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The Employees' State Insurance Act & The Scheme Checklist
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| Applicability of the Act & Scheme |
Is extended area-wise to factories using power and employing 10 or more persons and to non-power using manufacturing units and establishments employing 20 or more persons upto Rs. 6500/- per month. It has also been extended upon shops, hotels, restaurants, road motor transport undertakings. equipment maintenance staff in the hospitals. |
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| Coverage of employees |
Drawing wages (w.e.f. 1-10-2006) upto Rs. 10,0007-per month engaged either directly or thru' contractor. |
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| Rate of Contribution of the wages |
Employers' 4.75%
Employees' 1.75% |
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| The Esi Scheme Today |
No. of implemented Centres
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677 |
No. of Employers covered
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2.38 lacs |
No. of Insured Persons
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85 lacs |
No. of Beneficiaries
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330 lacs |
No. of Regional Offices/SRO's
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26 |
No. of ESI Hospitals/Annexes
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183 |
No. of ESI Dispensaries
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1453 |
| No. of Panel Clinics |
2950 |
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Manner and Time Limit for making payment of contribution
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The total amount of contribution (employee's share and employer's share) is to be deposited with the authorised bank through a challan in the prescribed Form in quadruplicate on or before 21" of month following the calendar month in which the wages fall due. |
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Benefits to the employees under the Act |
Medical sickness, extended sickness for certain diseases, enhanced sickness, dependants, maternity, besides funeral expenses, rehabilitation allowance, medical benefit to insured person and his or her spouse. |
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Wages for Esi Contributions |
Registers/fifes to be maintained by the employers |
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| To be deemed as wages |
• Basic pay
• Dearness allowance
• House rent allowance
• City compensatory
• Overtime wages (but not
to be taken into account
for determining the coverage of an employee)
• Payment for day of rest
• Production incentive
• Bonus other than statutory bonus
• Night shift allowance
• Heat, Gas & Dust allowance
• Payment for unsubstituted holidays
• Meal/food allowance
• Suspension allowance
• Lay off compensation
• Children education allowance (not being reimbursement for actual tuition fee)
• Conveyance |
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| NOT to be deemed as wages |
• Contribution paid by the employer to any pension/provident fund or
• Sum paid to defray special Daily allowance paid for the period spent on tour.
• Gratuity payable on discharge
• Pay in lieu of notice of retrenchment compensation
• Benefits paid under the ESI Scheme
• Encashment of leave
• Payment of Inam which does not form part of the terms of employment
• Washing allowance
• Amount towards reimbursement for duty related journey. |
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Contribution period |
1st April to 30thSeptember
1stOctober to 31st March |
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| Benefit period |
If the person joined insurable employment for the first time, say on contribution period will be from 5th January to 31" March and his corresponding first benefit will be from 5" October to 31" December. |
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| Penalties |
Different punishments have been prescribed for different types of offences in terms of section 85 :
(i) (six months imprisonment and fine Rs. 5,000),
(ii) (one year imprisonment and fine), and 85-A :
(five years imprisonment and not less to 2 years) and 85-C(2) of the ESI Act, which are self-explanatory Besides these provisions, action also can be taken under section 406 of the I PC in cases where an employer deducts contributions from the wages of his employees but does not pay the same to the corporation which amounts to criminal breach of |
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| The ESI Benefits |
Employees' State Insurance Act, 1946 Is the first major legislation on comprehensive social security for workers in Independent India. The Act envisages social protection of workers in conceivable exigencies such as deployed In organised sector of Independent India. The details of benefits, conditions for eligibility ana duration or benefits is& as follows;: |
| S/n |
Benefits |
Eligibility Conditions |
Duration & Scale of Benefits |
| 1. Sickness Benefit (SB) |
| 1 a |
Ordinary SB |
Payment of contribution for 7B days In one contribution period of 6 months.
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Upto 91 days in 2 consecutive benefit periods at the standard Sickness Benefit Rate (S0R) i.e. just above 50% of the wages. |
| 1 b |
Enhanced SB
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Sams as above |
14 flays for ubectomy & 7 days (or vasectomy. extendable on medical advice. Rate Of payment 100% of the wages. |
| 1 c |
Extended SB |
For 34 specific iong-ierm diseases. Continuous insurable employment for 2 years with 156 days contribution in consecutive contribution periods.
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124 days which may be extended up lo 2 years on medical advice during a period of three years in insurance employment. Rate: 70% wages approx. |
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| 2. Disablement Benefit (DB) |
| 2 a |
Temporary DB
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From day 1 of entering employ man! & irrespective of having paid any contribution.
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As long as temporary disablement lasts Rate : 70% of wages approx. |
| 2 b |
Permanent DB
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Same as above |
For whole life. Rate ; Up to 70% of wages depending upon loss of earning capacity. |
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| 3. Dependents Benefit |
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From day 1 of entoring insurable employment & Irrespective of having paid any contribution in case of death due to employment injury. |
For life to the widow or until her re-marriage. To the legitlmate dependant children till the age of 18 years. To dependent parents for life, Rate; 70% of the wages approx. shareable in fixed proportion. |
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| 4. Maternity Benefit |
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Payment of contribution for 70 days in 2 preceding contribution periods (1 year) |
12 Weeks in case of normal delivery. 6 weeks in case of miscarriage. Extendable by 4 weeks on medical advice Rate : Almost full wages. |
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| 5. Medical Benefit |
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Full medical facilities for self and dependants from day 1 of entering insurable employment. |
Full medical care till disease or disablement lasts. No ceiling or upper limit on expenditure for individual cases, Retired insured persons who have been in insurance employment for atleast 5 years before
superannuation and disabled insured persons and entitled to full medical care for self and spouse only on payment of Rs. 120/- as annual contribution. |
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| 6. Funeral Expenses |
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From day 1 of entering insurable employment. |
For defraying expenses on the funeral of an Insured person. Rate: Actual expenses subject to a maximum of Rs. 2500/- |
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| 7. Vocational Rehabilitation |
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In case of physical disablement due to employment injury. |
As long as vocational training lasts. Actual fee charged or Rs. 45/- a day whichever Is more. |
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| 8. Physical Rehabilitation |
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Same as above |
As long as a person is admitted In an artificial llmb center. Rate: 100 percent of wages. |
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