Cashless treatment of ESIC Employees and cash compensation for loss of wages: Loksabha Q&A

Cashless treatment of ESIC Employees and cash compensation for loss of wages: Loksabha Q&A

GOVERNMENT OF INDIA
MINISTRY OF LABOUR AND EMPLOYMENT
LOK SABHA

UNSTARRED QUESTION NO: 875
ANSWERED ON: 21.11.2016

ESIC Employees

YOGI ADITYANATH
Y. S. AVINASH REDDY
KOTHA PRABHAKAR REDDY

Will the Minister of LABOUR AND EMPLOYMENT be pleased to state:-

(a) whether the Government has stopped/proposes to stop the cashless treatment of ESIC Employees;
(b)if so, the details thereof and the reasons therefor;
(c)the steps being taken by the government to alleviate problems of ESIC employees in this regard;
(d)whether the Health Insurance Scheme run by the Government provides guarantee of income which is necessary for livelihood and if so, the details thereof; and
(e)if not, whether the Government proposes to implement such schemes in future?

ANSWER

MINISTER OF STATE (IC) FOR LABOUR AND EMPLOYMENT (SHRI BANDARU DATTATREYA)

(a) & (c): No, Madam. The employees under ESI Scheme are eligible for cashless treatment in the ESI Hospitals and tie up hospitals. In case of emergency treatment outside the ESI network, the employees are reimbursed on CGHS rates or respective state rates.

(b): Not applicable in view of answer at (a) above.
(d): Yes, Madam. Under ESI Scheme, cash compensation for loss of wages is paid as under:

1. Sickness Leave - For 91 days @ 70% of wages
2. Temporary disablement - Till the spell of sickness lasts @ 90% of wages
3. Maternity leave - For 12 weeks (under revision to 26 weeks) @ 100% of wages
4. Unemployment allowance- @50% for first year and 25% for second year.

(e): Not applicable.

Source: Loksabha.nic.in

Enhancement of reimbursement ceiling on medical expenditure incurred by State ESI Schemes

ESIC Employees enhancement of reimbursement ceiling on medical expenditure incurred by State ESI Schemes.

HEADQUARTERS OFFICE
EMPLOYEES’ STATE INSURANCE CORPORATION
(ISO 9001-2008 CERTIFIED)
PANCHDEEP BHAWAN, C.I.G MARG, NEW DELHI - 110002.
E-mail : med1-hq@esic.in, Website : www.esic.nic.in

File no, Pt.V-13(14)38/09-Med.I(ESIC/SC)

Dated: 5.1.2017

To,
All SSMCs /SMCs/DMD / DMN/RDs / MSs, ESI Corporation
All Principal Secretary Labour/ Health (dealing State ESI scheme)
All DIMSs/AMOs, State ESI Scheme

Sub: Enhancement of reimbursement ceiling on medical expenditure incurred by State ESI Schemes.

Sir / Madam,
Under ESIC 2.0, ESIC, is expanding its medical services with improved quality and equipping its own as well State run. facilities to maximize the medical benefits for ESI beneficiaries. During the meetings held with the State Govts, it was opined that reimbursement ceiling on medical expenditure is insufficient to rollout the medical benefits under ESIC 2.0.

Accordingly, ESI Corporation in its 170th meeting held on 15th December, 2016 has approved the enhancement of ceiling on medical expenditure incurred by State ESI Schemes, as under:

a) Increase in per capita ceiling of sharing expenditure with State Governments u/s 58 (3) from Rs. 2150 to Rs. 3000 per IP with sub ceiling of Rs. 1250 for "Administration" and Rs, 1750 for "Others” for the year 2017-18.

b) From 2018-19 "Administrative" sub-ceiling will be increased in line with CPI within the overall ceiling of Rs. 3000/- per capita.

c). The ceiling of Rs. 3000/- will be fixed from 2017-2018 to 2019-20 and reviewed annually from 2020-21 on the basis of WPI and expenditure pattern of the States.

d). The State Govt. shall present Project Implementation Plan (PIP), in accordance with the guidelines issued by ESIC time to time, by 31st October every year for the next financial year for its inclusion of the Budget of the Corporation. The PIP should contain the proposal for next Financial year and the progress made during the first six months of the current year.

i. No scheme should be included which has not been duly approved by the ESIC,
ii. Should it be proposed, during the course of a financial year, to finance any scheme which has not been included into the estimates of that year, the sanction of the ESIC shall he obtained to the method for financing it.
iii. The funds shall not be appropriated for expenditure on any item which has not been approved,
iv. The PO ESIC, is authorised to re-appropriate funds from one primary unit of appropriation to another.

e) Funds for 2017-18, will be released as per current ceiling of Rs.2150/- for the first quarter. However, the PIPs for the year 2017-18 should be submitted by 31st January, 2017 to the ESIC for release of fund as per revised ceiling.

f) The plan submitted would be duly monitored by ESIC, for effective impiementation. The funds shall be released on quarter]y basis in accordance with the letter No. V-24/11/10/2001-Med-I issued on 19th April, 2016.(enclosed).

This is for your information and further necessary action.

Yours Sincerely,
(Dr. Naveen Saxena)
OSD, MEDICAL

Order Copy

Implementation of the recommendations of the 7th Central Pay Commission : Revision of provisions regulating pension / gratuity / commutation of pension / family pension / disability pension / ex-gratia lump-sum compensation, etc

Implementation of the recommendations of the 7th Central Pay Commission : Revision of provisions regulating pension / gratuity / commutation of pension / family pension / disability pension / ex-gratia lump-sum compensation, etc

HEADQUARTERS
EMPLOYEES STATE INSURANCE CORPORATION
(An ISO 9001-2000 certified organisation)
PANCHDEEP BHAWAN C.I.G MARG New Delhi - 2

No.A-27/17/1/7th CPC/2016-E.III

Dated: 01.11.2016

MEMORANDUM

Subject: Implementation of the recommendations of the Seventh Central Pay Commission - Revision of provisions regulating pension / gratuity / commutation of pension / family pension / disability pension / ex-gratia lump-sum compensation, etc.

Reference is invited to the following communication issued by Government of India, Ministry of Personnel, Public Grievances & Pensions, Department of Pension & Pensioners’ Welfare :-

1. F.No.38/37/2016-P&PW(A) dated 4th August, 2016.
2. F.No.38/37/2016-P&PW(A)(i) dated 4th August, 2016.
3. F.No.38/37/2016-P&PW(A)(ii) dated 4th August, 2016.

The above resolutions / references (may please be downloaded from Government portal) of the Govt. of India have been adopted by the ESI Corporation in its 169th meeting held on 6th September, 2016 and ratified by the Ministry of Labour & Employment as communicated vide their letter No.A-11014/01/2016-SS-I dated 25.10.2016 to make it applicable to the ESI Pensioners. Accordingly it is requested to take immediate necessary action for revision of pension/ family pension of the ESIC pensioners.

For revision of pension of pre 2016 pensioners/ family pensioner, there is no necessity for the pension disbursing authority to refer the case to the Hqrs Office for revision of pension. The pension disbursing authority i.e. the field units should initiate suo-moto action for revision of pension and payment of arrears as per the Govt. of India Orders dated 4th August, 2016. The instructions as contained in the Office Memorandum dated 4th August, 2016 may be gone through carefully and pension be fixed and arrears disbursed at the earliest.

In the case of post 2016 pensioners/ family pensioner i.e. pensioner who retired/ retires on or after 1.1.2016, the Field Unit should submit the revised pension proposal based on the instructions of the Govt. of India circulated vide letter dated 4th August, 2016 to the Accounts Branch-IV (Hqrs Office) for issue of revised PPO.

Accordingly they are advised to obtain the option letters from the Govt. servants in terms of Rule 5 of Central Civil Service (Revised Pay) Rules, 2016 and action may be taken to process their cases expeditiously. Arrears, difference in pension, commutation, gratuity etc. shall be payable to them after getting HQ Office specific sanction.

It is also intimated that above revision of pension is to be pre-audited and due prescribed procedures may be ensured in this regard.

Receipt of this Memorandum may kindly be acknowledged

Hindi version follows

(J.SRIVASTAVA)
ASSISTANT DIRECTOR

ESIC 7th CPC Order

7th Pay Commission Revision of pay scale for the ESIC Employees

7th Pay Commission Revision of pay scale for the ESIC Employees

HEADQUARTERS

EMPLOYEES STATE INSURANCE CORPORATION

(An ISO 9001-2000 certifed organisation)

PANCHDEEP BHAWAN C.I.G MARG New Delhi - 2

No.A-27/17/1/7th CPC/2016-E.III

Dated: 26.10.2016

MEMORANDUM

Subject: Implementation of the recommendations of the Seventh Central Pay Commission as accepted by the Central Government - Revision of pay scale of the employees of the Corporation- Reg.

The ESI Corporation in its 169th meeting held on 06-09-2016 has given approval to amendment of the First Schedule of the ESIC (Staff and Conditions of Service) Regulations, 1959 giving effect to the implementation of the 7th Central Pay Commission’s recommendations in the ESI Corporation, as accepted by the Central Government. The said approval of the Corporation has been ratified by the Ministry of Labour & Employment (MoL&E) as communicated vide their letter No.A-11014/01/2016-SS-I dated 25.10.2016.

2. In accordance with the above, the revised level as well as the initial pay in the new pay matrix corresponding to the existing pay in the Pay Band and Grade Pay applicable to various categories of employees of ESI Corporation are given at Annexure - 1 & 2.

3. A copy of the Central Civil Services (Revised Pay) Rules, 2016 as notified by the Central Govt. vide Ministry of Finance (Department of Expenditure) Notification No.GSR-721(E) dated 25.07.2016 (may please be downloaded from Government portal) may be referred to for the purpose of fixation of pay in the revised level of pay as well as the initial pay in the new pay matrix. The revised level of pay in the new pay matrix along with the CCS (Revised Pay) Rules, 2016 may kindly be brought to the notice of all employees immediately. The employees may exercise their options in writing in the prescribed proforma given at Annexure – 3 within three months of the issue of this Memorandum as per Rule 5 & 6 of the CC5 (Revised Pay) Rules, 2016. It should be ensured that the contents of this order are noted by all employees including those who are on leave and those who have since retired from the services of the Corporation after 01.01.2016 so that the need for extending the date for exercising the option does not arise. The option once exercised shall be final.

4. Following guidelines are given for expediting the fixation of pay in the revised pay matrix regulating the payment of arrears of pay as a result of implementation of the recommendations of the 7th Central Pay Commission.

(i) Those employees, who give timely option to switch over to the revised level of pay in the new pay matrix, their pay may be fixed in the level corresponding to the applicable pre-revised Pay Band plus Grade Pay. Pay and allowances for the month of November, 2016 may be drawn and paid on the basis of revised pay matrix and the applicable existing pre-revised allowances after deduction of enhanced subscription to the Provident Fund, which will be calculated with reference to the revised basic pay. In so far as the employees who have joined on or after 01.01.2004 are concerned, the enhanced deduction under the New Pension Scheme will be calculated w.r.t. the revised Basic Pay and DA thereon.

(ii) In terms of CCS (Revised Pay) Rules, 2016, there shall be two dates for grant of increment namely, 1st January and 1st July of every year, instead of existing date of 1st July, provided that an employee shall be entitled to only one annual increment either on 1st January or 1st July depending on the date of his appointment, promotion or grant of financial upgradation. The increment in respect of an employee appointed or promoted or granted financial upgradation including upgradation under Modified Assured Career Progression Scheme (MACPS) during the period between the 2nd day of January and 1st day of July (both inclusive) shall be granted on 1st day of January and the increment in respect of an employee appointed or promoted or granted financial upgradation including upgradation under MACPS during the period between the 2nd day of July and 1st day of January (both inclusive) shall be granted on 1st day of July. For drawing the annual increment, the rule position stated in the respective CCS (RP) Rule, 2016 may be referred to.

For fixation of pay, the Government of India, Ministry of Finance, Department of Expenditure O.M. No. 1-5/2016-IC dated 29.07.2016 may be referred to (This may please be downloaded from the Government portal). In order to ensure correct and systematic fixation of pay in the revised pay matrix, a proforma for the purpose (Statement of Fixation of Pay) annexed with the said Government of India O.M. dated 01.08.2016 is enclosed (Annexure- 5). The statement should be prepared in triplicate and one copy thereof should be pasted in the Service Book of the Government servant concerned and another copy made available to the concerned accounting authorities for post-check. Attention is also invited in this connection to the Government decision contained in Government Resolution No.1-2/2016-IC dated 25th July, 2016 (This may please be downloaded from Government portal), which may be referred to.

(i) Bills may be drawn separately in respect of arrears of pay and allowance for the period from 1st January, 2016 (or the date opted by the employee) to 31st October, 2016. The arrears, computed after deduction of subscription to GPF and NPS on revised Basic Pay, may be paid in one installment. DDOs will ensure that action is taken simultaneously with regard to Corporations’ contribution towards enhanced subscription of New Pension Scheme, minimal level of GPF. Income Tax, as may be due, shall be deducted before payment of arrears.

(iv) The revised pay structure effective from 01.01.2016 includes the Dearness Allowance of 125% sanctioned from 01.01.2016 in the pre-revised pay structure. Thus, Dearness Allowance in the revised pay structure shall be zero from 01.01.2016. The rate and the date of effect of the first installment of Dearness Allowance in the revised pay structure shall be as per the orders to be issued in this behalf in future, by the Government of India.

(v) The decision on the revised rates and the date of effect of all Allowances (other than Dearness Allowance), based on the recommendations of the 7th Central Pay Commission are yet to be notified by the Government of India. Until then, all such Allowances shall continue to be reckoned and paid at the existing rates under the terms and conditions prevailing in the pre-revised pay structure as if the existing pay structure has not been revised under the CCS (RP) Rules, 2016 issued on 25.07.2016.

(vi) With a view to expediting the authorization and disbursement of arrears, it has been decided that the arrear claims may be paid without pre-check of the fixation of pay in the revised pay structure. The facility to disburse arrears without pre-check of fixation of pay, will not, however, be available in respect of those Corporation employees who have relinquished service on account of dismissal, resignation, discharge, retirement, etc., after the date of implementation of the Pay Commission’s recommendations but before the preparation and drawl of the arrear claims as well as in respect of those employees who had expired prior to exercising their option for the drawl of pay in the revised pay structure.

(vii) The requirement of pre-check of pay fixation having been dispensed with, it is not unlikely that the arrears due in some cases be computed incorrectly, leading to overpayments that might have to be recovered subsequently. Therefore, the Drawing and Disbursing Officers should, therefore, make it clear to the employees under their administrative control, while disbursing the arrears, that the payments are being made subject to adjustment from amounts that may be due to them subsequently should any discrepancy is noticed later. For this purpose, an Undertaking (Annexure-4) may also be obtained in writing from every employee at the time of disbursement of the arrears upto October, 2016 to the effect that any excess payment that may be found to have been made as a result of incorrect fixation of pay in the revised pay scales I pay matrix, will be refunded by him / her to the Corporation either by adjustment against future payments or otherwise.

(viii) Officer In charge of Finance and Accounts Branch of each Field Office is hereby authorized to concur the pay fixation for implementation of 7th Central Pay Commission recommendations as accepted by the Central Government, wherever Joint Director (Finance) is not posted. Pay as per the above instructions is to be fixed and arrear shall be drawn for employees from place of their present posting. Thereafter, copy of “Due and Drawn” statement may be sent to the concerned offices (where the official has been working since 0101.16), immediately after release of arrears, for making necessary entries in the relevant registers.

(ix) Since the funds for payment of October, 2016 salary (second limit) has already been released on 24.10.2016 to all accounting units, requisition of funds in response to this Memorandum may be raised separately with Finance & Accounts Division of Hqrs. Office, for early disbursement of arrears.

Receipt of this Memorandum may kindly be acknowledged. Hindi version follows.

Encl.: As above

(S.K. SINHA)
DIRECTOR

Original Source: www.esic.nic.in

Salary Disbursement for October, 2016 on 28.10.2016 : ESIC

Salary Disbursement for October, 2016 on 28.10.2016 : ESIC

HEADQUARTERS OFFICE
EMPLOYEES STATE INSURANCE CORPORATION
PANCHDEEP BHAWAN. C.I.G. ROAD. NEW DELHI-2
(AN ISO 9001-2008 QMS CERTIFIED ORGANISATION)

No. F-29/13/02-E-VI

Date: 25/10/2016

To,
1. All Regional Directors! All Jt Directors (I/c)
2. Regional Offices/Sub Regional Offices
3. Ins. Commissioner (NTA), Dwarka, Delhi
4. D(M)Delhil D(M) Noida/ D(M) Chennai
5. All Deans of ESIC Medical Institutions/Medical Superintendents, ESIC Hospitals / Model Hospitals
6. Cash Br / Fin.&A/cs Br., Hqrs. Office
7. Website Contents Manager, Hqrs. office for uploading in ESIC website.

Sub: Disbursement of salary for the month of October, 2016 on 28.10.2016.

Sir,

I am directed to inform you that the Director General has accorded his kind approval for the disbursement of salary for the month of October, 2016 to the employees / officers of the entire ESIC in accordance with Rule 217(2) of Central Treasury Rules on 28.10.2016 on account of Diwali.

This issued with the concurrence of Financial Commissioner.

Yours faithfully,

(PRABHA SAINI)
ASST. DIRECTOR