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West Bengal Health Scheme Cell


About the Cell

A beneficiary under this scheme can get reimbursement of the cost of all indoor treatment in empanelled hospitals within the state of West Bengal and the cost of OPD treatment for 15 (Fifteen) diseases as specified as per clause of this scheme. Besides these, treatment can also be availed in 9 (Nine) enlisted hospitals outside West Bengal. Claim of only indoor treatment in non-empanelled hospitals within the state is also reimbursable subject to the compliance of guidelines.

1. Short title and commencement:

(i)This Scheme may be called “West Bengal Health Scheme for the Beneficiaries of Grant – in – aid Colleges and Universities, 2017”.
(ii) It shall come into force on such date, as the State Government may, by notification in the Official Gazette, appoint.

2. Application:

(l) This scheme shall apply to the serving teachers including Librarian and Graduate Laboratory Instructors of the Government-aided colleges and serving teachers and officers of State aided -Universities and their beneficiaries including Librarian and Graduate Laboratory Instructors.
(2) The provision of enrolment under this scheme shall be optional.
(3) A teacher/officer shall not be entitled to draw the regular medical allowance, if opted for this scheme, with effect from the date of effect of such enrolment under clause
(4) A teacher/officer shall have the liberty to opt out of this scheme at any time. Provided that where a teacher/officer or his/her beneficiary has enjoyed any benefit under this scheme, such employee shall not be allowed to opt out of the scheme within five years from the month following the month in which he/she enjoyed the benefit. A teacher/officer enrolled under this scheme shall not be eligible to be enrolled again if he/she opts out of the scheme for whatever reason.

3. Enrolment:

a) Government-aided College Teachers and State-aided University Teachers & Officers will have to apply online for enrolment in West Bengal Health Scheme Portal of Finance Department’s website: http://wbfin.nic.in’
A new URL will be made available under this portal for beneficiaries of Grant- in- aid Colleges and Universities.
b) Filled up (uploaded with scanned photo and signature of all beneficiaries) application shall be submitted to the concerned DDO. Concerned DDO shall verify the application and approve or reject accordingly. If approved, the employee can take the system generated printout of Certificate of Enrolment (if required) for each beneficiary. If rejected, the application shall be sent back to the applicant with reason of rejection. This application can be again submitted to the concerned authority after modification. Detailed procedure and guidelines for online application will be provided in the website.
c) On successful enrolment under the health scheme, the drawal of regular medical allowance shall be discontinued with effect from the 1st day of the month following the month in which the certificate is issued.
d) i) The Enrolment of existing teachers/Officers under the scheme shall be completed within 1(one) year from the date of notification of the enrolment process.
ii) If one opts under the scheme and spouse name is included, both husband and wife will be covered under the scheme and both will not be entitled to draw regular medical allowance.

4. Criteria for Reimbursement of claims:

i) Enrolled teachers of Grant-in-aid colleges and teachers/officers of Grant-in-aid universities will get the facility of medical treatment in Government hospitals, in hospitals managed by local bodies like municipalities, in State-aided hospitals, in selected Specialty hospitals outside the state, in empanelled private hospitals, nursing homes, Institutions, Clinics, Laboratories, Diagnostic centres (commonly called ‘Health Care Organisation’ or HCO) as listed in Finance Department’s Notification No.3473-F dt. 11.05.09, and as amended from time to time. List of such HCOs will be available in the Heath Scheme portal.
The beneficiaries under this Health Scheme may also avail the indoor medical treatment facilities in any non-empanelled private hospital/nursing home. Reimbursement of the cost of such indoor medical treatment will be made under the health scheme in the following manner:
a) Cost up to 80% of the West Bengal Health Scheme Approved Rates may be reimbursed for the indoor medical treatment, if availed in a non-empanelled private hospital/nursing home with bed capacity more than 80 (eighty).
b) For indoor medical treatment in a non-empanelled private hospital/nursing home with bed capacity 80 (eighty) or less, costs up to 60% of the West Bengal Health Scheme Approved Rates may be reimbursed. a) b) c) d)

5. Settlement of Reimbursement of claim

i. Teachers/officers have to apply with details of claim online in the West Bengal Health Scheme Portal. The duly filled in application along with supporting vouchers will have to be submitted to the concerned Head of office (principal/vice-principal/TIC) as the case may be for consideration of claim. The head of office will verify and will give necessary approval if the claim amount is within financial power. On approval, a Sanction order will be generated. The DDO will then take necessary action for the payment to the beneficiary as per Sanction Order’
ii. If the admissible claim amount is more than the prescribed limit mentioned above, the concerned authority will forward the same to the appropriate authority for necessary approval if required.

Composition

Jt.Convenors: Adity Sarbajna & Jayanta Kr. Sikdar

Members:

  1. Rathindranath Basu
  2. Ujjal Biswas
  3. Suman Tamang
  4. Tarikul islam Golder
  5. Dipen Sherpa
  6. Samir Kumar Biswas

(Members approved by GB)

For Enrolment please Contact:
Adity Sarbajna-9830454464
E-mail : aditysarbajna@surendranathcollege.ac.in

For Document submission contact:
Jayanta Kr. Sikdar-9933919744
E-mail: jayantasikdar@surendranathcollege.ac.in

For Reimbursement related information Contact:
Tarikul Islam Golder-8240901118
E-mail: tarikulislamgolder@surendranathcollege.ac.in