I agree with what others have written above. If you are covered under ESI, it is mandatory for you to keep paying ESI. PF has criteria for exemption, but ESI does not.
As for what Mr. Sanjeev Chauhan has written, ESI is applicable when the town/city where your establishment is located has a municipality population of 25,000 and above. If the population is less than 25,000, the WC, i.e., Workmen's Compensation Act, automatically applies.
Benefits of ESIC
The section 46 of the Act envisages the following six social security benefits:
- **Medical Benefit:** Full medical care is provided to an insured person and his family members from the day he enters insurable employment. There is no ceiling on expenditure on the treatment of an insured person or his family member. Medical care is also provided to retired and permanently disabled insured persons and their spouses on payment of a token annual premium of Rs. 120/-.
- **Sickness Benefit (SB):** Sickness Benefit in the form of cash compensation at the rate of 70 percent of wages is payable to insured workers during periods of certified sickness for a maximum of 91 days in a year. To qualify for sickness benefit, the insured worker is required to contribute for 78 days in a contribution period of 6 months.
- **Extended Sickness Benefit (ESB):** SB extendable up to two years in the case of 34 malignant and long-term diseases at an enhanced rate of 80 percent of wages.
- **Enhanced Sickness Benefit:** Enhanced Sickness Benefit equal to full wage is payable to insured persons undergoing sterilization for 7 days/14 days for male and female workers, respectively.
- **Maternity Benefit (MB):** Maternity Benefit for confinement/pregnancy is payable for three months, which is extendable by a further one month on medical advice at the rate of full wage subject to contribution for 70 days in the preceding year.
- **Disablement Benefit:**
- **Temporary Disablement Benefit (TDB):** From day one of entering insurable employment and irrespective of having paid any contribution in case of employment injury. Temporary Disablement Benefit at the rate of 90% of wage is payable so long as disability continues.
- **Permanent Disablement Benefit (PDB):** The benefit is paid at the rate of 90% of wage in the form of monthly payment depending upon the extent of loss of earning capacity as certified by a Medical Board.
- **Dependants' Benefit (DB):** DB paid at the rate of 90% of wage in the form of monthly payment to the dependants of a deceased insured person in cases where death occurs due to employment injury or occupational hazards.
- **Other Benefits:**
- **Funeral Expenses:** An amount of Rs. 10,000/- is payable to the dependents or to the person who performs last rites from day one of entering insurable employment.
- **Confinement Expenses:** An insured woman or an I.P. in respect of his wife in case confinement occurs at a place where necessary medical facilities under the ESI Scheme are not available.
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 becomes unemployed after being insured for three or more years, due to closure of factory/establishment, retrenchment, or permanent invalidity, is entitled to:
- Unemployment Allowance equal to 50% of wage for a maximum period of up to 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/traveling allowance borne by ESIC.
An interesting feature of the ESI Scheme is that the contributions are related to the paying capacity as a fixed percentage of the workers' wages, whereas they are provided social security benefits according to individual needs without distinction.
Cash Benefits are disbursed by the Corporation through its Branch Offices (BOs) / Pay Offices (POs), subject to certain contributory conditions.
Hope that takes care of all your concerns!
Regards,
Aditya Joshi