Medical benefits to dependent parents of Central Government Employees

13 DEC 2019

For availing of medical facilities under Central Government Health Scheme (CGHS), parents are deemed to be dependent on the Central Government employee if they are normally residing with the employee and their monthly income from all sources including pension/ family pension does not exceed Rs. 9,000 plus the amount of Dearness Relief thereon. This condition of dependency is applicable to Pensioners of State Government(s) as well.

Also check: CGHS medical facilities reimbursement to Central Government pensioners

Regarding any scheme for providing medical facility to the dependent parents of employees of private sector, The Employees’ State Insurance (ESI) Act, 1948 read with ESI (Central) Rule, 1950 provides for medical benefits to the dependent parents of the Insured person i.e. an employee who works in a factory/ establishment having 10 or more workers & registered under the said Act and drawing salary less than Rs. 21,000 per month (Rs. 25,000 in case of persons with disability). Income limit for dependency of parents from all sources is Rs. 9,000 per month. The ESI Act is not applicable to Central Government employees and their dependents.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Lok Sabha here today.

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Maternity benefits to workers in the private sector are regulated under Employees’ State Insurance (ESI) Act, 1948 and Maternity Benefit (MB) Act, 1961. The Government has already enhanced paid maternity leave from 12 weeks to 26 weeks for up to two surviving children under the ESI Act,1948 vide notification dated 20.01.2017. So far as enhanced benefits under MB Act, 1961 are concerned, the Government introduced Maternity Benefit (Amendment) Bill, 2016 before Rajya Sabha. The said Bill was passed by the Rajya Sabha on 11.08.2016 and Lok Sabha has also passed the Bill with some amendments on 09.03.2017.

Both the Acts provide for protection of rights of working women through robust and proper mechanism including inspections by the field officers. The Acts provide for stringent penalties, including imprisonment, for violations of its provisions to ensure proper implementation.

This information was given by Shri Bandaru Dattatreya, the Minister of State (IC) for Labour and Employment,in written reply to a question in Rajya Sabha today.

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The move will help 1.2 crore people who will now be eligible for health care benefits.

The Centre’s move to increase the wage ceiling for employee coverage under the Employees’ Provident Funds and Miscellaneous Provisions Act, 1952, to Rs 25,000 per month from the existing Rs 15,000 per month limit is expected to benefit a larger working population and include approximately 30 lakh more workers to the Employees State Insurance (ESI) pool.

The move would also benefit 1.2 crore more people who will now be eligible for health care benefits at more than 1,500 clinics and hospitals run by the ESIC directly or indirectly. Earlier as of March 31, 2016, there were around 2.1 crore persons who were insured under the ESI Act and a total of over 6 crore beneficiaries. Employees and employers contribute to the Employees’ State Insurance Corporation at the specified rates, which are currently, 1.75 per cent of the wages (employee’s contribution) and 4.75 per cent of the wages (employer’s contribution) paid/payable in respect of the employees in every wage period.

However, the increased wage ceiling is expected to pose a challenge to employers in terms of the wage costs to be borne by them, said Nishith Desai Associates, legal and tax councillors.

Employers, it noted, would now be required to make provisions of cash benefit and health insurance for an extended employee population who draw wages up to Rs 21,000 per month. It also sees this as a challenge for the government to ensure that the quality of medical facilities (including hospital infrastructure) provided under the ESI Act are improved such that the desired benefit is achieved. It is a positive move with the objective of expanding the ambit of social security schemes to a larger working population.

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The Government, in principle, decided to enhance the threshold limit of wage for coverage under the Employees State Insurance (ESI) Act, 1948 from existing Rs.15,000/- pm to Rs. 21,000/- pm. For this purpose, a Notification had been issued on 06.10.2016 inviting suggestion/objections from all stakeholders.

As on 31.03.3016, the number of Insured Persons(IPs) under ESI Scheme were 2.14 crores. The additional number of IPs on account of wage revision are estimated to be 35 Lakhs.

The ESI Corporation has taken a number of decisions to absorb the increased number of workers under its net like-

Increasing hospital bed strength of ESI Hospitals by 50%, if the bed occupancy of the concerned hospital has been consistently more than 70% in last three financial years.

Up-gradation of its dispensaries into 6 & 30 bedded hospitals in a phased manner.

Partnering with private medical practitioners & private clinics for providing healthcare facilities in those areas where ESI does not have them.

This information was given by Shri Bandaru Dattatreya, the Minister of State (IC) for Labour and Employment, in reply to a question in Rajya Sabha today.

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The Cabinet Committee on Economic Affairs today approved the proposal for providing non-plan budgetary support of Rs. 128.26 crore for liquidation of statutory dues (Provident Fund, Gratuity, Pension, Employees State Insurance and Bonus) and salary and wages from 01-10-2012 to 31-03-2013 in respect of ten Central Public Sector Enterprises (CPSEs) under the Department of Heavy Industry, namely Hindustan Cables Ltd., HMT Ltd., HMT (Watches) Ltd., HMT (Chinar Watches) Ltd., Nagaland Pulp & Paper Co. Ltd., Triveni Structurals Ltd., Tungbhadra Steel Products Ltd., Nepa Ltd., HMT Bearings Ltd. and Hindustan Photo Films Limited.

Revival/closure plans of Hindustan Cables Limited, Triveni Structurals Ltd., HMT (Watches) Ltd., HMT (Chinar Watches) Ltd. and Hindustan Photo Films Limited are yet to be finalized; revival plans of Nepa Ltd. and HMT Ltd. have recently been approved; and revival plans of HMT Bearings Ltd., Nagaland Pulp & Paper Company Ltd. and Tungbhadra Steel Products Ltd. are yet to materialize. It was, therefore, considered essential that the interim financial support from the Government be provided so that the operation of these companies may not be affected. Non-settlement of these liabilities has been causing serious hardship not only to the employees of the companies but also adversely affecting the day-to¬day operation of the companies resulting in further deterioration of their performance.

Payment of outstanding dues of salary and wages would mitigate the hardships of the employees thereby motivating them for better output and prepare them to achieve the goal of revival/re-structuring of the companies. In addition, clearance of outstanding statutory dues (Provident Fund, Gratuity, Pension, Employees State Insurance) would result in fulfillment of statutory obligations.

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