The corporates are compulsorily made to deduct ESI from the employees who are drawing less than Rs. 15,000/- per month. Corporates also pay their contributions.
Some corporates also reimburse medical expenses apart from ESI contribution. According to the ESI Act, a company that is paying payments for contracts like security and other labor hire charges has to ensure the contribution of ESI by their contractors.
So, according to me, when a corporate is paying medical reimbursements, is it necessary to contribute to ESI? Moreover, is it necessary to supervise the contributions to ESI by contractors? Why should we not give employees the choice to contribute to ESI by employees and employers when medical reimbursement is available?
From United Kingdom, Oxford
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2Some corporates also reimburse medical expenses apart from ESI contribution. According to the ESI Act, a company that is paying payments for contracts like security and other labor hire charges has to ensure the contribution of ESI by their contractors.
So, according to me, when a corporate is paying medical reimbursements, is it necessary to contribute to ESI? Moreover, is it necessary to supervise the contributions to ESI by contractors? Why should we not give employees the choice to contribute to ESI by employees and employers when medical reimbursement is available?
From United Kingdom, Oxford
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Dear Subbu,
Paying medical reimbursement means you have an alternate medical scheme. If you provide equal or better benefits than ESIC, there is a provision to get exempted. Accordingly, contact an ESI office and, as per their advice, write to the Ministry of Labour, Government of India for exemption.
Abbas P.S.
From India, Bangalore
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Paying medical reimbursement means you have an alternate medical scheme. If you provide equal or better benefits than ESIC, there is a provision to get exempted. Accordingly, contact an ESI office and, as per their advice, write to the Ministry of Labour, Government of India for exemption.
Abbas P.S.
From India, Bangalore
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Dear Subbu,
I know of a leading cement industry that even owns a hospital, providing the best medical treatment available to its employees. However, that industry was unable to obtain an exemption from ESI because ESI not only covers medical treatment and reimbursement but also offers a range of other benefits.
In my opinion, it may be challenging for you to obtain an exemption when you are only reimbursing medical expenses. Even though the employees working for the contractor are his employees, as the principal employer, you are responsible for ensuring that the contractor makes contributions. If the contractor fails to remit the contributions, you can contact the contractor and instruct them to do so. If the issue persists, it would be advisable to work with a contractor who consistently remits contributions.
Best regards,
M.V. Kannan
From India, Madras
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I know of a leading cement industry that even owns a hospital, providing the best medical treatment available to its employees. However, that industry was unable to obtain an exemption from ESI because ESI not only covers medical treatment and reimbursement but also offers a range of other benefits.
In my opinion, it may be challenging for you to obtain an exemption when you are only reimbursing medical expenses. Even though the employees working for the contractor are his employees, as the principal employer, you are responsible for ensuring that the contractor makes contributions. If the contractor fails to remit the contributions, you can contact the contractor and instruct them to do so. If the issue persists, it would be advisable to work with a contractor who consistently remits contributions.
Best regards,
M.V. Kannan
From India, Madras
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Dear Kannan,
ESI provides better treatments by collaborating with multi-specialty hospitals. Therefore, with our own hospital, equal or better benefits cannot be provided. Hence, it is crucial to ensure better treatment and convince the Ministry of Labour in this regard.
Our experience indicates that the units of ITI Ltd in Bangalore and Palakkad have been exempted from ESIC for a considerable period. They are granted exemptions for two years at a time, from October 1 to September 30. This means we need to correspond with the ministry every two years. However, there is a specific timeframe for submitting the application. Following the amendment in 2010, applications must reach three months before the expiry date.
Abbas.P.S
From India, Bangalore
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ESI provides better treatments by collaborating with multi-specialty hospitals. Therefore, with our own hospital, equal or better benefits cannot be provided. Hence, it is crucial to ensure better treatment and convince the Ministry of Labour in this regard.
Our experience indicates that the units of ITI Ltd in Bangalore and Palakkad have been exempted from ESIC for a considerable period. They are granted exemptions for two years at a time, from October 1 to September 30. This means we need to correspond with the ministry every two years. However, there is a specific timeframe for submitting the application. Following the amendment in 2010, applications must reach three months before the expiry date.
Abbas.P.S
From India, Bangalore
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My opinion is that all persons do not have interest in going to ESI hospital or ESI dispensary, so we should give options to employees for taking ESI benefits.
From United Kingdom, Oxford
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From United Kingdom, Oxford
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Dear Abbas,
Thanks for the update. Do you have information on any exemptions given to other units in Tamil Nadu? I shall be thankful if you can forward the amendment 2010 cited by you. If so, please provide me with the necessary details.
Regards, M.V. KANNAN
From India, Madras
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Thanks for the update. Do you have information on any exemptions given to other units in Tamil Nadu? I shall be thankful if you can forward the amendment 2010 cited by you. If so, please provide me with the necessary details.
Regards, M.V. KANNAN
From India, Madras
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Dear Subbu & Kannan,
I shall quote sections 87 to 91 of the ESI Act. Accordingly, some persons, a class of persons, a factory, or a class of factories, etc., may be exempted from ESIC under certain conditions.
87. Exemption of a factory or establishment or class of factories or establishments.
The appropriate Government may, by notification in the Official Gazette and subject to such conditions as may be specified in the notification, exempt any factory or establishment or class of factories or establishments in any specified area from the operation of this Act for a period not exceeding one year and may, from time to time, by like notification renew any such exemption for periods not exceeding one year at a time.
88. Exemption of persons or class of persons.
The appropriate Government may, by notification in the Official Gazette and subject to such conditions as it may deem fit to impose, exempt any persons or class of persons employed in any factory or establishment or class of factories or establishments to which this Act applies from the operation of the Act.
89. Corporation to make representation.
No exemption shall be granted or renewed under section 87 or section 88 unless a reasonable opportunity has been given to the Corporation to make any representation it may wish to make in regard to the proposal, and such representation has been considered by the appropriate Government.
90. Exemption of factories or establishments belonging to Government or any local authority.
The appropriate Government may, after consultation with the Corporation, by notification in the Official Gazette and subject to such conditions as may be specified in the notification, exempt any factory or establishment belonging to any local authority from the operation of this Act if the employees in any such factory or establishment are otherwise in receipt of benefits substantially similar or superior to the benefits provided under this Act.
91. Exemption from one or more provisions of the Act.
The appropriate Government may, with the consent of the Corporation, by notification in the Official Gazette, exempt any employees or class of employees in any factory or establishment or class of factories or establishments from one or more of the provisions relating to the benefits provided under this Act.
91A. Exemptions to be either prospective or retrospective.
Any notification granting exemption under section 87, section 88, section 90, or section 91 may be issued so as to take effect either prospectively or retrospectively on such date as may be specified therein.
Abbas. P. S
From India, Bangalore
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I shall quote sections 87 to 91 of the ESI Act. Accordingly, some persons, a class of persons, a factory, or a class of factories, etc., may be exempted from ESIC under certain conditions.
87. Exemption of a factory or establishment or class of factories or establishments.
The appropriate Government may, by notification in the Official Gazette and subject to such conditions as may be specified in the notification, exempt any factory or establishment or class of factories or establishments in any specified area from the operation of this Act for a period not exceeding one year and may, from time to time, by like notification renew any such exemption for periods not exceeding one year at a time.
88. Exemption of persons or class of persons.
The appropriate Government may, by notification in the Official Gazette and subject to such conditions as it may deem fit to impose, exempt any persons or class of persons employed in any factory or establishment or class of factories or establishments to which this Act applies from the operation of the Act.
89. Corporation to make representation.
No exemption shall be granted or renewed under section 87 or section 88 unless a reasonable opportunity has been given to the Corporation to make any representation it may wish to make in regard to the proposal, and such representation has been considered by the appropriate Government.
90. Exemption of factories or establishments belonging to Government or any local authority.
The appropriate Government may, after consultation with the Corporation, by notification in the Official Gazette and subject to such conditions as may be specified in the notification, exempt any factory or establishment belonging to any local authority from the operation of this Act if the employees in any such factory or establishment are otherwise in receipt of benefits substantially similar or superior to the benefits provided under this Act.
91. Exemption from one or more provisions of the Act.
The appropriate Government may, with the consent of the Corporation, by notification in the Official Gazette, exempt any employees or class of employees in any factory or establishment or class of factories or establishments from one or more of the provisions relating to the benefits provided under this Act.
91A. Exemptions to be either prospective or retrospective.
Any notification granting exemption under section 87, section 88, section 90, or section 91 may be issued so as to take effect either prospectively or retrospectively on such date as may be specified therein.
Abbas. P. S
From India, Bangalore
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Dear Kannan,
I shall quote TAXGURU dated 3.9.2010 regarding the ESI amendment 2010. Note that point number 9 deals with exemption.
ESIC Amendment Act, 2010- Key Highlights
September 3, 2010 in Corporate Law by admin
The Government of India has notified ESIC Amendment Act 2010 via the official gazette dated 25 May 2010. The Employees State Insurance Act, ESI Act for short, was enacted by the Government of India in 1948. The Government of India, through a notification in the Official Gazette dated 25 May 2010, has enacted The Employees' State Insurance (Amendment) Act, 2010 to amend the earlier ESIC Act, 1948.
These amendments will substantially improve the medical and other benefits under the Scheme. Emphasis has been given to the development and expansion of infrastructure for augmenting the benefits under the Scheme.
Benefits under the scheme have also been extended to apprentices and trainees employed under the Apprentice Act and Standing Order Act. The amendments also aim to improve the administration of the scheme and to overcome practical difficulties experienced in the past during inspection and assessment.
The ESI Act of 2010 replaces the old Act of 1948. The rationale is to expand the infrastructure for augmenting the benefits available under the scheme. The scope of existing benefits is also being extended by adding/modifying the existing provisions.
Introduction
The Government of India, through a notification in the Official Gazette dated 25 May 2010, has enacted The Employees' State Insurance (Amendment) Act, 2010 to amend the ESIC Act, 1948. Except section 18, provisions as contained in the Amendment Act will be applicable with effect from 1 June 2010. Provisions of section 18 shall be deemed to have come into force with effect from 3 July 2008.
Objectives
These amendments will substantially improve the medical and other benefits under the Scheme. Emphasis has been given to the development and expansion of infrastructure for augmenting the benefits under the Scheme. Benefits under the scheme have also been extended to apprentices and trainees employed under the Apprentice Act and Standing Order Act. The amendments also aim to improve the administration of the scheme and to overcome practical difficulties experienced in the past during inspection and assessment.
Salient features of some of the important amendments
1. Vide amendment in sub-section 5 to section 1 of the ESIC Act, 1948 (hereinafter referred to as Act), the appropriate Government is empowered to extend the provisions of ESIC Act 1948 to any other establishment or class of establishments, industrial, commercial, agricultural or otherwise after giving one month notice of its intention of doing so by notification in the Official Gazette instead of the notice period of six months.
2. The definition of "dependents" as contained in clause 6A of section 2 of the Act has been extended to enlarge the number of beneficiaries under the act such as:
- A widow, a legitimate or adopted son below the age of 25 years, and an unmarried legitimate or adopted daughter.
- The age limit of the dependants has been enhanced from 18 to 25 [sub-clause (i) and (ii)].
- Exclusion granted to apprentices engaged under the Apprentices Act, 1961, or under the Standing Orders of the establishment for coverage under the scheme has been withdrawn vide amendment in clause 9 of the Act. Hence, apprentices engaged under the Apprentices Act, 1961, or under Standing Orders of the establishment will also be covered under the purview of the ESIC Scheme with effect from 1 June 2010.
- A dependent parent as per the definition of "family" has been substituted to include "A minor brother or sister wholly dependent upon the earnings of the insured person in case the insured person is unmarried and his or her parents are not alive". It has also been clarified that dependent parents include "Dependent parents, whose income from all sources does not exceed such income as prescribed by the Central Government".
3. The definition of Factory under Section 2(12) has been amended to expand the coverage of smaller factories. The amended Act covers all factories that employ 10 or more persons irrespective of whether the manufacturing process is being carried out with the aid of power or without the aid of power.
4. A Deputy General – ESIC is being made Chairman of the Medical Benefit Council to improve the quality of medical benefits. (Section 10 of the Act)
5. The ESIC Corporation can now appoint consultants and specialists on a contract basis for better delivery of super-specialty services. (A new proviso added to clause (a) sub-section (2) of section 17)
6. The designation of Inspector has been re-designated as "Social Security Officer to enroll them as a facilitator of the Scheme rather than to act as mere inspectors. (amendment to section 45)
7. The ESIC Corporation may nominate any officer duly authorized to carry out re-inspection or test inspection of the records and returns already inspected by the Social Security Officer. (A new sub-section 4 added to section 45 of the Act).
Medical benefits to the insured person and his spouse have been extended under circumstances where the insured person retires under Voluntary Retirement Scheme or takes premature retirement. In the earlier Act, the benefit was applicable only on attaining the age of superannuation.
1. The procedure for the determination of contribution has been streamlined to avoid undue hardship as the Inspectors shall not inspect the books of accounts of the establishment beyond the period of five years. It will resolve all difficulties pertaining to the production of records beyond the period of five years for the purpose of inspection and verification. (A new proviso added to section 45A of the Act)
2. After section 45A, a new section 45AA has been inserted. It provides that if an employer is not satisfied with the order of the ESIC Corporation, he may prefer an appeal to an appellate authority within sixty days of the date of the order, after depositing 25% of the contribution so ordered OR the contribution as per his calculations, whichever is higher. It also provides that if the employer finally succeeds in the appeal, the excess amount deposited shall be refunded together with interest thereon as may be specified in regulation.
3. An accident occurring to an insured person while commuting from his residence to the place of employment and vice-a-versa shall be deemed to have arisen out of and in the course of employment for the purpose of benefit under the Act. A new section 51 E has been added for this purpose.
4. Medical benefits to the insured person and his spouse have been extended under circumstances where the insured person retires under Voluntary Retirement Scheme or takes premature retirement. Proviso to subsection 3 of section 56 has been substituted to provide the same.
5. State Governments are allowed to set up autonomous organizations to provide certain benefits to employees in case of sickness, maternity, and employment injury under the Scheme. (sub-section 5 has been inserted into section 58 of the Act)
6. The ESIC Corporation can enter into an agreement with any local authority, private body, or individual for commissioning and running the ESI hospitals through third party participation for providing medical treatment and attendance to insured persons. (sub-section 3 has been inserted into section 59 of the Act).
7. ESIC Corporation may establish medical colleges, nursing colleges, and training institutes for its paramedical staff and other employees with a view to improve the quality of the services. A new section 59B has been included in the Act.
8. A new Chapter VA has been added to enable the provision for extending medical care to non-insured persons against payment of user-charges to facilitate providing medical care to below the poverty line (BPL) families and other unorganized sector workers covered under the Rashtriya Swasthya Bima Yojana (RSBY).
"9. Exemption of a factory or establishment or class of factories or establishments from the operation of this Act will be granted only if the employees in such factories or establishments are otherwise in receipt of benefits substantially similar or superior to the benefits provided under this Act. It has also been provided that the application for renewal of exemption shall be made three months before the date of expiry of the exemption period and a decision on the same will be taken by the appropriate Government within a period of two months of receipt of such application. (new proviso added to section 87 of the Act)"
10. Exemption granted to a factory or establishment from the operation of this Act shall be prospective and not retrospective as per section 91 of the Act.
Directives for Reimbursement of Expenditure
Introduction
In view of complaints received from various employers regarding delay/non-reimbursement of expenditure incurred by them for emergency treatment of their employees, ESIC Corporation has issued guidelines to all the concerned authorities via a letter dated 21 May 2010 covering terms, conditions, and procedures to be followed for the timely reimbursement of expenditure incurred by the employer on the treatment of its employees covered under ESIC Scheme for providing medical care in emergencies.
Salient features of the guidelines
- Like super specialty care, reimbursement will be made by Senior State Medical Commissioner (SSMC) / State Medical Commissioner (SMC) of the State concerned in respect of emergency treatment, and the total expenditure will be borne by ESIC.
- Employers will have to submit treatment papers and original bills to SSMC / SMC of the State.
- SSMC / SMC shall check the entitlement of the Insured Person.
- SSMC / SMC / Medical Referee shall verify the emergency nature of the case. The reimbursement shall be limited to approved rates of the empaneled hospitals/ Central Government Health Scheme (CGHS) rates.
- To avail cashless facilities, employers may take the Insured Persons in case of emergency to empaneled hospitals of ESIC
From India, Bangalore
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I shall quote TAXGURU dated 3.9.2010 regarding the ESI amendment 2010. Note that point number 9 deals with exemption.
ESIC Amendment Act, 2010- Key Highlights
September 3, 2010 in Corporate Law by admin
The Government of India has notified ESIC Amendment Act 2010 via the official gazette dated 25 May 2010. The Employees State Insurance Act, ESI Act for short, was enacted by the Government of India in 1948. The Government of India, through a notification in the Official Gazette dated 25 May 2010, has enacted The Employees' State Insurance (Amendment) Act, 2010 to amend the earlier ESIC Act, 1948.
These amendments will substantially improve the medical and other benefits under the Scheme. Emphasis has been given to the development and expansion of infrastructure for augmenting the benefits under the Scheme.
Benefits under the scheme have also been extended to apprentices and trainees employed under the Apprentice Act and Standing Order Act. The amendments also aim to improve the administration of the scheme and to overcome practical difficulties experienced in the past during inspection and assessment.
The ESI Act of 2010 replaces the old Act of 1948. The rationale is to expand the infrastructure for augmenting the benefits available under the scheme. The scope of existing benefits is also being extended by adding/modifying the existing provisions.
Introduction
The Government of India, through a notification in the Official Gazette dated 25 May 2010, has enacted The Employees' State Insurance (Amendment) Act, 2010 to amend the ESIC Act, 1948. Except section 18, provisions as contained in the Amendment Act will be applicable with effect from 1 June 2010. Provisions of section 18 shall be deemed to have come into force with effect from 3 July 2008.
Objectives
These amendments will substantially improve the medical and other benefits under the Scheme. Emphasis has been given to the development and expansion of infrastructure for augmenting the benefits under the Scheme. Benefits under the scheme have also been extended to apprentices and trainees employed under the Apprentice Act and Standing Order Act. The amendments also aim to improve the administration of the scheme and to overcome practical difficulties experienced in the past during inspection and assessment.
Salient features of some of the important amendments
1. Vide amendment in sub-section 5 to section 1 of the ESIC Act, 1948 (hereinafter referred to as Act), the appropriate Government is empowered to extend the provisions of ESIC Act 1948 to any other establishment or class of establishments, industrial, commercial, agricultural or otherwise after giving one month notice of its intention of doing so by notification in the Official Gazette instead of the notice period of six months.
2. The definition of "dependents" as contained in clause 6A of section 2 of the Act has been extended to enlarge the number of beneficiaries under the act such as:
- A widow, a legitimate or adopted son below the age of 25 years, and an unmarried legitimate or adopted daughter.
- The age limit of the dependants has been enhanced from 18 to 25 [sub-clause (i) and (ii)].
- Exclusion granted to apprentices engaged under the Apprentices Act, 1961, or under the Standing Orders of the establishment for coverage under the scheme has been withdrawn vide amendment in clause 9 of the Act. Hence, apprentices engaged under the Apprentices Act, 1961, or under Standing Orders of the establishment will also be covered under the purview of the ESIC Scheme with effect from 1 June 2010.
- A dependent parent as per the definition of "family" has been substituted to include "A minor brother or sister wholly dependent upon the earnings of the insured person in case the insured person is unmarried and his or her parents are not alive". It has also been clarified that dependent parents include "Dependent parents, whose income from all sources does not exceed such income as prescribed by the Central Government".
3. The definition of Factory under Section 2(12) has been amended to expand the coverage of smaller factories. The amended Act covers all factories that employ 10 or more persons irrespective of whether the manufacturing process is being carried out with the aid of power or without the aid of power.
4. A Deputy General – ESIC is being made Chairman of the Medical Benefit Council to improve the quality of medical benefits. (Section 10 of the Act)
5. The ESIC Corporation can now appoint consultants and specialists on a contract basis for better delivery of super-specialty services. (A new proviso added to clause (a) sub-section (2) of section 17)
6. The designation of Inspector has been re-designated as "Social Security Officer to enroll them as a facilitator of the Scheme rather than to act as mere inspectors. (amendment to section 45)
7. The ESIC Corporation may nominate any officer duly authorized to carry out re-inspection or test inspection of the records and returns already inspected by the Social Security Officer. (A new sub-section 4 added to section 45 of the Act).
Medical benefits to the insured person and his spouse have been extended under circumstances where the insured person retires under Voluntary Retirement Scheme or takes premature retirement. In the earlier Act, the benefit was applicable only on attaining the age of superannuation.
1. The procedure for the determination of contribution has been streamlined to avoid undue hardship as the Inspectors shall not inspect the books of accounts of the establishment beyond the period of five years. It will resolve all difficulties pertaining to the production of records beyond the period of five years for the purpose of inspection and verification. (A new proviso added to section 45A of the Act)
2. After section 45A, a new section 45AA has been inserted. It provides that if an employer is not satisfied with the order of the ESIC Corporation, he may prefer an appeal to an appellate authority within sixty days of the date of the order, after depositing 25% of the contribution so ordered OR the contribution as per his calculations, whichever is higher. It also provides that if the employer finally succeeds in the appeal, the excess amount deposited shall be refunded together with interest thereon as may be specified in regulation.
3. An accident occurring to an insured person while commuting from his residence to the place of employment and vice-a-versa shall be deemed to have arisen out of and in the course of employment for the purpose of benefit under the Act. A new section 51 E has been added for this purpose.
4. Medical benefits to the insured person and his spouse have been extended under circumstances where the insured person retires under Voluntary Retirement Scheme or takes premature retirement. Proviso to subsection 3 of section 56 has been substituted to provide the same.
5. State Governments are allowed to set up autonomous organizations to provide certain benefits to employees in case of sickness, maternity, and employment injury under the Scheme. (sub-section 5 has been inserted into section 58 of the Act)
6. The ESIC Corporation can enter into an agreement with any local authority, private body, or individual for commissioning and running the ESI hospitals through third party participation for providing medical treatment and attendance to insured persons. (sub-section 3 has been inserted into section 59 of the Act).
7. ESIC Corporation may establish medical colleges, nursing colleges, and training institutes for its paramedical staff and other employees with a view to improve the quality of the services. A new section 59B has been included in the Act.
8. A new Chapter VA has been added to enable the provision for extending medical care to non-insured persons against payment of user-charges to facilitate providing medical care to below the poverty line (BPL) families and other unorganized sector workers covered under the Rashtriya Swasthya Bima Yojana (RSBY).
"9. Exemption of a factory or establishment or class of factories or establishments from the operation of this Act will be granted only if the employees in such factories or establishments are otherwise in receipt of benefits substantially similar or superior to the benefits provided under this Act. It has also been provided that the application for renewal of exemption shall be made three months before the date of expiry of the exemption period and a decision on the same will be taken by the appropriate Government within a period of two months of receipt of such application. (new proviso added to section 87 of the Act)"
10. Exemption granted to a factory or establishment from the operation of this Act shall be prospective and not retrospective as per section 91 of the Act.
Directives for Reimbursement of Expenditure
Introduction
In view of complaints received from various employers regarding delay/non-reimbursement of expenditure incurred by them for emergency treatment of their employees, ESIC Corporation has issued guidelines to all the concerned authorities via a letter dated 21 May 2010 covering terms, conditions, and procedures to be followed for the timely reimbursement of expenditure incurred by the employer on the treatment of its employees covered under ESIC Scheme for providing medical care in emergencies.
Salient features of the guidelines
- Like super specialty care, reimbursement will be made by Senior State Medical Commissioner (SSMC) / State Medical Commissioner (SMC) of the State concerned in respect of emergency treatment, and the total expenditure will be borne by ESIC.
- Employers will have to submit treatment papers and original bills to SSMC / SMC of the State.
- SSMC / SMC shall check the entitlement of the Insured Person.
- SSMC / SMC / Medical Referee shall verify the emergency nature of the case. The reimbursement shall be limited to approved rates of the empaneled hospitals/ Central Government Health Scheme (CGHS) rates.
- To avail cashless facilities, employers may take the Insured Persons in case of emergency to empaneled hospitals of ESIC
From India, Bangalore
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