scorecardresearchESI scheme: From eligibility to benefits, here's all you need to know

ESI scheme: From eligibility to benefits, here's all you need to know

Updated: 24 Dec 2022, 11:17 AM IST
TL;DR.
The primary goal of the ESI scheme is to protect employees from certain health-related contingencies due to an occupational disease or injury. Read below as we discuss the eligibility and benefits of the scheme.
Workers are protected by the ESI scheme, which provides medical treatment for the insured and their dependents as well as a range of monetary benefits for loss of income or disability.

Workers are protected by the ESI scheme, which provides medical treatment for the insured and their dependents as well as a range of monetary benefits for loss of income or disability.

A multi-faceted social security scheme called the Employees' State Insurance Scheme of India (ESIC) was created to offer socio-economic security to employees in the organised sector. The Employees' State Insurance Corporation is the statutory body that oversees the ESI scheme.

The primary goal 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 an occupational disease or injury, which reduce the employee's ability to earn a living or result in income loss. This initiative helps employees reduce the financial strain brought on by such sad circumstances.

Workers are protected by the ESI scheme, which provides medical treatment for the insured and their dependents as well as a range of monetary benefits for loss of income or disability. Additionally, in the event that an insured person passes away or is injured at work owing to occupational risks, the plan provides dependant benefits, often known as pensions.

Who is eligible under the 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 in retail, hospitality, and publishing businesses as well as those working in private and medical institutions. Employers of non-seasonal enterprises with 10 (20 in certain states) or more employees have a responsibility to register workers in the ESIC scheme.

Currently, the ESIC scheme does not cover workers or employees making more than Rs. 21,000 per month, and for disabled individuals, the monthly maximum salary is Rs. 25,000.

How is the contribution made under the ESI scheme?

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

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

What are the benefits of the ESI scheme?

The scheme covers the insured's medical expenditures through economical and reasonable health care services. Coverage begins on the individual's first day of employment. This applies to the insured as well as their dependents.

For the duration of the maternity period, the recipient is eligible to receive 100 percent of their daily pay for up to 26 weeks, with the possibility of an additional month depending on a doctor's recommendation. The benefit lasts for six weeks in cases of miscarriage and twelve in those of adoption.

If a worker is temporarily disabled, they are entitled to a 90 percent monthly income while they recuperate. 90 percent of the monthly salary may be accessed for the rest of one's life in the event of a permanent disability.

Recipients don't need to worry about the change in employment because the insured person's status is unaffected by changing jobs, and his or her insurance number will stay the same. Therefore, the member may still make contributions to the health insurance scheme depending on whether the new employer has registered with the ESIC.

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First Published: 24 Dec 2022, 11:17 AM IST