The Employees' State Insurance Corporation would, therefore, essentially be an integral part of the Social Security Scheme of India entertained first through legislation under the Employees' State Insurance Act, 1948. This was implemented to provide security benefits to employees and their dependants during sickness, maternity, temporary or permanent disablement, and death caused by employment injury. It provides for the Employees' State Insurance Corporation, whereby every worker, irrespective of any ailment or mishap in the course of industry operations, gets sufficient health attention and support regarding their finances, consequently ensuring vigor and health in the workforce.

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What Is ESIC?

The ESIC Act, of 2024, has broadly mandated a self-financing scheme covering facilities of Social Security and Health Insurance for Indian workers. It makes itself applicable to all establishments having 10 or more employees, thus including those workers whose wage earnings are on or less than Rs. 21,000 per month. 

This move certifies umbrella benefits that include medical services through ESIC hospitals, dispensaries, and clinics under a pan-India network. It provides financial support to the insured in times of sickness, maternity, disablement, or death, and dependent benefits in case of death of the insured due to employment injury.

Applicability Of ESIC

ESIC applies to the following categories of employees:

• Factory

ESIC applies to factories where manufacturing activities are conducted and where there are 10 or more employees. It means any industrial establishment or premise where goods are manufactured, either with the use of machinery or equipment. All factories fall under the purview of the ESIC Act, of 1947; its applicability extends to large manufacturing units and smaller units of production, too, spread over a large number of industries like textiles, engineering, pharmaceuticals, and other small and large-scale production facilities.

• Non-Manufacturing Establishment

This extends the coverage of ESIC to non-manufacturing establishments. Shops, hotels, restaurants, cinemas, theatres, newspaper establishments, educational institutions (private and Government), and other commercial establishments with 10 or more employees are covered. The scheme ensures that employees engaged in service-oriented sectors benefit under its provisions about medical care and financial assistance during incapacity.

• Employees Covered

ESIC not only applies to permanent workers but also extends its services to temporary employees in the specified establishments. Thus, for workers to benefit under the scheme as of 2024, they should earn up to Rupees 21,000 per month. This limit shall cover most the people working on entry-level to mid-level in any particular organization by giving them health care and various other social security-related benefits.

• Indirect Employees

Apart from direct employees, ESIC also covers indirect employees who are working through contractors or subcontractors on certain conditions. This should be an important consideration since workers indirectly appointed but working in ESIC-covered premises are also given the benefit of medical care and financial support during any emergency or health-related issue.

Features Of The ESIC

Medical care and attention

The scheme provides full medical care and attention to those employees, covered under the ESI Act, of 1948, during periods of incapacity for restoring health and working capacity.

Medical Benefits to Dependent Family Members:

The family members of the enrolled worker are also kept under the medical scheme; hence, the benefits are not solely dependent on the individual who is insured.

Scale of Benefit:

As of 31st March 2022, the ESI Scheme includes a considerable number of beneficiaries, amounting to 12.04 crore, which demonstrates its far-flung reach among the employees.

Categories of Benefits:

The benefits provided under the scheme may broadly be classified under two heads-cash benefits and noncash benefits in terms of medical care:

• Cash Benefits: Sickness benefits, maternity benefits, disablement benefits – temporary and permanent-, funeral expenses, Rehabilitation Allowance, Vocational Rehabilitation, and Medical Bonus.
• Non-Cash Benefits: Mostly comprised of medical care that is provided through a network of ESIC hospitals, dispensaries, and clinics.

Self-Financing and Contributory Nature:

• The ESI Scheme is self-supporting, financed by contributions from employees and employers. Contributions are made monthly at a fixed percentage of the wages paid.
• The employee's contribution currently stands at 0.75% of wages, whereas that of the employer is at 3.25% of wages paid.
• Whether the Employer will contribute on behalf of those employees whose average daily wage is not more than rupees 137. In that case, the said worker would be exempted from paying his contribution.

Contribution Mechanism:

• The employer shall deduct employees' contributions from wages and shall pay his contribution and the employees contribution with ESIC on or before 15 days from the end of the calendar month in which the contributions become due.
• Online contributions or through some public sector banks that are specially designated and authorized would prove to be easy and convenient for the management of contributions.

Process Of ESIC Registration

• First of all, log in to the official website of ESIC. Most probably, there will be a section on the home page regarding "Online Services" or "e-Services."
• In case you are a new user, first click on "Click here to Register" or "New Registration" and fill in your name, email ID, and mobile number. In the case of a previously registered user, log in accordingly.
• Log in and select the service you intend to apply for. Among these are services that the ESIC is delivering online, which include registration, payment of contribution, and claim of benefits.
• An applicant shall fill up the online application form corresponding to the chosen service with the correct details. These could relate to personal details, employment details, or bank account details in case one is claiming benefits.
• Upload documents, if necessary, which are instructed. It may belong to ID proof, address proof, salary details, etc.
• Check all the entries that are made and documents you uploaded. See that all entered information should be correct and then submit it.
• One has to pay online in case of services, if any, requiring a fee through the online payment gateway.

Contribution Process

Contribution rates (Reduced w.e.f. 01/07/2019)

Calendar of Contribution Payment: Contributions have to be deposited with ESIC within 15 days from the end of the calendar month within which the wages became due. Contributions may be paid online on the ESIC portal or by contributing banks.

Recent Reforms And Future Outlook

The ESIC has gone through various reforms related to service improvement, coverage increase, transparency, and accountability. Some of the key reforms include:

• Digitalization: Online portals for registration, contribution payment, and processing for claim settlement are developed to smoothen the administrative process and bring down delays. 
• Expansion in coverage: A proposal to extend the ESIC facility to more sectors, especially informal and small-scale establishments, using awareness campaigns, outreach programs, and other mobilization efforts. Up-gradation, expansion of ESI hospitals, dispensaries, and clinics to provide quality and accessible healthcare; Partnerships with the Private Sector: entering into tie-ups with private health players, more so with the most modern and provided by Community Health Centres to lessen the burden on public healthcare infrastructure.

Conclusion

ESIC has remained one of the cornerstones of India's social security architecture and is instrumental in providing relevant benefits to millions of employees and their dependents. Though the scheme has undergone myriad changes with the changing socio-economic scenario during all these decades, continuous reforms and some strategic initiatives may become necessary to weed out existing challenges and ensure further growth on a sustainable footing. In other words, ESIC is that lifeline that Assurance for Health and Welfare of Indian Workers dispenses an amalgamation of assured medical care and monetary support during a time of distress. This can be further strengthened by enhanced awareness about the scheme, extension of coverage, and improvement in functional efficiency, thereby leaving a positive imprint on the country's socio-economic development. Because of this, continued efforts by all its stakeholders—government, employers, employees, and healthcare providers—are needed if ESIC is to live up to its promise and be one of India's mainstays in the social security framework.