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ESI Scheme- An Introduction

The Employees’ State Insurance Scheme is an integrated measure of social insurance embodied in the Employees’ State Insurance Act and is designed to accomplish the task of protecting ‘employees’ as defined in the Employees State Insurance Act, 1948 against the impact of contingencies of sickness, maternity, disablement and death due to employment injury and to provide medical care to insured persons and their families. The ESI Scheme applies to factories and other establishments viz. Road Transport, Hotels, Restaurants, Cinemas, newspapers, Shops, Educational/ Medical Institutions, etc., wherein 10 or more persons are employed. Employees of the aforesaid categories of factories and establishments, drawing wages up to 21000/- a month, are entitled to social security cover under the ESI Act.

The ESI Scheme is financed by contributions from employers and employees. The rate of contribution by the employer is 3.25% of the wages payable to employees. The employee’s contribution is at the rate of 0.75% of the wages payable to him/her. Employees, earning up to ₹ 176/- a day as daily wages, are exempted from payment of their share of contribution.

The main benefits provided under ESI Scheme are sickness benefit. Disablement Benefit, Dependants Benefit, Maternity Benefit and Medical Benefit. Besides, other benefits being provided to beneficiaries are Unemployment Allowance (RGSKY), Confinement Expenses, Funeral Expenses, Vocation Rehabilitation, Skill upgradation training and Atal Bimit Vyakti Kalyan Yojana (ABVKY). AND Covid-19 relief Scheme (CRS).

Coverage & Infrastructure     

In the beginning, the ESI Scheme was implemented as just two industrial centres in the country in 1952, namely Kanpur and Delhi. There was no looking back since then in terms of its geographic reach and demographic coverage. Keeping pace with the progress of industrialization, ESI Scheme stands implemented in 606 districts in 35 states and Union Territories of the country. As of 31.03.2022, The Act applies to over 15.94 lakh factories and establishments across the country, benefiting over 3,10 crores of Insured Persons/family units. The total beneficiaries’ stands over 12.03 crores.

Ever since its inception in 1952, the infrastructural network of the scheme has kept expanding to meet the social security requirements of an ever-increasing worker population. ESI Corporation has so far set up 106 hospitals (109 ESIS hospitals & 51 ESIC hospitals) for inpatient services. Primary and outpatient medical services are provided through a network of about 1502/329 ESI Dispensaries/ISM Units. In order to provide primary medical services and cash benefits ay one place, The Corporation has opened 89 Dispensary-cum-Branch-Offices (DCBO).

For payments of Cash Benefits, the Corporation operates through a network of over 598BO & 89 DCBO Offices, whose functioning is supervised by 64 Regional/sub-Regional Offices.

In the State of Maharashtra, the Scheme is supervised through its Regional Office in Mumbai and 6 sub-regional offices spread throughout the State and the ESI Scheme extends to 34 districts. It caters to 40 lakh Insured Persons working at 2.33 lakh units and the total number of beneficiaries stands at 1.55 crores.

There are Branch offices in the State which include 14 Dispensary-cum-branch Offices and the total number of ESI Hospitals in the state stands at 15(03 ESIC Hospitals and 12 ESIS Hospitals). As of date, Maharashtra is home to 99 Dispensaries (ESIC -14 DCBOs, ESIS – 85 Dispensaries) and 598 Insured Medical Practitioners (IMPs) to ensure doorstep delivery of medical facilities in all corners of the state. 182 hospitals have been empanelled to provide Secondary Medical Care and 139 Hospitals have been empanelled to provide Super Speciality Treatment in the State. In addition to this, 1075 PMJAY empanelled hospitals are also available to provide medical care to beneficiaries of the ESI Act in Maharashtra.

Last updated / Reviewed : 2023-03-24