(a) the criteria for the reimbursement of expenses incurred by the State Governments on the Employees`
State Insurance Services (ESISs);
(b) whether any discussion was held and decision taken in the Board of Trustees meeting of the Employees
State Insurance Corporation (ESIC) on the reimbursement of expenses incurred over the prescribed ceiling to
the State Governments;
(c) if so, the details thereof; and
(d) the follow-up action taken thereon?
MINISTER OF THE STATE (INDEPENDENT CHARGE) IN THE MINISTRY OF LABOUR AND EMPLOYMENT
(SHRI OSCAR FERNANDES)
(a) to (d): A statement is laid on the Table of the House.
STATEMENT REFERRED TO IN REPLY TO PARTS (a) TO (d) OF THE LOK SABHA STARRED QUESTION NO. 383 FOR 30.04.2007
REGARDING `REIMBURSEMENT OF EXPENSES ON ESI`.
(a) to (d): The expenditure incurred by the State Government on provision of medical care services is reimbursed
to the State Governments by ESIC on the basis of prescribed ceiling of Rs. 1000/- per Insured Person per annum.
The ESI Corporation in its meeting held on 23.12.2006 approved the enhancement of ceiling on medical care from
Rs. 900/- per Insured Person per annum to Rs. 1,000/- per Insured Person per annum with effect from 01.04.2007.
In addition to Rs. 1,000/-, the ESI Corporation has also decided to give an incentive of Rs. 50/- per Insured
Person per annum to the State Governments on fulfilling the stipulated terms and conditions for improvement of
medical scheme. There was no discussion in the meeting of the ESI Corporation held on 23.12.2006 regarding
reimbursement of expenses over the prescribed ceiling. The instructions conveying the enhancement of ceiling
to State Governments have been issued by the ESI Corporation on 24.01.2007.