Your‌ ‌Quick‌ ‌Guide‌ ‌to‌ ‌ESI‌ ‌Scheme‌

If you are confused about the ESI scheme, this blog can be a great read for you. 

Let’s dive in. 

Understanding ESI scheme

ESIC stands for Employees’ State Insurance Corporation. 

ESIC provides medical hospitalization facilities in ESIC recognized hospitals, nursing homes/dispensaries, etc., at concessional rates or free of cost to employees and their families insured under the ESI scheme (including self and dependents). 

Calculating ESIC is easier using payroll management software.

The establishment charges, such as bed charges, consultation fees, etc., are inclusive of maintenance charges like food and lodging are covered under this scheme.

It is an insurance plan that works towards securing this right. It has around 30 lakh subscribers and provides medical care to eligible dependents.

 

The History of ESI Scheme

The ESIC scheme came into existence with the ESIC act in 1952.

The ESIC act passed by the parliament of India enables the ESIC to provide medical coverage for unorganized workers who are employed in private establishments and earn less than Rs 21000 per month.

The scheme covers around 93 of the Indian workforce, which constitute 491 million people, according to 2011 census data. ESIC hospitals were set up across the country by setting up regional branch offices under ESIC HQ at Delhi city.

Since its inception, ESIC has provided medical benefits to employees working under ESIC’s ambit like Workmen’s Compensation Medical Benefit (WCMB), Maternity Benefits (MB), and ESIC Mediclaim Scheme.

ESIC has been instrumental in providing medical benefits to the unorganized sector of the workforce, which is categorized as “Below Poverty Line” (BPL). 

ESI services include:

  • Injury compensation
  • Maternity benefit
  • Medical reimbursement
  • Sickness benefit
  • Accident benefit.

ESIC hospitals aim at providing the free best quality of healthcare to BPL workers and ESIC members whose monthly income does not exceed Rs 21000.

In addition to this, ESIC provides medicines, tests, X-rays investigations, daycare procedures at 50% discounted rates to all its beneficiaries. 

 

How can the ESI scheme benefit employees?

The top benefits of the ESI scheme are:

  • The ESIC scheme provides support to its members and their dependants, who suffer from an illness or accident, through cash benefits 
  • ESIC can also pay certain costs directly related to their health needs, including the cost of medicines.
  • When a temporary incapacity for work has reached 26 weeks, the scheme can provide an allowance linked to previous earnings for those who have made sufficient social security contributions.

 

Latest Updates

  • ESIC plans to provide ESIC medical cards to all its beneficiaries who can avail ESIC benefits across all empanelled ESIC hospitals.
  • ESI scheme has been popularizing healthcare awareness among BPL employees, especially women through education on family planning methods by providing free tests, treatment to eligible beneficiaries. 
  • ESIC plans to implement a Maternity Benefit Scheme without contribution deduction where female members can get cash benefits for six weeks before delivery and eight weeks after childbirth.

 

What are the documents required for ESI registration?

Every employee who has worked for 240 days in the last one year is eligible to avail of ESIC medical facilities.

ESIC registration can be done by visiting ESIC Seva Kendra (E-SKK).

The necessary documents required to register one’s self under ESIC are:

  • An application form duly filled and signed by the employee concerned.
  • Proof of Identity: A photocopy of any of the following documents– PAN Card, Passport, Photo Credit Card, Voter ID card, Aadhaar Card, Driving License, etc. If an individual does not possess any of these IDs, s/hhe can apply for a ‘Letter of Identification’. 
  • A photocopy of your work permit (if you are employed on contract).
  • Evidence of employment: Details of the employer, designation, salary drawn, etc., along with a salary slip for the last three months (current salary slip will suffice even if it is for a period beyond ESIC claim).
  • ESIC claim form duly filled and signed by the employee concerned.

That’s all you should know about the ESI scheme. Now that you have enough knowledge, be confident the next time anyone asks you about the same. 

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