The Employee State Insurance Corporation (ESIC) is a significant social security organization in India established to provide comprehensive benefits to workers and employees in the organized sector and their dependents. Set up under the ESI Act of 1948, ESIC aims to safeguard employees against financial distress during times of illness, maternity, disablement, or death due to employment-related injuries.
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Employers and employees contribute to the ESIC fund, and in return, covered individuals gain access to a range of medical, cash, and other benefits. ESIC operates a vast network of hospitals, dispensaries, and medical facilities across the country, ensuring that insured individuals receive quality healthcare services.
What is Employee State Insurance Corporation (ESIC) Scheme?
The ESIC, meaning “Employees State Insurance Corporation,” is an important social security program in India. It aims to provide protection and healthcare benefits to employees and their families. The abbreviation ESI stands for “Employees’ State Insurance.”
The main purpose of ESIC is to ensure the well-being of workers by offering a comprehensive program that covers medical, maternity, and disability benefits. Employees and their dependents who are eligible for ESIC can access essential healthcare services at hospitals and clinics that are empanelled with ESIC. This coverage is crucial in providing medical treatment, hospitalization, and other necessary healthcare services.
In simple terms, ESIC is a program that ensures employees in India have access to healthcare and financial assistance when they need it. It helps protect their well-being and provides support for their families.
ESI Benefits and Features
| Feature | Benefit |
|---|---|
| Medical Coverage |
|
| Unemployment Protection |
|
| Maternity Benefits |
|
| Dependent Coverage |
|
| Physical Rehabilitation | Support for rehabilitation, especially for workplace injury-related disabilities. |
| Vocational Rehabilitation |
|
| Sickness Assistance |
|
| Funeral Expenses Coverage |
|
| Confinement Costs Assistance | Assistance for confinement costs if required medical care is unavailable locally. |
| Disability Support |
|
| Immediate Coverage | Coverage from the first day of employment for employees, workers, and dependents. |
| Old Age Medical Care | Annual payment of Rs. 120 for insured individuals and their spouses upon retirement or departure due to disability or voluntary retirement schemes. |
Also Read: Step-by-Step Process to Make ESIC Payment Online
Document Requirements for ESIC Registration
| Document | Description |
|---|---|
| Registration Certificate | Obtain under either the Factories Act or the Shops and Establishment Act. |
| Certificate of Establishment | Includes documents like the Company Registration Certificate or Partnership Deed. |
| GST Certificate | Provide proof of Goods and Services Tax (GST) registration for your establishment. |
| Memorandum of Association and Articles of Association | Applicable primarily to companies registering under ESIC. |
| Address Proof | Submit utility bills, rental agreements, or property tax receipts for your establishment as address proof. |
| Employee List | Compile a comprehensive list of all employees within your establishment. |
| PAN Cards | Include PAN cards for both the business establishment and its employees. |
| Compensation Details | Provide information regarding compensation for all employees. |
| Cancelled Company Bank Account Check | A cancelled check from your company’s bank account. |
| Lists of Directors and Shareholders | Important for companies registering under ESIC. |
| Employee Attendance Register | Maintain a record of employee attendance within your establishment. |
What Is the ESIC Coverage Limit Based on an Employee’s Monthly Wage?
ESIC benefits are for employees earning up to ₹21,000 monthly. This includes health insurance and other social security perks from ESIC. Keep in mind that this limit might change, so check the ESIC website or contact them for the latest info on coverage limits.
ESIC Eligibility for Registration
| ESIC Registration Criteria | Details |
|---|---|
| Employee Count | More than 10 employees (some states: 20 employees) |
| Salary Limit | Maximum monthly salary of Rs. 21,000/- |
| Mandatory Registration | Within 15 days from the date of applicability |
| Contribution Requirements | Employer Contribution: 3.25% of total monthly salary payable to each employee-Employee Contribution: 0.75% of monthly salary throughout the year |
| Exemption | Employees earning less than Rs. 176/- per day |
Here is the detailed eligibility criteria:
- Employee Count: The establishment, which can be a non-seasonal factory or any other business entity, must have more than 10 employees (in some states, this threshold is 20 employees).
- Salary Limit: Employees within the establishment must have a maximum monthly salary of Rs. 21,000/-. Those earning above this limit are not covered under the scheme.
- Mandatory Registration: If the establishment meets the above criteria, it is mandatory to register with the Employees State Insurance Corporation (ESIC) within 15 days from the date of applicability.
Under the ESIC scheme, there are contribution requirements for both employers and employees:
- Employer Contribution: Employers must contribute an amount equal to 3.25% of the total monthly salary payable to each employee.
- Employee Contribution: Employees are expected to contribute 0.75% of their monthly salary every month throughout the year.
However, it’s important to note that employees earning less than Rs. 176/- per day are exempt from making their contribution to the scheme.
Note: If a company or organization employs 10 or more individuals, the owner or employer is required to register it with the Employees State Insurance Corporation (ESIC). This registration ensures compliance with ESIC regulations and provides social security benefits to the employees.
What is Included Under the Employees’ State Insurance Scheme Coverage?
The Employees’ State Insurance Scheme (ESIS) was first introduced in 1952 in places like Kanpur and Delhi. Over time, as more factories and businesses popped up across India, this scheme became available everywhere.
Now, this scheme includes almost 12 lakh factories and businesses, helping more than 3 crore workers and their families. ESIC benefits for family members are a crucial part of this scheme. Currently, it provides support to over 13 crore people. Here’s a quick breakdown as of March 31, 2019:
- People Covered: About 3.49 crore individuals and families
- Employees: Approximately 3.14 crore workers
- Beneficiaries: Over 13.32 crore people
- Women Covered: Around 51.20 lakh
- Employers and Others: About 12.11 lakh
This scheme is like a safety net for many workers and their families, providing them with financial support and security across India.
How to Register for Employee State Insurance Corporation Schemes
Begin by logging into employer login ESIC Portal.
- Enter necessray details and submit
- You’ll receive a confirmation email containing your username and password.
- Use your new credentials to log in to the ESIC Portal.
- Click ‘New Employer Registration.’
- Choose your unit type and click ‘Submit.’
- Provide your company, employer, and employee information.
- Click ‘Submit’ to send the completed form.
- Make a payment covering six months of registration.
- After successful payment, you’ll get a Registration Letter (C-11) with a 17-digit Registration Number. This confirms your employer registration.
How to Apply for Employee State Insurance Card?
- Log in to the ESIC Portal using your username and password.
- Find the ‘Employee’ section on the new page and click on ‘e-Pehchan Card.’
- Choose the unit details you want to view.
- You’ll see details of all employees, but you can narrow down the search by entering the employee’s insurance number and name.
- Select ‘View Counter Foil,’ which represents the ‘e-Pehchan’ card, against the respective employee.
- Scroll down on the new page and click on ‘Print’ to download it as a PDF document.
- The respective employee should sign the card and affix family or dependents’ photographs. Either the employer or the ESIC official must attest and stamp these photos.
- Make sure the e-Pehchan Card bears the signature and stamp of the employer or the ESIC office.
How to Check EPF Claim Status?
- Open the UMANG App or download it if not already installed.
- Enter the required IP number or ESIC Insurance Number.
- Verify with the OTP received.
- Access the ‘Claim Status’ under services.
- Review the status of your claims or use advanced search for specific details.
List of Hospitals Under Employee State Insurance Corporation Schemes
The Employee State Insurance Corporation (ESIC) has a vast network of empanelled hospitals and dispensaries across India. The list of these healthcare facilities is extensive and constantly evolving. To access the most up-to-date and comprehensive information on the hospitals and dispensaries under the ESIC scheme, it is advisable to visit the official ESIC portal.
List of empanelled hospitals by ESIC: https://www.esic.gov.in/ssts
ESIC Headoffice and Helpline Number
Address: Panchdeep Bhawan, Comrade Indrajeet Gupta (CIG) Marg, New Delhi – 110 002
Phone Numbers:
- 011-23234092
- 011-23234093
- 011-23235496
- 011-23234098
- 011-23236051
- 011-23236998
- 011-23235187
Toll-Free/Help Desk Number: 1800-11-2526
Medical Helpline: 1800-11-3839
E-Mail Addresses:
- For Grievances/Suggestions: [email protected]
- For IT Related Issues: [email protected]
What is ESIC 2.0?
In 2015, the Employees State Insurance Scheme (ESIC) embarked on a series of healthcare reform initiatives, collectively referred to as ESIC 2.0, under the guidance of Hon’ble Prime Minister Shri Narendra Modi. These initiatives aimed to enhance and modernize the ESIC healthcare system. Here are the key components of these reforms:
- Online Availability of Electronic Health Records (EHR):
- Implementation of EHR to provide ESI Holders with convenient online access to their health records.
- Medical Helpline:
- Introduction of a medical helpline (1800-11-2526) to offer immediate medical assistance and guidance to beneficiaries.
- Special OPD:
- Establishment of Special Outpatient Departments (OPD) to cater to specific medical needs more efficiently.
- Regular Inspection by Hon’ble Member of ESIC:
- Instituting regular inspections by Hon’ble Members of ESIC to ensure the smooth functioning of ESIC and ESIC-affiliated hospitals.
- VIBGYOR – Operation Indradhanush:
- The VIBGYOR initiative, also known as Operation Indradhanush, was launched to ensure a comprehensive and colorful spectrum of healthcare services.
- Creation of Specialties (CT, ICU, MRI, CAT-Labs, Dialysis):
- Expanding healthcare capabilities by introducing specialized services like CT scans, ICU facilities, MRI, CAT-Labs, and Dialysis units.
- Behavioral Training and Specialized Care:
- Training programs for healthcare professionals, including doctors and para-medical staff, in areas such as behavioral healthcare.
- Establishment of specialized hospitals for child and maternal care.
- Implementation of queue management systems for improved patient flow.
- Introduction of “May I Help You” counters to assist beneficiaries.
- Quality Control on Drugs and Medicines:
- Implementation of stringent quality control measures for drugs and medicines to ensure the safety and efficacy of treatments.
- Pathological and X-Ray Services in PPP Model:
- Collaboration with the private sector through Public-Private Partnerships (PPP) to enhance pathological and X-ray services.
Employee’s State Insurance Corporation (ESIC) plays a pivotal role in ensuring the well-being and financial security of employees and their families in India. By offering comprehensive healthcare coverage, financial assistance during periods of illness, maternity benefits, and various other social security measures, ESIC has emerged as a crucial pillar of support for the workforce.
