Healthcare is essential for everyone. Diseases and health-related issues do not discriminate between people, so why should we discriminate when offering good quality and professional healthcare to anyone with a medical issue or ailment? India has a vast population and is said to be moving towards being the most populous country in the world. Among the citizens who reside in this country, many people are currently employed. They work regularly and ensure the development and progress of the country. These people are all essential to India becoming a stronger nation, and their presence is vital. We must take their medical needs into account. The government of India has initiated schemes to serve different purposes, and the Employees’ State Insurance Scheme (ESI Scheme) is no different. The ESIS is an integrated measure of Social Insurance embodied in the Employees’ State Insurance Act which protects ’employees’ as per the Employees’ State Insurance Act, 1948. The ESIS aims to protect eligible employees against various medical issues, including health-related issues such as sickness, maternity, disablement, or death due to employment injury, to provide medical care to insured persons and their families.

Employees’ State Insurance Scheme Eligibility

Every Scheme that the government of India has made seeks to serve some purpose, and the advantages offered to the person that has taken up the Scheme offered through the Scheme to serve that purpose are known as benefits. The group that the ESI Scheme benefits or ESIS benefits are given to is called the eligible group. The conditions that a person may have to belong to the eligible group that can avail of the ESI Scheme or ESIS benefits are called the ESI Scheme eligibility criteria. Most schemes started by the government have different eligibility criteria based on the final goal they seek to accomplish, just like the ESI Scheme eligibility criteria. Employees’ State Insurance Scheme (ESI Scheme) has been initiated to protect ’employees’ against the impact of incidences of sickness, maternity, disablement, and death due to employment injury and to provide medical care to insured persons and their families as defined in the Employees’ State Insurance Act, 1948.

General Employees’ State Insurance Scheme Benefits

There are some noteworthy Employees’ State Insurance Scheme benefits. In terms of medical ESI Scheme benefits or ESIS benefits, the medical expenses of the person who has taken the insurance offered under the Scheme will be covered through the necessary affordable and reasonable healthcare facilities. Additionally, the worker or the employee is covered from their first employment day. Regarding disability and the Employees’ State Insurance Scheme, if a worker meets the ESI Scheme eligibility conditions, is a beneficiary of the Scheme and becomes temporarily disabled for some reason, they will be eligible for a monthly wage of 90% until they recover concerning their disability. If the person becomes permanently disabled, 90% of the monthly wage amount can be availed for the entire life of the disabled person.
With regard to sickness, when a person has taken medical leave, cash flow will be offered when they are absent from their workplace so that they may have some means of livelihood and maintain their livelihood. The worker can avail 70% of the daily wage amount for a maximum of 91 days. This amount may be availed in two consecutive periods. In a situation where confinement has occurred at a particular location where required medical care under the Scheme is not available, the insured or the person who is their dependent may avail confinement costs.

There is a benefit related to the Employees’ State Insurance Scheme (ESI Scheme) based on the requirement of the person who is a beneficiary of the Scheme. This will be available to people that are permanently disabled. They will receive Vocational Rehabilitation (VR) training at VRS. Physical Rehabilitation will also be provided to a person if they meet the conditions of ESI Scheme eligibility or ESIS eligibility and are a beneficiary of the Scheme. This benefit is also provided based on the need, especially in the case of disability due to employment injury. In terms of Old Age Medical Care that may be offered, when the beneficiary retires on attaining the retirement age or under VRS or ERS or when a person has to leave work due to permanent disability, the insured person or beneficiary and their spouse will receive an amount of Rs.120 per annum.

Employment-Related Employees’ State Insurance Scheme Benefits

Employees who meet the ESI Scheme eligibility conditions may get work-specific or employment-specific Employees’ State Insurance Scheme or ESIS benefits. Through the Scheme, dependents of the person insured by the Employees’ State Insurance Scheme (ESI Scheme) or ESIS can get some form of monetary assistance in case of illness or injury due to work. In such instances, the dependents are eligible for monthly payments equally distributed among the surviving dependents. In terms of unemployment benefits, for 24 months, through the Scheme, a maximum of 50% of the average monthly wage for involuntary loss of non-employment or permanent invalidity due to injury is offered to the person. Under the Employees’ State Insurance Scheme (ESI Scheme), the workers or employees will be given coverage from the first day they are employed, including the insured as well as their dependents.

Maternity Employees’ State Insurance Scheme Benefits

Maternity benefits are crucial for healthcare and may be among the most critical medical needs. There are ESI Scheme benefits related to maternity as well. It is important to ensure that maternal needs and maternity-related medical services are of good quality. This is not only for the health of the pregnant woman or the mother but also for the health of the child that they will be giving birth to or have given birth to, as these children that are born through the maternal care provided through Employees’ State Insurance Scheme (ESI Scheme) will comprise our next generation. If the next generation is healthy and has also had a good start in life in the medical sense through ESIS, then they will be better employees and more productive citizens in the future as well. This will be beneficial to them and their families on a personal level but also on a national level as it will push forth the development of the country. When it comes to the Maternity benefits that may be availed, the beneficiary may avail 100% of the daily wages for up to 26 weeks, which can be extended to a further one month based on the medical advice per the Employees’ State Insurance Scheme (ESI Scheme). If the person goes through a miscarriage, the period that they will receive benefits is 6 weeks, whereas, in the case of adopting a child, they will have access to the necessary benefits for 12 weeks.

Funeral Employees’ State Insurance Scheme Benefits

ESI Scheme benefits may also cover costs related to funerals. A funeral is a difficult time for any person. It is hard to lose a loved one or a person that one cares about. During this time of grief and loss, it may be challenging to make all the necessary arrangements and payments to conduct the last rites of a person and adequately carry out their funeral. The Employees’ State Insurance Scheme (ESI Scheme) provides assistance when it comes to this situation. Funeral costs are also covered by the Employees’ State Insurance Scheme (ESI Scheme). The ESIS offers an amount of Rs.15,000 towards funeral costs. This is paid to the dependents or to the individual who does the last rites of the insured.

Where Is The Employees’ State Insurance Scheme Applicable?

The schemes started by the government of India may have different areas of focus concerning where they apply. ESI Scheme benefits may be availed by those who meet the ESI Scheme or ESIS eligibility criteria. The ESIS applies to any entity that employs ten or more people, such as shops, hotels, restaurants that are not engaged in manufacturing, cinemas, road motor transport establishments, newspaper establishments, and private educational and medical institutions. The lowest amount of employees that are necessary to subscribe to the Employment State Insurance Scheme (ESI Scheme) or ESIS varies with states, such as Maharashtra, Meghalaya, Mizoram, Nagaland, Goa, Chandigarh, and Assam-20; Jharkhand, Haryana, Karnataka, Rajasthan, Tripura, West Bengal, Andhra Pradesh, and Delhi-10.

Employment State Insurance Scheme & Wage Limit

There are particular conditions for employees who can take up the Employees’ State Insurance Scheme (ESI Scheme). Some of these conditions are also wage-related. Employees with an Rs.21,000 monthly salary can benefit from the Employees’ State Insurance Scheme (ESI Scheme). In simplified terms, employees currently working for factories/establishments with ten or more employees and drawing up wages of up to Rs.21,000 per month are entitled to health benefits or ESIS benefits under the ESI Act. There are exemptions to the rule for daily average wages of Rs.137. They do not have to contribute to the Scheme from their wages. Only the employer’s contribution amount may be paid to people who belong to such a category.

When Is ESIS Registration Required?

If a company, organization, or business establishment employs 10 or more employees/workers and, in the case of Maharashtra and Chandigarh, more than 20 employees, then registration for the Employment State Insurance Scheme (ESI Scheme) will be required. The company should register with the Employment State Insurance Scheme (ESI). As for workers or employees are covered or entitled under ESI when they earn less than an amount of Rs.21,000 per month and Rs.25,000 in the case of a disabled person or disabled worker. Some amount will be contributed by both the employee and employer when it comes to the Employment State Insurance Scheme (ESI Scheme). The worker contributes 1.75% of their salary, while the employer contributes 4.75% towards the Employment State Insurance Scheme (ESI Scheme) scheme. These rates change from time to time, so one must be aware of what the rates may be at the present moment. The workers whose daily average wage is up to Rs.50 do not have to contribute to the Employees’ State Insurance Scheme (ESI Scheme) fund. It must, however, be noted that employers must continue to contribute toward these workers.

Documents Necessary For ESIS Online Registration

Every Scheme may have different documentation to ensure a person’s identity, ensure that there is no fraud, and confirm the kind of benefits that a particular beneficiary may be used for, among several other reasons. One may want to know the documents they must produce for the Employees’ State Insurance Scheme (ESI). The Employees’ State Insurance Scheme (ESI Scheme) may be registered online. For registering for any scheme such as ESIS, a person must collate certain documents and present them accordingly. To register online for the Employees’ State Insurance Scheme (ESI Scheme) correctly, the person must also know the documents they must gather and present. There are a particular set of documents required for ESI online registration. These documents are the Registration Certificate acquired under the Shops and Establishment Act or Factories Act, Certificate of Registration in case of a partnership or a company, Articles of Association and Memorandum of Association of the company, List of all employees working in the establishment, Compensation details of all employees, PAN Card details of the Business Entity and all employees, a Cancelled cheque of the bank account of the company, List of shareholders and directors of the company, Register which includes the attendance details of the employees, Employer’s Registration Form (Form No.1) which should be downloaded online, filled and uploaded on the Employees’ State Insurance Scheme (ESI Scheme) website along with the documents mentioned above.

ESIS & Universal Healthcare

Universal healthcare is an important area of discussion. Healthcare affects everyone, and being able to provide every person with healthcare could change the lives of several people. Universal healthcare means that people from a particular country, region, society, etc., may be afforded healthcare regardless of their background, status, gender, age, caste, creed, etc. A citizen will have access to good quality healthcare throughout the territory of a nation that can provide universal healthcare to its citizens. While many countries have laid emphasis on universal healthcare, and some have even been successful in doing so, providing healthcare to all in India is a huge task because of the large size of the population of the country, which is now being said to be the biggest population of any country in the world. However, a different approach that the Government of India has taken to move towards the goal of providing everyone with good quality healthcare is possibly through schemes.

The Employees’ State Insurance Scheme (ESI Scheme) is such a scheme that lays focus on the employees of the country, providing them with different Employees’ State Insurance Scheme benefits through which they may be able also to find it easier to receive different kinds of medical services at medical facilities. The rest of the population may have the financial means to afford health-related treatments on their own despite other issues such as misinformation, malpractice, etc. It may not need the Employees’ State Insurance Scheme as much. So the groups that may subscribe to the Employees’ State Insurance Scheme (ESI Scheme) will generally belong to the group who cannot, thereby ensuring that universal healthcare may at least be afforded to some extent in the country as we move towards our goal of being able to provide everyone with medical services and reach the ideal situation of universal healthcare.

History Of The Scheme

Understanding the history of a scheme is essential, which is the case with the Employees’ State Insurance Scheme too. The history of a scheme may tell us how and when a scheme was started, what goal it seeks to serve in its initiation, and the impact it has made since its initiation. It is a crucial aspect that helps us understand if a scheme has been successful in its purpose, how necessary the Scheme is, and if the country’s administration has successfully created a scheme to serve an essential purpose. The Employees’ State Insurance Scheme (ESI Scheme) was inaugurated in Kanpur on 24th February 1952, also known as ESIS Day. The inauguration was done by the then Prime Minister Pandit Jawahar Lal Nehru. The venue was the Brijender Swarup Park, located in Kanpur. Prime Minister Pandit Jawahar Lal Nehru addressed 70,000 people in the Hindi language. There were lots of important names present at this event, which made it even more significant. Pt. Gobind Ballabh Pant, Chief Minister Uttar Pradesh, Babu Jagjivan Ram, Union Labour Minister, Raj Kumari Amrit Kaur, Union Health Minister, Sh. Chandrabhan Gupt, Union Food Minister, and Dr. C.L.Katial, the first Director General of the Employees’ State Insurance Scheme (ESI Scheme), were all present at the event.

The Employees’ State Insurance Scheme (ESI Scheme) was simultaneously launched in Delhi, and the initial coverage for both centers was 1,20,000 employees. Our first Prime Minister was the first honorary insured person of the Scheme. The Parliament’s promotion of the Employees’ State Insurance Act (ESI Act) to the public in 1948 was the first major social security legislation for workers in independent India. It was a time when the industry was still nascent, and the country depended heavily on an assortment of imported goods from developed or fast-developing countries.

The Employees’ State Insurance Scheme (ESI Scheme) was instigated in Kanpur and Delhi in 1952 because these cities comprised two major industrial hubs. The Scheme was then eventually introduced in other parts of the country. As of 31 March 2019, it has been implemented in more than 34 states and Union Territories. The ESI Act expands over 12 lakh factories and business establishments and benefits more than 3 crore workers or family units. The Scheme currently benefits more than 13 crore citizens of India in some form of employment.

What Is Not Covered Under ESIS?

Every Scheme has some benefits and goals that it lays focus on. While there may be some areas of focus of a scheme, there may also be some things that are excluded from a particular scheme. These areas not considered focus areas under a scheme are known as the exclusions to a scheme. The persons that meet the ESIS eligibility criteria may be able to have access to some benefits but must keep in mind what aspects are not covered under the benefits of the Scheme. The ESIS scheme currently does not cover workers or employees earning more than Rs.21,000 per month, and in the case of persons with a disability, the maximum wage is capped at Rs.25,000 per month. Also, in Maharashtra and Chandigarh, the current threshold for coverage is still 20 employees and not 10 employees in the case of other states or Union Territories.

The Infrastructure Of The Employees’ State Insurance Scheme

When observing different schemes and trying to pick between them, one may want to understand at least the basic infrastructure related to the particular Scheme. The Employees’ State Insurance Scheme (ESI Scheme) has its own infrastructure. Since the inception of the Employees’ State Insurance Scheme (ESI Scheme) in 1952, the ESI Corporation has set up many hospitals and annexes that offer different kinds of medical services to the beneficiaries of the ESIS and those who meet the ESIS eligibility criteria. The ESIS infrastructure network is the network through which workers or employees can adequately avail of healthcare services through the Scheme.

Conclusion

The Employees’ State Insurance Scheme (ESI Scheme) is an important scheme that focuses on the country’s employees, who are key to the development of the country. By aiming to protect those who are eligible employees against varying kinds of medical issues which may involve health-related issues such as sickness, maternity, disablement, or death due to employment injury to provide medical care to insured persons and their families, the Employees’ State Insurance Scheme (ESI Scheme) also ensures that the elements of productivity of the country will be protected if their health is maintained. Ensuring that the basic needs of the country’s employees are met to at least some extent will secure the steady development of the country. Since its inception, the Employees’ State Insurance Scheme (ESI Scheme) has served this purpose. It has therefore proved to be a critical scheme in India and for Indian citizens who are employees.

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