PPT used during training cum review of RSBY consultants held on 17th of November 2011 at Raipur

1. Rashtriya Swasthya Bima Yojna in the
State of Chhattisgarh
28th June 2011 RSBY RRM Ranchi 1

2. Main features
• Business Model for all Stakeholders
• Empowering the beneficiary
• Insurers
• Hospitals
• Government
• IT based

3. IMPLEMENTATION OF THE SCHEME
– Setting up of Nodal agency
– Identification of Insurance agency
– Appointment of DKM and FKOs
– BPL data base
– Enrollment of Beneficiaries and Delivery of
Smart Card to commence
– Empanelment of Government and private
institutions
– Payment of insurance premium to the
insurance service provider.
– Delivery of health services

4. State Nodal Agency-Chhattisgarh
Department of Health and Family Welfare – Nodal Department
 A Separate Nodal Agency under State Health Society has been
constituted.
Nodal Agency comprise of
 Director Health Services as Ex- officio CEO
 Additional CEO -functional or Executive CEO
 Consultant- Hospital, Enrollment, M&E and Computer programmer
 Accounts Manager and other support Staff.
 District RSBY Consultant ( in position 17/18 districts)
 Chief Medical and Health Officers are DKM and a separate Nodal
officer has been nominated for each district.
 The Hospital Administrator at District Hospital and Block programme
Manager under NRHM will coordinate Hospital activities
 Health Workers ( male and Female ) have been designated as FKO in
Rural areas whereas AWW work as FKO in Urban areas
17th November 2011 RSBY for consultants 4

5. www.rsby.in
4. Selection through tendering
Government State Nodal 9. Submission of data and bill Insurance
of India Company
Agency
10. Payment to Insurer
BPL Data
FKO
Health Care
Providers
8. Download of FKO
Data at DKM server
District Call
Kiosk Centre
6. Issuance of
BPL
FKO Card
Awareness Beneficiaries
Health
Camps
DKM

6. Status of scheme
• No of districts covered:- 18
• Total BPL families enrolled till date:- 15,48,696
• Total population enrolled:- 52,11,797
• Avg. Family size:- 3.4
• No of beneficiaries till date:- 1,43,849
• Claim amount generated till date:- Rs.6328.22
• Claim ratio:- 71.6
• Burnout ratio:- 105.2
• Hospitalization ratio:- Rs.4449.5
17th November 2011 For RSBY consultants 6

7. Moral hazards/ issues
• At the time of enrollment
• At the time of empanelment
• For utilization of services

8. Going Beyond BPL
• RSBY is being extended to other categories of
Unorganized sector workers who are non-BPL
• NREGA beneficiaries
• Building and Construction Workers
• Postman
• ASHA Workers/ Mitanin
• Anganwadi Workers
• Non-Government sectors
• In many of these categories people have
agreed to pay part or full premium by
themselves
• Some other ministries are also contemplating
to extend it to their targeted beneficiaries