Employee State Insurance Scheme: The Employees’ State Insurance Scheme (ESIS) is a government plan that helps workers and their families by giving them medical care, cash benefits during sickness or pregnancy, and support if they lose their job or get hurt. This plan is run by the Employees’ State Insurance Corporation (ESIC), which works under the Ministry of Labour and Employment.
This scheme covers workers in companies that have at least 10 employees. In Maharashtra and Chandigarh, the rule is a bit different the company needs to have at least 20 workers. Both workers and employers pay money into this scheme. For the financial year 2024-25, the worker pays 0.75% of their salary, and the employer pays 3.25%.
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If a worker earns ₹21,000 or less each month, they can join the scheme. For disabled workers, the income limit is ₹25,000. There is no age limit to join. When the scheme started in 1948, only non-seasonal factories were included. Later, it also covered hotels, shops, transport businesses, and more.
Hospitals and Medical Care under ESIC
ESIC runs many hospitals across India to give free health care to people who are part of the scheme. If a person is insured, they and their family members can get full medical treatment without any cost limit. Even if someone has retired or is permanently disabled, they can still get medical help by paying just ₹120 every year.
There are more than 150 ESI hospitals and about 42 hospital annexes for people who need to stay overnight or longer. For everyday medical needs, there are around 1,450 ESI dispensaries, 188 AYUSH units (which give traditional treatments), and 954 panel clinics. Some cities like Mumbai, Delhi, Kolkata, Chennai, and Indore even have special centres for work-related diseases.
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ESIC is also trying to improve its services. Soon, people covered under this scheme may be able to get free treatment at hospitals that are part of the Ayushman Bharat plan. This will give workers more choices, including private and trust-run hospitals.
Other Support and Cash Benefits for Workers
The ESI scheme does more than just offer health care. It also supports workers during tough times.
Sickness: If a person gets sick and cannot work, they can get 70% of their salary for up to 91 days in one year. But to receive this, they need to have worked and paid into the scheme for at least 78 days in the last six months.
Maternity: Women can get full wages for 26 weeks when they are pregnant or after giving birth. If needed, this can go up by another month based on a doctor’s advice. To get this help, they must have paid into the scheme for 70 days in the last two contribution periods.
Disability benefit: If someone gets injured and cannot work temporarily, they will get 90% of their salary every month until they are well again. If the disability is permanent, then they will keep getting 90% of their salary every month for the rest of their life.
