Employees’ State Insurance Corporation or ESIC is a statutory social security bodies under the ownership of Ministry of Labour and Employment, Government of India.
ESIC provides financial assistance to employees who suffer from illness or injury due to accidents at workplace. The scheme also helps employers to provide better working conditions and safety measures.
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Who is eligible for ESI scheme?
The Employee State Insurance Corporation was originally intended for factory workers but later became applicable to all establishments having 10 or more workers fulfilling certain criterias.
Employees covered under the ESI act are those who work in factories, establishments and organisations such as hotels, road transport, cinemas, educational or medical institutions, shops, wherein 10 or more persons are employed. Maharashtra and Chandigarh have the threshhold as 20 employees instead of 10.
Employees or workers with a monthly salary upto Rs 21,000 per month are eligible for the scheme. The scheme also covers dependents of the eligible members.
Worry not, if you are inelgible for employee state insurance because your monthly salary is more than Rs 21,000 , you will be covered by group health insurance by your organisation.
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What are the benefits of ESIC?
ESIC provides financial assistance to employees suffering from sickness, accident, disablement, or death due to occupational hazards. It also helps them meet the cost of treatment of dependents.
- Medical treatment
This also covers funeral costs, confinement costs, vocational rehabilitation, physical rehabilitation and old age medical care.
How does ESIC work?
If a business employes 10 or more workers (20+ in Maharashtra/Chandigarh), ESI registration is mandatory. Employees who suffer from any kind of injury while at work can apply for compensation under ESIC.
Pehchan Card is an ID card to avail benefits of the ESI scheme at empanelled hospitals. To dowbload the ESI Pehchan Card, employer needs to login into their account on the ESIC portal and fill the respective employee or worker’s details. Then a magnetic smart card for the workers is issued.
e-Pehchan card can also be downloaded directly from the portal.
How much does Employee State Insurance cost?
The ESI contribution : Employees contribute 1.75% of their salary while the employer contributes 4.75% for the ESI scheme. Those workers whose daily average wage is up to Rs. 50 are exempted from contributing to the scheme.
How to apply for ESI?
You can check the complete details on how to register on the ESI portal here.
Does the ESI Insurance scheme cover family members?
Yes, you can add the following family members for the medical benefits in the scheme :
- Minor Dependent Son Up to 25 Years
- Dependant Unmarried Daughter Up to 25 Years
- Dependant Infirm Son
- Dependant Infirm Unmarried Daughter
- Dependant Father
- Dependant Mother
- Minor Brother ( When there are no parents)
- Minor Sister (When there are no parents)
What else is covered under the employee state insurance scheme?
Apart from the medical benefits, ESI also covers some benefits like :
- Maternity benefits
- Temporary Disablement Benefit
- Permanent Disablement Benefit
What is salary for ESIC?
Rs. 21,000 is the threshold for wages under the Employees State Insurance Act, 1948.
How can I check my ESIC details?
- Login to ESIC portal with your username and password
- Navifate to Revenue -> Monthly Contributions -> View History
- Enter your employer code and the time period you want data for.
- Click on View to see your state insurance details
How to check ESIC status?
Which hospitals are covered under ESIC?
You can check the list of hospitals covered by ESIC here
Can I claim ESI in private hospital?
Yes, you person can claim private hospital bills by submitting ESI reimbursement form but you don’t get exact bill amounts, because bills will be cleared as per government hospital rates.
Can I continue ESI after I leave my job?
Yes, Employee State Insurance’s benefits will be valid till next contribution after resignation. ESI card will be valid till they contribute the next contribution or upto six months.
Is ESI mandatory?
Yes, for the organsisations that have 10 or more employees, ESI is mandatory for employees making less than Rs 21,000 per month.