ASSIGNMENT ON EMPLOYEE STATE INSURANCE

SUBMITTED TO: Mr. ASHUTOSH GUPTA

SUBMITTED BY: SUMEER MBA 3rd 10-156

EMPLOYEE STATE INSURANCE CORPORATION:

INTRODUCTION: Employees' State Insurance Corporation of India is an integrated social security system tailored to provide social protection to workers, immediate dependent or family, in the organized sector, in contingencies, such as, sickness, maternity and death or disablement due to an employment injury or occupational hazard.

ADMINISTRATION: The Employees State Insurance Scheme is administered by a Corporate body called the Employees State Insurance Corporation (ESIC), which has members representing employers, employees, the Central Government, State Governments, medical profession and the Parliament. A Standing Committee constituted from among the members of the Corporation acts as the Executive Body for the administration of the Scheme. Administration There is also a Medical Benefit Council to advise the Corporation on matters connected with the provision of Medical Benefit. The Director General who is the Chief Executive of the Corporation is also exofficio member of the Corporation and of its Standing Committee. Besides the Hqrs.Office in New Delhi, the Corporation has 23 Regional Offices and 12 sub-Regional Offices at Vijayawada, Vadodara, Surat, Hubli, Pune, Nagpur, Coimbatore, Madurai, Tirunelveli, Noida, Varanasi and Barrack pore and 844 Local Offices and Cash offices all over the country for the administration of the Scheme.

ESIC BENEFITS: MEDICAL BENEFITS: The Scheme provides full range of medical care to Insured person and family, through a network of ESI Dispensaries & Panel clinics, diagnostic centers and ESI Hospitals etc. Super speciality facilities are provided to the beneficiaries through recognized advanced medical institutions empanelled for the purpose on referral basis. The Corporation has set up a revolving fund in most of the States to ensure smooth flow of funds for superspeciality treatment of ESI beneficiaries. All Insured Persons and members of their family are entitled to free, full and comprehensive medical care under the Scheme. The package covers all aspects of health care from primary to super speciality facilities. SICKNESS BENEFITS: Sickness Benefit represents periodical cash payments made to an IP during the period of certified sickness occurring in a benefit period when IP requires medical treatment and attendance with abstention from work on medical grounds. The maximum duration of Sickness Benefit is 91 days in two consecutive benefit periods. There is a waiting period of 2 days which is waived if the insured person is certified sick within 15 days of the spell for which sickness benefit was last paid. The sickness benefit rate is roughly equivalent to 50% of the average daily wages of the insured person. MATERNITY BENEFITS: Maternity benefit consists of periodical cash payments in case of confinement or miscarriage or sickness arising out of pregnancy, confinement, premature birth of child or miscarriage, to an insured woman as certified by a duly appointed medical officer or mid wife.

 DISABLEMENT BENEFITS: Disablement benefit is admissible for disablement caused by employment injury. At the first instance, temporary disablement benefit is payable as long as the temporary disability lasts. If the employment injury results in partial or total/permanent disability, permanent disablement benefit is payable till the death of the insured person. No contributory conditions are prescribed for this benefit. While the rate of temporary disablement benefit is 70% or a little more of the wages and that of permanent disablement benefit is proportionate to the loss of earning capacity caused by the injury.

DEPENDANTS BENEFITS: Dependants benefit is a monthly pension payable to the eligible dependants of an insured person who dies as a result of an employment injury or occupational diseases. Beneficiaries and duration of benefit: a) Widow/ widows during life or until remarriage b) Legitimate or adopted son until age 18 or if legitimate son is infirm, till infirmity lasts c) Legitimate or adopted unmarried daughter until age 18 or until marriage, whichever is earlier, or if infirm, till infirmity lasts and she continues to be unmarried. In the absence of any widow or legitimate child, the benefit is payable to a parent or grandparent for life, to any other male dependent until age 18 or to an unmarried or widowed female dependent until age 18. FUNERAL EXPENSE BENEFITS: Funeral expenses are in the nature of a lump sum payment upto a maximum of Rs. 5000/- (with effect from 01.09.2009) made to defray the expenditure

on the funeral of deceased insured person. The amount is paid either to the eldest surviving member of the family or, in his absence, to the person who actually incurs the expenditure on the funeral.

APPLICABILITY:

It is applicable to: Non-seasonal factories using power in and employing ten or more persons. Non-seasonal and non-power using factories and establishments employing 20 or more persons Employees of the factories and establishments in receipt of wages not exceeding Rs. 7500/- per month are covered under this act.

Coverage
COVERAGE UNDER THE ESI ACT, 1948 The Act was originally applicable to non-seasonal factories using power and employing 20 or more persons; but it is now applicable to non-seasonal power using factories employing 10 or more persons and non-power using factories employing 20 or more persons. Under Section 1(5) of the Act, the Scheme has been extended to shops, hotels, restaurants, cinemas including preview theatre, road motor transport undertakings and newspaper establishment employing 20 or more persons. The existing wage-limit for coverage under the Act, is Rs.10,000/- per month (with effect from 1.10.2006). AREAS COVERED The ESI Scheme is being implemented area-wise by stages. The Scheme has already been implemented in different areas in the following States/Union Territories

STATES All the States except Nagaland, Manipur, Tripura, Sikkim, Arunachal Pradesh and Mizoram. UNION TERRITORIES Delhi, Chandigarh and Pondicherry

Contribution
E.S.I. Scheme being contributory in nature, all the employees in the factories or establishments to which the Act applies shall be insured in a manner provided by the Act. The contribution payable to the Corporation in respect of an employee shall comprise of employers contribution and employees contribution at a specified rate. The rates are revised from time to time. Currently, the employees contribution rate (w.e.f. 1.1.97) is 1.75% of the wages and that of employers is 4.75% of the wages paid/payable in respect of the employees in every wage period. Employees in receipt of a daily average wage upto Rs.50/- are exempted from payment of contribution. Employers will however contribute their own share in respect of these employees. Collection of Contribution An employer is liable to pay his contribution in respect of every employee and deduct employees contribution from wages bill and shall pay these contributions at the above specified rates to the Corporation within 21 days of the last day of the Calendar month in which the contributions fall due. The Corporation has authorized designated branches of the State Bank of India and some other banks to receive the payments on its behalf. Contribution Period and Benefit Period There are two contribution periods each of six months duration and two corresponding benefit periods also of six months duration as under. Contribution period Corresponding Cash Benefit period 1st April to 30th Sept. 1st January of the following year to 30th June.

1st Oct. to 31st March Finance

1st July to 31st December of the year following

The Scheme is mainly financed by contributions from employers and employees. The employers contribution is equal to four and three fourth per cent of the wages payable to employees. The employees contribution is at the rate of one and threefourth per cent of the wages payable to an employee. The State Governments share expenditure on the provision of medical care.

Conclusion: Employee state Insurance Corporation provides the benefits which are essential for the working class for their survival in the period of contingency. These benefits help them to survive when they are dependent on others. Employee state Insurance playing a vital role in providing such benefits.