Overview
Scheme Features
Scheme implemented since | 2020 |
|---|---|
Number of products managed by the scheme and using openIMIS | 2 |
Number of households covered | N/A |
Average size of a household | N/A |
Total number of employees using openIMIS | - |
Product Features
Household contribution amount | N/A |
|---|---|
Individual contribution | 31% (20% from employer and 11 % from contributor) of basic salary in formal sector, 21.33% of basic salary (solely by contributors) in migrant sector, 31% of basic salary (solely by contributors) in self employed sector and 20.37% (9 % from contributor and 11.37% from local government) in informal sector workers |
Average amount paid for a claim | medical (OP and IP) up to NRs. 100 thousand per annum |
Last Update | Dec 2021 |
Specifications of the openIMIS used:
Version | v1.1.3 (build 2021.4.12.1030) |
|---|---|
Has anything been modified (customization) | Customizations done for interoperability with SSF’s in-house beneficiary and payment management system (SoSYS). The Insuree Balance booking mechanism has been added via REST API. This update ensures that the balance and premium are updated in real-time during the eligibility check. The live balance check is now seamlessly integrated, providing accurate and up-to-date financial information for users. |
What standards are used to code services, items, diagnosis and products | ICD 11 for diagnosis Internal coding mechanism (same as HIB Nepal) for services and items |