ESI ACT AMENDMENTS

ESI ACT 1948

• Social security legislation Social security legislation

• certain benefits to employeescertain benefits to employees

• both in cash and kind both in cash and kind

• in case of in case of – sicknesssickness, , – maternitymaternity and and– employment injuryemployment injury – and to make provisions for other mattersand to make provisions for other matters

ESI Scheme - Administration

• Corporate body called the

• Employees' State Insurance CorporationEmployees' State Insurance Corporation

ESI Scheme - Benefits• Medical BenefitMedical Benefit

– medical treatment &– attendance on the

Insured Persons – and their family

members

• administered by the State Governments

• Through Directorate of Medical Services

• Cash benefitsCash benefits– sickness, – maternity and– employment injury

• administered by the Corporation

• Through Local Office

Directorate of Insurance Medical Services in Kerala State

Cost

• Cost of providing Medical Benefits is shared by the Corporation and the State Government in the ratio of 7:1

• Cost of providing Super Specialty treatment through tie-up Hospitals is, at present, borne by the ESI Corporation.

AgreementAgreement

• The agreement entered under section 58(3) of the ESI Act between State Government and ESI Corporation forms the basis for determining the Nature and Scale of medical treatment and sharing the cost there of.

• Please Note: This section can be amended if the ESIC desires so.

High Level CommitteesHigh Level Committees

• recommended the • establishment of an Organization • at the State level • in the shape of a Corporation similar to the ESI

Corporation at the centre • with all the necessary • financial and administrative powers• “for more effective functioning” of the Scheme in

the States.

Amendments to ESI Act

• Medical Benefits - Optimize efficiency• Proposed Introducing

– Section 58(5), – Section 58(6) and – Section 96(ee)

• passed by Lok Sabha on 3rd May 2010• passed by Rajya Sabha on 6th May 2010• received the assent of the President of India on

24th May, 2010• had become part of the Acthad become part of the Act..

Why this Bill?

• provisions of section 58(5) of the ESI Act

• proposed to set up

• Kerala ESIC

• entrust to it the entire administration of Medical Benefit in the State under

• General superintendence and control of the State Government.

FINANCIAL MEMORANDUM

• Rs1200/- per IP per Year– Will be paid by the ESI Corporation– for provision of Medical Care– 70% is spent towards administrative

expenditure including salaries to Medical officers, specialists, Para-medical staff etc.

– 30% towards drugs and dressings.

Fund sharing

• State Govt contribute 1/8 = Rs. 150• ESIC contribute 7/8 = Rs 1050

• Means no own income, like KSRTC; have to survive with 1/8 and 7/8 given by state & esic

• Entire cost of providing super specialty treatment to the beneficiaries through the tie-up arrangement is borne by the ESIC

Calculation

• 6,00,000 IP• Rs1200 per IP• =72 Crore per year = 6 Crore per month

• The income as on 30.09.2010 levels will be limited to 72 Cr per year.

• The MD of KESIC must meet the expenses from this 72 Cr – LIMITED TO Rs1200 PER IP PER YEAR.

• 1 IP = 1 CARD = 5 PERSONS (AVERAGE) SELF + SPOUSE + 2 CHILDREN + 2 PARENTS = 6

So what about us – the staff

• It is proposed to transfer all the assets and the liabilities including

• the personnel working in the Directorate of Medical Services, to the proposed State ESI Corporation to maintain continuity

• as per the ESI Act

Kerala Employees' State Insurance Bill, 2010

• To be enacted by the by the Legislature of the State of Kerala

• NOT YET ENACTED BY KERALA STATE

KERALA ESIC - MEMBERS1. CHAIRMAN – MINISTER2. VICE CHAIRMAN – STATE GOVT3. NOMINESS OF STATE GOVE = 2 4. MEMBERS – 2 MLA’S5. DOCTORS – 2 (KGIMOA)6. EMPLOYER REP = 37. EMPLOYEE REP = 38. ESIC all members in state9. Principal Secretary – Labour – Ex Officio 10.Principal Secretary – Health – Ex Officio 11.Principal Secretary – Finance – Ex Officio 12.Regional Director ESIC – Ex Officio 13.SMC – Ex Officio14.MD – Ex Officio

Executive committee – 2 years

1. Chairman - Principal Secretary – Labour – Ex Officio

2. Secretary – finance3. Employer = 14. Employee = 15. Doctor = 16. MLA = 17. Regional Dir ESIC8. SMC9. MD – EX OFFICIO

STAFF• The State Corporation may employ such other officers and Staff

including medical, Para-medical, Technicians and specialists as may be necessary with such designations for the efficient administration of Medical benefit under the Scheme. Provided that prior sanction of the State Government shall be obtained for creation of any post the maximum monthly salary of which exceeds such salary as may be prescribed by the State Government.

• 2. The method of recruitment, Scales of pay, retirement benefits, discipline and other conditions of service of the staff shall be such as may be prescribed by the State Corporation with the APPROVAL of the State Government

Clause 36: FUNDS OF THE STATE CORPORATION

1.1. Funds received from the Corporation and the State Funds received from the Corporation and the State Government.Government.

2. Grants, donations, gifts from the Government, Central or State, local authority, individuals or body whether incorporated or not, for all or any of the purposes of the State Act;

3. Interest on bank balances" term deposits, securities and investments;

4. Rents for the commercial use of its surplus or un-utilised properties;

5. User charges, wherever levied for utilizing its services

What should we do now?