India has a federal structure of Governance, where Health is a provincial subject and the Social Security and Labour fall in the concurrent list. Healthcare, Cash Compensation for Employment Injury in the formal sector is provided by the Employees State Insurance Corporation (ESIC) whereas the Pension and Provident Fund by Employees Provident Fund. The employees of factories & establishments in the formal sector are entitled to benefits of Social Security through ESI Scheme. However, (i) under coverage of employees in units registered under the Act (ii) units left out of registration under the Act (iii) notifying new area by arranging medical care were major challenge. Changing the mindset and attracting the employers and employees to voluntarily come forward for registration under this contributory social security scheme was challenging task. The good practice, has added 10.60 million Insured Persons and 41 million beneficiaries in one year period upto 31.3.2018. The 90% of the new registration has been from the area where the Act was already in force but either number of employees were under reported or the unit was not registered at all. The Amnesty Scheme SPREE was widely accepted both by the employers and employees. The PPP model of providing health care under tie up arrangement expedited extension of coverage to 503 Districts in the country from 383 districts a year before. Now ESI Scheme has 124 million beneficiaries.