ESIC | ESIC Card – Benefits, Eligibility, Apply, Download

ESIC & ESIC Card

ESIC stands for Employee’s State Insurance Corporation. As per the Employee’s State Insurance Act (ESI Act, 1948), the first step towards interest protection of employed workers in independent India, the workers are covered for health and medical benefits against uncertainties to conditions they are exposed to, such as sickness, maternity, temporary or permanent disablement, occupational disease or death due to employment injury or accidental death, resulting in loss of wages or earning capacity, total or partial. This is to avoid any financial distress and maintaining human dignity in times of such crises.

The ESIC is a dedicated supervising body to implement, manage and supervise the ESI scheme in different districts of India. It manages the collections of contributions, profile updating, issuing ESIC card, recording medical history of the insured employees and their family members, and delivery of benefits and reimbursements. It has a network of affiliated hospitals and dispensaries all over the country, where the beneficiaries can take medical benefits and treatments.

The ESI Act is applicable and now extended to many employers like Shops, Hotel, Cinema, Private Institutions, Educational Institutions, Transport business, Newspaper, etc. employing 10 or more persons. This scheme requires the employee and employer to contribute a portion to the ESIC. The ESIC card is different than Ayushman Card, as it is mainly for workers and employees of a business or company.

Persons who are not Covered under ESI Scheme?

• A proprietor or a partner whether drawing salary or not;
• A contractor lending the services of his employees;
• An Apprentice or Intern
• Persons employed on contract for service

What is ESIC Card?

The ESIC card is a health insurance card issued by the state ministry of labour, through the employer, to insured persons/employees/workers through which they can get medical benefits and treatments free of cost at ESIC network hospitals. The person should be enrolled under the ESI scheme to become the insured beneficiary to claim the benefits. The ESIC card covers the medical and health expenses of the insured person and his/her dependents.

ESIC Card or E-Pehchan Card in Detail

ESI card also known as E-Pehchan card is first issued as a Temporary Identification Certificate (TIC) which is valid only for 30 days. And when this TIC is linked with Aadhaar it becomes e-Pehchaan (Permanent Identification Certificate). This Aadhaar linking of each family member on the ESIC portal through the employer is necessary to receive the medical benefits granted under this scheme, without any issue. The contributions of these benefits is made by the employer on behalf of the insured person.

How are the Employees Registered under the ESI Scheme?

At the time of joining, the employee is required to provide his and his eligible family members’ details to the employer along with Family photo and IDs, after which the employer registers the family on the ESIC online portal.

ESIC Card – Benefits

The range of benefits includes, medical/surgical/obstetric treatments, supply of medicines, pathological tests and diagnosis, pre-natal and post-natal care, consultation, hospitalization, ambulance services, etc. where these service has also been extended to the dependent families.

• The medical benefit starts right from day one of joining the insurable employment and it lasts or valid for lifetime, it doesn’t expire even after changing jobs.
• After 2011, the family is also issued with a separate Pehchan card. And showing this Aadhar based Pehchan card the family is also eligible to take medical benefits from any of the ESIC dispensary or hospital in any part of the country.
• The ESI card can also be used to track the medical treatments and procedures he has undergone.
• If the person had not received the ESIC card yet after enrolment, and somehow he has to change his job. He can contact the previous employer or visit the nearest ESIC office.
• After changing a job, the insured person need to inform the new employer to update his ESIC details by providing them with his ESI Insurance Number

Various benefits of ESIC card

1. Medical Care:
The employees and their family members get all medical benefits right from day 1 of joining the insurable employment. This require employee contribution of Rs. 120/- yearly. This ESIC medical benefits can also be availed by the dependents of the insured person after his death, or after retirement of the insured employee.

2. Sickness Benefit
In case of sickness, you have to take medical leave that also will be covered. If you have worked for atleast 78 days in a contribution period, than you can get 70% of your average daily wage for up to 91 days in a year.

3. Extended Sickness Benefit
In case of prolonged medical leave, you can get extended benefit if you have worked for atleast 156 days for 4 contribution periods (each year from Jan to Dec is divided into two 6-monthly contribution periods.). The extended benefit is from 124 to 309 days, which may be extended to 2 years (730 days) on medical advise. Here you can get 80% of your average daily wage.

4. Temporary Disablement:
If an employee met with some accident during employment and faces any temporary disability, than he will get benefit of 90% of the average daily wage. Payable only where temporary disability lasts more than 3 days, as long as the disability lasts.

5. Permanent Disablement
In case of accidents or occupational disease, where the employee becomes permanently disabled and declared not fit for work. Than he will get 90% of the average daily wage or any percentage of his earning capacity.

6. Dependent Benefit:
This benefit is granted to the dependent of the employee who dies due to accident or any occupational disease, which is 90% of his average daily wage. The widow of the deceased employee will get for whole life or until her remarriage. And to each legitimate/adopted children till 25 years of age.

7. Medical Care to the Widow
Medical care to the widow of the deceased insured employee will also be granted same as the insured employee, where she is required to pay the yearly contribution of Rs. 120/-.

8. Maternity Benefit
Women employees are required to serve atleast 70 days in two consecutive contribution periods, to get maternity benefit of 100% average daily wage, for maternity leave of 26 weeks. In case of miscarriage, a maternity leave of 6 weeks will be provided. And in case of adoption 12 weeks of maternity leave.

9. Confinement Expenses:
A medical bonus of upto 5,000/- will be paid to the insured person, in respect of his wife in form of confinement expenses, where necessary medical facilities under the scheme is not available.

10. Funeral Expenses:
At the time of death of an insured employee, defraying and funeral expenses of upto 10,000/- will be reimbursed to the eldest member of the family or the person who will be carrying out the final rituals.

11. Unemployment Allowance under Rajiv Gandhi Sharmik Kalyan Yojna’(RGSKY):
In case of factory closure or business shutdown, the insured employees are eligible for upto 24 months of unemployment Allowance (50% of last average daily wage, for 1-12 months and 25% for 13-24 months).

Benefit to Family Members after death of the employee

The various benefits to the family members of the insured employee are:

• The widow of the deceased employee will get 90% of his average daily wage for the life, or until she remarries.
• The widow of the deceased employee will also get all the medical care benefits, where she is required to pay the contribution of Rs.120/- every year.
• The children of the deceased employee (whether legitimate or adopted) will each get the fixed proportion of the daily wage upto 25 years of their age.

ESIC Card – Eligibility & Coverage

Wage Limit Eligibility	The individuals should not be getting salary more than Rs. 21,000/- or Rs 25,000/- in case of disabilities. Check for latest updates regarding this limit from the official ESIC portal.
Businesses Covered	Shop, Restaurants, Hotel, Cinema, Transport business, Newspaper establishments, Manufacturing facilities, etc.
Who are Dependents	The immediate family members of the Insured person, including Husband/Wife and dependent children.
Yearly contribution by employee	The employee is required to pay a yearly contribution of Rs. 120/- to get the medical care benefits from ESIC hospitals and dispensaries.
ESIC card Validity	ESIC card is valid for lifetime. After changing job, you just need to inform the new employer along with your ESI insurance number.

Who is eligible for “ESI Card” or “e-Pehchan card” ?

The wage limit of an employee for coverage of health benefits through ESI Scheme is – salary not more than Rs. 21,000/- per month, or Rs. 25,000/- per month for persons with disability.

ESIC Card – How to Apply

For Employers:

Step #1: On the ESIC official Portal, the employer has to click on the Sign Up option, the following form will appear, direct link is provided here:
https://www.esic.in/ESICInsurance1/ESICInsurancePortal/Signup.aspx

Step #2: Enter the details and Submit the form. On submission, the employer will receive an automated mail with login credentials like username and password on the email ID given at the time of registration.

Step #3: Login to the employer portal using the login details you have received through email. On the Next page, you have to select the New Employer Registration option. select the Type of Unit from the drop down list and click on Submit button.

Step #4: In the next page, you have to provide all details of your Business in the Employee Registration form. After completing the form, employer will be redirected to the payment page.

ESIC Card – How to Download

For Employees: ESIC Card download

Follow the step-by-step instructions below for ESIC card download (e-Pehchan card):

Step #1: On the home page under services tab, employees have to click on Employee button.

Step #2: On the next page, click on the Sign Up link.

Step #3: You will see User Sign Up form as shown below. Enter the following details – Insurance Number (your employer will provide this), Date of Birth, Mobile Number and a Captcha for verification. Now click on Sign Up button to complete the signup process.

Step #4: You will receive OTP on your registered mobile number. Enter this OTP and create your password. Now you can login as employee to the ESIC portal using your mobile number and this Password.

Step #4: ESIC card download pdf | After logging in, you will see the following screen, and on the left side you will see the last link for View/Print ePehchan Card. Click on it, a preview of your ePehchan card will open. From here you can easily save or download ESIC Card pdf format. This is how you can download ESIC card.

Frequently Asked Questions (FAQs)