©2011, Cognizant

Social Security -A Corporate View

| ©2010, Cognizant 2

ESI- Highlights

Benefits Technology

| ©2010, Cognizant 3

Focus to Improvements

| ©2010, Cognizant 4

ESI “Optimize & Attract”

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In recent years, India, like several other developing countries, has established

different types of social security scheme. The ESIS is one among such scheme. Its

main objectives is to provide medical benefit’s for citizens who’s earnings fall under

certain limit of income.

Feedback recording….gains

IP 1 : I took my wife for antenatal care and for delivery to ESI hospital, Ayanavaram, Chennai. The treatment was very

good

IP 2: I took my mother for asthma treatment to the ESI hospital Vellore. She was feeling better than when she was

treated in a private hospital

IP 3: Fifteen days back I went to the ESI clinic with an ear ache. Medical services were good. I suffer from this

complaint frequently. And I visit ESI regularly for treatment. I am satisfied with their service.

Scenario

These factors affect diverse groups of individuals differently and play distinctive roles in the decision to seek

medical care (mostly taken by the individual) and in the decision regarding the subsequent number of visits

to ESI dispensaries or private facilities.

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Feedback recording…focus to improve

IP 1:

The conditions in the dispensaries are appalling. We have to ultimately go to a government hospital or arrange

money for private treatment. What then, is the use of the ESI

IP 2:

The timing does not suit our working hours. We find it difficult to take leave or permission to go to the clinic in

the morning hours. Finally we end up going to private doctors

IP 3 :

In the out-patient’s clinic there are not enough places; with many patients the place is not very comfortable.

Receiving the OP card itself takes a long time. The sanitation conditions in these facilities are also not very good

IP 4 :

Not enough diagnostics facilities are available in these clinics. Where diagnostic facilities are available most of

the doctors are men and female beneficiaries registered under this scheme are reluctant to approach them for

diagnosis. They prefer getting treatment from private nursing homes or private clinics, several times out-of-

pocket expenditure incurred for treatment and reimbursement at times takes several weeks

Scenario

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IP Medical Officers examine the patient

IP is issued with reference letter and

routed to Pvt Network hospital

Medical Facility unavailable

ESI – Current & Proposed Flow

IP is treated in ESI hospital

Approaches the Network (empanelled) Hospital and produce the reference letter at reception

Based on the cap limit(eligibility certificate) the Hospital intimates ESiC

Medical Facility availableApproaches ESI

Hospital

Case is received at ESIC & payment is processed

ESIC should send Instant SMS on every stage of the Cashless

cycle. Helpline facility should be

available for updates on the

case

Register online in ESIC web portal

Officers check the system and approves

System calculates the eligibility and mail is triggered to the officer

Case is received at PVt Hospital & treatment is initiated

Existing processProposed process

©2011, Cognizant 8

Provident Fund

| ©2010, Cognizant 9

EPF - gains

Provident Fund International worker

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EPF - Focus to Improve

BenefitsAdministration

| ©2010, Cognizant 11

Forms

RPFC, Chennai moves Form to relevant section within or relevant RPFC of other region

Relevant RPFC(Regional Provident Fund Commissioner) moves required

documents(Cheque & Annexure k) for EPF

transfer

PF – Current & Proposed Flow

Receipt of cheque and its realization is handled RPFC Chennai (Group 30)

Group 30 at RPFC reflects the transferred amount to associate’s PF a/c

Submitted @ RPFC

On transference of the amount RPFC confirms about the PF transfer completion.

RPFC, Chennai moves Form to relevant section within or relevant RPFC of other region

The minimum period of PF transfer to take effect is around 6 months if it is within Tamilnadu and around a year for transfer across interstate RPFC offices.

3 days-60 days

15-30 days

90 days

30- 60 days

Processed only at year end

Processed only at year end

Confirms only during annual statement release

Relevant RPFC(Regional Provident Fund

Commissioner) moves required -Annexure k for

EPF transfer

30 – 45 days

Receipt of Annexure K, NEFT Transfer is made to employee’s current PF a/c

On transference of the amount RPFC should send instant SMS about the PF transfer , closure status

The minimum period of PF transfer to take effect is 2 months if it is within Tamilnadu and around 3 months for transfer across interstate RPFC offices. and Closure 2 months. Existing processProposed process

©2011, Cognizant 12

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