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  1. 1. ESIC
  2. 2.  The Employees’ State Insurance Scheme is an integrated measure of Social Insurance embodied in the Employees’ State Insurance Act and is designed to accomplish the task of protecting ‘employees’ as defined in the Employees’ State Insurance Act against the hazards of sickness, maternity, disablement and death due to employment injury and to provide medical care to insured persons and their families.
  3. 3. Constitution of Corporation  A Chairman and a vice chairman to be appointed by the Central Government;  one person each representing each of the States in which this Act is in force to be appointed by the State Government concerned;  one person to be appointed by the Central Government to represent the Union territories;  Persons representing employers to be appointed by the Central Government in consultation with such organizations of employers as may be recognized for the purpose by the Central Government; cont…
  4. 4. Cont…  Ten persons representing employees to be appointed by the Central Government in consultation with such organisations of employees as may be recognised for the purpose by the Central Government;  Two persons representing the medical profession to be appointed by the Central Government in consultation with such organizations of medical practitioners as may be recognised for the purpose by the Central Government;  Three members of Parliament of whom two shall be members of the House of the People (Lok Sabha) and one shall be a member of the Council of States (Rajya Sabha) elected respectively by the members of the House of the people and the members of the Council of States; and  The Director General of the Corporation, ex officio.
  5. 5. Act Applicability: The ESI Act 1948 applies to  Non – seasonal Factories using power in and Employing ten (10) or More persons  Non – seasonal and non- power using factories and establishments employing twenty(20) or more persons  Employees of the Factories and Establishments in receipt of wages not exceeding Rs.10,000 /- Per month are covered under this Act.
  6. 6. Contribution:  The Scheme is primarily funded by contribution raised from Insured Employees and their employers  Payable such as 1. Employees’ Contribution – 1.75% of the Wages 2. Employers’ Contribution – 4.75% of the Wages TOTAL - 6.5 % of the Wages Employees in receipt of an average daily wage of Rs.40/- or Less, are exempted from Payment of their share of contribution (w.e.f 8.4.00) but are entitled to all social security benefits under the Scheme. Cont…
  7. 7. Cont…  Employees covered under the ESI Act, are required to pay contribution towards the scheme on a monthly basis. A contribution period means a six month time span from 1st April to 30th September and 1st October to 31st March.  Cash benefits under the scheme are generally linked with contributions paid. The benefit period starts three months after the closure of a contribution period. The two type of periods are elucidated below. Contribution Period Benefit Period 1st April to 30th September 1st January to 30th June of the following year 1st October to 31st March 1st July to 31st Dec.
  8. 8. Benefits of ESIC – At A Glance
  9. 9. Medical Benefits  The Scheme provides full range of medical care to Insured person and family, through a network of ESI Dispensaries & Panel clinics, diagnostic centres and ESI Hospitals etc. Super speciality facilities are provided to the beneficiaries through recognised 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 super-speciality treatment of ESI beneficiaries.
  10. 10. 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. 
  11. 11. 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.   
  12. 12. Disablement benefit 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.
  13. 13. Dependant Benefits  Dependants benefit is paid as family pension to the dependants of a deceased insured person in the event of death due to employment injury or occupational disease and is equivalent to about 70% of the wages.
  14. 14. Funeral Expenses  Funeral expenses are in the nature of a lump sum payment unto a maximum of Rs. 2500/- 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.
  15. 15. Rehabilitation:  Physical rehabilitation Insured Persons who suffer physical disablement due to employment injury are provided artificial appliances or other physical aids such as wheel chairs, crutches, dentures and spectacles etc.
  16. 16.  Vocational Rehabilitation The Corporation at its cost arranges for the vocational rehabilitation of disabled insured persons provided the disability has been assessed at above 40 percent and the beneficiary is not over 45 years of age. The training is provided at vocational rehabilitation centres run by the Govt. of India etc. The fee charged or Rs.123/- a day whichever is more, travelling expenses etc are borne by the Corporation.
  17. 17. Levy of Interest & Damages …  Under Section 39(5)(a) of the ESI act, read with Regulation 31(A) of the ESI (General) Regulations 1950, the employer is liable to pay simple interest at the rate of 15 percent per annum in respect of each day of default or delay in payment contributions. In addition, under the Provision of Regulation 31-C of ESI (General) Regulations, 1950, read with sec.85(B)(i) of the ESI Act, the Corporation is empowered to recover damage as under: Period of delay in Rate of Damages payment of Contribution on the amount due i). Up to less than 2 months 5% ii). 2 months and above but less than 4 months 10% iii).4 months and above but less than 6 months 15% iv). 6 months and above 25% Interest and damages can also recovered as arrears of land revenue Section 45(c) to Section 45(I) by the Recovery Officer of ESI Corporation.
  18. 18. Obligation of the Employers …
  19. 19. Obligation of the Employers … 1). Get the Factory / establishment registered with in 15 days after the Act becomes applicable. Submit Form 01 to the Regional office for this purpose. Obtain Employer’s code No. for use in all ESIC Forms / documents and correspondence with the offices of the ESI Corporation. 2). Fill up Declaration Forms in respect of all coverable employees and submit the same to the Regional Office/ Local Office of the corporation well before the ‘Appointed Day’ and obtain insurance Numbers from the concerned Local Office/ Regional Office, In respect of newly appointed employees, fill up the declaration form soon after appointment of such employees and submit the same to the Local Office Concerned.
  20. 20. Obligation of the Employers … 3). Pending receipt of identity cards/ identity certificates you may issue “certificate of employment” in Form 86 to the covered employee(s) enabling them to avail cash/medical Benefits. 4). Pay ESI contribution (Employee's Share @4.75% and the Employer’s share @ 1.75% of the wages) with in 21 days of the month following, in which the wages fall due.
  21. 21. Obligation of the Employers … 5).Maintain an Accident Book as prescribed under the Factory Act / ESI Act. 6).Submit an Accident Report to the Local Office / ESI Dispensary concerned immediately in respect of accidents that could result in death or disablement and within 24 hours of its occurrence otherwise. Minor accidents which do not cause absence from work need not be reported 7).Grant leave to insured employees on the basis of sickness certificates issued by any authorized ESI doctor.
  22. 22. Obligation of the Employers … Maintain the following records/ registers properly for the purpose of inspection 2. Attendance Registers / Muster Rolls (in respect of all employees including those employed through contractors) 3. Wage register 4. Cash Book / Bank Book 5. Account Books including Ledgers and Vouchers, Balance Sheet. 6. Employees’ Register 7. Accident Book 8. Returns of Contribution 9. Return of Declaration Forms 10. Copies of Challans 11. Inspection Book
  23. 23. Obligation of the Employers … 9. Submit return of contribution within 42 days of the expiry of contribution period. 10. Intimate the date of closure of shifting (Temporary or Permanent) of the Factory / Establishment to the Regional office / Local Office within seven days of its closure or shifting 11. Promptly report change in business activity, ownership of the concern or its management. 12. Ascertain the liability towards ESI dues, while taking over the ownership of any factory/establishment by purchase, gift, lease or license or in any other manner whatsoever as new owner is liable to discharge the past liabilities if any.
  24. 24. ???????????? Any Questions ?????? ?????