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ESIC Scheme 2022: The Employees’ State Insurance Scheme is an integrated measure of Social Insurance embodied in the Employees’ State Insurance Act and it is designed to accomplish the task of protecting ’employees’ as defined in the Employees’ State Insurance Act, 1948 against the impact of incidences of sickness, maternity, disablement and death due to employment injury and to provide medical care to insured persons and their families. The ESI Scheme applies to factories and other establishments viz. Road Transport, Hotels, Restaurants, Cinemas, Newspaper, Shops, and Educational/Medical Institutions wherein 10 or more persons are employed. However, in some States threshold limit for coverage of establishments is still 20. Employees of the aforesaid categories of factories and establishments, drawing wages up to Rs.15,000/- a month, are entitled to social security cover under the ESI Act. ESI Corporation has also decided to enhance the wage ceiling for coverage of employees under the ESI Act from Rs.15,000/- to Rs.21,000/-.
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ESIC Yojana 2022 – Apply Online
ESI Corporation has extended the benefits of the ESI Scheme to the workers deployed on the construction sites located in the implemented areas under the ESI Scheme w.e.f. 1st August 2015. The ESI Scheme is financed by contributions from employers and employees. The rate of contribution by the employer is 4.75% of the wages payable to employees. The employees’ contribution is at the rate of 1.75% of the wages payable to an employee. Employees, earning less than Rs. 137/- a day as daily wages, are exempted from payment of their share of contribution.
ESIC Scheme 2022 Full Details
ESIC Yojana 2022
Coverage under the ESI Act.
- All nonseasonal factories using power and employing 10 or more persons and non-power using factories employing 20 or more persons are coverable under the ESI Act. The Act. has also been extended to establishments like shops, hotels, restaurants, cinema halls, road motor transport agencies, and newspaper establishments employing 20 or more persons. All employees in such factories and establishments getting wages up to Rs.6500/-P.M. are coverable under the Act.
Section 46 of the Act envisages the following six social security benefits:-
- Medical Benefit: Full medical care is provided to an Insured person and his family members from the day he enters insurable employment. There is no ceiling on expenditure on the treatment of an Insured Person or his family member. Medical care is also provided to retired and permanently disabled insured persons and their spouses on payment of a token annual premium of Rs.120/-
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- System of Treatment
- The scale of Medical Benefit
- Benefits to Retired IPs
- Administration of Medical Benefits in a State
- Domiciliary treatment
- Specialist consultation
- In-Patient treatment
- Imaging Services
- Artificial Limbs & Aids
- Special Provisions
- Reimbursement
Sickness Benefit(SB): Sickness Benefit in the form of cash compensation at the rate of 70 percent of wages is payable to insured workers during the periods of certified sickness for a maximum of 91 days in a year. In order to qualify for sickness benefit, the Insured Person is required to contribute for 78 days in a contribution period of 6 months.
- 1. Extended Sickness Benefit(ESB): SB is extendable up to two years in the case of 34 malignant and long-term diseases at an enhanced rate of 80 percent of wages.
- 2. Enhanced Sickness Benefit: Enhanced Sickness Benefit equal to full wage is payable to insured persons undergoing sterilization for family planning up to 7 days/14 days for Vasectomy and Tubectomy respectively.
- Maternity Benefit (MB): Maternity Benefit for confinement/pregnancy is payable for Twenty Six (26) weeks, which is extendable by a further one month on medical advice at the rate of full wage subject to contribution for 70 days in the preceding two contributions Periods.
- (d) Disablement Benefit:-
- Temporary disablement benefit (TDB): From day one of entering insurable employment & irrespective of having paid any contribution in case of employment injury. Temporary Disablement Benefit at the rate of 90% of wage is payable so long as the disability continues.
- Permanent disablement benefit (PDB): The benefit is paid at the rate of 90% of wage in the form of monthly payments depending upon the extent of loss of earning capacity as certified by a Medical Board.
- (e) Dependants Benefit(DB): DB is paid at the rate of 90% of wage in the form of monthly payment to the dependants of a deceased Insured person in cases where death occurs due to employment injury or occupational hazards.
- In addition, the scheme also provides some other need-based benefits to insured workers.
- Vocational Rehabilitation: To permanently disabled Insured Persons for undergoing VR Training at VRS.
- Physical Rehabilitation: In case of physical disablement due to employment injury.
Organizational Setup
- The Director of the ESI Scheme is the HEAD of the Department and is in overall charge of the Scheme under the administrative control of the Labour and Employment Department. He is assisted by one Joint Director, one Deputy Director, One Assistant Director, One Accounts Officer, One Establishment Officer, four Section Officers, and 55 other staff. Besides one Central medical Store managed by one Deputy Director, one Medical Officer, one Store Manager, one Store Superintendent, and 11 other staff is also functioning in the ESI Directorate. The ESI Dispensaries and Hospitals are grouped under 3 zones(Central, Northern, Southern)each headed by a joint Director-Cum-Superintendent. They also work as Medical Superintendents of the hospitals where they are stationed i.e ESI Hospital, Choudwar, Kansbhal, and J.K.Pur. In addition, there are two Superintendents at ESI Hospital, Bhubaneswar and Brajrajnagar. The Dispensaries are headed by Insurance Medical Officer in charge either in Class-II or Junior Class-I rank. Administrative and financial powers have been delegated to the Joint Directors, Superintendents, and Insurance Medical officer in Charge of smooth management of the Hospitals/Dispensaries.
What Is Employees’ State Insurance Scheme
- The primary objective of the Government of India to launch the ESI scheme is to cover workers from certain health-related contingencies such as permanent or temporary disablement, sickness, death due to employment injury, or occupational disease, which impacts the earning capacity of the worker or leads to loss of income. This scheme enables workers to negate the financial burden due to such unfortunate eventualities. The scheme also offers maternity benefits to the beneficiaries. ESI scheme is a cover for workers which protects them with medical care for the insured and their dependents as well as offers a variety of cash benefits during the loss of wages or disablement. Also, the scheme offers a pension known as a dependent benefit to the family members of the insured person in case of death or injury due to occupational hazards while at work.
When is ESI Registration Required
- If a company/organization/business establishment employs 10 or more employees/workers and in the case of Maharashtra and Chandigarh more than 20 employees ESI registration is required. The company should register itself with the ESIC. As for workers or employees, they are covered or entitled under ESI when they earn less than Rs.21,000 per month and Rs.25,000 in the case of a person with a disability. The worker contributes 1.75% of their salary while the employer contributes 4.75% towards the ESI scheme. Please note that these rates are revised from time to time. Those workers whose daily average wage is up to Rs.50 are exempted from contributing to the ESI fund; however, employers will continue to contribute to these workers.
Documents Necessary For ESI Online Registration
- The Registration Certificate is acquired under the Shops and Establishment Act or Factories Act.
- Certificate of Registration in case of a partnership or a company.
- Articles of Association and Memorandum of Association of the company.
- List of all employees working in the establishment.
- Compensation details of all employees.
- PAN Card details of the Business Entity and of all employees.
- Canceled cheque of the bank account of the company.
- List of shareholders and directors of the company.
- Register which includes the attendance details of the employees.
- Employer’s Registration Form (Form No.1) should be downloaded online, filled, and uploaded on the ESIC website along with the above-mentioned documents.