Government of West Bengal
Finance Department
Audit Branch
No. 5594-F(P) Dated, the 6 th day of September, 2017.
NOTIFICATION
Sub: Extension of Coverage of "Swasthya Sathi" Scheme
The State Government has introduced "Swasthya Sathi", a Comprehensive Group Health Insurance scheme for different categories of volunteers / workers vide Finance Department No. 1104-F(P) Dated 25th February 2016. The Scheme already covers ASHA Workers, ICDS Workers, ICDS Helpers, Home Guards / NVF, Civic Police Volunteers, Civil Defence Volunteers, Village Police Volunteers at Gram Panchayats, Self Help Group members of WBSRLM, Self Help Group Members of Urban Development & Municipal Affairs Department, Disaster Management workers, contractual / casual / daily rated workers in various Departments, three-tier Panchayat Members and other contractual employees of Panchayat & Rural Development Department, and part-time lecturers and contractual staff of Colleges and Universities.
2. It has been under active consideration of the Government to expand the coverage of Swasthya Sathi to include other employees / workers / volunteers / teachers engaged in government work. Accordingly, after careful consideration, the Governor is pleased hereby to decide that the following groups of employees / workers / volunteers / teachers etc. as mentioned against the corresponding Administrative Department as in the table below be covered under "Swasthya Sathi" with immediate effect in addition to those already covered under the Scheme:-
Table
Department Employees
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Workers I Volunteers I Teachers etc.
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Higher Education / School Education
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Para Teachers
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Siksha Bandhu
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Special Educators
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Contractual staff of Sarba Siksha Mission including Circle level Resource Centre
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Teachers and non-teaching employees of Primary and Secondary Schools
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Panchayat & Rural Development
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Samprasarak / Samprasarika of Shishu Shiksha Kendras
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Samprasarak / Samprasarika of Madhyamik Shiksha Kendras
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Contractual Homeopathic Doctors / Compounders at Gram Pamchayat level
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Minority Affairs & Madrasah Education
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Samprasarak / Samprasarika of Madrasa Shiksha Kendras, Shishu Shiksha Kendras and Madhyamik Shiksha Kendras.
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Teachers and non-teaching employees of recognised aided Madrasahs
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Animal Husbandry
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Pranibandhu
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Fire & Emergency Services
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Fire and Auxiliary Workers
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Self-Help Group & Self Employment
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Prakalpa Sahayaks & Supervisors
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Health and Family Welfare
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Rogi Sahayaks
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Auxiliary Nurse Midwife of National Health Mission
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Other Contractual staff of National Rural Health Mission & National Urban Health Mission including ASHA supervisors and Rashtriya Bal Swasthya Karyakram doctors
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Contractual staff of Rashtriya Swasthya Bima Yojna & Swasthya Sathi
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Contractual Staff of West Bengal Health & Family Welfare Samity
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Contractual Homeopathic, Ayush and Unani Doctors and compounders at Gram Panchayat level
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Urban Development
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Elected representatives of Municipalities
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Employees of Development Authorities not covered under West Bengal Health Scheme & Municipal Affairs
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Employees of Urban Local Bodies not covered under West Bengal Health Scheme
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Sanitary workers and workers engaged under West Bengal Urban Employment Scheme in Urban Local Bodies
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3. Employees / workers / teachers who are in receipt of monthly medical allowance can opt for the Scheme by forgoing the monthly medical allowance.
4. It has also been decided that apart from contractual/casual/daily rated workers covered under No. 4570-F(P) dated 31.08.2016, all contractual/casual/daily rated employees engaged by any Department with specific approval of the Finance Department and drawing remuneration from the treasuries or from grant-in-aid shall also be eligible to be enrolled under Swasthya Sathi scheme.
[H. K. DWIVEDI]
Principle Secretary to the
Government of west Bengal
Source: http://www.wbfin.nic.in/writereaddata/5594-F(P).pdf
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Differences between "Swasthya Sathi" and "WB Health Scheme"
WB Health Scheme
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SWASTHYA SATHI
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1) There is no upper limit of cost in WB Health Scheme (1lakh cashless and above that will be paid as Reimbursement of which 80% can be taken as Advance).
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1) SWASTHYA SATHI has a upper limit of 1.5 lakh and 5 lakh (for critical illness).
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2) WB Health Scheme is actually meant for Government Employees.
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2) SWASTHYA SATHI meant for unorganised sector.
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3) All OPD expenses are paid in WB Health Scheme.
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3) All OPD expenses are NOT paid in SWASTHYA SATHI.
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4) Almost all Private, PPP & Government Hospitals are listed under WB Health Scheme
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4) Where only few Private Hospitals are listed under SWASTHASATHI, e.g. only three Private in Kolkata they are Park, Medica & RN Tagore,
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5) The Family premium to the Insurance company (National Insurance and United Insurance) ranges between Rs. 1729/- to Rs. 3549/- depending on district (Minimum for Dakshin Dinajpur and Maximum for Kolkata) but Medical Allowance is Rs-3600/- per year.
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