What is Covered in ESIS?
The ESIS covers a majority of employed Indian residents. However, before enrolling on the plan, one must take a look at its inclusions. Here’s a closer look at what is covered under ESIS.
The scheme is now extended to cinemas and preview theatres, restaurants, newspaper establishments, hotels, shops and road-motor transport undertakings.
Private educational and medical institutions with 10 or more employees. However, you should note that this is applicable to certain selected states and union territories only.
It is accessible to over 3.49 crore Indian families and individuals as of March 2021.
According to Section 1(5), the government has notified that ESIS insurance covers shops and restaurants involved in sales.
Cash Benefits of ESIS
Benefits
|
Cash Value
|
Disablement benefit
|
For temporary disablement, you will receive 90% of the last wages as long as the disablement lasts. For permanent disablement, you will receive the wages on a pro-rata basis for the rest of your life.
|
Maternity Benefit
|
You receive 100% of the wage for 12 weeks.
|
RGSKY for Unemployment
|
You receive 50% of the wage for one year in case of unemployment.
|
Dependant Benefit
|
You receive 90% of the wage.
|
Funeral Benefits
|
Funeral benefits are covered up to ₹10,000.
|
There is an increasing demand for ESIS after its launch in 1952. The prime reason for the growth of ESIS insurance is the fulfilment of the social needs of all the employees.
When is ESIS Registration Required?
For companies that have more than 10 employees, it becomes mandatory to register with the Employee State Insurance Corporation (ESIC). Also, employees earning less than ₹21,000 every month will contribute 1.75% of their salary towards the ESIS, whereas the employer will contribute 4.75% towards the same. This makes a total contribution of 6.5% towards ESS. The company has to register with ESIC within 15 days of its eligibility.
Procedure for ESIS Registration
When an organisation hires 10 or more employees, it is liable for the company to register under ESIS. As mentioned above, employees earning less than ₹21,000 monthly need to contribute 1.75% of their wage to ESIS, while the employer needs to contribute 4.75% of the employee’s wage. The organisation needs to register for ESIS within 15 days from the time the scheme applies to the company.
The procedures to register for ESIS are explained below:
Step 1: Download Form No.1 (Employers Registration Form) in PDF and fill in the necessary details.
Step 2: Submit the same online with the requested documents. Documentation plays an essential role while enrolling for a policy. Here’s a list of the required documents:
Documents Required for ESIS
Certificate of registration from the Factories Act and Establishment Act.
Memorandum and Articles of Association
Registration certificate for a partnership entity
Employee list of an organisation
Annual Income details
Cancelled bank leaf
Names of the company directors
Names of the company shareholders
Attendance account of the employees
Employee State Insurance Act 1948
ESIS was established with an aim to offer social insurance to individuals, according to the provisions of the Employees State Insurance Act. The primary objective of the act was to financially safeguard the salaried employees and their family members from unforeseen medical issues, temporary and personal disablement, maternity, and death.
In simple words, ESIS offers medical security to the insured people and their loved ones under unavoidable health issues. This scheme applies to employees of factories, shops, restaurants, hotels, and other business entities such as road transport, newspaper, cinemas, and educational institutions that have more than 10 employees earning a minimum of ₹15,000.
In certain states, this facility applies to institutes that have more than 20 employees. Also, ESIS authorities have decided to increase the monthly wage amount from ₹15,000 to ₹21,000, and the benefits are extended to people working in construction sites that are located in ESIS mentioned areas since August 01, 2015.
As mentioned above, the employer, as well as the employee, contributes towards the ESIS. However, employees earning ₹137 or less as a daily wage, are exempted from the contribution. In this case, only the employer makes the necessary contribution.
ESIS and its Application
The Employees State Insurance Corporation (ESIC) established the Employees’ State Insurance Act, 1948. It is their responsibility to ensure the seamless administration of the scheme.
The ESIS has its headquarters in New Delhi but has an extended network across the country. Today, over 151 hospitals and 42 hospital annexes are available for inpatient services under the scheme. Other primary and out-patient medical facilities are offered via a network of about 1450/188 ESI dispensaries/AYUSH units and 954 panel clinics. Also, there is a Medical Benefit Council offering expert guidance to the ESIC regarding its administrative responsibilities.
Dos and Don’ts of ESIS
As a beneficiary of ESI, you should be aware of the following important dos and don’ts.
If you are switching from one organisation to another, make sure that your new employer is informed about the ESI Registration Number. That way, you can continue to enjoy the benefits under it as and when needed.
Ensure that you do not lose or damage the Pehchan Card as it serves the purpose of social security.
In case the card is lost, you or any of your dependents will have to immediately report the loss at the nearest Branch Office or Dispensary.
The suggested processes for referrals should be strictly followed.
In case you plan to relocate for professional purposes, you have to get Form 105 signed by your existing employer so as to continue availing the benefits under the ESI scheme in another location.
You have to mandatorily follow the doctors’ medications and prescribed treatments (if any).
Redressal of Public Grievances
You can lodge your complaint regarding the ESI scheme by using any of the following methods:
By going to the official ESIC website at 222.esic.nic.in and selecting the ‘Grievance Redressal’ option in the ‘Services’ section on the homepage.
By using the CPGRAMS portal at https://pgportal.gov.in/signin
By sending an e-mail to pg-hqrs@esic.in or by using any Hqrs office or field office’s e-mail address.
Through toll-free helpline numbers: 1800-11-2526 (general Helpline) and 1800-11-3839 (medical helpline).
Through hard copy complaints like by post, by hand, through complaint box, etc.
By walking into the respective field office or headquarter office.
Final Takeaway
Despite all this, there is certain unawareness of the scheme that leads to multiple queries in the minds of the buyers. Some frequently asked questions (FAQs) about this scheme are mentioned below.
To sum up, the responsibilities of an employee increase with a rise in workload. Moreover, our sedentary lifestyle demands special attention, which is possible only with ESIS. The guaranteed protection from ESIS makes multiple lives easier. Apart from ESIS, you can also buy a health insurance plan to give yourself financial backing. Go to the official website of Bajaj MARKETS now and choose the best-suited insurance plan from a wide range of options available.