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The Employees’ State Insurance (ESI) scheme is a social security program under the ESI Act, 1948. It provides medical, disability, maternity, and unemployment benefits to eligible employees. Omnivoo enrolls eligible employees and manages all ESI contributions.

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Eligibility

ESI applies to employees whose gross monthly salary is ₹21,000 or less (₹25,000 for persons with disability).
  • If your gross salary is above ₹21,000/month, you are not covered under ESI.
  • Once enrolled, you continue to receive benefits for the contribution period even if your salary later exceeds the threshold.
Most employees with a CTC above approximately ₹3,50,000 per annum will exceed the ₹21,000 gross threshold and will not be ESI-eligible. Omnivoo automatically determines eligibility based on your salary structure.

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Contribution Rates

Example: Employee with gross salary of ₹18,000/month:

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Contribution Periods and Benefit Periods

ESI works on a 6-month cycle: This means you start receiving benefits after the contribution period ends, with a lag.

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ESI Benefits

  • Free treatment at ESI hospitals and dispensaries for the insured person and dependents.
  • Includes outpatient, inpatient, specialist consultations, and medicines.
  • Available across India, not limited to your work city.
  • 70% of daily wage for up to 91 days per year.
  • Payable when you are unable to work due to certified illness.
  • Requires a minimum of 78 days of contributions in the relevant contribution period.
  • Full daily wage for 26 weeks (extendable by 1 month on medical grounds).
  • Requires 70 days of contributions in the preceding contribution period.
  • Temporary disablement: 90% of daily wage for the entire duration.
  • Permanent disablement: Monthly pension based on the extent of disability.
  • Monthly pension to dependents if the insured person dies due to employment injury.
  • 90% of daily wage distributed among dependents.
  • 50% of daily wage for up to 90 days.
  • Available if you become unemployed (not due to misconduct).
  • Requires a minimum of 2 years of insurable employment.

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ESI Card

After enrollment, ESIC issues an ESI card (Pehchan Card) linked to your Aadhaar:
  • Use it to access ESI hospitals and dispensaries.
  • It covers you and your dependents (spouse, children, dependent parents).
  • Available in digital format via the ESIC portal.

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When You Become Ineligible

If your salary increases above ₹21,000/month (e.g., due to a salary revision):
  1. ESI contributions stop from the month you become ineligible.
  2. You continue to receive benefits for the remainder of the current benefit period.
  3. After the benefit period ends, ESI coverage lapses.
  4. Omnivoo may offer group health insurance as an alternative for non-ESI employees.
When ESI coverage ends, ensure you have alternative health insurance. Omnivoo will notify you when your salary revision makes you ineligible for ESI.

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For Employers: ESI Compliance

Omnivoo handles:
  • ESI registration for eligible employees
  • Monthly contribution calculation and deposit (by the 15th of each month)
  • Half-yearly ESI returns
  • IP number generation and management
ESI costs for eligible employees are included in the CTC. No additional action is required from employers.