Comprehensive Guide on Employee State Insurance (ESI) in India

1. Introduction to Employee State Insurance (ESI)

Employee State Insurance (ESI) is a social security and health insurance scheme governed by the Employees State Insurance Act, 1948. It is regulated by the Employees State Insurance Corporation (ESIC) under the Ministry of Labour & Employment, Government of India. The primary objective of ESI is to provide financial protection and medical benefits to employees and their dependents.

2. Applicability of ESI Registration

2.1 Mandatory ESI Registration

• Factories: All factories employing 10 or more workers must register for ESI.
• Establishments (Other than Factories):
  
  • In some states, registration is required for 10 or more employees.
  • In other states, the threshold is 20 or more employees.

2.2 States with 10 Employee Threshold

Jharkhand, Kerala, Orissa, Pondicherry, Punjab, Rajasthan, Tripura, Delhi, Karnataka, West Bengal, Andhra Pradesh, Bihar, Chhattisgarh, Gujarat, Haryana, Uttarakhand.

2.3 States with 20 Employee Threshold

All other states where the 20-employee limit applies.

3. Benefits of ESI Scheme

ESI provides various benefits to employees and their dependents:

3.1 Medical Benefits

• Full medical care for employees and their families.
• Access to ESIC hospitals and dispensaries.

3.2 Sickness Benefits

• 70% of average daily wages for up to 91 days during a certified illness.

3.3 Maternity Benefits

• 100% of average daily wages for 26 weeks (extendable by 4 weeks).

3.4 Dependents’ Benefit

• Monthly payments to dependents in case of an employee’s death due to employment-related injury or disease.

3.5 Disablement Benefit

• Monthly payments in case of temporary or permanent disability caused due to workplace accidents.

3.6 Funeral Expenses

• A lump sum payment for funeral costs up to Rs. 15,000.

4. Online ESI Registration Process

4.1 Steps for Registration

1. Visit the ESIC Portal: Navigate to esic.in.
2. Sign Up/Login: Employers must register by creating an account.
3. Fill in Establishment Details:
   
   • Name, Address, Date of Incorporation
   • PAN, Type of Establishment
4. Provide Employee Details:
   
   • Employee Count, Salary Details, Aadhaar & PAN for IP Number
5. Upload Documents:
   
   • PAN Card of Proprietor/Partner/Director
   • Proof of Address (Electricity Bill, Water Bill, etc.)
   • Aadhaar Card
   • GST Certificate/Shop & Establishment Certificate
   • Digital Signature Certificate (DSC)
   • Bank Account Details
6. Submit Application
7. Receive ESIC Number: Post-verification, an ESIC number will be issued.

5. Employer’s Responsibilities Under ESI

5.1 Contribution Requirements

• Employee Contribution: 0.75% of wages
• Employer Contribution: 3.25% of wages

5.2 Timely Compliance

• Monthly ESI returns must be filed online.
• Contributions must be deposited within 15 days of the following month.

This guide provides all the necessary information for ESI registration and compliance. For expert assistance, consult ReturnFilings.Com to ensure seamless compliance with all regulatory requirements. For professional assistance, reach out to us on email: info@returnfilings.com or on whatsapp: https://wa.me/919910123091.

6. Additional Resources

For further reading, explore:

• Provident Fund (PF) Registration Compliance: Process, Requirements, and Employer Obligations.
• PF and ESI Statutory Returns & Compliance: Filing Process, Deadlines, and Employer Responsibilities.
• Trade License Registration: Process, Documents Required, and Compliance.
• Shop and Establishment Registration: Process, Eligibility, and Compliance Requirements.

Frequently Asked Questions (FAQs) on Employee State Insurance (ESI) in India

A. General Information about ESI

1. What is Employee State Insurance (ESI)?

The Employees’ State Insurance (ESI) scheme is a social security scheme that provides medical benefits, sickness benefits, maternity benefits, disablement benefits, and dependents’ benefits to employees and their families.

2. What is the purpose of ESI?

The primary purpose is to provide financial and medical assistance to employees during times of sickness, maternity, disablement, or death due to employment-related injuries.

3. Who is eligible for ESI?

Generally, employees earning wages up to a certain threshold (as notified by the government) and working in covered establishments are eligible for ESI. Certain establishments are covered irrespective of the wage threshold. Consult the latest notifications for specific details.

4. What are the benefits of ESI?

Benefits include:

4. • Medical benefits for the employee and their family.
   • Sickness benefit (cash payment during sick leave).
   • Maternity benefit (paid leave for pregnant employees).
   • Disablement benefit (for temporary or permanent disability due to work-related injury).
   • Dependents’ benefit (financial assistance to family members in case of the employee’s death due to a work-related injury).

B. Registration and Contribution

5. Who needs to register under ESI?

Establishments covered under the ESI Act, based on the number of employees and wage criteria, are required to register with the ESIC.

6. How can an employer register under ESI?

Employers can register their establishments online through the ESIC portal.

7. What documents are required for ESI registration?

Typical documents include:

7. • Registration certificate of the establishment.
   • PAN card of the establishment.
   • Details of employees (name, address, wages).
   • Bank account details.
   • Proof of address of the establishment.
8. What is the ESI contribution rate?

The ESI contribution is shared between the employer and the employee. The rates are notified by the ESIC and are subject to change. Check the latest ESIC notifications for the current rates.

9. How are ESI contributions paid?

ESI contributions are typically paid online through the ESIC portal.

10. What is the ESI contribution period?

Contributions are usually made monthly.

C. Benefits and Claims

11. How can an employee avail ESI benefits?

Employees can avail benefits by visiting an ESIC-empanelled hospital or dispensary and presenting their ESI card (Pehchan Card). For cash benefits, employees need to submit claim forms.

12. How can I get an ESI card?

After registration, the employee is issued an ESI card (Pehchan Card) by the ESIC.

13. What is the process for claiming sickness benefit?

Employees need to submit a sickness certificate from a recognized medical practitioner and a claim form to the ESIC.

14. What is the process for claiming maternity benefit?

Pregnant employees need to submit a maternity certificate from a recognized medical practitioner and a claim form to the ESIC.

D. Compliance and Other Aspects

15. What are the compliance requirements for employers under ESI?

Employers must:

15. • Register their establishment.
    • Pay ESI contributions on time.
    • Maintain records of employees and their wages.
    • Submit regular returns to the ESIC.
16. What are the penalties for non-compliance with ESI regulations?

Non-compliance can lead to fines and legal action.

17. What is the role of the ESIC?

The ESIC administers the ESI scheme, manages the funds, and provides benefits to insured employees.

E. Other generally asked questions related to Employee State Insurance (ESI):

           18.   How do I register for ESI online?

            Covered in the registration process details.

19. What is the ESI contribution rate in India?

Refer to the latest ESIC notifications.

20. How do I check my ESI contribution status?

Through the ESIC portal.

21. How do I get an ESI card?

Issued after registration.

22. What are the benefits of ESI?

Medical benefits, sickness benefits, maternity benefits, etc.

23. How do I claim ESI benefits?

By submitting claim forms and relevant documents.

24. What is the ESI Act?

The Employees’ State Insurance Act, 1948.

25. How do I find an ESIC-empanelled hospital?

List available on ESIC website.

26. What is the full form of ESIC?

Employees’ State Insurance Corporation.