person i.e., either of the below mentioned cases:-
a) Retiree without Spouse (unmarried, legally separated and divorced)
b) Surviving Spouse (Family Pensioner)
(* If employee and spouse both are alive, family floater premium have to be paid.)
(i) For Base Policy of Sum Insured 2 Lacs: Room Rent/ICU Rent per day will be as per attached joint note of IBA Dated 19/07/2023 – https://www.iba.org.in/hr-ir/joint-notes.html
(ii) For Base policy + top up policy with Sum Insured ranging from Rs. 3 lacs to 12 lacs( i.e.
Base policy of Rs 2 lacs + top up of Rs 1 lac to Rs 10 Lacs ): Room rent per day shall be payable
up to Rs.5000/- and ICU charges upto Rs.7500/-
5. Retirees who are not covered under expiring Retirees policy 2022-23 ONLY can be covered under Retirees policy 2023-24.
6. Retirees can opt with/without domiciliary option in Retirees policy 2023-24 irrespective of
option they have chosen in last year’s policy 2022-23.
6. Retirees who are not covered under the top-up policy 2022-23, can avail Top-up policy for 2023-24.
7. TOP-UP POLICY AND SUPER TOP-UP POLICY IS SAME.
Other features in the modified policy are;
- A base Policy of Rs.2 lakh with caps/limits along with top-up options varying from Rs.1 lakh to 10 lakhs.
- Caps are applicable if the base policy is only opted for by retirees on the following occasions.
- Caps on bedroom/room rent /boarding expenses per day.
- Caps on ICU charges per day for base policy
- Caps on stand-alone ceiling/cap on treatment.
- Caps on costs of implants
- Caps on Physician/Specialist consultation charges.
- Caps on operation.
- Once the top-up variant is opted for by the retiree, the entire policy i.e.base policy + top-up policy will not have the caps mentioned.
BASE RATES: 2023-24 for Retired Employees (Without Domiciliary)
Amount in Rupees
Base Sum insured | Premium for family | GST @ 18% | Total Premium | Premium for Single | GST @18% | Total |
200000 | 22419 | 4035 | 26454 | 15133 | 2724 | 17857 |
BASE RATES: 2023-24 for Retired Employees (With Domiciliary)
Amount in Rupees
Base Sum insured | Premium for family | GST @ 18% | Total Premium | Premium for Single | GST @18% | Total |
200000 | 41530 | 7475 | 49005 | 28033 | 5046 | 33079 |
Details of premium rates for base policies, top-up policies, and premiums for Single Retirees are attached below.
Top-up rates 2023-24 for retired employees without domiciliary (Amt. in Rs)
Retirees top-up sum insured (Rs) | Top up premium family (without domiciliary) | GST 18% | Total top-up premium | Top-up premium (for Single) | GST 18% | Top up premium (single) |
100000 | 23106 | 4143 | 27159 | 15536 | 2796 | 18332 |
200000 | 43152 | 7767 | 50919 | 29128 | 5243 | 34371 |
300000 | 49164 | 8850 | 58014 | 33186 | 5973 | 39159 |
400000 | 51576 | 9284 | 60860 | 34814 | 6267 | 41081 |
500000 | 59388 | 10690 | 70078 | 40087 | 7216 | 47303 |
600000 | 65364 | 11766 | 77130 | 44121 | 7942 | 52063 |
700000 | 68376 | 12308 | 80684 | 46154 | 8308 | 54462 |
800000 | 73788 | 13282 | 87070 | 49807 | 8965 | 58772 |
900000 | 79200 | 14256 | 93756 | 53460 | 9623 | 63083 |
1000000 | 86412 | 15554 | 101966 | 58329 | 10499 | 68828 |
Top-up rates 2023-24 for retired employees with domiciliary (Amt. in Rs)
Retirees top-up sum insured (Rs) | Top up premium family | GST 18% | Total top-up premium | Top-up premium (for Single) | GST 18% | Top up premium (single) |
100000 | 44810 | 8066 | 52876 | 30247 | 5444 | 35691 |
200000 | 76100 | 13698 | 89798 | 51368 | 9246 | 60614 |
300000 | 124450 | 22401 | 146851 | 84004 | 15121 | 99125 |
400000 | 165800 | 29844 | 195644 | 111915 | 20145 | 132060 |
500000 | 196150 | 35307 | 231457 | 132402 | 23832 | 156234 |
600000 | 219490 | 39508 | 258998 | 148156 | 26668 | 174824 |
700000 | 243820 | 43888 | 287708 | 164579 | 29624 | 194203 |
800000 | 271140 | 48805 | 319945 | 183020 | 32944 | 215964 |
900000 | 299450 | 53901 | 353351 | 202129 | 36383 | 238512 |
1000000 | 309750 | 55755 | 365505 | 209082 | 37635 | 246717 |
Source: Circular of National Insurance Company