GOVERNMENT OF TAMIL NADU 
                                                                                                                                                           
                                                                                                                                                           
                                                                                                                                                                                           
                              
                              
                              
                                 TENDER DOCUMENT TO SELECT INSURANCE COMPANY TO IMPLEMENT 
                                                                                                                                                           
                                                    “CHIEF MINISTER’S COMPREHENSIVE HEALTH INSURANCE SCHEME” 
                                                                                                                                                           
                                                                                                                                                           
                                                                                                                                                           
                                                                                                                                                           
                                                                                                                       PROJECT DIRECTOR, 
                                                                                            Tamil Nadu Health Systems Society, 
                                                                                No. 359, Anna Salai, DMS Annexe Building, 
                                                                                                    Teynampet, Chennai – 600 006. 
                                                                                                                                                           
                                                             INDEX 
                 S. No.                                   Particulars                                    Page No. 
                    1.     Invitation of Bid                                                                  1 
                    2.     Enclosure – I            G.O. (Ms) No. 169 H & F W (EAP-II(2)  
                                                    Department,  Dated : 11.07.2011 and                      14 
                                                    amendments thereto. 
                    3.     Enclosure – 2.           The “Chief Minister’s Comprehensive  
                                                    Health Insurance Scheme”                                 31 
                                                    Guidelines, 2017 
                                a.  Annexure – A            Activity Chart                                   57 
                                b.  Annexure – B            Hospitals covered under the                      58 
                                                            Scheme 
                                c.  Annexure – C            Total procedures to be covered                   59 
                                d.  Annexure – D            Procedures for with coverage up to               92 
                                                            Rs.2 Lakhs  is provided  
                                e.  Annexure – E            Follow up procedures to be                       96 
                                                            covered 
                                f.  Annexure – F            Diagnostic Procedures to be                     101 
                                                            covered 
                                g.  Annexure – G            The tentative list of Surgeries /  
                                                            Therapies to  be reserved for                   103 
                                                            Government Hospitals. 
                                h.  Annexure – H         High End Procedures                                108 
                    4.     Enclosure – 3            Financial Bid                                           109 
                    5.     Enclosure – 4            Agreement                                               110 
                                                                    
                                   GOVERNMENT OF TAMIL NADU 
                                                       
                 TENDER DOCUMENT TO SELECT PUBLIC SECTOR INSURANCE COMPANY  
                                             TO IMPLEMENT  
                       “Chief Minister’s Comprehensive Health Insurance Scheme” 
                                                      
             Invitation of Bid  
                    The    Government      of    Tamil    Nadu     has    decided     through 
             G.O.(Ms).No.169,H&FW (EAP-II(2)) Department, Dated 11.07.2011 to launch 
             the “Chief Minister’s Comprehensive Health Insurance Scheme” to achieve the 
             objective of providing quality health care to the people of Tamil Nadu. As per 
             the directions given in the above G.O. and also in the G.O.(Ms) No.189/H&FW 
             (EAP-II(2))  Dept.,  dated.29.07.2011  and  G.O.(Ms)  No.275/H&FW  (EAP-II(2)) 
             Dept., dated.02.11.2011, the CMCHISTN is being implemented for four years 
             and extended one more year as per G.O.(Ms) No.4/H&FW (EAP-II(2)) Dept., 
             dated.06.01.2016 in the state. Now as per the administrative sanction given in 
             the G.O.(Ms) No.268 H&FW Department dated 17.11.16, this tender is invited 
             for selecting the Public Sector insurance partner for implementing the above 
             scheme. 
              
             1.     DEFINITIONS:- 
             In this tender document unless the context otherwise provides 
              
                    (a)  “Scheme”  means,  the  “Chief  Minister’s  Comprehensive  Health 
                          Insurance  Scheme” as  per  G.O.  (Ms)  No.169  H&FW  (EAP-II  (2)) 
                          Department, Dated 11.07.2011 and amendments thereto including 
                          the subsequent modifications (Enclosure –1) 
                           
                    (b)  “Guidelines”  means  the  “Chief  Minister’s  Comprehensive  Health 
                          Insurance Scheme” Guidelines, 2017, which is given in Enclosure-2. 
                                                     1
                                                        (c)  “Tender  Accepting  Authority”  means,  the  State  Empowered 
                                                                           Committee constituted by the Government of Tamil Nadu as per 
                                                                           G.O.(Ms).No.169                                           H&FW  (EAP-II  (2))                                                        Department,                                   Dated 
                                                                           11.07.2011  and  amendments  thereto  (Enclosure  –1).  All  the 
                                                                           subsequent modification in the G.O will be part of the tender. 
                                       
                                                        (d)  “Tender Inviting Authority” means, The Project Director, Tamil Nadu 
                                                                           Health Systems Project, Chennai 600 006. 
                                       
                                                        (e)               Words and expressions used but not defined in this document, but 
                                                                           defined in the Tamil Nadu Transparency in Tenders Act, 1998 and 
                                                                           Rules, 2000 framed there under (Tamil Nadu Act Number 43 of 
                                                                           1998), the Scheme or the Guidelines shall have the same meanings 
                                                                           respectively  assigned  to  them  in  that  Act,  the  Scheme  or  the 
                                                                           Guidelines, as the case may be. 
                                       
                                      2.                SUBMISSION OF BIDS 
                                                        By virtue of the provisions contained in the Tamil Nadu Transparency in 
                                      Tenders Act, 1998 (Tamil Nadu Act Number 43 of 1998) and the Rules framed 
                                      there under, the Project Director, Tamil Nadu Health Systems Project seeks 
                                      detailed  bids  from  Public  Sector  Insurance  Companies  interested  in 
                                      implementing the Scheme, as detailed in the Scheme and the Guidelines. The 
                                      proposed document should include the following:  
                                       
                                       SECTION A – TECHNICAL BID: 
                                       
                                       QUALIFYING CRITERIA: 
                                               (i)                The bidder should be a Public Sector Insurance Company authorized 
                                                                  to  conduct  the  business  of  Health  Insurance  by  the  Insurance 
                                                                  Regulatory  and  Development Authority (IRDA).  Copy  of  valid  IRDA 
                                                                  license  to conduct health insurance business, attested by a Notary 
                                                                  Public or by a Group A or B Officer of the Central Government or 
                                                                  State Government shall be enclosed. 
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