• Employee State Insurance Corporation Scheme

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    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:

    Benefits Details
    Medical Benefit Complete medical care is provided to the insured individual as well as his/her family members. No limits are specified for such medical expenses.
    Sickness Benefit A cash compensation at the rate of 70% of the wages payable is paid for certified sicknesses.
    Disablement Benefit A benefit equal to 90% of the wages payable is paid on a monthly basis. In case of temporary disablement, the benefit is paid only as long as the person is disabled.
    Maternity Benefit Maternity benefit is payable for a period of 3 months and may be extended by an extra month.
    Dependent Benefit If an insured individual passes away due to occupational hazards or employment injury, the family members will receive monthly instalments equal to 90% of the wages payable.
    Funeral expenses An amount equal to Rs.10,000 is payable to the dependents to perform final rites of the deceased individual.
    Confinement expenses In case an individual is confined in a place where ESIC facilities cannot be availed, an amount equal to Rs.5,000 is provided. This benefit is payable for a maximum 2 times.

    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.

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