Employee State Insurance Corporation Scheme

• Enjoy options to cover yourself, your spouse, kids and even your parents
• Enjoy access to 10,000+ hospitals for cashless treatment
• Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

This scheme was created with the objective to provide protection against sickness, disablement, maternity, etc. to employees of the organised sector. This social security scheme provides complete medical care to all employees who are registered under the Employees’ State Insurance Act, 1948. It is a multi-dimensional scheme that provides financial assistance to the members of the employee’s family in case of his/her death or a certain predetermined benefit if he/she is absent from work due to sickness or disablement.

Eligibility for Employee State Insurance Corporation Scheme

The scheme is applicable to factories and other establishments where the following conditions are met:

• At least 10 members are employed for road transport, hotels, cinemas, newspaper, shops, educational/medical institutions. This limit is 20 in certain states.
• Employees whose wages are Rs.15,000 per month are eligible for this scheme.

Features of Employee State Insurance Corporation Scheme

This scheme was introduced for socio-economic welfare of the employees and hence is designed in a way that the employees can reap maximum benefits.

• The employer as well as the employee contribute towards the scheme. While the employer’s contribution is 4.75% of the wages payable, the employee’s contribution is 1.75% of the wages payable. However, employees whose wages are lesser than Rs.137 per day need not pay the employee contribution.
• The contribution of the state government towards this policy is 1/8th of the medical benefit expenditure. The limit for such contributions is Rs.1,500 per person.
• The employer is expected to pay his/her share of the contribution and deduct the employee’s contribution as per the rates mentioned.
• The employer is required to pay the contribution within 21 days of the month when the contributions are due.
• The scheme has two contribution periods and two cash benefit periods:

• Contribution period

• April 1 to September 30
• October 1 to March 31

• Cash benefit period

• January 1 to June 31
• July 1 to December 31

Benefits of Employee State Insurance Corporation Scheme

The Employees’ State Insurance Corporation provides an array of benefits as mentioned below:

Employee State Insurance Card or Pehchan card

The Employee State Insurance Corporation provides a card to each of the members enrolled under the ESIC scheme. When an insured person wishes to avail medical benefits offered under the scheme, he/she has to produce the ESI card to the hospital. The ESI or Pehchan card helps identify the insured individual. The employer or the insured person as well as his/her nominee, both, are given a Pehchan card each. In case the member passes away, the nominee will have to produce the ESI card while making a claim for the death benefit.

All about the ESI card:

• The ESI card will have all the personal details of the insured person such as name, father’s name, address, photograph, biometric data and so on.
• The same ESI card can be retained even if the individual switches the job.
• The benefits available under the ESIC scheme depend on the length of contribution too. Hence it is best to register oneself in the new employer’s portal after starting the new job.
• The card will help hospital officials identify the person and track his/her medical history too.
• The biometrics have to be submitted at an ESIC Pehchan Card Camp by the insured person.
• A temporary I card will be provided to the employee so that he/she can avail benefits even before the ESI card is issued. The temporary I card has a short validity of 90 days.
• If the insured has not received the Pehchan card, he/she can apply for it after switching the employer.

What is present on the Pehchan card

The details regarding the insured person printed on an ESI card are:

• Family photograph
• Insurance number
• Name of the insured person
• Date of birth
• Address

The card also has a micro line, magnetic stripe, statutory instructions, UV text, micro text, and hologram.

The Employee State Insurance Corporation has been a lifeline for millions of Indian employees who are part of the workforce that drives the country’s economy. This scheme was designed keeping in mind the impoverished sections of the society who can’t afford to buy even the most basic health insurance policies. With plans such as this, the ESI Corporation aims to provide much needed support to many such families.