ESI Scheme
ESI (Employee State Insurance) operates following the ESI Act of 1948. It is a government scheme designed to provide social security benefits to workers. The administration of this scheme falls under the purview of the Employee State Insurance Corporation (ESIC). Employers must formally register their establishments with ESIC and furnish worker details for inclusion in the program.
Complying with the intricate regulations stipulated by the government can pose a significant challenge for employers. IndiaFilings’ ESI experts are available to assist you with these matters.
Definition and Scope of Establishments Under the ESI Act
The Employee State Insurance (ESI) Act categorises an establishment as any organised entity involving men or women, regardless of its physical location. This includes retail outlets and commercial shops, which are mandated to enroll in the ESI scheme if they employ 10 workers or 20 in certain states, provided these employees earn up to Rs. 21,000 per month, or Rs. 25,000 for individuals with disabilities.
Who is eligible for ESI Registration?
According to the official notice, the following state government-affiliated entities fall under the scope of the ESI Act according to Section 1(5):
- Retail outlets
- Dining establishments or hotels solely involved in sales
- Movie theatres, including preview facilities
- Establishments related to road transportation
- Newspaper organisations (exempt from the Factory Act)
- Private healthcare facilities
- Private educational institutions
- Casual workers employed by Municipal Corporations or Bodies
- Retail outlets
- Hotels and dining establishments
- Establishments related to road transportation
- Cinemas, including preview theatres
- Newspaper organisations
- Businesses involved in:
- Insurance
- Non-Banking Financial Companies (NBFCs)
- Port trusts
- Airport authorities
- Warehousing
Eligibility Criteria for ESI Registration
The eligibility criteria for ESI registration are as follows:
- Employees in establishments, factories, or shops with more than 10 employees are eligible for ESI benefits under Section 2(12) of the ESI Act, 1948.
- All workers and their dependents across various industries and sectors can receive ESI medical benefits from ESIC-run hospitals and dispensaries.
Women employees earning less than Rs. 21,000 per month and individuals with disabilities earning less than Rs. 25,000 per month are eligible for maternity benefits under the ESI Act. This includes medical and cash benefits, as well as paid leave for various conditions such as pregnancy (pre and post-delivery), medical termination, miscarriage, and adoption.
Advantages of ESIC Registration
ESIC registration offers employees a comprehensive suite of benefits, safeguarding their health, income, and family. Key benefits include:
- Sickness Benefit: Employees are entitled to receive 70% of their wages for up to 91 days a year during certified sickness periods.
- Extended Sickness Benefit: Employees can receive an extended benefit at 80% of their wages for up to two years for certain long-term and severe diseases.
- Enhanced Sickness Benefit: Full wage compensation is provided for employees undergoing sterilisation, with 7 days for Vasectomy and 14 days for Tubectomy.
- Medical Benefits: Comprehensive medical care is available to employees and their families, ensuring their well-being.
- Retired Medical Benefits: Retired employees and their spouses are eligible for continued medical benefits upon paying an annual premium of Rs. 120.
- Maternity Benefit: Pregnant women are entitled to total wages as maternity benefit for 26 weeks, extendable by a month, ensuring financial stability during childbirth.
- Dependents’ Benefit: In the unfortunate event of an employee’s death due to employment injury, 90% of the employee’s wages are provided to their dependents as a monthly payment.
- Temporary Disablement Benefit: Employees suffering from an employment injury receive 90% of their wages as a benefit until the disability lasts.
- Permanent Disablement Benefit: In cases of permanent disability, employees are entitled to a monthly payment of 90% of their wages based on the loss of earning capacity as assessed by a Medical Board.
- Funeral Expenses: A fixed sum of Rs. 15,000 is provided to the dependents or the individual conducting the last rites, assisting with funeral expenses.