Understanding the ESI Scheme (ESIS) is essential for both employees and employers alike. Employees can ensure they receive the medical and financial support they deserve, while employers can navigate the legal requirements and fulfil their obligations towards their workforce. With far-reaching employee health insurance benefits and the potential to alleviate financial burdens during emergencies, the ESIS is a valuable asset for employees and an essential component of the social security landscape. Let’s discuss the scheme in detail.
What Is Employees’ State Insurance Scheme?
The primary goal of the Government of India’s ESI scheme is to protect employees from certain health-related contingencies, such as permanent or temporary disability, illness, death due to an occupational disease or injury, which reduces the employee’s ability to earn a living, or results in income loss. This programme enables employees to lessen the financial strain brought on by such sad circumstances. The programme also provides its users with maternity benefits and employer employee insurance tax benefit.
Workers are protected by the ESI plan, which provides employee medical insurance treatment for the insured and their dependents, as well as a range of monetary benefits for loss of income or disability. Additionally, the plan provides dependent benefits to family members of the insured person in the event of death or injury as a result of workplace dangers.
Who is Covered Under the Employees’ State Insurance Scheme?
In 1952, Kanpur and Delhi, the two main industrial hubs at the time, introduced the ESIS. However, as the industrial revolution gathered steam, the plan began to spread across the nation. The ESIS has been adopted in more than 34 states and Union Territories as of March 31, 2019, as a result of the rise in industrialisation over time.
More than 3 crore workers or family units are now benefiting from the ESI Act, which presently includes approximately 12 lakh industrial and commercial buildings. More than 13 crore beneficiaries presently receive benefits from the programme.
Employee Benefits Health Insurance Scheme does not cover workers or employees making more than ₹21,000 per month, and for disabled individuals, the monthly maximum salary is ₹25,000. The current criterion for coverage in Maharashtra and Chandigarh is still 20 employees, not 10, as it is in other states or UTs.
Are There Any Do’s and Don’ts of the ESI Scheme?
The following are some significant details an ESI beneficiary should be aware of:
- Make sure the new employer is aware of your ESI Registration Number if you change jobs.
- To use the services of ESI hospitals and dispensaries, you must have an ESI Card/Pehchan Card or an e-Pehchan Card.
- Adhere to the doctor’s directions.
- Make sure the ESI smart card is not lost. The e-Pehchan card is available, although getting one can be difficult. Additionally, inform the ESIC branch office or pharmacy of the card’s theft.
What are the Benefits of the ESI Scheme?
As a beneficiary of the ESIS, you can claim two types of benefits:
- Medical Benefits: These benefits are available to you and your dependents. You must go to one of the ESI-approved hospitals to take advantage of this.
- Cash Benefits: Employees and workers who are eligible for the ESI programme may receive cash benefits in the event of sickness, temporary or permanent disability, maternity, unemployment, support for dependents, funeral expenses, and physical and occupational rehabilitation.
Wrapping Up
Employee Benefits Health Insurance Scheme stands as a remarkable initiative designed to protect and support the Indian workforce. Throughout this discussion, we have delved into frequently asked questions regarding the ESIS and its benefits, shedding light on its fundamental aspects.
The ESIS is a vital component of India’s social security system, providing comprehensive healthcare and financial support to employees and their families. By promoting employee well-being and safeguarding their interests, this scheme contributes to a more equitable and inclusive society. It is incumbent upon all stakeholders to familiarise themselves with the scheme’s intricacies, ensuring that its benefits are maximised and that the Indian workforce thrives in a secure and supportive environment.
