ESIC Scheme 2024- Employee State Insurance Scheme Benefits, Eligibility, Features

The Employees State Insurance Corporation administers the ESIC Scheme, which serves as a social security and health insurance initiative. Enacted in 1948 by the Government of India, the Employees State Insurance Act was a significant step to enhance social security for workers in post-independence India.

ESIC Scheme 2024

The legislation aimed to provide a safety net for the growing workforce in manufacturing sectors, which expanded rapidly during the 1950s industrial revolution. Its primary objective was to ensure the well-being of employees, particularly in times of health-related emergencies.

The program offers various benefits, such as 26 weeks of maternity coverage, structured payouts in unfortunate circumstances, and three years of unemployment insurance, contributing to the overall welfare of workers.

About ESIC Scheme 2024

The ESIC Scheme in 2023 represents a comprehensive social security initiative designed to safeguard individuals employed in the organized sector and their dependents. This multifaceted program offers financial assistance for medical emergencies arising from industrial risks, illnesses, or pregnancy.

Oversight and management of the integrated ESIC Scheme fall under the jurisdiction of the Employee State Insurance Corporation. The scheme operates in accordance with the Employees’ State Insurance Act, which mandates that every employer ensures the enrollment of new employees in this program.

Objectives Of The ESIC Scheme

The main objective of the ESIC Scheme by the Government of India is to safeguard employees against specific health-related uncertainties, including permanent or temporary disability, illness, or death resulting from occupational diseases or injuries. These incidents may diminish an employee’s earning capacity or lead to income loss.

The scheme is designed to help employees alleviate the financial burden arising from such unfortunate situations. Additionally, the program extends maternity benefits to its beneficiaries, contributing to the overall well-being and security of the workforce.

The Employees’ State Insurance Act of 1948

The Employees’ State Insurance Act of 1948, commonly referred to as the ESI Act, holds historical significance as the inaugural piece of social security legislation enacted by the Parliament of India post-independence. This act serves as the foundation for the Employees’ State Insurance (ESI) Scheme, providing medical insurance and essential benefits to workers and employees across various sectors. Applicable to factories, business establishments, and diverse organizations such as hotels, road transportation, cinemas, newspapers, educational or medical institutions, and shops, the ESI Act covers workplaces where a minimum of 10 people are employed.

In the unfortunate event of work-related contingencies, the ESI system extends benefits to both workers and their dependents. Eligibility for this social security program, governed by the ESI Act, encompasses employees or workers engaged in the aforementioned categories with a monthly income of up to Rs. 21,000. The overarching aim of the ESI Act is to shield individuals from the adverse effects of poverty, squalor, and social degradation, preserving their dignity during times of crisis.

Features of the ESIC Scheme

The ESIC Scheme encompasses several key features designed to provide comprehensive social security coverage. Here are some of its notable features:

1. Coverage Criteria: All employees with a monthly salary of Rs. 21,000 or less are intended to be covered by the Employee State Insurance Scheme.
2. Contribution Structure: Employers contribute 3.25% of the payroll, and employees contribute 0.75%. The government, in 2019, reduced the overall contribution from 6.5% to 4%. Employees earning less than Rs. 137 per day are exempt from their contribution.
3. Medical Benefits: The insured and their dependant family members are eligible for medical benefits for specified conditions.
4. Timely Contribution: Employers are required to pay any overdue contributions within the first 21 days of the month.
5. Government Support: State governments are obligated to cover 1/8th of all medical costs, up to Rs. 1500 per person, under the ESI program.
6. Continued Benefits: Even if an insured person opts for early retirement or is enrolled in the Voluntary Early Retirement Scheme (VRS), they continue to receive benefits.
7. Medical Education Promotion: The program encourages the establishment of more medical schools to enhance patient care.
8. Unemployment Benefits: Individuals without a job can receive benefits from the program for up to three years, provided they submit relevant documents, including a dismissal letter from their previous employer.
9. Maternity Benefits: Female employees receive additional perks during pregnancy. They can extend their 26-week maternity leave by up to one month without compromising their pay slab.
10. Coverage for Work-Related Travel Accidents: The scheme takes into account accidents that occur while traveling due to work-related risks.

These features collectively contribute to the overarching goal of the ESIC Scheme, which is to provide financial and medical support to employees and their dependents during various contingencies.

ESIC Scheme Benefits

The ESIC scheme offers a range of benefits to ensure the well-being of covered individuals. Here are some key benefits:

1. Medical Benefits:
   • Affordable and reasonable healthcare facilities cover the insured’s medical costs.
   • Coverage begins from the start of the employee’s employment.
2. Disability Benefits:
   • Temporary Disability: Individuals experiencing temporary disability receive 90% of their monthly wage during the recovery period.
   • Permanent Disability: In the case of permanent impairment, 90% of the monthly salary can be availed for the rest of the individual’s life.
3. Maternity Benefits:
   • The beneficiary is entitled to 100% of the daily pay for up to 26 weeks during maternity leave.
   • Maternity leave can be extended by an additional month based on a doctor’s recommendation.
   • Benefits also extend to six weeks in cases of miscarriage and twelve weeks in cases of adoption.
4. Dependents Benefits:
   • Insured individuals’ dependents receive financial support in the event of illness or accidents at work.
   • Monthly payments are provided to dependents in such cases, with equal distribution among surviving dependents.
5. Unemployment Benefits:
   • In the event of injury-related permanent disability or involuntary job loss, the program offers up to 50% of the average monthly wage.
   • This benefit is provided for a maximum of 24 months.
6. Sickness Benefits:
   • Cash flow is provided during a medical leave of absence.
   • The employee is eligible to receive 70% of the daily wage for up to 91 days during two consecutive periods.

These benefits collectively contribute to the financial and medical security of employees covered under the ESIC scheme, addressing various contingencies such as medical emergencies, disabilities, maternity needs, and unemployment.

Employees State Insurance Scheme Contribution Rates

ESIC Scheme Contribution Period

Eligibility for Employees State Insurance Scheme

To be eligible for the Employee State Insurance (ESI) Scheme, individuals must meet the following criteria:

1. Employment in a Non-Seasonal Business:
   • The individual must be employed by a non-seasonal business. Seasonal businesses are typically excluded from the coverage of the ESI Scheme.
2. Minimum Workforce Size:
   • The business or establishment where the individual is employed must have a minimum workforce size of 10 or more employees. The ESI Scheme is generally applicable to workplaces that meet this criterion.
3. Minimum Monthly Income:
   • The employee should have a monthly income of at least Rs. 21,000. This income threshold is used to determine eligibility for coverage under the ESI Scheme.

Documents Required

The ESIC scheme typically requires specific documents for enrollment and compliance. Here is a list of documents commonly required:

1. Certificate of Registration (for Partnership or Company):
   • This certificate establishes the legal status of the business entity.
2. Registration Certificate under the Shops and Establishment Act or Factories Act:
   • Documentation proving compliance with local labor laws.
3. List of All Employees:
   • A comprehensive list of all employees working in the establishment.
4. Articles of Association and Memorandum of Association:
   • Legal documents outlining the company’s structure and purpose.
5. PAN Card Details:
   • PAN details of both the business entity and all employees.
6. Compensation Details of Employees:
   • Information regarding the compensation or salary details of all employees.
7. List of Shareholders and Directors:
   • Details of individuals holding shares and the directors of the company.
8. Canceled Cheque:
   • A canceled cheque from the company’s bank account for verification purposes.
9. Employer’s Registration Form (Form No.1):
   • This form, available online, needs to be downloaded, filled, and uploaded on the ESIC website. It typically includes basic information about the employer.
10. Attendance Register:
    • A register containing attendance details of the employees.

Steps to Register For The ESIC Scheme

The steps you provided outline the process for registering for the ESIC scheme. Here’s a summarized version for clarity:

1. Visit the Official Website:
   • Go to the official website of ESIC: https://esic.gov.in/.
2. Sign-Up:
   • Click on the “Sign-Up” button on the homepage.
3. Fill Sign-Up Form:
   • Complete the sign-up form with required details such as name, mobile number, employer’s name, email ID, region, and state.
   • Confirm company details by selecting the checkbox.
4. Submit and Receive Credentials:
   • Click “Submit” to receive login credentials on your email ID.
5. Login:
   • Log in to the ESIC portal using the provided credentials.
6. New User Registration:
   • Click on “New User Registration” after successful login.
7. Enter Company Details:
   • Enter the unit name, factory address, and nearest police station details.
   • Provide information about the nature and category of the business.
8. Business Commencement Details:
   • Enter the date of business commencement.
   • Select the constitution of ownership and ownership details.
9. Employee Details:
   • Enter the total number of employees and those earning less than Rs. 21,000 per month.
   • Provide the date of hiring the first ten employees.
10. Employee Declaration:
    • Complete the Employee Declaration Form, including details of the insured person (IP).
11. Select ESI Branch Office:
    • Choose the ESI branch office and inspection division.
12. Payment:
    • Click “Pay Initial Contribution” and proceed to make the payment.
    • Continue and complete the payment process.
13. Registration Completion:
    • After successful payment, the registration process is complete.

Steps to Login on the ESIC Portal

1. Visit the Official Website:
   • Go to the official website of ESIC: https://esic.gov.in/.
2. Access Employee/Insured Login:
   • Click on the “Employee/Insured Login” option on the homepage.
3. Enter Login Credentials:
   • Enter your login ID, password, and the captcha code provided.
4. Click on Login:
   • Finally, click on the “Login” button to access your registered account.

Contact Details

If you have any queries related to the ESIC Scheme, you can contact the Employees’ State Insurance Corporation using the following details:

ESI Head Office:

• Address: Panchdeep Bhawan, Comrade Indrajeet Gupta (CIG) Marg, New Delhi – 110 002

Phone Numbers:

• 011-23234092
• 23235496
• 23234093
• 23234098
• 23236998
• 23236051
• 23235187

Medical Helpline:

• 1800-11-3839

Toll-Free/Help Desk Number:

• 1800-11-2526

E-Mail Address:

• For IT Related Issues: itcare@esic.nic.in
• For Grievances/Suggestions: pg-hqrs@esic.nic.in

Feel free to reach out to these contact points for assistance or information regarding the ESIC Scheme.