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

~ PMUY Admin

The ESIC Scheme is a social security and health insurance scheme run by the Employees State Insurance Corporation. The Employees State Insurance Act, of 1948 was enacted by the Government of India through the Parliament to strengthen the social security for workers in independent India. To speed up manufacturing processes, manufacturing sectors started hiring many workers during the industrial revolution of the 1950s. The purpose of the legislation was to give these numerous employees a security mechanism, particularly in the event of health-related emergencies. A few of the many benefits offered by this program include maternity coverage for 26 weeks, staggered payouts in the event of an unfortunate event, and three years of unemployment insurance.

ESIC

About ESIC Scheme 2024

The Employee State Insurance Scheme, a multidimensional social security program, aims to provide socio-economic protection to people working in the organized sector and their dependents. Individuals can take use of financial support via this insurance plan for medical emergencies brought on by industrial dangers, illness, or pregnancy. The Employee State Insurance Corporation is the corporate entity in charge of managing this integrated ESIC Scheme. The Employees’ State Insurance Act, which mandates that every business make sure a new employee is enrolled in this program, is what governs this scheme.

ESIC Online Payment

Details of Employees State Insurance Scheme

Name ESIC Scheme
Managed by Employees State Insurance Scheme
Objective lessen the financial strain brought on by health-related contingencies
Beneficiaries Employees
Official Website https://esic.gov.in/

ESIC Scheme Objective

The primary goal of the Government of India’s ESI scheme is to protect employees from certain health-related contingencies, such as permanent or temporary disability, illness, or death due to an occupational disease or injury, which reduces the employee’s ability to earn a living or results in income loss. This program enables employees to lessen the financial strain brought on by such sad circumstances. The program also provides its beneficiaries with maternity benefits.

ESIC Scheme Act, 1948

The Employees’ State Insurance Act, of 1948, often known as the ESI Act, was published by the Parliament and was the first significant piece of social security legislation passed in the nation after independence. The ESI Act of 1948 offers medical insurance and other necessary benefits to workers and employees who work in factories, business establishments, and organizations like hotels, road transportation, cinemas, newspapers, educational or medical institutions, and shops, where there are at least 10 people employed. In the event of any unlucky circumstances at work, the ESI system provides benefits to both the workers and their dependents. Employees or workers engaged in the aforementioned categories and earning up to Rs. 21,000 per month are eligible for this social security program under the ESI Act. The ESI Act strives to safeguard people from poverty, squalor, and social degradation to uphold their dignity during times of crisis.

ESIC Atal Bimit Vyakti Kalyan Yojana

Features of the ESIC Scheme

Some of the key features of the ESIC scheme are as follows:

  • All employees receiving a salary of less than or equal to Rs. 21,000 per month are intended to be covered by the Employee State Insurance Scheme.
  • Employers are currently required to contribute 3.25% of payroll, and employees are required to contribute 0.75%. In 2019, the government decreased the overall payment from 6.5% to 4%. Be aware that employees are excused from paying their part if their daily wages are less than Rs. 137.
  • The insurer and their dependant family members may receive medical benefits for certain conditions.
  • Within the first 21 days of the month, employers must pay any overdue contributions.
  • Under the ESI program, state governments are required to cover 1/8th of all medical costs up to Rs. 1500 per person.
  • Even if an insured person chooses to retire early or is enrolled in the VHS plan, the plan will still provide benefits to them.
  • The program promotes the establishment of more medical schools to help improve patient care.
  • For up to three years, even a person without a job can continue to receive benefits from the program. However, they must include their letter of dismissal and other relevant information about their previous employer.
  • When experiencing issues related to pregnancy, female employees are eligible for additional perks. Without compromising their pay slab, they are permitted to extend their 26-week maternity leave by a maximum of one month.
  • This plan takes into account accidents that occurred while traveling due to work-related risks.

ESIC Scheme Benefits

Some of the key benefits of the ESIC scheme are as follows:

  • Medical: As part of the plan, inexpensive and reasonable healthcare facilities pay the insured’s medical costs. Additionally, the worker or employee is protected from the start of their employment.
  • Disability: If a worker experiences a temporary disability, they are entitled to a 90% monthly wage while they recover. 90% of the monthly salary may be used for the rest of one’s life in the event of a permanent impairment.
  • Maternity: The beneficiary of the program is entitled to 100% of the daily pay for up to 26 weeks, which may be extended by 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.
  • Dependents: Under the plan, the insured’s dependents are provided with financial support if they become ill or sustain accidents at work. Dependents are qualified for monthly payments in such cases, which are split evenly among the surviving dependents.
  • Unemployment: The program provides up to 50% of the average monthly wage for a maximum of 24 months in the event of an injury-related permanent disability or involuntary loss of a job.
  • Sickness: The plan provides cash flow during a medical leave of absence. For a total of 91 days, the employee is eligible to receive 70% of the daily wage. This is available for two consecutive periods.

Esic Covid 19 Relief Scheme

Employees State Insurance Scheme Contribution Rates

Employee’s Contribution Rate 0.75% of the total wage
Employer’s Contribution Rate 3.25% of the total wage paid to the employees

ESIC Scheme Contribution Period

Tenure Months
Contribution Periods 1st April-30th September 1st October-31st March
Cash benefit Periods 1st January-31st June 1st July-31st December

What Situations Require ESI Registration

A corporation, organization, or business institution must register for ESI if it employs ten or more workers or twenty or more in Chandigarh and Maharashtra. The business needs to register with the ESIC. When workers or employees make less than Rs. 21,000 per month or Rs. 25,000 in the case of a disabled individual, they are eligible for coverage under the ESI. The employee contributes 1.75 percent of their wage, while the company kicks in 4.7 percent, to the ESI program. Please be aware that these prices may occasionally change. Employees with a daily average pay of up to Rs. 50 are excluded from making contributions to the ESI fund, but employers will still make contributions on their behalf.

What Does ESIS Cover

The majority of employed Indian residents are covered by the ESIS.

  • The program has recently been expanded to include restaurants, hotels, stores, cinemas and preview theatres, newspapers, hotels, and road-motor transport companies.
  • As of March 2021, it is available to more than 3.49 crore Indian families and individuals.
  • Private healthcare and educational organizations with ten or more personnel. You should be aware that this only applies to a limited few states and union territories.
  • The government has been informed that ESIS insurance covers restaurants and retail establishments, under Section 1(5).

What ESIS Does Not Cover

The ESIS scheme’s exclusions are as follows:

  • Employees making 21,000 rupees or more a month are not covered by the employee state insurance program.
  • While the remaining states and Union Territories limit coverage under the ESIS program to a maximum of 10 employees, states like Chandigarh and Maharashtra allow up to 20 employees to be covered.
  • Disability-related individuals with monthly incomes of 25,000 rupees or more are not eligible for coverage under ESIS.

Eligibility for Employees State Insurance Scheme

You must meet the following eligibility requirements to apply for the Employee State Insurance Scheme:

  • He or she must be employed by a non-seasonal business with a minimum workforce size of 10 or more.
  • A worker should make at least Rs. 21,000 per month.

Documents Required

The document required for the ESIC scheme are as follows:

  • Certificate of Registration in case of a partnership or a company
  • The Registration Certificate acquired under the Shops and Establishment Act or Factories Act
  • List of all employees working in the establishment
  • Articles of Association and Memorandum of Association of the company
  • PAN Card details of the Business Entity and all employees.
  • Compensation details of all employees.
  • List of shareholders and directors of the company
  • Canceled cheque of the bank account of the company
  • Employer’s Registration Form (Form No.1) which should be downloaded online, filled, and uploaded on the ESIC website along with the above-mentioned documents
  • Register which includes the attendance details of the employees.

Cash Benefits of ESIC Scheme

Benefits Cash Value
Disablement benefit You will be paid 90% of your previous wages for as long as you are temporarily disabled. You will be paid for the remainder of your life on a pro-rata basis for permanent disability
Dependant Benefit You get 90% of the salary
Maternity Benefit For 12 weeks, you are fully compensated
Funeral Benefits Benefits for funerals are granted up to 10,000 rupees
RGSKY for Unemployment In the event of unemployment, you receive 50% of your salary for one year

Steps to Register for ESIC Scheme

To register for the ESIC scheme, the user needs to follow the below-given steps:

  • First of all, go to the official websiteof ESIC i.e., https://esic.gov.in/
  • The homepage of the website will open on the screen
  • Click on the Sign-Up button
  • Sign Up form will open on the screen
  • Now, fill in the form with all the required details like your name, mobile number, employer’s name, email ID, region, and state
  • Select the checkbox to confirm all your company details
  • After that, click on the Submit button and you will receive your login credentials on your email ID
  • Now, login to the ESIC portal using your login credentials
  • Once you are successfully logged in, click on the New User Registration option
  • A new page will open on the screen
  • Now, enter your unit’s name, the address of your factory, and its nearest police station
  • After that, click on the Next button
  • Enter the nature and category of the business
  • Now, enter the date of commencement of the business
  • Select the constitution of ownership and the ownership details
  • After that, enter the total number of employees working in your factory and the number of employees earning less than 21,000 rupees per month
  • Click on the Save button
  • Proceed further and enter the date when the first ten employees were hired in the company
  • Now, click on the Employee Declaration Form
  • After that, enter the name of the IP, date of birth, father’s name, gender, family details, marital status, and date of joining
  • Click on submit button
  • A new page will open on the screen
  • Now, select the ESI branch office and inspection division
  • After that, click on the Submit button
  • Click on the Pay Initial Contribution button
  • Proceed further and click on the Continue button to make the payment
  • After successful payment, the registration process will be completed

Steps to Login on the ESIC Portal

To login into the ESIC Portal, the user needs to follow the below-given steps:

  • First of all, go to the official website of ESIC i.e., https://esic.gov.in/
  • The homepage of the website will open on the screen
  • Click on the Employee/Insured Login option
  • The login page will open on the screen
  • Now, enter your login id, password, and the captcha
  • Finally, click on the Login button to get logged in to your registered account

Contact Details

For any other query related to the ESIC Scheme, feel free to contact at the below given details:

  • ESI Head Office:
    • Employees’ State Insurance Corporation
    • 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