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IBA launches New Group Medical Insurance Policy for Bank Employees

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IBA has finalised the tender of Group Medical Insurance Policy for Bank Employees fo year 2025-26 and the procedure has also been completed. National Insurance Co. continues to be the insurer.

The following are the important improvements/modifications:

Award staff Rs. 4.00 lacs (now Rs. 3 lacs)
Officers upto Scale V Rs. 5.25 lacs (now Rs. 4 lacs)
Officers Scale VI & above Rs. 7.00 lacs (now Rs. 4 lacs)
Corporate Buffer Rs. 125 crores (now Rs. 100 crores)
  1. For Cataract operation, upper cap shall be Rs.40,000/- per eye.
  2. Hormonal therapy for cancer and Immunotherapy for non-cancer to be included.
  3. Robotic surgery shall be considered in cases where the condition of patient warrants such treatment. This needs to be vetted by the treating doctor.
  4. Thyroid cancer shall be included under critical illness.
  5. For retirees: Mentally/physically challenged dependent family member shall be included by way of add-on. Premium to be paid by retiree/spouse.
  6. Top-up options to be made available for Rs. 1 lac, 2 lacs, 3 lacs and 4 lacs, the premium of which shall be borne by the retiree/spouse.

The following rates of premium has been accordingly finalized for the ensuing Policy for 2025-26.

In-service staff Insurance cover Premium
Workmen (clerical/Substaff) 4.00 lacs 31,001
Officers Scale I to V 5.25 lacs 40,231
Officers Scale VI and above 7.00 lacs 60,001

(Rates are Without GST)

Note: Premium for the in-service staff will be paid by the Banks. Additional premium for domiciliary treatment coverage, Ex-gratia amount for critical illness (Rs. 1 lac) and Corporate Buffer (Rs.125 crores) amount will also be paid by the Banks.

Retirees (with spouse) Insurance cover Premium
Retired Workmen 3.00 lacs 27,001
4.00 lacs 31,001
Retired officers upto scale V 5.25 lacs 40,231
Retired officers Scale VI & above 5.25 lacs 40,231
7.00 lacs 60,001

(Rates are Without GST) (without Domiciliary cover)

Retirees (without spouse) Insurance cover Premium
Retired Workmen 3.00 lacs 24,301
4.00 lacs 29,251
Retired officers upto scale V 5.25 lacs 37,181
Retired officers Scale VI & above 5.25 lacs 37,181
7.00 lacs 48,001

(Rates are Without GST) (without Domiciliary cover)

Retirees TOP UP Premium – with spouse Premium – without spouse
Rs. 1 lac 12,501 10,621
Rs. 2 lacs 20,001 17,001
Rs. 3 lacs 29,301 24,901
Rs. 4 lacs 39,001 31,201

(Rates are Without GST)

Optional – Add on For Retirees – for dependent physically or mentally challenged family member
Insurance cover Rs. 3.00 lacs 10,001
Insurance cover Rs. 4.00 lacs 12,501
Insurance cover Rs. 5.25 lacs 15,001
Insurance cover Rs. 7.00 lacs 35,001
Optional – Add on For Retirees – for dependent physically or mentally challenged family member
Top up – Rs. 1 lac 5,001
Top up – Rs. 2 lacs 10,001
Top up – Rs. 3 lacs 20,001
Top up – Rs. 4 lacs 30,001

GST on premium: As per the decision of the GST Council/announcement by the Government, only individual Medical Insurance Policies are exempted from GST. From AIBEA/UFBU, it has been taken up with the Government to exempt GST on premium for Group Policy for the senior citizens.

Policy coverage:

The Policy will cover all the features and provisions as provided in the Scheme under the 10th Bipartite Settlement dated 25-5-2015 with subsequent modifications/improvements which include the following:

  1. Treatment for Age Related Macular Degeneration (ARMD) and Intra vitreal injections for eye disorders other than ARMD also.
  2. Approved targeted therapies for treatment of Cancer in Day Care and standalone basis (Immunotherapy – Monoclonal Antibody Cancer treatment on standalone basis).
  3. Hormonal therapy for cancer and Immunotherapy for non-cancer to be included.
  4. Robotic surgery shall be considered in cases where the condition of patient warrants such treatment. This needs to be vetted by the treating doctor.
  5. Thyroid cancer shall be included under critical illness for payment of ex-gratia of Rs. one lac.
  6. Domiciliary coverage will continue to be extended for serving employees and dependent family members.
  7. Retired workmen employees will have the option to take the base policy for Rs. 3 lacs or Rs. 4 lacs.
  8. Retired Scale VI and above officers will have the option to take the base policy of Rs. 5.25 lacs or Rs. 7 lacs.
  9. Employees will be permitted to add/update dependents during the currency of the Policy on account of birth of a child/marriage of the employee.
  10. Substitution/change of dependents shall be allowed before the commencement of the Policy (1-11-2025) and not during the policy period.
  11. Corporate Buffer amount is increased to Rs. 125 crores.
  12. A Committee consisting of CGM-HR/GM-HR of 5 participating member banks will be formed to monitor the performance of TPAs on regular basis and will recommend to delist hospitals/medical units in the event of adverse feedbacks. If the performance of the TPA is found wanting despite repeated observation of deficiency in the service, the Committee may recommend removal of the TPA.

xiii. Retirees who have not joined the Policy so far will be given an opportunity to join the Policy now.