Employee state Insurance act-1948

Employee state Insurance act-1948 Objective :- The Object of the Act is to secure sickness, Maternity, Disablement and Dependants benefits to the dependents of such employee

Eligible :- Any person employed for wages (up to Rs. 10,000) in or in connection with the work of a factory or establishment end.

Contribution :- Every Employee has to pay 1.75% and employer has to pay 4.75% of the wages towards ESI contribution

Contribution Period & Benefit Period :-

Benefits under the Scheme :- 1) Medical Benefit 2) Cash Benefit - : [ a) Sickness Benefit, b) Maternity Benefit, c) Disablement Benefits,d) Dependent Benefit, e) Funeral Expenses ]

Employee state Insurance act-1948 Objective :- The Object of the Act is to secure sickness, Maternity, Disablement and Dependants benefits to the dependents of such employee

Eligible :- Any person employed for wages (up to Rs. 10,000) in or in connection with the work of a factory or establishment end.

Contribution :- Every Employee has to pay 1.75% and employer has to pay 4.75% of the wages towards ESI contribution

Contribution Period & Benefit Period :-

Benefits under the Scheme :- 1) Medical Benefit 2) Cash Benefit - : [ a) Sickness Benefit, b) Maternity Benefit, c) Disablement Benefits,d) Dependent Benefit, e) Funeral Expenses ]

Rate of Contribution :ESIThe rates of contribution from 01.01.1997 are:-Employees Contribution --- 1.75 % of the wagesEmployers Contribution --- 4.75 % of the wages Total --- 6.50 % of the wages

Employees in receipt of average daily wage of Rs.50/- or less. are exempted from payment of their share of contribution but are entitled for all benefits under the Scheme. However, employer has to pay employers contribution on the wages paid to such employees.

Under the provisions of Employees provident Fund Act,1952 employer has to pay additional 1.10% towards administration and EDLI Charges. That means Employer has to pay total 13.10% towards contribution under PF.

Advantages to Employers:Employers who are covered under the ESI Act, have the following benefits;Absolved from the liability of providing medical allowance, reimbursement of actual medical expenses or taking medical insurance policy.Exempted from applicability of the :a) Maternity Benefit Act;Workmen's Compensation Act.No need to provide sick leave separately to the employees.Employers Contribution towards ESI Scheme is qualified as expenses under Income tax Act.

Benefits to the Employees:ESI Act.Employees are entitled for benefits in cash and kind which includes:Medical Benefit for Self and familySickness Benefit - for selfMaternity Benefit - for self Disablement BenefitTemporary Disablement Benefit - for self Permanent Disablement Benefit - for self Dependents Benefit for dependents in case of death due to employment injury.In addition, the scheme also provides some other benefits to insured persons such as :Funeral Expenses to the eldest surviving member of the family Old age Medicare for self and spouseVocational Rehabilitation

Procedure to claim medical benefitAn employee is given declaration Form at the time of joining. Employee has to fill in and sign the Form and then return the same to the concern person along with two post card size photographs of the member and his family.If the insured person is not staying with his family then he has to give his own photograph.This Form is submitted to ESI Branch office along with Return of Declaration Form .Branch office issue Temporary Identity cards to the insured person first and then after app. 4 months permanent card is issued to the insured person.

Procedure to claim medical benefitsAfter getting the temporary card insured person has to approach Insurance medical practitioner and registered the temporary identity card.After registration of the temporary card member can approach the Insurance Medical Practitioner(ESI Doctor) whenever he or any of his family member is sick and can avail free medical benefit.In case if the insured person has not received the card temporary or permanent) still he can avail the benefit by obtaining Form No.86 and letter from the employer confirming that ESI contributions in respect of the insured person are paid regularly.

Benefits to the Employees:Medical BenefitInsured person and his dependent family members are entitled to free, full and comprehensive medical care.Medical benefit is Extended to the insured person and his dependent family members from the date he / she enters the insurable employment.The Medical care consists of Out patient treatment, In patient treatment ;Diagnostic services, Free supply of drugs and dressings ;Super speciality treatment ; andHospital services.

Extension of Medical Benefit:ESI Scheme also provides for comprehensive medical cover to the retired and disabled insured person and their spouses.Contribution payment of Rs.120/- Per annum, per couple are required to be paid.Insured persons shall be in continuous employment for at least 5 years before retirement.Medical benefits are administered through Insurance Medical Practitioners, dispensaries, clinics and Hospitals in implemented areas.

Sickness BenefitDuring the period of sickness an employee is entitled for the periodical payments is called sickness benefit.To avail the sickness benefit employee has to fulfill following conditions:Employee has to be in insurable employment for a period of more than nine months and;ESI contribution should have been payable for at least 78 days in relevant contribution period.Maximum period for which this benefit can be avails is for 91 days in two consecutive benefit period I.e. January to December. There is a waiting period of 2 days. I.e. for the first two days of sickness no payments are made except in a case if an employee is certified sick within a spell of 15 days of the last sickness benefit paid.The rates of payment varies from Rs.14- p.d. to Rs.125- p.d. averaging just above 50 percent of the daily wages of an Insured person.How to avail Sickness Benefit:Insured person who is sick has to approach ESI Doctor to avail medical benefit. Doctor will issue him medical certificate in appropriate Form. The period of certificate will not be for more than seven days.This certificate duly signed on the back side shall be submitted to ESI Branch office preferably within three days along with fitness certificate issued by the doctor.Then Branch office will give payment to the insured person.Insured person shall submit duplicate copy of the certificate to the employer for intimation for remaining absent on health ground.It may be noted that whenever an insured person is on ESI Leave he can either receive payment from ESI Corporation or from his employer. Getting double payment is an offence.

Extended Sickness BenefitIf insured person is suffering from T.B., leprosy mental diseases or the 34 specified long term diseases is entitled to Extended Sickness benefit.Insured person is entitled for further period of 124/309 days benefit.(In addition to 91 days Sickness benefit)The rate of benefit is 40% more than the rate provided under the standard sickness benefit.To avail this benefit an insured person should have been in continuous employment for two years and should have contributed for at least 156 days in 4 preceding contribution period.

Maternity BenefitInsured women are entitled for cash payment in case of confinement or miscarriage or sickness arising out of pregnancy is called maternity benefit.This benefit is normally payable for 12 weeks. However, in case sickness arising out of pregnancy duly certified by the authorised Medical Officer additional one month benefit is given.The rate of benefit is double the standard sickness Benefit rate, I.e. almost full wages.To avail this benefit an insured women should have completed nine months employment and contribution should have been payable for not less than 70 days in in the immediately preceding two consecutive contribution period corresponding to the benefit period in which confinement occurs.

Disablement benefitTemporary disablement benefit:In case of disability arising to insured person by an accident arising out of and in the course of employment this benefit is available..The insured person is paid the benefit for the entire period as certified by the Insurance medical Practitioner for which in insured person does not work.The rate of benefit is not less than 70% of the daily average wages of insured person. The only condition to avail this benefit is that the insured person should be attending his duties during the normal working hours or extra hours if permitted.

2. Permanent disablement benefitIn case if an employment injury or occupational disease results in permanent , partial or total loss of earning capacity of an insured person he is entitled for this benefit.If entitled periodical payments are made to insured person for life.The rate of benefit depends on the quantum of actual loss of earning capacity as determined by the medical board.The rate of this benefit is enhanced periodically in view of the rise in cost of living. Commutation of this benefit is also permissible subject to that the rate of daily benefit does not exceed Rs.1.50 p.d.and also if the commuted value (One time lump sum payment ) does not exceed Rs.30,000/-.

Dependents benefitIf an insured person dies as a result of employment injury or occupational disease monthly pension is paid to his dependents is called dependent benefit.Dependants are: widow, legitimate or adopted children's up to the age of 18 if not then parents or grandparents.

The rate of monthly pension is roughly equivalent to about 70% of the wage rate of the insured person. The amount is distributed as 60% to widow and balance 40% to the childrens.

How to avail disablement & dependent benefit:

Whenever an accident occur during the course of an employment employer has to send report of an accident to the concern branch officer in prescribed Form ,along with witness statement, within 24 hours of an accident.

If possible and if the ESI Hospital/ dispensary is nearby then insured person who met with an accident has to be shifted there or otherwise to Pvt. Hospital or dispensary.

An entry shall be made in Accident register.

Branch officer/ Investigator from ESI department visits the office of the establishment for enquiry and the papers are submitted to the Regional office for approval.

After approval from head office the benefit (payment) is made to the insured person.

To avail dependants benefit similar procedure is followed except some more documents such as death certificate , age proof of children's is sought by the ESI office.

Employee State Insurance Act-1948

Form to be used under ESI Scheme

Form No. 1 :- ESI Declaration form for New EntrantsForm No. 1B :- Changes in Family declaration Form No. 72 :- Application for Duplicate Card Form MRO 266 :- Application form for change of Name / Year of Birth of insured person WomanForm No.6 :- ESI half yearly return ESI Challans :- With in 21 days from the case of every Month .Form 37 :- For registering with Local ESI doctor

Provident fund & Misc. Provision Act

Employees Provident Fund Act, 1952Introduction:Employees Provident Fund Act is one of the Social Security Scheme introduced by the Central Govt.The basic object of the Act is to provide monthly compulsory savings for the employees consisting of matching contribution from both employee as well as employer.Employees Provident Fund organisation pay interest every year on the accumulations received in respect of the member.Last year I.e. 2005-06 EPFO credited interest @ 8.50% on monthly running balance to the employees account.PF department issues PF slips every year to all the employees through the employer which consist of summary of opening balance of employees & employers share employees share, employers share, interest earned on employees & employers share.PF Slip issued by the PF department does not include the employers contribution towards Employees pension Scheme I.e.8.33% cont.

Benefits under the PF Act,1952Employees Provident Fund Act,1952 provides for following benefitsNon refundable advances during the employment & Withdrawal benefit after leaving the service.Forms to be filled in:Form No2 (Nomination Form) & Form No. 11 at the time of joiningForm No. 19 & 10-C for withdrawal or Form No. 13 for transfer of PF accumulations at the time of leaving.

Rate of Contribution: PF

Provident fund & Misc. Provision Act

PF Process:-

Day One :- Filling up PF Form No. :- 2 ( PF & EPS Declaration form ) and send it to Zonal office for submission to PF consultant.PF number will be provided by Zonal office through PF MIS.

Withdrawal & Transfer Process :-

If an employee resigned , then he has to fill Form :- 13 for Transferring the PF fund from previous company to Present company.If an employee resigned , then he has to fill Form :- 19 for withdrawal of Provident fund and Form :- 10 C for withdrawal of Pension scheme.

Death of an Employee :- In case death of Employee, Form:- 5(IF) for insurance refund, Form:- 20 for Provident fund withdrawal, Form 10 D for Pension Withdrawal

Withdrawal Benefit :-

Employees who leave the service have two options.1. To transfer their PF accumulation to the present establishment by filling Form No. 13.2. To apply for withdrawal of contribution by filling up Form No.19 & 10C3. If the employee leaves the service before six months then the employee is not entitled for withdrawal of EPS Scheme.

Employees Pension Scheme 1995 :-

Various benefits available under Employees Pension Scheme 1995 1. Monthly Members Pension Scheme.2. Widow & Children Pension.3. Orphan Pension.4. Reduced Pension.5. Disablement Pension.

Eligibility :- An employee who has worked for more than 10 years or more and has attained age of 58 years is entitled for pension.

Provident fund & Misc. Provision ActForm to be used under Provident Fund Scheme

Form 2 :- PF & EPS Declaration for every new EntrantsForm 19 & 10C:- Withdrawal form for left employeForm 13 :- For Transfer of PF / EPSFrom 31 :- For application of advance from FundForm 10 D :- Application for pension ( Death Case )Form 5 (IF) :- Insurance refund ( Death Case )Form 20 :- Provident fund withdrawn ( Death case Form 12 A :- Monthly return which is submitted along with triplicate copyFrom 3A & 6A :- Annual Return

Reduced Pension :- An employee who has worked for more than 10 years can also avail reduced pension, after attaining age of 50 years, if he is not employed anywhere or in an establishment where PF Act is not applicable. In case of reduced pension for every year short of 58 year 3% pension will be deducted from monthly pension amount.

The pension amount will be worked out on the following formula.

Members Monthly =Pensionable Salary * Pensionable Service Pension -------------------------------------------------- 70If a member leaves the service before completion of 10 years of membership then he has following option.A. To opt for Scheme CertificateB. To withdraw the amount.Member has to fill Form 10-C to avail the benefit & Form 10-D to claim pension.

4)It is also observed that the Sub contractors are not returning the Salary Sheet to the Consultant. It is therefore Suggested that the Sub Contractor shall return the Signed salary sheet to Consultant without fail in the same month as per schedule.

5) Data in attendance sheet should be as per prescribed period i. e. 21st to 20th.

6)Sometimes Salary Rate of all the employees are not given at a time.The same shall be given together only and not in piecemeal.

7)Every month a list shall be obtained from Sub-contractor providing details of new joiners with their Rate of Salary, Date of Joining & list of employees who left the Services. As this list is required to prepare & submit monthly return in Form 5-10 to Pf department and also for updating of our records.

Suggestions to Improve the Compliance

1)To fill in ESI / PF Form at the time of joining only. This will enable the Company to submit the Forms to concern ESI Office for obtaining TIC which will enable the employees of the sub- contractors to avail various benefits under ESI Act 1948. It may please be noted that non submission of ESI Declaration Form within 10 days from the date of joining is an offence punishable under Section 85(g) of the ESI Act, 1948. Similarly Non-submission of PF Nomination Form may also deprive the member of availing pension facility.

2)Please ensure that Sub-Contractors provide attendance data of their employees on or before 25th of every month. This will be of a great help to workout PF ESI Contribution as per Time Schedule fixed and remit the same to respective Govt. authorities within stipulated time. At the same time it will help the contractors to disburse the salary to their employees within stipulated time i.e. on or before seventh of every month.

3) It is observed that we are getting salary rates from the employees which are inclusive of reimbursements such as conveyance Railway Pass, Mobile Phone expenses. etc. So the Subcontractor shall give the rates excluding these reimbursement.

Thank You .