Table 1.

Key features of RSBY.

Parameter	Description	Additional comments/caveats
Benefits covered	Cost of hospitalization for 725 + procedures at empanelled hospitals up to INR 30,000 per annum per household INR 100 per admission up to INR 1000 for transport cost per annum per household.	Pre-existing conditions are covered; minimal exclusions; day surgeries covered; outpatient expenditure is not covered
Eligibility criteria	Must be on the official state BPL list Limited to five members of the household including household head, spouse and three dependents	All enrolled members must be present at enrolment to be enrolled; infants are covered through mother
Premium and fees	INR 30 registration fee per household per annum paid by household	Average premium for participating districts is around INR 560, funded by the government
Financing	75%/25% Government of India/state government	The ratio is 90%/10% in Northeast states and Jammu & Kashmir
Policy period	One year from month of enrolment	Enrolment can take place over four months each year and can vary across states
Management	Both public and private insurance companies can bid to work in a district or more than a district recommended by state governments	In each district only one insurance company is finally selected for a particular tear
Service provider	Both public and private providers can apply to join the network of providers empanelled under the scheme	Minimum eligibility criteria on quality of services have been laid down by the MoL&E

Source: Ministry of Labour and Employment, 2008b