From eligibility to benefits, here’s all you need to know

A multi-faceted social security scheme called Employees’ State Insurance Scheme of India (ESIC) has been created to provide socio-economic security to employees in the organized sector. The State Employees’ Insurance Corporation is the statutory body that oversees the ESI scheme.

The main objective of the Government of India’s ESI scheme is to protect employees against certain health-related contingencies such as permanent or temporary disability, illness or death due to occupational disease or injury, which reduce the employee’s ability to earn life or result in loss of income. This initiative helps employees reduce the financial pressure caused by such sad circumstances.

Workers are protected by the ESI scheme, which provides medical treatment to the insured and their dependents, as well as a number of monetary benefits for loss of income or disability. In addition, in the event that an insured person dies or is injured on the job due to occupational hazards, the plan provides dependent benefits, often known as pensions.

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Who is eligible under ESI scheme?

Daily wage workers in manufacturing, transportation and construction are eligible for the scheme, and some states have also expanded it to include employees of retail, hospitality and publishing businesses, as well as those working in medical and private institutions. Employers of non-seasonal companies with 10 (20 in certain states) or more employees have the responsibility to register workers in the ESIC scheme.

Currently, the ESIC scheme does not cover workers or employees who earn more than Rs. 21,000 per month, and for persons with disabilities, the maximum monthly salary is Rs. 25,000.

How is the contribution made in the ESI scheme?

Employees are required to contribute 0.75 percent of their monthly salary, while employers must contribute 3.25 percent of the employee’s salary. Within a per capita limit of Rs. 1,500 per insured per year, state governments contribute 1/8th of the cost of medical coverage.

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Employers must deposit their fees with the company within 15 days from the end of the calendar month. The ESIC portal accepts online payments for these deposits. State Bank of India and some other public sector banks have been given permission by the company to accept the money.

What are the benefits of ESI scheme?

The scheme covers the insured’s medical expenses through affordable and reasonable healthcare services. Coverage begins on the person’s first day of work. This applies to both policyholders and their dependents.

During the maternity period, the beneficiary is entitled to receive 100 percent of her daily salary for a maximum of 26 weeks, with the possibility of an additional month based on a doctor’s recommendation. The benefit lasts six weeks in cases of spontaneous abortion and twelve weeks in cases of adoption.

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If a worker is temporarily disabled, they will be entitled to a monthly income of 90 percent while they recover. It will be possible to access 90 percent of the monthly salary for the rest of your life in case of permanent disability.

Beneficiaries do not have to worry about changing jobs because the insured’s situation is not affected by the change of job and their insurance number will remain the same. Therefore, the member can still contribute to the health insurance based on whether the new employer is registered with the ESIC.

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Important life insurance terms you should know

First published: December 24, 2022, 11:17 am IST

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