Implementation of ESI Scheme in Meghalaya

The Employees’ State Insurance Scheme (ESIS) Meghalaya was implemented from September 1980 in Shillong area and extended to Byrnihat in May 2005.

The ESIS is a multi-dimensional Social Security Scheme for the Welfare of the Labour Class and Weaker Section of Society, and all those under coverage are entitled to two types of benefits:

Cash Benefit

These benefits are administered by the ESI Corporation through their Local Offices in Shillong and Byrnihat, comprising of:

  • Sickness Benefit
  • Extended Sick Benefit
  • Enhanced Sickness Benefit
  • Maternity Benefit
  • Dependent Benefit
  • Disablement Benefit
  • Funeral Benefit

Medical Benefit

The Administrative Head for provision of Medical Benefit in Meghalaya is the Administrative Medical Officer (AMO), ESI Scheme.

Medical Benefit is provided through Dispensaries established by the State Government:

  • ESI Dispensary, Shillong: Manned by the Insurance Medical Officer (IMO) and supporting Staff.
  • ESI Dispensary, Byrnihat: Manned by the Insurance Medical Officer (IMO) on contract basis, presently functioning from the Dispensary at EPIP.

The AMO and IMO are presently functioning from a rented building at Lower Lachaumiere, Shillong.

Key Statistics & Coverage

Total Insured Persons

16,130
as on 31/03/2025

Covered Establishments (Shillong)

1,087
under ESI Dispensary Shillong

Covered Establishments (Byrnihat)

247
under ESI Dispensary Byrnihat

Expenditure Sharing
(Corporation : State)

7 : 1
Shareable basis ratio

Treatment Entitlement: Beneficiaries are entitled to reasonable medical, surgical, and obstetric treatment. Treatment is provided as per the Live List prepared by the Regional Office of the ESI Corporation. There is no ceiling on expenditure on the treatment of an IP or their family members.

Retired & Disabled Care: Medical care is also provided to retired and permanently disabled Insured Persons or their spouses on payment of a token annual premium of ₹ 120/-.

Financial Sharing: The total expenditure incurred in administering the Medical Benefits in each State is shared by the State Government and the Corporation in the agreed ratio of 7:1. For purpose of sharing, the Corporation has w.e.f. 1st April 1970 prescribed the maximum per capita ceiling on total expenditure on Medical Benefit:

  • Current ceiling w.e.f. 1.4.2015: ₹ 2,150/- per insured person family unit per annum.
  • w.e.f. 1.4.2017: Increased to ₹ 3,000/- per insured person family unit per annum.

Referrals & Care Levels

Secondary / Speciality Care: Insured Persons needing Secondary/Speciality care are referred to Government and Private Hospitals within the state, and expenditures are reimbursed accordingly.
Super Speciality Care (SST): Insured Persons are referred to ESI Model Hospital, Beltola, Guwahati for further investigation and treatment. The expenditure of SST is totally borne by the ESI Corporation outside the existing ceiling.
Medical benefits to the Insured persons and their family members are being provided, as far as practicable, as per the guidelines laid down in the ESI Medical Manual and as per the Meghalaya Employees’ State Insurance (Medical Benefit) Rules 1978.
It is incumbent upon the State Government to provide the Medical benefit as per Section 58 of the ESI Act 1948.

Telemedicine Services: Inaugurated on 1st December 2016 providing consultation services on a daily basis by connecting with Specialist/Super-specialist Doctors of ESIC Hospital, Joka, Kolkata.