Employees State Insurance Scheme (ESIS): Features & Benefits

Employee State Insurance Scheme (ESIS) is a social security scheme that provides financial and medical benefits to employees in India. The scheme is administered by the Employee State Insurance Corporation (ESIC), a statutory body created under the Employee State Insurance Act, 1948. In this article, we will discuss the features and benefits of the Employee State Insurance Scheme.

Features of Employee State Insurance Scheme

The following are the features of the employee state insurance act:

1. Eligibility

The ESIS insurance is available to employees who earn less than Rs. 21,000 per month. This includes both employees who are working either full-time or on contractual basis. This criterion ensures that you are provided sufficient coverage no matter what your income level.

2. Medical benefits

The ESI scheme provides medical benefits to employees and their dependents. This includes hospitalization, medical treatment, and maternity benefits. The scheme covers both illnesses, either pre-existing or new. This benefit is suitable for people who might not be able to afford a separate health plan due to financial constraints.

3. .Cash benefits

The employee state insurance also provides cash benefits to employees who are unable to work due to sickness or injury. This includes up to 70% of the employee's salary during the period of absence. This acts as an alternate source of income and can be used to take care of vital expenses as well.

4. Registration

Employers are required to register their employees under the Employee State Insurance Scheme within 15 days of the employee's joining date. Failure to do so may result in action on the employer by the authorities.

Benefits of Employee State Insurance Scheme

These are the benefits of the employee state insurance act:

- Health benefits

The scheme provides health benefits to employees and their dependents. This includes hospitalization, medical treatment, and maternity benefits. The scheme covers both pre-existing and new illnesses. This provides employees and their families with an access to quality healthcare services.

- Financial benefits

The scheme provides financial benefits to employees who are unable to work due to sickness or injury. This includes up to 70% of the employee's salary during the period of absence. This helps employees to cope with financial difficulties during the period of illness.

- Disability benefits

In case of permanent or temporary disability, the scheme provides benefits up to 90% of the employee's salary. This helps employees to maintain their standard of living and meet their financial obligations.

- Maternity benefits

The scheme provides maternity benefits to female employees. This includes paid leave and medical expenses. This ensures that female employees are able to take care of their health during pregnancy and after childbirth.

- Funeral expenses

In case of the employee's death, the scheme provides funeral expenses up to Rs. 10,000. This helps the employee's family to cope with the financial burden of funeral expenses.

- Reduced absenteeism

The Employee State Insurance Scheme provides medical benefits to employees. This ensures that employees are able to access healthcare services when needed. As a result, employees are less likely to miss work due to illness, leading to reduced absenteeism.

- Improved productivity

The scheme provides financial and medical benefits to employees. This ensures that employees are able to maintain their standard of living and cope with financial difficulties during the period of illness. As a result, employees are more likely to be motivated and productive at work.

Is ESIS Sufficient Enough for You?

The benefits offer under employee state insurance provide the financial support you might require during emergencies. However, in a major medical emergency, the amount offered under the scheme might not be sufficient enough to cover the cost of treatment. Having a back up plan is important in such situations. Purchasing a health insurance policy can be beneficial for you. The sum insured amount in the policy is more than enough to cover the cost of a major procedure. Additionally, the policy also covers other expenses such as ambulance fees, room rent, doctor visits and medical tests charges. The policy makes sure you are covered and not required to pay out of pocket, thus ensuring you have enough savings for other emergencies. Having an additional health plan provides an added layer of financial security without having to rely on one single policy.*

Conclusion

The scheme provided by the government serves many benefits for you as mentioned above. It does reduce the financial burden from your shoulders posed by medical emergencies. However, having another policy, like health insurance, provides you with an extra layer of financial support. You might exhaust the benefits of the government provided insurance scheme, which might cause problems in covering the medical costs. Having a health plan ensures you do not face such situations and have sufficient amount of monetary back up to take of the medical expenses.   *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.