What is ESIC Form 105 and How to Download It?
ESIC Form 105 is a certificate of entitlement that is issued by the employer to an employee who is covered under the Employees’ State Insurance Corporation (ESIC) scheme. This form is useful when an employee is temporarily working in a location where their registered ESIC dispensary is not available. In such cases, the employee can submit this form to the nearest ESIC dispensary and avail medical benefits.
ESIC Form 105 has to be filled by the employer with the following details:
- Name and address of the establishment and its ESIC code number.
- Name and insurance number of the employee.
- Identification marks of the employee.
- Exact period of temporary duty or authorized leave.
- Declaration that the employee is on temporary duty or authorized leave.
Along with ESIC Form 105, the employee also has to submit ESIC Med Form 10, which is a declaration by the employee regarding their sickness or injury. This form has to be filled by the employee with the following details:
- Name and insurance number of the employee.
- Date of commencement of sickness or injury.
- Nature and cause of sickness or injury.
- Name and address of the doctor or hospital where treatment is taken.
- Declaration that the employee has not claimed any other benefit for the same sickness or injury.
ESIC Form 105 and ESIC Med Form 10 can be downloaded from the official website of ESIC or from various online sources. Here are some links where you can find these forms in PDF format:
ESIC Form 105 and ESIC Med Form 10 are important documents for employees who are covered under the ESIC scheme and need to avail medical benefits in a different location. Employees should keep these forms handy and submit them to the nearest ESIC dispensary whenever required.
Benefits of ESIC Scheme
The ESIC Scheme offers a range of benefits to the employees and their dependents who are covered under it. These benefits are designed to provide socio-economic protection to the workers in case of any contingency arising out of their employment. Some of the major benefits of ESIC Scheme are:
- Sickness Benefit: This benefit provides 70% of the average daily wages in cash for up to 91 days in two consecutive benefit periods, in case of sickness certified by an authorized medical officer. The benefit can be extended up to two years in case of 34 malignant and long-term diseases at 80% of wages[^1^].
- Maternity Benefit: This benefit provides 100% of the average daily wages in cash for up to 26 weeks in case of confinement (delivery) and 6 weeks in case of miscarriage. The benefit is also available for 12 weeks for commissioning mothers (who use surrogates) and adopting mothers[^2^].
- Disablement Benefit: This benefit provides a monthly payment for temporary or permanent disablement due to a work-related injury or occupational disease. The amount of payment depends on the extent and duration of disablement. For temporary disablement, 90% of the average daily wages are paid till the injury lasts. For permanent disablement, a monthly pension is paid for the whole life based on the loss of earning capacity[^2^].
- Dependants’ Benefit: This benefit provides a monthly pension to the dependents of a deceased employee who died due to a work-related injury or occupational disease. The pension is apportioned among the widow/widower, children, and other dependents according to a prescribed formula. The minimum pension is Rs. 1,800 per month and the maximum pension is Rs. 14,040 per month[^2^].
- Medical Benefit: This benefit provides reasonable medical care for the employee and their family members from day one of entering into insurable employment. The medical care includes consultation, diagnosis, treatment, medicines, hospitalization, specialist services, etc. There is no upper limit on the expenses and if the ESIC hospital lacks required facilities, the patient is referred to a private hospital and the bills are reimbursed by ESIC[^3^] [^4^].
- Unemployment Allowance: This benefit provides a monthly cash allowance for up to 24 months in case of involuntary loss of employment or permanent invalidity due to non-employment injury. The amount of allowance depends on the contribution period and the average daily wages. The minimum allowance is Rs. 3,000 per month and the maximum allowance is Rs. 6,000 per month[^2^].
The ESIC Scheme is a comprehensive social security scheme that covers various contingencies faced by employees in the organized sector. By contributing a small percentage of their wages, employees can avail these benefits and secure their well-being and that of their families.