ESIC Scheme Apply Online & Application Form | ESIC Scheme Check Beneficiary Category & Last Date | ESIC Scheme Check Benefits & Features | ESIC Scheme Check Selection & Implementation Procedure | ESIC Scheme Check Eligibility & All Details | 

The Employees’ State Insurance Corporation (ESIC) Scheme is a social security and health insurance scheme in India. It is managed by the Employees’ State Insurance Corporation, a statutory body under the Ministry of Labour and Employment. The scheme provides comprehensive medical care and cash benefits to employees and their dependents in case of sickness, maternity, disablement, or death due to employment-related injuries.

This article will provide all types of information about the ESIC Scheme 2024 like purpose, Eligibility Criteria, Benefits, Features, important documents, etc. We will also share the process to apply online for this scheme. To get complete information about this scheme, read this article till the end.

ESIC Scheme          

The Employees’ State Insurance Corporation (ESIC) is a social security scheme in India that provides various benefits to employees and their dependents. It is a comprehensive health insurance scheme that aims to provide medical care and financial assistance to workers in times of need. In this blog post, we will explore the different medical benefits offered by the ESIC Scheme.

The ESIC Scheme covers employees earning a monthly wage of up to Rs. 21,000. Both the employer and the employee contribute a certain percentage of the employee’s wages towards the scheme. The contributions are used to fund the various benefits provided by the ESIC. The scheme covers employees working in factories, establishments, and establishments specified by the government. It also covers employees engaged in hazardous occupations or activities, such as mining, construction, and certain types of manufacturing.

Highlights of ESIC Scheme 2024

The highlights of this scheme are as follows:- 

Objectives of ESIC Scheme 2024

The primary objective of the ESIC Scheme is to provide social protection to employees and their families against unforeseen contingencies. It aims to ensure that employees have access to quality medical care and financial support during times of need. The scheme also promotes preventive healthcare measures and strives to create a healthy and productive workforce.

In conclusion, the ESIC scheme provides a range of medical benefits to employees and their dependents. From maternity and sickness benefits to disability and funeral benefits, the scheme aims to provide financial assistance and healthcare support in times of need. By understanding the different benefits offered by the ESIC scheme, employees can make the most of this social security scheme and ensure their well-being and that of their dependents.

Beneficiary Category 

The ESIC Scheme covers a wide range of employees from various industries and sectors. It includes both organized and unorganized sector workers, such as factory workers, construction workers, mine workers, and employees in establishments with 10 or more employees. The scheme also covers employees earning a monthly wage of up to Rs. 21,000.

Application Enrollment Last Dates

Application enrollment for the ESIC Scheme is open throughout the year. Employees can register themselves and their dependents by submitting the necessary documents and completing the enrollment process. It is essential to enroll within the specified time frame to avail the benefits of the scheme.

Selection Procedure 

The selection procedure for the ESIC Scheme involves verifying the eligibility criteria and documents submitted by the employee. Once the verification process is complete, the employee and their dependents are issued an ESIC card, which serves as proof of enrollment. The card enables them to avail the medical and cash benefits provided by the scheme.

Implementation Procedure 

The implementation procedure of the ESIC Scheme involves the establishment of ESIC hospitals, dispensaries, and medical institutions across the country. These healthcare facilities provide medical services, including outpatient care, inpatient care, maternity benefits, and specialist consultations. The scheme also facilitates tie-ups with private hospitals to ensure adequate healthcare access for beneficiaries.

Supervision Body 

The Employees’ State Insurance Corporation is the supervisory body responsible for overseeing the implementation and functioning of the ESIC Scheme. It monitors the delivery of healthcare services, manages the funds collected through contributions, and resolves any disputes or grievances related to the scheme.

Maternity Benefit

One of the key benefits provided by the Scheme is maternity benefits. Under this benefit, eligible women employees are entitled to paid leave for a specified period before and after childbirth. The scheme covers the expenses of prenatal and postnatal care, including medical consultations, tests, medicines, and hospitalization.

Sickness Benefit

ESIC also offers sickness benefits to employees who are unable to work due to illness or temporary disability. The scheme provides financial assistance in the form of cash benefits for the period of absence from work. The amount of benefit is calculated based on the average daily wage of the employee.

Temporary Disablement Benefit

In case an employee suffers a temporary disability due to an accident or illness, the Scheme provides temporary disablement benefit. This benefit is provided as a cash compensation to cover the loss of wages during the period of temporary disablement. The amount of benefit is calculated based on the average daily wage of the employee.

Permanent Disablement Benefit

If an employee suffers a permanent disability due to an employment injury, the Scheme provides permanent disablement benefit. This benefit is provided as a monthly pension to compensate for the loss of earning capacity. The amount of benefit is determined based on the degree of disability.

Dependents’ Benefit

In the unfortunate event of an employee’s death due to employment-related causes, the Scheme provides dependents’ benefit. This benefit is provided as a monthly pension to the dependents of the deceased employee. The amount of benefit is determined based on the average daily wage of the employee.

Funeral Benefit

The Scheme also includes funeral benefit, which is provided to cover the expenses of the employee’s funeral in case of death. The amount of benefit is fixed and is paid to the person who performs the last rites of the deceased employee.

Atal Beemit Vyakti Kalyan Yojana

In addition to the above benefits, the Scheme also offers the Atal Beemit Vyakti Kalyan Yojana. This scheme provides financial assistance to employees who become unemployed due to closure of the establishment, retrenchment, or permanent invalidity. The scheme provides cash benefits for a maximum period of up to two years.

Enhanced Sickness Benefit

Under certain circumstances, such as undergoing sterilization or suffering from specified long-term diseases, employees are entitled to enhanced sickness benefit. This benefit provides higher cash benefits to cover the additional expenses incurred during the period of sickness.

Ayushman Bharat

The Scheme is also integrated with the Ayushman Bharat scheme, which is a government-sponsored health insurance scheme. The integration allows ESIC beneficiaries to avail medical services under the Ayushman Bharat scheme, thereby expanding the scope of healthcare benefits.

Key Guidelines 

The key guidelines are as follows:- 

• Employees and employers are required to contribute a certain percentage of their wages towards the ESIC Scheme.
• Dependents of employees, including spouses, children, and dependent parents, are eligible for benefits under the scheme.
• Medical benefits include free medical treatment, medicines, hospitalization, and specialist consultations.
• Cash benefits are provided in the form of sickness benefits, maternity benefits, disablement benefits, and dependent benefits.
• ESIC cards are issued to enrolled employees and their dependents, which serve as proof of eligibility.
• Employees can seek medical treatment at ESIC hospitals, dispensaries, and tie-up hospitals.
• The scheme covers employees during the period of employment and even after retirement.
• Employees can avail of benefits even if they change jobs or locations within the country.
• ESIC benefits are portable and can be availed in any part of India.
• The scheme provides financial assistance for funeral expenses in case of the employee’s death.

Important Instructions 

Some important instructions issued for applicants are as follows:- 

• Keep the ESIC card safe and carry it at all times for easy access to medical services.
• Inform the ESIC office in case of any changes in personal details or employment status.
• Submit all necessary documents and forms accurately and within the specified time frame.
• Utilize the services of ESIC hospitals and dispensaries for primary healthcare needs.
• Follow the prescribed procedures for availing cash benefits, such as submitting medical certificates and claim forms.
• Report any discrepancies or issues regarding the scheme to the ESIC office for timely resolution.
• Stay updated with the latest notifications and circulars issued by the ESIC for any changes or additions to the scheme.
• Cooperate with the ESIC officials during inspections or audits to ensure compliance with the scheme.
• Keep track of the contributions made towards the ESIC Scheme and ensure timely payment.
• Seek guidance from the ESIC office or authorized personnel in case of any doubts or queries regarding the scheme.

Tips & Tricks

Some tips and tricks are as follows:-

• Regularly visit ESIC hospitals and dispensaries for preventive check-ups and early detection of health issues.
• Utilize the cash benefits provided by the scheme for medical expenses and recovery periods.
• Maintain a record of medical certificates, prescriptions, and bills for easy claim processing.
• Explore tie-up hospitals and clinics for specialized treatments and consultations.
• Stay informed about the ESIC Scheme’s coverage and benefits to make the most of the available services.
• Encourage fellow employees and colleagues to enroll in the scheme for collective welfare.
• Participate in health awareness programs and initiatives organized by the ESIC for better healthcare outcomes.
• Stay updated with the latest medical advancements and treatments covered under the scheme.
• Follow a healthy lifestyle and practice preventive measures to reduce the risk of illnesses and injuries.
• Regularly review and update personal and dependent details to ensure accurate and timely benefits.

General Points to Remember

Some general points to remember are as follows:-

• The ESIC Scheme is a valuable social security measure for employees and their families.
• Enrollment in the scheme provides access to quality medical care and financial support during times of need.
• Employees and employers must contribute towards the scheme to ensure its sustainability and effectiveness.
• Compliance with the ESIC guidelines and instructions is essential for availing the benefits of the scheme.
• Regular communication and coordination with the ESIC office can help resolve any issues or concerns.
• Employees should make the most of the available healthcare services and facilities provided by the scheme.
• Timely reporting of any changes or discrepancies is crucial to maintain accurate records and eligibility.
• Employees should actively participate in creating awareness about the ESIC Scheme and its benefits.
• Health and well-being should be a priority for employees, both within and outside the workplace.
• The ESIC Scheme is a testament to the government’s commitment to the welfare of its workforce.

Benefits of ESIC Scheme 2024

The benefits of this scheme are as follows:-

• Medical Benefits: Covers hospitalization, outpatient care, medicines, and other medical expenses.
• Maternity Benefit: Provides financial assistance to women during pregnancy and childbirth.
• Sickness Benefit: Offers financial support to employees during periods of illness.
• Temporary Disablement Benefit: Provides financial assistance in case of temporary disability due to employment injury.
• Permanent Disablement Benefit: Offers financial assistance in case of permanent disability due to employment injury.
• Dependents’ Benefit: Extends medical benefits to the insured employee’s spouse and dependent children.
• Funeral Benefit: Provides financial assistance to the family of the insured employee in case of death.
• Atal Beemit Vyakti Kalyan Yojana: Offers unemployment relief for insured employees who lose their jobs.
• Enhanced Sickness Benefit: Provides full wages for a specific period during sterilization leave.
• Ayushman Bharat: Provides access to secondary and tertiary healthcare services under the government’s healthcare scheme.

Features Of ESIC Scheme 2024

The features of this scheme are as follows:-

• Contributory Scheme: Funded by contributions from both employers and employees.
• Coverage: Applicable to factories and establishments employing 10 or more workers (in some states, the threshold is 20).
• Easy Registration: Online registration process available for employers.
• Cashless Medical Care: Medical benefits can be availed at designated hospitals and dispensaries.
• Nationwide Coverage: Scheme operational across various regions in India.
• Transparent Administration: Managed by the Employees’ State Insurance Corporation (ESIC).
• Regular Upgradation: Benefits and features are periodically reviewed and updated.
• Grievance Redressal Mechanism: System in place to address employee concerns.
• Online Services: Various services available online for employers and employees.
• Awareness Programs: ESIC conducts awareness programs to educate beneficiaries about the scheme.

ESIC Scheme Eligibility Criteria 

The applicants will need to follow the below-mentioned points to apply online for this scheme:-

Eligibility Criteria for Employees

Employees working in establishments covered under the ESIC scheme are eligible for its benefits. The following are the eligibility criteria for employees:-

• The employee should be working in a factory or establishment covered under the ESIC Act.
• The monthly wage of the employee should not exceed the prescribed limit, which is currently Rs. 21,000 per month.
• The employee should be working for at least 78 days in a contribution period (which is usually six months) to be eligible for the benefits.
• The employee should not be availing any similar benefits under any other law.

It is important to note that employees who are covered under the ESIC scheme are not eligible for benefits under the Employees’ Provident Fund (EPF) scheme.

Eligibility Criteria for Dependents

The ESIC scheme also provides benefits to the dependents of eligible employees. The following are the eligibility criteria for dependents:-

• Spouse: The spouse of the employee is eligible for benefits under the ESIC scheme.
• Children: Unmarried children (including adopted children) of the employee who are under the age of 25 and financially dependent on the employee are eligible for benefits.
• Parents: If the employee does not have a spouse or children, his/her parents who are dependent on the employee are eligible for benefits.

Important Documents 

Some of the important documents required to apply online for this scheme are as follows:-

• Aadhar Card
• Residence Certificate
• Income Certificate 
• Educational Certificates 
• Bank Account Details 
• Latest Passport Size Photos 
• Mobile No
• Email ID 

ESIC Scheme Apply Online 2024

The applicants will need to follow the below-mentioned points to apply online:-

• Visit the Official ESIC Website.
• Click “Sign Up” and enter the details:-
  • Name
  • Mobile number
  • Employer name
  • Email ID
  • Region and state
• Confirm details and click “Submit“.
• Log in with the received credentials.
• Click “New User Registration“.
• Enter details:-
  • Unit name
  • Factory address and nearest police station
• Click “Next” and enter:
  • Business nature and category
  • Business commencement date
  • Proprietorship details
• Enter:-
  • Total employees
  • Employees earning less than Rs. 21,000
• Select the first 10 employees’ hiring date and click “Declaration”.
• Enter employee details:-
  • Name
  • Date of birth
  • Father’s name
  • Gender
  • Family details
  • Marital status
  • Joining date
• Click “Submit“.
• Select the ESI branch office and inspection division, then click “Submit“.
• Click “Pay Initial Contribution“, then “Continue” and make payment.

Logging in under ESIC Scheme (Employer)

The applicants will need to follow the below-mentioned points to login:-

• Visit the official ESIC website.
• Click “Employer Login“.
• Enter username, password, and captcha code.
• Click “Login“.

Important Downloads

The links to important files are as follows:-

ESIC Scheme: Top 10 FAQs

Are you confused about the ESIC Scheme? Don’t worry, you’re not alone. The ESIC Scheme can be complex, but understanding it is crucial for both employers and employees. In this article, we will answer the top 10 frequently asked questions about the ESIC Scheme to help you navigate through the intricacies of this important social security scheme.

What is the ESIC Scheme?

The Employees’ State Insurance Corporation (ESIC) Scheme is a social security scheme designed to provide medical and cash benefits to employees in case of sickness, maternity, disablement, or death due to employment injury. It is a self-financing scheme where both the employer and the employee contribute towards the fund.

Who is eligible for the ESIC Scheme?

All employees earning wages up to Rs. 21,000 per month are eligible for the ESIC Scheme. However, certain categories of employees such as seasonal workers, apprentice, and casual laborers may be exempted from the scheme.

How is the contribution calculated?

The contribution towards the ESIC Scheme is calculated as a percentage of the employee’s wages. The current rate of contribution is 1.75% of the employee’s wages, while the employer contributes 4.75% of the employee’s wages.

What are the benefits under the ESIC Scheme?

The ESIC Scheme provides a wide range of benefits including medical benefits, cash benefits, maternity benefits, and dependent benefits. Employees can avail of free medical treatment at ESIC hospitals and dispensaries, cash benefits in case of temporary or permanent disablement, maternity benefits for pregnant women, and dependent benefits in case of the employee’s death.

Can an employer opt-out of the ESIC Scheme?

No, the ESIC Scheme is mandatory for all covered establishments. It is illegal for an employer to opt-out of the scheme or to deny employees the benefits under the scheme.

How to register under the ESIC Scheme?

Employers need to register themselves and their employees under the ESIC Scheme within 15 days of the enactment of the Act in their establishment. They can do so by submitting the required documents and paying the applicable contribution.

Can employees claim benefits under the ESIC Scheme?

Yes, employees can claim benefits under the ESIC Scheme by submitting a claim form along with the necessary documents to the ESIC authorities. The claims are then processed, and the benefits are disbursed accordingly.

Are ESIC benefits transferable?

No, ESIC benefits are not transferable from one location to another. Employees need to re-register themselves at the new location to avail of the benefits under the ESIC Scheme.

What is the penalty for non-compliance with the ESIC Scheme?

Employers who fail to comply with the ESIC Scheme may be liable to pay a penalty or face legal action. It is essential for employers to ensure timely registration and contribution towards the scheme to avoid any penalties.

How to contact the ESIC authorities for more information?

For more information about the ESIC Scheme, employers and employees can contact the ESIC authorities through their regional offices or visit the official ESIC website. They can also reach out to the helpdesk for any queries related to the scheme.
In conclusion, the ESIC Scheme is a vital social security scheme that provides much-needed benefits to employees in times of need. By understanding the intricacies of the scheme and complying with its provisions, both employers and employees can ensure a secure and stable future.