Employees State Insurance - Beneficiaries in Kerala.

Beneficiaries  Initially factories employing 20 or more persons for wages using power in the manufacturing process alone were brought under the provision of ESI Act as per the then prevalent definition of section 2 (12) of ESI Act. Subsequently, the scheme was extended under section 1 (5) of ESI Act to the following establishments in the State with effect from 30-03-1975. a) Factories employing 10 or more persons for wages and using power in the manufacturing process. b) Factories employing 20 or more persons for wages and not using power in the manufacturing process. c) Shops and cinema theatres employing 20 or more persons. d) Hotels and restaurants employing 20 or persons. e) News paper and advertising establishments employing 20 or more persons. f) Motor transport undertakings employing 20 or more persons.  As on 31-03-2002 nearly 10274 factories/ establishments and 381900 employees have been brought under the purview of ESI Act in the State of Kerala. Wage Ceiling * The Wage ceiling for coverage of employees under ESI Act has been enhanced to Rs.7,500/- per month with effect from 01.04.2004 Contribution * ESI scheme is mainly financed by contribution raised from employees covered under the scheme and their employers, as a fixed percentage of wages collected by the ESI Corporation. As of now the rates of contribution are: 1)      Employees` contribution ………….. 1.75% of wages 2)      Employers` contribution …………... 4.75% of wages Thus, the total per capita contribution collected by the Corporation works out to 6.5% of the wages per covered employee. Employees earning up to Rs. 40/- a day as wages are exempted from payment of their part of contribution. Sharing of Expenditure * The State Government and the ESI Corporation share the expenditure on medical benefit in the ratio 1:7, within the per capita ceiling of Rs.900/- per Insured Person per annum with effect from 01.04.2005. Social Security Benefits * The Corporation extends most of the social security benefits to the insured persons as defined by the International Labour Organisation. Rajiv Gandhi Shramik Kalyan Yojna The ESI Corporation launched an unemployment allowance scheme called Rajiv Gandhi Shramik Kalyan Yojna for those Insured Persons who are rendered unemployed in voluntarily due to closure of the factory, retrenchment or permanent invalidity arising out of non-employment injury. Under this scheme, the eligible workers are entitled to a daily rate of allowance and medical care for self and family during the period of unemployment up to six months. The major benefits available under the scheme are: 1)      Full medical facilities 2)      Sickness benefit (monetary) 3)      Temporary disablement benefit (monetary) 4)      Permanent  disablement benefit (monetary) 5)      Maternity benefit to women employees (monetary) 6)      Dependants’ benefit/Family pension (monetary) The other benefits granted to the insured population include: ·        Medical facilities to retired employees, their spouses. ·        Rehabilitation allowance                           ·        Funeral expenses ·        Family welfare services ·        Vocational rehabilitation ·        Occupational health services ·        Immunisation The details about the benefits, contributory conditions and scale of payment etc. are as follows: BENEFITS  &  ELIGIBILITY DURATION RATE / SCALE 1.SICKNESS BENEFIT ORDINARY      : Payment of contribution for half the number of days in one contribution period. Upto 91days in two consecutive benefit periods. 50% of the wages approximately. ENHANCED     : Same as above. 14 days for tubectomy & 7 days for vasectomy. Extendable on medical advice. Full wages approximately. EXTENDED      : For 29 specified long term diseases.Continuous insurable employment for two years. 124 days which may be extended upto two years on medical advice during a period of three years. 70% of the wages approximately. 2. DISABLEMENT BENEFIT TEMPORARY  :From day one of entering insurable employment & irrespective of having paid any contribution. As long as temporary disablement lasts. 70% of the wages approximately. PERMANENT   : Same as above. For whole life. Depending on the loss of earning capacity but subject to a maximum of 70% of the wages.       3.DEPENDENTS BENEFIT From day one of entering insurable employment & irrespective of having paid any contribution. For life to the widow or until her remarriage. To dependant parents for life. To legitimate dependant children till the age of 18 years. 70% of the wages at a specified proportionate rate to individual dependants. 4. MATERNITY BENEFIT Payment of contribution for a minimum of 80 days in one or two consecutive contribution periods. 12 weeks in case of normal delivery. 6 weeks in case of mis- carriage. Extendable by 4 weeks on medical advice. Full wages approximately, i.e. double the standard benefit rate. 5. MEDICAL BENEFIT From day one of entering insurable employment for self & dependants. On a nominal contribution of Rs.120/- per annum to retired IPs and their spouses. Full medical care till disease or disablement lasts. There is no upper ceiling on expenditure on medical care including super specialty  FUNERAL  EXPENSES From day one of entering insurable employment. For defraying expenses on the funeral of an insured person. Actual expenses subject to a maximum of Rs. 2500/- VOCATIONAL  REHABILITATION From day one of entering insurable employment. As long as vocational training lasts.  Actual fee or Rs. 45/- a day whichever is more.  PHYSICAL  REHABILITATION From day one of entering insurable employment. As long as a person is admitted to artificial limb centre 100% of the wages approximately.