**Executive Summary:**
This notification from the Employees' State Insurance Corporation (ESIC) announces amendments to the Employees' State Insurance General Regulations, 1950. The amendments, effective November 19, 2018, introduce Regulation 96B regarding reimbursement for medical treatment. The notification follows a period of public consultation that ended thirty days after the initial announcement on September 5, 2018.
**Key Points / Main Content:**
* **Amendment Regulations:**
* The regulations are called the Employees' State Insurance General Amendment Regulations, 2018.
* A new Regulation 96B is inserted into the Employees' State Insurance General Regulations, 1950.
* **Regulation 96B: Medical Benefit Reimbursement:**
* Insured individuals and their families (where the medical benefit extends to the family) are entitled to reimbursement for medical treatment in emergency situations.
* Reimbursement is limited to the rates prescribed and published by the State Government, the Corporation, or the Central Government Health Scheme (CGHS).
**Impact Analysis:**
**Insured Persons and Their Families:**
* *Impact:* Entitled to reimbursement for medical treatment in emergency situations up to specified rate limits.
* *Action Required:* Understand the reimbursement process and the applicable rate limits set by the relevant authority (State Government, ESIC, or CGHS).
**Employees' State Insurance Corporation:**
* *Impact:* Responsible for implementing the new reimbursement regulation.
* *Action Required:* Ensure the reimbursement process aligns with Regulation 96B and that relevant stakeholders are informed.
**State Governments/Central Government:**
* *Impact:* Medical reimbursement to the extent of rates prescribed and published by them
* *Action Required:* Ensure the reimbursement process aligns with Regulation 96B and that relevant stakeholders are informed.
Key Entities Referenced
Employees' State Insurance Corporation: An Indian organisation which is responsible for administering the Employees' State Insurance scheme.
Employees State Insurance General Regulations, 1950: A set of regulations pertaining to the Employees' State Insurance scheme, which this notification seeks to amend.
Employees State Insurance Act, 1948: An act of the Indian Parliament related to Employees' State Insurance.
New Delhi: The location where the notification was issued.
Central Government Health CGHS: Central Government Health Scheme, a health scheme for central government employees in India.
S. RAVICHANDRAN: Additional Commissioner who signed the notification.
Employees' State Insurance General Amendment Regulations, 2018: The title of the amendment regulations introduced by this notification.
Mayapuri, New Delhi: Location of the Government of India Press.
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EMPLOYEES' STATE INSURANCE CORPORATION
NOTIFICATION
New Delhi, the 30th October, 2018
No. N-12/13/1/2016-P&D—Whereas draft regulation further to amend the Employees’ State Insurance (General)
Regulations, 1950 was published as required under sub-section (1) of section 97 of the Employees’ State Insurance
Act,1948 (34 of 1948), in the Gazette of India, Part-III–Section–4, dated the 05th September, 2018 for inviting objections
and suggestions from all persons likely to be affected thereby till the expiry of the period of Thirty days from the date on
which this notification was published, are made available to the public:-
And whereas, the said Gazette were made available to the public on 05.09.2018;
And whereas, objections and suggestions received from any of the persons likely to be affected thereby have been
considered by the Employees' State Insurance Corporation;
Now, therefore, in exercise of the powers conferred by Section 97 read with Section 57 of the Employees’ State
Insurance Act, 1948 (34 of 1948), the Employees' State Insurance Corporation, hereby makes the following Regulations
further to amend the Employees' State Insurance (General) Regulations, 1950, namely;
1. This Regulation may be called Employees' State Insurance (General) Amendment Regulations, 2018.
2. In the Employees' State Insurance(General) Regulation,1950 , a new Regulation 96-B shall be inserted as under:
Regulation 96B: SCALE OF MEDICAL BENEFIT FOR REMBURSEMENT
“ An Insured Person and his family ( where such medial benefit is extended to his family) shall be entitled to
receive reimbursement of medical treatment in emergent condition to the extent rates prescribed and published by
State Government or the Corporation or for the Central Government Health (CGHS)”.
S. RAVICHANDRAN, Addl. Commissioner (P&D)
[ADVT.-III/4/Exty./347/18]
Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064
and Published by the Controller of Publications, Delhi-110054.