ESI - Employees’ Benefits Explained
At Vetri Audit Services Private Limited, we help employers and employees navigate the intricacies of the Employees’ State Insurance (ESI) scheme. ESI is a self-financing social security scheme designed to provide socio-economic protection to workers and their dependents during health-related contingencies.
Who is Eligible?
Employees are eligible for ESI benefits if they:
- Are employed in an establishment registered under the ESI Act.
- Earn a gross monthly salary of ₹21,000 or less (₹25,000 for employees with disabilities).
- Are registered with the Employees' State Insurance Corporation (ESIC) and possess a valid Insurance Number and Pehchan Card.
Key Benefits under the ESI Scheme
| Benefit Type | Description |
|---|---|
| Medical Benefit | Comprehensive medical care for insured employees and their dependents from day one, including outpatient consultations, hospitalization, surgeries, diagnostics, and prescribed medicines through ESIC hospitals and clinics. |
| Sickness Benefit | 70% of the average daily wage paid for up to 91 days per year during medically certified leave, subject to a minimum contribution of 78 days in the last 6 months. |
| Maternity Benefit | Female employees receive full wage for 26 weeks, extendable in certain medical conditions, provided they have contributed for at least 70 days in the two preceding contribution periods. |
| Disablement Benefit |
Temporary: 90% of wages during the certified period of disability. Permanent: Monthly compensation based on assessed loss of earning capacity. |
| Dependents’ Benefit | Monthly pension to eligible dependents (widow, children, or parents) if an insured employee dies due to employment injury. |
| Funeral Expenses | One-time financial assistance of up to ₹15,000 to cover funeral costs of a deceased insured employee. |
| Unemployment Allowance | Under the Rajiv Gandhi Shramik Kalyan Yojana, 50% of average wages for up to 2 years during involuntary job loss due to retrenchment, closure, or permanent invalidity. |
| Rehabilitation Services | Physical and vocational rehabilitation support for insured persons with employment-related injuries or disabilities. |
| Vocational Training | Free training and financial support during periods of disablement or unemployment. |
| Super Specialty Treatment | Free access to advanced treatment like dialysis, chemotherapy, cardiac surgery, etc., through empaneled super-specialty hospitals. |
Contribution Requirements for Benefits
| Benefit Type | Minimum Contribution |
|---|---|
| Sickness Benefit | 78 days in the previous 6 months |
| Maternity Benefit | 70 days across the last 2 contribution periods |
| Disablement Benefit | Eligible from day one of employment |
| Medical Benefit | Available from the first day of ESI coverage |
Additional Notes
- The ESI Pehchan Card is mandatory to avail of any benefit.
- Services can be accessed at ESIC dispensaries and empaneled private hospitals.
- ESI coverage extends to dependents including spouses, children, and dependent parents.
- ESIC maintains an online portal for employees to check their benefits and contribution history.
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