Full Details of Social Security Schemes for Employees
ESIC Benefits Under Section 46: Full Details of Social Security Schemes for Employees
Introduction
The Employees' State Insurance Corporation (ESIC) is a vital social security scheme in India under the ESI Act, 1948. It provides comprehensive benefits to employees and their families, covering medical care, sickness, maternity, disability, and more. Under Section 46 of the ESI Act, insured persons are entitled to a range of six major social security benefits, ensuring their health and income are protected during difficult times.
Six Key Benefits Under Section 46 of the ESI Act
1. Medical Benefit
Eligibility: Available from the first day of insurable employment.
Coverage: Includes full medical care for the insured person and their family members.
No Expense Limit: There is no ceiling on treatment costs.
For Retirees & Disabled: Retired and permanently disabled insured persons and their spouses can also access medical benefits by paying a nominal premium of Rs. 120 annually.
Medical Facilities Include:
Specialist consultation
In-patient treatment
Imaging services
Artificial limbs and aids
Reimbursement facilities
State-level administration for smooth delivery
2. Sickness Benefit (SB)
Compensation: 70% of the average daily wage.
Duration: Maximum of 91 days in a year.
Eligibility: Minimum 78 days of contribution in a 6-month period.
Other Types of Sickness Benefits:
Extended Sickness Benefit (ESB): For 34 long-term diseases. Payable up to 2 years at 80% of wages.
Enhanced Sickness Benefit: 100% of wages for sterilization procedures (7 days for vasectomy, 14 days for tubectomy).
3. Maternity Benefit (MB)
Eligibility: 70 days of contribution in the preceding two contribution periods.
Benefit: Full wages for 26 weeks (extendable by 1 month on medical advice).
Use: For pregnancy, childbirth, and postnatal recovery.
4. Disablement Benefit
Temporary Disablement Benefit (TDB):
When: From day one of employment injury.
Compensation: 90% of wage until recovery.
Permanent Disablement Benefit (PDB):
Compensation: 90% of wage monthly based on certified disability level.
5. Dependants' Benefit (DB)
Eligibility: In case of death due to employment injury or occupational hazard.
Compensation: 90% of the insured person’s wage is paid monthly to dependents.
6. Other Benefits
a) Funeral Expenses
Amount: Rs. 15,000
Given To: Dependent or person performing last rites.
b) Confinement Expenses
Eligibility: When delivery takes place in an area without ESI medical facilities.
c) Vocational Rehabilitation
For: Permanently disabled insured persons.
Purpose: Training for alternative employment.
d) Physical Rehabilitation
For: Physical disablement due to employment injury.
Unemployment Support Schemes
Rajiv Gandhi Shramik Kalyan Yojana
Who Can Apply: Insured person unemployed due to factory closure, retrenchment, or permanent invalidity (40%+).
Benefits:
50% of wage as unemployment allowance (for up to 2 years).
Free medical care for self and family.
Skill training with free travel and course fee by ESIC.
Atal Beemit Vyakti Kalyan Yojana (ABVKY)
Objective: One-time unemployment relief for insured persons.
Eligibility:
Must have worked for at least 1 year before unemployment.
Minimum 78 days of contribution in the last year.
Relief: 50% of average daily wage, up to 90 days in a lifetime.
How to Claim:
Online at www.esic.gov.in
Submit claim form, affidavit, Aadhaar, and bank details at the nearest ESIC Branch Office/Designated Claims Branch Office (DCBO), in person or by post.
Incentives for Employers Hiring Persons with Disabilities
Minimum Wage Limit for Eligibility: Rs. 25,000/month.
Employer’s Contribution: Paid by the Central Government for 3 years to encourage inclusive hiring.
Benefits: Insured disabled employees enjoy full ESIC benefits including medical, cash, and social security.
Contributions and Conditions
ESIC contributions are based on wages, ensuring affordability.
Benefits, however, are based on individual needs, not contribution size.
Cash benefits are provided through ESIC Branch Offices (BOs) or Pay Offices (POs).
Conclusion
The ESIC Scheme under Section 46 is a robust welfare system designed to support workers during times of sickness, disability, maternity, unemployment, and even after retirement. It not only safeguards the health and income of employees but also promotes inclusive growth through employer incentives for hiring persons with disabilities.
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