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Core Purpose

Proposes amendments to Employees' State Insurance (General) Regulations, 1950, introducing medical benefits for retired employees.

Detailed Summary

The Employees' State Insurance Corporation proposes to amend the Employees' State Insurance (General) Regulations, 1950 by inserting a new Regulation 103 AA concerning medical benefits for retired employees. Employees who contributed for at least five years after 01.04.2012, ceased coverage due to wage limits, and retired on or after 01.04.2017 with wages up to ₹30,000 per month are eligible. This includes superannuation, voluntary retirement, or premature retirement. Eligibility is subject to scheme conditions, employer certificate as per Director General's format, and contribution payment. Existing beneficiaries under Rule 60 and 61 of ESI (Central) Rules, 1950 are also eligible under similar conditions. Employers must issue certificates to employees upon request.

Full Text

REGD. No. D. L.-33004/99 The Gazette of India CG-DL-E-03042025-262243 EXTRAORDINARY PART III—Section 4 PUBLISHED BY AUTHORITY No. 272] NEW DELHI, WEDNESDAY, APRIL 2, 2025/ CHAITRA 12, 1947 EMPLOYEES' STATE INSURANCE CORPORATION NOTIFICATION New Delhi, the 4th March, 2025 F.No. R-12/16/9/2022-Policy-Bft-II.—The following draft of certain regulations further to amend the Employees' State Insurance (General) Regulations, 1950, which the Employees' State Insurance Corporation proposes to make in exercise of the powers conferred under section 97 of the Employees' State Insurance Act, 1948 (34 of 1948), is hereby published as required by sub-section (1) of the said section for information of all persons likely to be affected thereby and notice is hereby given that the said draft regulations will be taken into consideration after expiry of a period of thirty days from the date on which copies of the Official Gazette in which this notification is published, are made available to the public:- 1. Any objection or suggestion, which may be received from any person in respect of the said draft regulation within the period specified above, will be considered by the Employees' State Insurance Corporation. 2. The objections and suggestions, if any, may be addressed to Shri Deepak Joshi, Insurance Commissioner (Benefit) Employees' State Insurance Corporation, Panchdeep Bhawan, C.I.G. Marg, New Delhi- 110002 (e.mail: ac- benefit@esic.nic.in). DRAFT REGULATIONS 1. This Regulation may be called Employees' State Insurance (General) Amendment Regulations, 2025. 2. In the Employees' State Insurance (General) Regulations, 1950, a new Regulation 103 AA shall be inserted as under: Regulation 103 AA: Medical benefit to retired beneficiaries 1. An employee in respect of whom contribution is or was payable for not less than five years after 01.04.2012 and who subsequently ceased to be covered under the Act due to exceeding the wage limit, superannuating on attaining the age of superannuation, retiring under a Voluntary Retirement Scheme or taking premature retirement with wages up to rupees thirty thousand per month on or after 01.04.2017, shall be eligible to receive medical benefit for self and his/her spouse, subject to: i. the fulfilment of other conditions of the scheme notified by the Corporation ii. production of certificate from the employer in the form which may be specified by the Director General for the purpose. iii. the payment of contribution at the rate and manner as notified in the scheme by the Corporation Provided that an Insured person who is availing medical benefit under Rule 60 and 61 of ESI (Central) Rules, 1950 shall also be eligible to receive medical benefit as per sub-regulation (1) for self and his/her spouse on fulfilment of other conditions of the scheme and payment of contribution at the rate and manner as notified in the scheme by the Corporation. 2. An employer shall, on demand, issue the certificate as referred to in sub-regulation (1) to person employed by him. DEEPAK JOSHI, Insurance Commissioner (P&D) [ADVT.- III/4/Exty./05/2025-26]

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