Tamil Nadu Government Pensioners Health Fund Scheme, 1995 — Enhancement of Subscription — Orders — Issued

GOVERNMENT OF TAMIL NADU-2012
FINANCE (PENSION) DEPARTMENT

G.O.No.7, Dated: 6th January, 2012
(Margazhi-21, Thiruvalluvar Aandu 2042)

Tamil Nadu Government Pensioners Health Fund Scheme, 1995 — Enhancement of Subscription — Orders — Issued.

ORDER:

The Government in their order first read above had constituted a fund called “Tamil Nadu Government Pensioners’ Health Fund” with effect from 01.07.1995 to provide financial assistance to pensioners for undergoing specialised treatment / surgery, when they are affected by major ailments.

2. In the Government Order third read above the subscription recoverable from the pensioners was enhanced to Rs.50/-per month with effect from 01.04.2008 and the maximum limit was enhanced to Rs.1,00,000/- or 75% of the actual cost of treatment, whichever is less.

3. In the Government order fourth read above, the Tamil Nadu Government Pensioners’ Health Fund Scheme, 1995 was extended to the spouse of the pensioners with effect from 17.02.2009, subject to the maximum limit of Rs.1,00,000/- or 75% of the actual cost of treatment, whichever is less, for both the pensioner and spouse combined together and the contribution recoverable from the pensioners’ monthly pension was enhanced from Rs.50/- to Rs.100/- per month with effect from 01 .09.2009.

4. In the Government Order fifth read above, the scheme was extended to the family pensioners including teacher family pensioners, with effect from 01.09.2009 for whom subscription to the fund was fixed at Rs.75/- per month on their option to enroll under the scheme.

5. Though initially the scheme was introduced as a financially self sustaining one, the receipt of funds under the scheme by way of subscription collected from the pensioners was not sufficient to meet the claims received from the pensioners resulting in a backlog of pending applications for sanction of assistance under the scheme. Owing to extension of the scheme to the spouse of the pensioners and family pensioners and also due to the extension of the facility for those pensioners/ family pensioners who have undergone treatment / surgery even in unaccredited hospitals, claims received under the scheme increased enormously, leading to a deficit of more than Rs.4 crores per month which has to be supported by the Government and so far around Rs.80 crores has been sanctioned by the Government as additional grant to the fund from the inception of the scheme.

6. In order to avoid the ever increasing additional burden to the Government and to make a break even point, the Government, after careful examination decided to enhance the subscription recoverable from the pension of the State Government pensioners. Accordingly Government direct that the subscription from the pensioners shall be enhanced from Rs.100/- per month to Rs.150/- per month with effect from 01 .01 .2012 i.e. from the pension payable for the month of January, 2012. The Government also direct that the subscription recoverable from the family pensioners shall be enhanced from Rs.75/- per month to Rs.100/-per month with effect from 01 .01.2012 i.e. from the family pension payable for the month of January, 2012.

7. There shall be no change in the other terms and conditions of the scheme.

(BY ORDER OF THE GOVERNOR)

K. SHANMUGAM,

PRINCIPAL SECRETARY TO GOVERNMENT

Source: www.tn.gov.in/
[http://www.tn.gov.in/gosdb/gorders/finance/fin_e_7_2012.pdf]

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PARLIAMENT PASSES EMPLOYEES’ STATE INSURANCE (AMENDMENT BILL) 2009

Ministry of Labour & Employment

PARLIAMENT PASSES EMPLOYEES’ STATE INSURANCE (AMENDMENT BILL) 2009

The Parliament today passed the Employees’ State Insurance (Amendment) Bill, 2009. The Employees’ State Insurance Scheme is a welfare scheme framed for workers covered under the Employees’ State Insurance Act, 1948 providing for medical benefits for the employees and their families and payment of benefits to the employees in cases of sickness, maternity and employment injury. The Scheme is applicable to power-using factories employing 10 or more persons and non-power using factories and certain other establishments employing 20 or more persons.

Keeping in-view the changing economic scenario, the Act needed important amendments. The salient features of the amendments are as follows:—

(i) The age limit of the dependants has been enhanced from 18 to 25 for the purpose of dependants’ benefit. It will benefit large number of workers.

(i) It extended social security benefits to those apprentices who are covered by Standing Orders and also to those trainees whose training is extended to misuse exemption granted to apprentice from provisions of the ESI Act.

(ii) The definition of “Factory” under Section 2(12) has been amended to facilitate coverage of smaller factories and cover all factories which employ 10 or more persons whether these are run by power or without power.

(iii) DG-ESIC is being made Chairman of Medical Benefit Council to improve quality of medical benefits.

(iv) It enabled ESIC to appoint consultants and specialists on contract basis for better delivery of super-speciality services.

(v) The post of Insurance Inspector is re-designated as Social Security Officer to give them the role of facilitator rather than to act as mere inspectors.

(vi) The procedure for determination of contribution has been streamlined to avoid harassment of employers as the Inspectors now no more to inspect the books of accounts of the establishment beyond five years as under present system of unlimited period.

(vii) It has added the benefit for workers for the accidents happening while commuting to the place of work and vice versa;

(viii) State Governments are allowed to set up autonomous organisations to give ESI Scheme benefits.

(ix) It extended medical treatment to those who retire under Voluntary Retirement Scheme or take premature retirement.

(x) It enabled ESIC to enter into agreement with any local autho­rity, private body or individual for commissioning and running ESI hospitals through third party participation wherever the hospitals are not fully utilised on account of closure of factories or Insured Persons not being available.

(xi) It will improve the quality of its service delivery and raise infrastructural facilities by opening medical colleges and training facilities in order to increase its medical and Para- medical staff.

(xii) It provided for grant of exemption by appropriate Government to factories/establishments only if the employees get substantially similar or superior benefits.

(xiii) The exemptions shall be granted only prospectively as the ESIC already has made provision of infrastructure to provide service to the IPs for the past period.

(xiv) A new Chapter V-A has been added to enable provision for extending medical care to non insured persons against payment of user charges to facilitate providing of medical care to the BPL families and other unorganised sector workers covered under the Rashtriya Swasthya Bima Yojana (RSBY).

These amendments will ensure coverage of more workers under the ESI Scheme in the organised sector and will also enable the ESI Corporation to participate in schemes such as RSBY that may be framed for the workers in the unorganised sector. The amendments are also aimed at improving service delivery to the existing members of ESI Scheme as well as bringing the provisions of the Act in tune with the changing circumstances.

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