ESIC board to discuss allowing other companies health insurance

Monday, Apr 6, 2015,20:23 IST By metro vaartha A A A

New Delhi | The Employees’ State Insurance Corporation will discuss tomorrow a proposal to provide an option to its 1.95 crore subscribers to choose health insurance products available in the market in lieu of mandatory scheme run by it.
The proposal is listed on agenda of the board meeting of ESIC to be held tomorrow, a source said.
The board will also deliberate on whether ESIC should continue to run its four functional medical colleges and make its eight under-construction medical colleges functional.
At present, as per Employees’ State Insurance Act, 1948, it is mandatory for formal sector workers getting gross pay of up to Rs 15,000 per month to subscribe to health insurance scheme run by the ESIC. According to the proposal, formal sector workers covered under the scheme can subscribe a health insurance product approved by the Insurance Regulatory Development Authority in lieu of the scheme run by ESIC.
Under the scheme, employers contribute 4.75 per cent of the gross pay as contribution towards the health insurance scheme of the workers and employees pays 1.75 per cent. ESI scheme is designed to protect formal sector workers against the events of sickness, maternity, disablement and death due to employment injury and to provide medical care to the insured employees and their families. Thus the total number of beneficiaries of the scheme is about 8 crore.
The board will also discuss whether ESIC should continue to run its medical colleges or not. The ESIC in its board meeting held on December 5 last year had decided to exit from medical education, as its core function is to provide social security i.e, cash benefit and medical benefit to insured persons. Last month, the Labour Ministry had decided that it will continue to run its existing and upcoming medical colleges.
However, it was also decided that ESIC will not venture into the medical education sector and hence will not set up any new medical college in future. The ESIC’s four function medical colleges are Rajajinagar (Bangalore), K K Nagar (Chennai), Joka (Kolkata) and Rohini (Delhi).
According to the proposal, three medical colleges — Faridabad (Haryana), Sanathnagar (Telangana) and Coimbatore (Tamil Nadu) will be handed over to states as there are sufficient number of insured persons.
The Labour Ministry has decided that if states are not willing to run these colleges then ESIC will run on PPP mode or on its own. Similarly, it was also proposed to transfer four medical colleges — Mandi (Himachal Pradesh), Alwar (Rajasthan), Paripally (Kerala) and Bihta (Bihar) –  to respective states where the number of insured persons is less.
The ministry has decided that if the states are not willing then those will be funded by ESIC on PPP mode or divest the property. It was also proposed to transfer ESIC’s Gulbarga medical college to state where there are not sufficient insured persons. The ministry has decided that if the state is not willing then ESIC will run it on its own or in PPP mode.
As per the conditions of the transfer of medical colleges to states, the insured persons will continue to get treatment on cashless mode and the states will bear the balance liability of construction or provide for 50 per cent revenue share if construction is done fully by ESIC.

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