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.

State Governments are instrumental in delivering healthcare services under the ESI Act. An enabling provision was inserted in the Act to establish a body at the State level to address certain operational issues.

A committee, entitled Medical Services and Medical Education (MSME), was constituted to explore various options to improve operational efficiency.

The extension of the ESI scheme was not progressing at the desired pace. In 2010 the threshold coverage level was reduced from 20 to 10 employees through an amendment to the Act. Moreover, in sparsely populated areas many establishments could not be covered even with the threshold of 10 employees.

To ensure adequacy and improve the quality of social security benefits the following actions have been taken:
 

The ESIC has taken the following measures to proactively improve the scheme:
 

The Employees  Provident Fund Organisation (EPFO), under the Ministry of Labour & Employment, Government of India provides social security benefits to its members in terms of provident fund and old age pensions under the Employees' Provident Funds & Miscellaneous Provisions Act, 1952 (referred to as the Act hereafter), enacted by the Parliament of India, which extends to the whole of India except the state of Jammu and Kashmir.