EMPLOYEES’ STATE INSURANCE (AMENDMENT BILL) 2009


 

The Parliament today passed the Employees' State Insurance (Amendment) Bill, 2009.  The Employees' State Insurance Scheme is a welfare scheme framed for workers covered under the Employees' State Insurance Act, 1948 providing for medical benefits for the employees and their families and payment of benefits to the employees in cases of sickness, maternity and employment injury. The Scheme is applicable to power-using factories employing 10 or more persons and non-power using factories and certain other establishments employing 20 or more persons.

 

            Keeping in-view the changing economic scenario, the Act needed important amendments.  The salient features of the amendments are as follows:—

 

(i)         The age limit of the dependants has been enhanced from 18 to 25 for the purpose of dependants' benefit. It will benefit large number of workers.

 

(i)         It extended social security benefits to those apprentices who are covered by Standing Orders and also to those trainees whose training is extended to misuse exemption granted to apprentice from provisions of the ESI Act.

 

(ii)        The definition of "Factory" under Section 2(12) has been amended to facilitate coverage of smaller factories and cover all factories which employ 10 or more persons whether these are run by power or without power.

 

(iii)      DG-ESIC is being made Chairman of Medical Benefit Council to improve quality of medical benefits.

 

(iv)       It enabled ESIC to appoint consultants and specialists on contract basis for better delivery of super-speciality services.

 

(v)         The post of Insurance Inspector is re-designated as Social Security Officer to give them the role of facilitator rather than to act as mere inspectors.

 

(vi)       The procedure for determination of contribution has been streamlined to avoid harassment of employers as the Inspectors now no more to inspect the books of accounts of the establishment beyond five years as under present system of unlimited period.

 

(vii)         It has added the benefit for workers for the accidents happening while commuting to the place of work and vice versa;

 

(viii)    State Governments are allowed to set up autonomous organisations to give ESI Scheme benefits.

 

(ix)      It extended medical treatment to those who retire under Voluntary Retirement Scheme or take premature retirement.

 

(x)       It enabled ESIC to enter into agreement with any local autho­rity, private body or individual for commissioning and running ESI hospitals through third party participation wherever the hospitals are not fully utilised on account of closure of factories or Insured Persons not being available.

 

(xi)      It will improve the quality of its service delivery and raise infrastructural facilities by opening medical colleges and training facilities in order to increase its medical and Para- medical staff.

 

(xii)  It provided for grant of exemption by appropriate Government to factories/establishments only if the employees get substantially similar or superior benefits.

 

(xiii)         The exemptions shall be granted only prospectively as the ESIC already has made provision of infrastructure to provide service to the IPs for the past period.

 

(xiv)   A new Chapter V-A has been added to enable provision for extending medical care to non insured persons against payment of user charges to facilitate providing of medical care to the BPL families and other unorganised sector workers covered under the Rashtriya Swasthya Bima Yojana (RSBY).

 

            These amendments will ensure coverage of more workers under the ESI Scheme in the organised sector and will also enable the ESI Corporation to participate in schemes such as RSBY that may be framed for the workers in the unorganised sector.  The amendments are also aimed at improving service delivery to the existing members of ESI Scheme as well as bringing the provisions of the Act in tune with the changing circumstances.



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APPLICABILITY OF THE ACT & SCHEME:

 Is extended in area-wise to factories using power and employing 10 or more persons and to non-power using manufacturing units and establish-ments employing 20 or more person upto Rs.15,000/- per month w.e.f. 01.04.10. It has also been extend-ed upon shops, hotels, restaurants, roads motor transport undertakings, equip-ment maintenance staff in the hospitals.

COVERAGE OF EMPLOYEES:

 Drawing wages Upto Rs.15,000/- per month Engaged either directly or thru’ contractor

RATE OF CONTRIBUTION OF THE WAGES:

 Employers’ 4.75%

 Employees’ 1.75%

MANNER AND TIME LIMIT FOR MAKING PAYMENT OF CONTRIBUTION:

 The total amount of contribution (employee’s share and employer’s share) is to be deposited with the authorized bank through a challan in the prescribed form in quadruplicate on ore before 21st of month following the calendar month in which the wages fall due.

BENEFITS TO THE EMPLOYEES UNDER THE ACT:

 Medical Benefit
 Sickness Benefit(SB)
 Maternity Benefit(MB)
 Disablement Benefit
 Dependants’ Benefit(DB)
 Funeral Expenses

 In addition, the scheme also provides some other need based benefits to insured workers.

WAGES FOR ESI CONTRIBUTIONS:

 Registers/files to be maintained by the employers

CONTRIBUTION PERIOD:

 If the person joined insurance employment for the first time, say on 5th January, his first contribution period will be from 5th January to 31st March and his corresponding first benefit will be from 5th October to 31st December.

TO BE DEEMED AS WAGES:

• Basic pay
• Dearness allowance
• House rent allowance
• City compensatory allowance
• Overtime wages (but not to be taken into account for determining the coverage of an employee)
• Payment for day of rest
• Production incentive
• Bonus other than statutory bonus
• Night shift allowance
• Heat, Gas & Dust allowance
• Payment for unsubstituted holidays
• Meal/food allowance
• Suspension allowance
• Lay off compensation
• Children education allowance (not being reimbursement for actual tuition fee)

NOT TO BE DEEMED AS WAGES:

• Contribution paid by kthe employer to any pension/provident fund or under ESI Act.
• Sum paid to defray special expenses entailed by the nature of employment – Daily allowance paid for the period spent on tour.
• Gratuity payable on discharge.
• Pay in lieu of notice of retrenchment compensation
• Benefits paid under the ESI Scheme.
• Encashment of leave
• Payment of Inam which does not form part of the terms of employment.
• Washing allowance for livery
• Conveyance Amount towards reimbursement for duty related journey

PENALTIES :

 Different punishment have been prescribed for different types of offences in terms of Section 85: (I) (six months imprisonment and fine Rs.5000), (ii) (one year imprisonment and fine), and 85-A: (five years imprisonment and not less to 2 years) and 85-C (2) of the ESI Act, which are self explanatory. Besides these provisions, action also can be taken under section 406 of the IPC in cases where an employer deducts contributions from the wages of his employees but does not pay the same to the corporation which amounts to criminal breach of trust.

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