Medical benefit to retired beneficiaries under ESI – Draft Regulations

Medical benefit to retired beneficiaries under Employee State Insurance – Draft Regulations

Employee State Insurance Corporation has notified draft Employees’ State Insurance (General) Amendment Regulations, 2025.

The draft regulations proposes to provide for Medical benefit to retired beneficiaries as under:

Regulation 103AA: 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.

Download the Draft Regulation Notification Click Here >>

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