Best government's health insurance plan | The ESI Scheme by Decode

Presently, more than 10 million Indians are working in the private sector including the manufacturing sector with having tensions for their health, income, and for their dependents as well.

To reduce this level of stress of many employees, the Government of India had implemented the ESI scheme which has many benefits for insured employees and workers.

What is an ESI Scheme?

ESI (Employee's State Insurance) scheme was founded on 25th February 1952 to provide security against health-related eventualities by the Government of India. There were two major industrial areas at that time, so the ESI scheme was initially implemented in both areas. This scheme enables workers and employees to nullify the financial burden due to such unfortunate casualties.

• This scheme provides medical care for an insured employee and his dependents. (such as - Wife, children, mother, and father) 

• This scheme also offers many benefits to the insured and their dependents like free medical care, maternity, pension, etc.

• This scheme is for employees working in a company or an organization with more than 10 employees.

Where ESI schemes are implemented?

As of 31st March 2021, ESI Scheme has been implemented in 568 districts in all the states and Union Territories, except Lakshadweep. Presently, this scheme covers more than 2.13 crores of insured employees and total beneficiaries are more than 8.28 crores.

Infrastructure network of ESI scheme in India:

• There are 5 Occupational disease centers in India -

1. In Mumbai ( Maharashtra).
2. In New Delhi.
3. In Kolkata (West Bengal).
4. In Chennai (Tamil Nadu) and
5. In Indore ( Madhya Pradesh).

• There are 151 hospitals for In-Patient Services.

• There are 1,450 ESI Dispensaries, 188 Ayush Units, and 954 Panel Clinics.

• There are 628 Branch offices and 185 Pay Offices ( Supervised by 62 regional, sub-regional and Divisional Offices).

Who is eligible for the ESI scheme?

A worker or an employee who earns less than Rs.21,000 per month and less than Rs.25,000 per month in the case of a person with a disability is eligible for ESI Scheme.

Contributions in ESI scheme:

Employee - 0.75% of Gross salary

Employer - 3.25%

Note - Contributions given by employees are not refundable under any circumstances but they are eligible for the benefits that it offers.

What are the benefits given under the ESI scheme?

Following are the benefits given to the insured employee :

1. During illness leave, amount of 70% of the salary is paid by ESIC ( Employees State Insurance Corporation).
2. If any serious casualties happen with an employee during work ( like- burn, cut, handicap, injury, etc.) then ESIC will give 90% of the salary to an employee as a pension for a lifetime.
3. During maternity, ESIC pays the salary for 6 months in leave period to the female employee.
4. During Miscarriage, ESIC provides 6 weeks extra leave without deducting a single penny from the female employee's salary.
5. ESIC provides free medical care to the insured employees and to their dependents
6. ESIC also provides the facility of reimbursement of money if an insured employee has taken treatments from another private hospital that are nominated by ESIC.

Note:- From 2021, the Government of India issued a notification regarding the reimbursement that if there are no ESIC hospitals nearby an insured employee within 10kms then he/she is eligible for free treatment by showing E- Pehchan card issued by ESIC.

7. In case of death of the insured employee, ESIC gives Rs. 15,000 to his/her family and Nominee will get a pension for a lifetime.

To claim all these above benefits, you have to register under ESI Scheme. You can easily register on the ESIC website or from the ESIC offices that are nearby you.

If you are an employee of a private organization where total employees are more than 10 employees, you still have not registered under the Scheme. So, what are you waiting for?????

Go and register now!!!!!!!