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This integrated scheme of health insurance provides comprehensive medical cover and cash benefits in the contingencies of sickness, maternity, disablement and death due to employment injury to the Insured Persons and their dependents.The existing wage limit for coverage under the Act is Rs. 15,000/- per month ( w.e.f. 01/05/2010).

The section 46 of the Act envisages following six social security benefits :-

(a) Medical Benefit :

(b) Sickness Benefit(SB) :

(c) Maternity Benefit(MB) :

(d) Disablement Benefit

(e) Dependantsí Benefit(DB) :

(f) Other Benefits :

- Funeral Expenses :

- Confinement Expenses :

In addition, the scheme also provides some other need based benefits to insured workers.

- Vocational Rehabilitation :To permanently disabled Insured Person for undergoing VR Training at VRS.

- Physical Rehabilitation : In case of physical disablement due to employment injury.

- Old Age Medical Care: For Insured Person retiring on attaining the age of superannuation or under VRS/ERS and person having to leave service due to permanent disability insured person & spouse on payment of Rs. 120/- per annum.

- Rajiv Gandhi Shramik Kalyan Yojana - This scheme of Unemployment allowance was introduced w.e.f. 01-04-2005. An Insured Person who become unemployed after being insured three or more years, due to closure of factory/establishment, retrenchment or permanent invalidity are entitled to :-

* Unemployment Allowance equal to 50% of wage for a maximum period of upto one year.

* Medical care for self and family from ESI Hospitals/Dispensaries during the period IP receives unemployment allowance.

* Vocational Training provided for upgrading skills - Expenditure on fee/travelling allowance borne by ESIC.

When it is so beneficial to the employees, why there should be a wage limit & why all the employees are not covered. Many employees of the organized sector are loosing these various benefits under ESI Act due to the wage ceiling for coverage.

It is advisable to cover all the employees compulsorily by limiting the contributions to the wage ceiling that is fixed from time to time to improve the scheme & to extend the coverage to all the employees where ESI Act is applicable.

From India, Hyderabad

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Dear seniors, Plz tell me what are the benefits an employee gets if he is not covered under esic i.e, if his wage is more than 15000 per months. Regards ranj
From India, Ahmadabad
The employees may be (at the option of the employer) covered under personal accident policy & Group Health Insurance plan upto 2 lakhs coverage & under WC policy may be within the salary that was agreed in interview as a part of CTC & a medical expenses reimbursement scheme with a ceiling limit& no benefits after retirement, resignation etc,
From India, Hyderabad

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