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Dear HR Veterans, In view of amendment in ESI with respect to wage ceiling limit upto 15,0000/- rupees. In our company some of our employees have gross salary more than 15,000/- rs and both employee and employer contribution is made but, no medical facilities is extended to employees in own company hospital, in this case i seek clarification whether they should be covered under ESIC or not or get medical facilities in ESIC hospital or not ?
Regards
Gaurav

From India, Pune
Dear,

ESI benefit is only applicable to employees who gross salary is less than or equal to 15000. But if any employee's salary get increased in between the contribution period(April to Sept or Oct to March) , then the contribution for that employee should be made till the end of that contribution period. Let say,you increased some employee's gross salary and made it more than 15000 on 10th Nov '15, then you have to deposit both contributions till 31st March'16 .After that period you should take them out of the scheme.

The employees can opt for the ESI benefits from the corresponding benefits period ie after 3 months of closure of any contribution period.

The medical benefit can only from taken from any of the ESI dispensary or ESI affiliated hospitals.

For any kinds of treatment the insured employee or his dependent should visit ESI dispensary first . In case the ESI dispensary or affiliated hospitals fails to provide full treatment then in this case they will refer your case to other hospitals and in that case they also reimburse the expenses at the maximum extent as per ESI policy.

Hope this will be helpful for you.

From India, Delhi
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