On 4th March 2025, the Employees’ State Insurance Corporation (ESIC) issued a draft notification proposing an amendment to the Employees’ State Insurance (General) Regulations, 1950. The proposed amendment introduces Regulation 103 AA, which extends medical benefits to certain categories of retired employees and their spouses. This includes employees who contributed to the ESIC scheme for at least five years after 1st April 2012 and later ceased coverage due to reasons such as crossing the wage threshold, retirement, or opting for voluntary or premature retirement after 1st April 2017, with wages not exceeding ₹30,000 per month.
To be eligible, retirees must fulfill other conditions specified in the scheme, provide a certificate from their employer in a prescribed format, and pay contributions as notified by the Corporation. Those already receiving benefits under Rules 60 and 61 of the ESI (Central) Rules, 1950, will also be eligible under this regulation, provided they meet the same conditions and payment requirements.
ESIC has invited objections and suggestions from stakeholders, which must be submitted within 30 days of the Gazette’s availability to the public. Responses can be sent to Shri Deepak Joshi, Insurance Commissioner (Benefit), at ESIC’s New Delhi office or via email. Employers are mandated to issue the necessary certification upon request. The move aims to address medical needs of employees post-retirement while maintaining procedural compliance.
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 (email: 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]
