ESI PF Consultant in Greater Noida
- ESI REGISTRATION
- PF REGISTRATION
- PF RETURN FILING
- PAYROLL COMPLIANCE etc.
ESI Corporation: दिलाये कामगारों को 'चिंता से मुक्ति'
KNOW YOUR ESI SCHEME
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 hazards 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, Newspaper, Shops, Educational/Medical Institutions wherein 10 or more persons are employed. However, in some States threshold limit for coverage of establishments is still 20. Employees of the aforesaid categories of factories and establishments, drawing wages upto Rs. 15,000/- a month, are entitled to social security cover under ESI Act. The ESI Scheme is financed mainly by contributions from employers and employees.
The rate of contribution by employer is 4.75% of the wages payable to employees. The employees’ contribution is at the rate of 1.75% of the wages payable to an employee. Employees, earning less than Rs. 100/- a day as daily wages, are exempted from payment of their share contribution.
REGISTRATION, CONTRIBUTIONS AND ALLIED PROVISIONS
The employer, once allotted the ESIC registration number for their factory establishment through ESIC portal www.esic.in can login to the employer portal and register their employees, as soon as they are employed by them. In case of first employment (the employee
has not worked anywhere before joining the employer), the employer has tregister the employee under the ESI Scheme by submitting the details of the employee, their family members, their place of residence and that of their family members, the dispensary to which they want to avail medical treatment, etc. Once the registration process is completed, the employee will be allotted an insurance number, which is unique and will be valid throughout the life of the employee, even if the employee changes job. In case, the employee is already
having an insurance number, the employer has to enter that number and proceed with updating the details of the employee, as the insurance number is unique for each employee and is valid throughout the life of the employee, irrespective of his changing jobs.
As explained above, entire Online Process of ESIC may further be illustrated through some slides for easy understanding of online work flow, etc., at ESIC website www.esic.in. The sample illustrations have been classified in following sub-heads and also shown at the page no.
i) Employee Registration
ii) Register New IP or Already Registered
iii) Creation of Declaration Form (DF) by filling all the relevant details of IP
iv) Submission of Declaration Form
v) Generation of IP Number
PEHCHAN CARD
On registration every insured person (IP) is provided with a ‘Temporary Identification
Certificate’ (TIC) which is valid ordinarily for a period of 3 months. Within this period, the IP
alongwith this TIC, their family photo both duly attested by their employer has to approach
the nearest/any of the Branch Office, wherein the IP’s photograph would be taken and the
fingerprints of the IP and their family members would be scanned.
On completion of the
procedure, the Pehchan Card would be delivered to the IP in about 2 weeks time. These two
sets of Pehchan Card ensure fast and convenient delivery of the services and help the IP and
their family members to avail medical facilities anywhere, anytime across all ESI Dispensaries
and Hospitals. The Pehchan Card has the insurance number, name of the IP and the
photograph of the IP/ family members printed on it.
If you lose your Identity or Pehchan Card before it has run its normal life, a duplicate card
is issued on payment as prescribed.
BENEFITS UNDER ESI SCHEME
- Sickness Benefit
- Disablement Benefit
- Dependents’ Benefit
- Maternity Benefit
- Medical Benefit
Besides the above mentioned, other benefits being provided to the beneficiaries are Confinement Expenses, Funeral Expenses, Vocational Rehabilitation, Physical Rehabilitation, Unemployment Allowance and Skill Upgradation Training.
BENEFITS ELIGIBILITY CONDITIONS, DURATION & SCALE OF BENEFITS
SICKNESS BENEFIT
(a) Sickness Benefit
Eligibility: Payment of contribution for 78 days in corresponding contribution period.
Duration & scale of benefits: Up to 91 days in two consecutive benefit periods.
Rate : 70% of the average daily wages for 91 days in a year.
(b) Enhanced Sickness Benefit (For Vasectomy/Tubectomy)
Eligibility: Payment of contribution for 78 days in corresponding contribution period.
Duration & scale of benefits: 14 days for Tubectomy & 7 days for Vasectomy, extendable on
medical advice.
Rate : 100% of the average daily wages.
(c) Extended Sickness Benefit
Eligibility: For 34 specified long term diseases. Continuous insurable employment for two
years with 156 days’ contribution in four consecutive contribution periods.
Duration & scale of benefits: 124 days, this may be extended upto two years on medical
advice during a period of two years.
Rate : 80% of the average daily wages.
DISABLEMENT BENEFIT
(a) Temporary Disablement Benefit
(b) Permanent Disablement Benefit
DEPENDANTS’ BENEFIT
MATERNITY BENEFIT
MEDICAL BENEFIT
OTHER BENEFITS
(a) Confinement Expenses
Eligibility: From day one of entering insurable employment for disablement due to
employment injury.
Duration & scale of benefits: As long as temporary disablement lasts.
Rate: 90% of the average daily wages.
Eligibility: From day one of entering insurable employment for disablement due to
employment injury.
Duration & scale of benefits: For whole life.
Rate: For permanent total disablement – % of the average daily wages. For permanent partial
disablement – Proportionate to the loss of earning capacity as determined by medical board.
Eligibility: From day one of entering insurable employment in case of death due to
employment injury.
Duration & scale of benefits: For life to the widow or until her re-marriage. To dependant
children till the age of 25 years. To dependant parents etc. subject to conditions.
Rate: 90% of the average daily wages shareable in fixed proportion among all dependants.
Eligibility: Payment of contribution of 70 days in two preceding contribution periods.
Duration & scale of benefits: Up to 12 weeks in case of confinement. Up to 6 weeks in case of
miscarriage. Extendable by 1 Month on medical advice in case of Sickness arising out of
Pregnancy, Confinement, Miscarriage.
Rate: 100% of the average daily wages.
Eligibility:Fullmedicalfacilitiesforselfandfamilyfromdayoneofenteringinsurable employment.
Duration & scale of benefits: Full medical care till he/she remains in insurable employment.
No ceiling on expenditure. Retired insured persons who have been in insurable employment for
at least five years before retirement on superannuation or under VRS or premature retirement
and insured persons becoming disabled due to an employment injury are entitled to full medical
careforselfandspouseonlyonpaymentof`120/-asannual contribution.
Medical Benefit under the ESI Scheme has now been extended to the widow/spouses of
deceased/retired/superannuated Insured Persons as well as to the widow/spouses of Insured
Persons who ceases to be in an insurable employment on account of Permanent Disablement,
and also to widows of Insured Persons who are in receipt of Dependants’ Benefit.
OTHER BENEFITS
(a) Confinement Expenses
Eligibility: From day one of entering insurable employment for disablement due to
employment injury.
Duration & scale of benefits: As long as temporary disablement lasts.
Rate: 90% of the average daily wages.
Eligibility: From day one of entering insurable employment for disablement due to
employment injury.
Duration & scale of benefits: For whole life.
Rate: For permanent total disablement – % of the average daily wages. For permanent partial
disablement – Proportionate to the loss of earning capacity as determined by medical board.
Eligibility: From day one of entering insurable employment in case of death due to
employment injury.
Duration & scale of benefits: For life to the widow or until her re-marriage. To dependant
children till the age of 25 years. To dependant parents etc. subject to conditions.
Rate: 90% of the average daily wages shareable in fixed proportion among all dependants.
Eligibility: Payment of contribution of 70 days in two preceding contribution periods.
Duration & scale of benefits: Up to 12 weeks in case of confinement. Up to 6 weeks in case of
miscarriage. Extendable by 1 Month on medical advice in case of Sickness arising out of
Pregnancy, Confinement, Miscarriage.
Rate: 100% of the average daily wages.
Eligibility:Fullmedicalfacilitiesforselfandfamilyfromdayoneofenteringinsurable employment.
Duration & scale of benefits: Full medical care till he/she remains in insurable employment.
No ceiling on expenditure. Retired insured persons who have been in insurable employment for
at least five years before retirement on superannuation or under VRS or premature retirement
and insured persons becoming disabled due to an employment injury are entitled to full medical
careforselfandspouseonlyonpaymentof`120/-asannual contribution.
Medical Benefit under the ESI Scheme has now been extended to the widow/spouses of
deceased/retired/superannuated Insured Persons as well as to the widow/spouses of Insured
Persons who ceases to be in an insurable employment on account of Permanent Disablement,
and also to widows of Insured Persons who are in receipt of Dependants’ Benefit.
Eligibility: An Insured Woman or an I.P. in respect of his wife is eligible if confinement occurs
at a place where necessary medical facilities under ESI Scheme are not available.
Duration & scale of benefits: Up to two confinements only.
Rate: ` 5000/- per case.
(b) Funeral Expenses
c) Vocational Training:
(d) Physical Rehabilitation
(e) Unemployment Allowance – Rajiv Gandhi Shramik Kalyan Yujana (RGSKY)
(f) Skill Up gradation Training under RGSKY:
Eligibility: From day one of entering insurable employment.
Duration & scale of benefits: For defraying expenses on the funeral of an Insured Person.
Rate: Actual expenses subject to a maximum of ` 10000/- .
(
Eligibility: In case of physical disablement due to employment injury.
Duration & scale of benefits: As long as vocational training lasts.
Rate: Actual fee charged or `123/- a day, whichever is higher.
Eligibility: In case of physical disablement due to employment injury.
Duration & scale of benefits: As long as a person is admitted in an artificial limb centre.
Rate: 100% of the average daily wages.
Eligibility: In case of involuntarily loss of employment due to closure of factory, retrenchment
or permanent invalidity due to non-employment injury and the contribution in respect of him
have been paid/ payable for a minimum of three years prior to the loss of employment.
Duration & scale of benefits: Maximum twelve months during life time.
Rate: 50% of the average daily wages.
Eligibility: In case of involuntarily loss of employment due to closure of factory, retrenchment
or permanent invalidity due to non-employment injury and the contribution in respect of him
have been paid/ payable for a minimum of three years prior to the loss of employment.
Duration & scale of benefits: For a duration of maximum 6 months.
SUPER-SPECIALITY TREATMENT
BENEFIT AFTER RETIREMENT
The eligibility for super-speciality treatment is 3 months (with contribution paid for at least 39 days)
of insurable employment for insured person (for self) and 6 months (with contribution paid for at
least 78 days) of insurable employment by insured person for their family members. Such tertiary
care (super-speciality treatment) is provided through in-house super speciality facilities available in
some of ESI Hospital or ESI-PGIMSRs or through large no. of advanced empanelled medical
institutions on referral basis through more the 1000 + tie-up hospitals all across India.
An insured person who leaves the insurable employment on attainment of the age of
superannuation or retires under a voluntary Retirement Scheme or takes premature retirement,
after being an insured person for not less than 5 years, shall be eligible to receive medical benefit for
himself and his spouse subject to production of proof thereof, and payment of a nominal
contribution of ` 120/- (rupees one hundred and twenty only) for one year. In case, the insured
person expires, his spouse is entitled to the medical benefit for the remaining period for which the
contribution was made, and she can continue to receive the medical benefit on payment of the
contribution of `120/- (rupees one hundred and twenty only) per annum for further period. This
medical benefit is also admissible to an insured person who ceases to be in employment on
account of permanent disablement caused due to employment injury for himself and his spouse on payment of similar contribution till the date on which he would have vacated the employment on
attaining the age of superannuation, had not sustained such permanent disablement.