Employee State Insurance Corporation Health Scheme

Contribution Period

What is Covered? 

Most of the Indian residents can avail the benefits of ESIS. Now, let us take a look at what all are covered under Employee State Insurance Scheme: 

1. Employees working at cinemas, newspaper establishments, restaurants, restaurants, hotels, and shops can avail the benefits of this scheme. 

1. In addition, people working medical and private educational institutes that have an employee capacity of over ten employees can apply for this scheme. 
2. The scheme is accessible to more than 3.49 crore people. 

What is Not Covered? 

The Employee State Insurance Scheme is not applicable to the ones who are earning over Rs.21,000 per month or Rs.25,000, in case of a person with a disability. Apart from this, states like Chandigarh and Maharashtra, the minimum employee capacity of an organization should be 20 employees to apply for this scheme. 

Eligibility Criteria

To apply for Employee State Insurance Scheme, you need to fulfil the following eligibility criteria: 

1. An employee should earn Rs.21,000 per month. 
2. He or she should work in a non-seasonal company that has an employee capacity of more than ten employees. 

Documents Required

You need to submit the following documents to apply for Employee State Insurance Scheme: 

1. Factories Act and Establishment Act registration certificate 
2. Memorandum and Articles of Association 
3. List of all employees in an enterprise 
4. Address proof of all employees, including Permanent Account Number (PAN) Card 
5. Names of directors and shareholders of the company 

1. Annual income details of the company 
2. Cancelled cheque leaf

Documents Required for ESI Returns

1. Register for Form 6
2. Attendance register
3. Inspection book
4. Register of wages
5. Register of any accidents on the premises
6. Returns and monthly challans submitted for ESI

How to Register for ESIC?

Given below are the step by step process to register for ESIC: 

1. Visit ESIC Portal
2. Sign Up to the portal using your details like your name, employer’s name, mobile number, email ID, region, and state. 
3. Click on the checkbox to confirm all your company details. 
4. Click on ‘Submit’. 
5. You will receive your login credentials to your email ID. 

1. Now, login to the ESIC portal using your credentials. 
2. Click on ‘New User Registration’. 
3. Choose your unit type and click on ‘Submit’. 
4. You will be redirected to a new page where you need to submit your unit’s name, address of your factory, and its nearest police station. 
5. Click on ‘Next’. 

1. Next, enter the nature and category of the business, and click on ‘Next’. 
2. Now, enter the date of commencement of the business. 
3. Choose the constitution of ownership and the ownership details. 
4. Click on ‘Save’ 
5. Enter the total number of employees working in your factory and the number of employees earning less than Rs.21,000 per month. Click on ‘Save’. 

1. Enter the date when first ten employees were hired in the company and click on ‘Employee Declaration Form’. 
2. Now, enter the name of the IP, father’s name, date of birth, gender, family details, marital status, and date of joining. 
3. Click on ‘submit’. 
4. You will be redirected to a new page . 
5. Choose ESI branch office and inspection division and click on ‘Submit’. 

1. Click on ‘Pay Initial Contribution’ and click on ‘Submit’ button. 
2. Click on ‘Continue’ to make the ESIC payment. 

ESIC Login Steps

1. Visit the Official Website. 
2. A new page will open where you will have to click on 'Employee/Insured Login'.
3. Enter your login id, password, and the captcha.

How to Apply for ESI Card (Pehchan Card)?

The ESI Card or Pehchan Card is an ID card that used to receive the benefits of ESIS scheme at its network hospitals. The card contains the insured’s name, his or her father’s name, address, as well as the unique ESI number. Apart from this, the card also contains the passport size photograph of an insured and his or her dependent. Given below are the steps to download ESI Card: 

1. Visit ESIC Login Portal
2. Login using your credentials. 
3. Under the ‘Employee’, click on ‘e-Pehchan Card’. 
4. Choose the unit details and click on ‘View’. 

1. You will be able to view details of all workers. 
2. Choose ‘View Counter Foil’ against the respective employee. The ‘Counter Foil’ is the ‘e-Pehchan Card’. 
3. Click on ‘Print’ to download it in PDF format. 
4. You need to sign in to the hard copy of the document along with the photographs of your dependents. This photo should be be attested by the ESIC official or your employer. 

How to Claim ESI Benefits?

A beneficiary can claim the following types of benefits from ESI Scheme: 

1. Medical Benefits: The insured and their dependents can avail healthcare benefits from any ESI network hospitals. 
2. Cash Benefits: The employees who are beneficiaries of this scheme can receive cash benefits in case of sickness, permanent or temporary disability, dependent, maternity, funeral costs, unemployment, confinement, physical and vocational rehabilitation. 

How to Check Claim Status of ESIC Online?

Given below are the steps to check claim status of ESIC online: 

1. Open the UMANG App. 
2. Enter your ESIC Insurance Number and click on ‘Get OTP’. 
3. You will receive an OTP on your registered mobile number. 
4. Enter the OTP and click on ‘Submit’. 
5. Go to ‘Services’ menu and choose ‘Claim Status’. 

1. You will be able to see the claim status, if you have raised any claim. 

ESI Head Office & Helpline Number

The following are the details of ESI Head Office and helpline number: 

Employees’ State Insurance Corporation Panchdeep Bhawan, 

Comrade Indrajeet Gupta (CIG) Marg,

New Delhi – 110 002

Toll Free Number: 1800-11-2526

Benefits of Employees State Insurance Scheme

Given below are the features and benefits of Employees State Insurance Scheme: 

1. Medical: The scheme offers affordable medical facilities to the insured. The employee will receive the insurance coverage from the day one of his or her employment. 
2. Disability: An employee or a worker will receive 90% monthly wage till he or she recovers in case of temporary disablement. However, if an employee has permanent disability, he or she will receive 90% monthly wage for lifetime. 
3. Maternity: The offers beneficiary 100% daily wages for up to 26 weeks, whereas, in the case of miscarriage and adoption, the beneficiary will get 100% daily wages for up to six weeks and 12 weeks, respectively.  
4. Sickness: The scheme provides cash flow during medical leave. The employees can get 70% of the daily wage for a maximum period of 91 days. However, this facility can be availed twice a year. 

1. Dependents: ESIC scheme offers financial assistance to the dependents of the insured in case of any illnesses. 
2. Unemployment: Through the ESIC scheme, the insured will receive 50% of the average monthly wage in case of unemployment or due to permanent invalidity caused by an injury. 
3. Confinement Costs: The insured or the dependents will receive the confinement costs if confinement occurs where there is no healthcare under ESIC scheme. 
4. Old Age Medical Care: When an insured retires from the company after the age of 60 years, the insured or his spouse will receive Rs.120 per annum.