What is ESIC? Discover Its Benefits and Why They Matter

ESIC is a Government of India organisation designed to operate the Employees’ State Insurance scheme. In other words, it normally provides medical and financial benefits to employees and their families. Assistance is provided to the employee when he is incapable of performing his duties due to sickness, employment injury, or maternity. It is mandatory for all the organisations to enroll in the ESI scheme if they run a company with 10 or more employees. It is collected through the contribution of both employees and employers. 0.75% is deducted from employees’ gross salaries, while 3,25% is deducted from the employer’s side. In today’s guide we will explore what is ESIC, what is the full form of ESIC, who is covered under ESIC, and other several benefits of ESIC. 

Employees' State Insurance scheme
Employees' State Insurance scheme

Who Falls Under ESIC Coverage?

ESIC stands for Employees’ State Insurance Corporation. Generally, ESIC covers those employees whose earnings are up to ₹ 21,000 per month and who are employed in organizations that employ 10 or more workers. Salary specifications for disabled employees are different, their maximum gross salary can be up to 25,000.  However, the minimum number of workers can vary from state to state. It covers manufacturing industries, service sectors, and health care amongst others.

Key Features of ESIC

As we have already learned about what is ESIC and who falls under ESIC coverage, lets see some of the key features of ESIC: 

  • Full Range of Service:

    It covers medical treatments, hospitalization, and rehabilitation services. It helps to make healthcare more affordable for employees.

  • Social Security:

    Cash benefits are provided to workers by ESIC during sickness, disability, and employment injury. These benefits are provided to help them and their family members to maintain their economic stability.

  • Family Benefit:

    ESIC ensures the other family members of the insured person get similar financial assistance and healthcare benefits.

Employees' State Insurance scheme

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Benefits of ESIC

1. Medical benefits

The ESIC provides all medical care to the employees and their families. Some of these include:

  • Outpatient Services: These services cover all the visits to the doctors for consultation and treatment.
  • Inpatient Services: These services are provided to patients admitted to the hospital due to serious sickness or surgery.
  • Specialist services: You can benefit from accessing specialists such as surgeons, radiologists, and physiotherapists.
  • Maternity benefits: full benefits to women workers during pregnancy and childbirth.

2. Sickness Benefits

Financial support is provided to the employee who cannot work due to sickness. An employee is provided with 70% of his average salary. This amount is paid for a maximum period of 91 days in a year. In this way, employees can recover from their sickness without worrying about losing their income.

3. Maternity Benefits

Female employees can avail of maternity benefits when they are pregnant and can get paid for 26 weeks without working. Full wages are paid during the period. It can extend to a maximum of six months in case any complications arise. This is a very helpful and useful benefit for all the women working in any industry as it helps them balance their health and career.    

4. Disablement Benefits

In cases of temporary or permanent disablement due to employment injury, ESIC does provide cash compensation:

  • Temporary Disablement Benefit (TDB): If an employee gets injured during work, they are provided with 90% of wages while unable to work. 
  • Permanent Disablement Benefit (PDB): Workers experiencing permanent disability will be given 90% wages for life by ESIC.

5. Dependents' Benefit

If an insured employee passes away due to work-related disability or injury, the employer is responsible for providing monthly financial compensation to their family members. 

6. Funeral Expenses

ESIC also provides financial assistance for funeral expenses. A big amount is paid to the family of the insured employee to cover the cost of the funeral. 

7. Rajiv Gandhi Shramik Kalyan Yojana (Unemployment Allowance)

In case the insured employee lost their job due to factory closure or permanent disablement, they are eligible for an unemployment allowance. This scheme offers financial assistance for up to 24 months, providing security to workers who are suddenly put out of work.

Employees' State Insurance scheme

What is IP Number in ESIC

The ESIC IP number stands for ESIC Insurance Number is a unique identification number assigned to every insured employee. This unique IP number is assigned to each person so they can be identified easily and can get ESIC benefits. It acts as a personalized reference to ensure easy access to ESIC services.

How to Avail ESIC Benefits

  • Employer's Role

    Employers play an important role in getting their workers covered under ESIC. They have to register their establishments under the ESIC scheme and also pay part of the premium. The employer contributes 3.25% of the employee's wages, while the employee pays 0.75%.

  • ESIC Card

    The employee is issued an ESIC card after registration, which serves as identity proof and is utilized for availing the benefits. This card will be utilized at the time of availing medical services and cash benefits.

  • Availing ESIC Dispensaries and Hospitals

    ESIC maintains a network of dispensaries and hospitals across India to ensure employees get easy access to medical care.

  • Online Claims

    Most of the services provided by the ESIC have been digitized, so that the employees can easily claim the benefits.

Employees' State Insurance scheme
Employees' State Insurance scheme

Why ESIC Benefits Matter

  • Affordable Health Care to Low-Wage Workers

    Health coverage by the ESIC is important for workers so that they can get quality health care without the additional burdens of costly medical bills.

  • Financial Security in Times of Distress

    In cases of sickness, or injury at work, workers can rely on the help given by ESIC for their financial needs while they are not able to work.

  • Boosts Productivity

    Workers are less stressed when they know that their hospitalization expenses are taken care of by the company, leading to higher productivity. ESIC helps to create a healthier and more secure work environment, benefiting both employees and employers.

  • Women Empowerment

    ESIC is very beneficial for women in time of their pregnancy as they can rest at home while getting paid without working for 26 weeks. More women will come into the workforce without the fear of losing income or job stability during pregnancies.

  • Families in Critical Times

    The family members of the insured person also get benefits from ESIC.

Conclusion

For the employees with low wages ESIC plays a big role by providing several financial, medical and social security benefits. Understanding what is ESIC is important, as these benefits help them raise their living standard and help them stabilize a more productive workforce. No matter if it is healthcare, maternity benefits, or protection against disability and job loss, ESIC ensures all employees and their families are cared for.  

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