Employees’ State Insurance Scheme
ActiveLaunched by
Ministry of Labour and Employment, Government of India
Launched Date
Inaugurated On Feb 24, 1952
Available in
Scheme Description
The Employees’ State Insurance (ESI) Scheme is a social security and health insurance program designed for employees in the organized sector in India. It is administered by the Employees' State Insurance Corporation (ESIC), under the Ministry of Labour and Employment. The scheme aims to provide comprehensive social security benefits to workers and their families in the event of sickness, maternity, disability, and death due to employment-related accidents. The ESI Scheme was first launched in 1952 and has since expanded across India, providing medical, cash, and disability benefits.
The key feature of the ESI Scheme is the provision of healthcare services, including medical treatment, hospitalization, and surgical procedures, free of cost at ESI hospitals and dispensaries. It also covers maternity benefits, unemployment allowance, and disability pensions for the insured workers. Additionally, the scheme provides financial support to families in case of the insured worker’s death or disability. The ESI Fund is primarily financed by contributions from both the employer and the employee, with the employer contributing a larger portion of the premium.
Benefits
- •Provides full medical care to the insured employee and their family members from day one.
- •Offers outpatient and inpatient treatment through ESI hospitals and dispensaries.
- •Covers specialist consultations, diagnostic services, and free medicines.
- •Grants cash benefit at 70% of wages during sickness for up to 91 days in a year.
- •Provides extended sickness benefit at 80% of wages for certain long-term diseases for up to 2 years.
- •Offers enhanced sickness benefit (100% wages) for insured women undergoing sterilization.
- •Provides maternity benefit at full wages for 26 weeks, extendable in special cases.
- •Includes pre-natal and post-natal medical care for insured women.
- •Gives 90% of wages as compensation during temporary disablement due to employment injury.
- •Offers monthly payments for permanent disablement based on loss of earning capacity.
- •Provides dependents’ benefit (monthly pension) to family in case of death due to employment injury.
- •Pays lump sum amount of ₹15,000 for funeral expenses.
- •Offers vocational rehabilitation for permanently disabled employees under 45 years of age.
- •Provides confinement expenses in case of childbirth in non-ESI areas.
Eligibility
- •The employee must be working in a factory or establishment covered under the ESI Act.
- •The establishment must have 10 or more employees (in some states, 20 or more).
- •The employee's monthly gross salary must not exceed ₹21,000 (₹25,000 for persons with disabilities).
- •The employee must be drawing wages from an employer who contributes to the ESI scheme.
- •The employer must register the employee under the ESI scheme.
- •The employee must contribute 0.75% of their wages, and the employer must contribute 3.25%.
- •The employee becomes eligible for medical benefits from day one of registration.
- •Cash benefits (like sickness and maternity) are available after a minimum contribution period, depending on the benefit type.
- •The employee must not be covered under any other similar government healthcare scheme for the same benefits.
Documents Needed
- •Employer: Registration certificate under Shops and Establishment Act or Factories Act
- •Employer: PAN card of the business entity
- •Employer: Address proof of the establishment (e.g. electricity bill, rent agreement)
- •Employer: Bank account details of the company
- •Employer: License or registration certificate (e.g. GST, EPFO, municipal license)
- •Employer: List of all employees with their personal and job-related details
- •Employee: Passport-sized photograph
- •Employee: Aadhar car, PAN card
- •Employee: Bank account details for receiving benefits
- •Employee: Address proof (e.g. voter ID, utility bill, ration card)
- •Employee: Family details with Aadhar numbers of dependents (if available)
- •Employee: Mobile number and email ID
- •Employee: Previous employment details (if applicable)
Application Process
- •The employer must register the factory or establishment under the ESI Act through the official ESIC portal (https://www.esic.gov.in).
- •After registration, the employer receives a 17-digit unique identification number (Employer Code Number).
- •The employer is required to register all eligible employees under the ESI scheme.
- •Employee details are uploaded via the ESIC online portal using Form-1 (Employee Registration Form).
- •Once registered, the employee receives a Permanent ESI Number and can download the ESI e-Pehchan card.
- •The employee must submit photographs and family details to receive full benefits.
- •Contributions (from both employer and employee) must be regularly paid through the ESIC portal.
- •The employee can then avail medical and cash benefits as per eligibility.
- •For availing specific benefits (e.g. sickness, maternity), the employee must submit the respective claim forms through the employer.