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Waseela-e-Sehet Background

BISP launched Health Insurance Scheme called “Waseela-e-Sehet Initiative” in 2010 in Faisalabad district on Pilot basis. The core objective of Waseela-e-Sehet Pilot Project was to protect the underprivileged and vulnerable population from economic consequences of potential health shocks and steer out of the catastrophic illnesses by providing social assistance through a health insurance.

The insurance covered BISP Beneficiaries of all age groups up to maximum of Rs. 25,000 per family per annum.  The package included: (a) Pre-existing diseases, (b) Full hospitalization (24 hours or more) procedures that involve day long indoor treatment, day care surgeries, Maternal and child health (MNCH) package, (c) Diagnostic tests during hospitalization; one day prior and five days after the event and (d) Transportation cost to admitted patients.

BISP signed a Contract Agreement with State Life Insurance Company (SLIC) on 3rd February 2012 for provision of Insurance Services for three years subject to yearly extension based on satisfactory performance.

After completion of three years i.e., from April 2012-15, Faisalabad pilot was granted transitory extension from 16th April to 30th June by Secretary BISP for smooth transfer of Pilot to Punjab Health Insurance Company, as one option, under consideration of BISP Management. BISP has paid premium accounting to Rs.2250/family/annum for 2012-13, Rs.1800/family/annum for 2013-14 and adjusted from ERF Rs. 1030/family/annum for 2014-15 for said enrolled families and against which the utilization remained 904 (Surgical 283, Med 621), 1672(Surgical 564, Med 1108), and 1758(Surgical 385, Medical 1372) for respective years. Since the Inception of the Pilot Project; 43,782, 58,688 and 58,688 families have been enrolled in years 2012-2013, 2013-2014 and 2014-2015 respectively hereby covering 270,612, 404,551 and 518,586 populations.

Post 18th Constitutional amendment, the subject of health sector has been devolved to the provinces. A discussion on BISP’s mandate on the subject matter has emerged; in addition to its overlaps with other programs especially the Prime Minister’s National Health Insurance initiated by Ministry of Health Regulatory Services and BISP management decided to wrap up this initiative to prevent overlapping. BISP facilitated Ministry of Health for designing project and common standards and quality assurance, benefit levels and data provision.

Furthermore, contract agreement for BISP Health Insurance Pilot with SLIC expired on 30th June 2015 and no further extension was granted. Additionally SLIC has discontinued the services provision to BISP beneficiaries in Faisalabad as well upon expiry of the contract. Reconciliation for the Equalization Reserve Fund (ERF) with SLIC, Currently having an amount of approximately Rs. 110 Millions as BISP share (as on April 2015), has been taken up with Insurance Company via BISP finance wing to settle the ERF with the approval of BISP management.

More recently, Prime Minister of Pakistan Nawaz Sharif has launched National Health Program, the first national health insurance program on Dec 31, 2016. The health insurance program is the first of its kind in Pakistan, for providing free medical treatment to the deserving people. Launching of health insurance program is fulfillment of another promise by PML(N) government. BISP has shared its data for targeting under this new imitative.

 

Table: Salient Features of the Programme in District Faisalabad

S# Features 1st Policy Year

April 2012 – 2013

2nd Policy Year

April 2013 – Feb 2014

3rd Policy Year

Feb 2014 – April 2015

1 Eligibility All eligible BISP Beneficiary families of District Faisalabad All eligible BISP Beneficiary families of District Faisalabad All eligible BISP Beneficiary families of District Faisalabad
2 Families Enrolled 43782 58,688 58,688
3 Population Covered 270,612 404,551 404,551
4 Coverage limit Max Rs. 25,000 / family / year Max Rs. 25,000 / family / year Max Rs. 25,000 / family / year
5 Coverage Specifications Pre-existing diseases covered

Hospitalization, deliveries and accidents / emergencies

Same as for 1st Policy year Addition of transportation cost to all admitted patients ,MNCH package, post discharge medicine
6 Premium Premium @ Rs 2250 / family / annum Premium @ Rs 1800 / family / annum Premium @ Rs 1030 / family / annum
7 Utilization 904 (Surgical 283, Med 621) 1672 (Surgical 564, Med 1108) 1758(Surgical385, Medical 1372)
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