Social Security - A Corporate View

1. Social Security -A Corporate View

2. ESI- Highlights Benefits Technology

3. Focus to Improvements

4. ESI “Optimize & Attract”

5. Feedback recording….gains In recent years, India, like several other developing countries, has established different types of social security scheme. The ESIS is one among such scheme. Its main objectives is to provide medical benefit’s for citizens who’s earnings fall under certain limit of income. Scenario IP 1 : I took my wife for antenatal care and for delivery to ESI hospital, Ayanavaram, Chennai. The treatment was very good IP 2: I took my mother for asthma treatment to the ESI hospital Vellore. She was feeling better than when she was treated in a private hospital IP 3: Fifteen days back I went to the ESI clinic with an ear ache. Medical services were good. I suffer from this complaint frequently. And I visit ESI regularly for treatment. I am satisfied with their service. These factors affect diverse groups of individuals differently and play distinctive roles in the decision to seek medical care (mostly taken by the individual) and in the decision regarding the subsequent number of visits to ESI dispensaries or private facilities.

6. Feedback recording…focus to improve Scenario IP 1: The conditions in the dispensaries are appalling. We have to ultimately go to a government hospital or arrange money for private treatment. What then, is the use of the ESI IP 2: The timing does not suit our working hours. We find it difficult to take leave or permission to go to the clinic in the morning hours. Finally we end up going to private doctors IP 3 : In the out-patient’s clinic there are not enough places; with many patients the place is not very comfortable. Receiving the OP card itself takes a long time. The sanitation conditions in these facilities are also not very good IP 4 : Not enough diagnostics facilities are available in these clinics. Where diagnostic facilities are available most of the doctors are men and female beneficiaries registered under this scheme are reluctant to approach them for diagnosis. They prefer getting treatment from private nursing homes or private clinics, several times out-of-pocket expenditure incurred for treatment and reimbursement at times takes several weeks

7. ESI – Current & Proposed Flow Medical Facility available Approaches ESI Hospital Medical Officers examine the patient IP is treated in ESI hospital IP Medical Facility unavailable Register online in ESIC web portal IP is issued with reference letter and routed to Pvt Network hospital System calculates the eligibility and mail is triggered to the officer Approaches the Network (empanelled) Hospital and produce the reference letter at reception ESIC should send Instant SMS on every stage of the Cashless cycle. Helpline facility should be available for updates on the case Officers check the system and approves Based on the cap limit(eligibility certificate) the Hospital intimates ESiC Case is received at PVt Hospital & treatment is initiated Case is received at ESIC & payment is processed Proposed process Existing process

8. Provident Fund

9. EPF - gains Provident Fund International worker

10. EPF - Focus to Improve Administration Benefits

11. PF – Current & Proposed Flow Submitted @ RPFC Relevant RPFC(Regional Provident Fund Commissioner) moves required documents(Cheque & Annexure k) for EPF transfer RPFC, Chennai moves Form to relevant section within or relevant RPFC of other region Forms 3 days-60 days 30- 60 days RPFC, Chennai moves Form to relevant section within or relevant RPFC of other region 90 days Receipt of cheque and its realization is handled RPFC Chennai (Group 30) 15-30 days Relevant RPFC(Regional Provident Fund Commissioner) moves required -Annexure k for EPF transfer Processed only at year end Group 30 at RPFC reflects the transferred amount to associate’s PF a/c 30 – 45 days Receipt of Annexure K, NEFT Transfer is made to employee’s current PF a/c Processed only at year end On transference of the amount RPFC confirms about the PF transfer completion. The minimum period of PF transfer to take effect is around 6 months if it is within Tamilnadu and around a year for transfer across interstate RPFC offices. On transference of the amount RPFC should send instant SMS about the PF transfer , closure status The minimum period of PF transfer to take effect is 2 months if it is within Tamilnadu and around 3 months for transfer across interstate RPFC offices. and Closure 2 months. Confirms only during annual statement release Proposed process Existing process

12. Thank You