Since India's four labour codes came into force, many HR teams have heard that every employer must now give a free annual health check-up to every employee over 40. The rules notified so far are narrower than that. For most private employers, the answer depends on your state, and most states are finalising their rules right now. This guide sets out what the law says today, where your company is likely to stand, and what to do before January 2027.

The short answer

  • The Occupational Safety, Health and Working Conditions Code, 2020 (OSH Code) came into force on 21 November 2025. It lets the government require a free annual health check-up for employees above a prescribed age.
  • The central rules, notified on 8 May 2026, make the employee annual health check-up mandatory for employees aged 40 and above in dock work and in building or other construction work. Mines follow separate examination rules. Factories were in the draft central rules but not in the final ones.
  • Factories, plantations and most other private workplaces follow their state's OSH rules. The draft rules published by Karnataka and Maharashtra require a free check-up for factory workers aged 40 and above, completed within 120 days of 1 January each year.
  • The Centre expects every state to publish its labour code rules by 31 October 2026. Where a state keeps the 120-day window, the first cycle will run from 1 January to 30 April 2027.
  • If your state's rules apply to you, a programme budgeted and set up before January will cost less than a camp organised in a hurry in March.

What has changed and what is coming

  • 21 Nov 2025: The four labour codes, including the OSH Code, came into force. The legal basis for the 40+ check-up exists; the rules decide who it covers.
  • 7 May 2026: ESIC launched free annual check-ups for ESI beneficiaries aged 40+. Available only to employees insured under ESI.
  • 8 May 2026: The OSH (Central) Rules, 2026 were notified. Check-up mandatory for employees aged 40+ in dock and construction work under central jurisdiction.
  • 24 Sep 2026: The Labour Secretary said ten states had published their rules. The remaining states and UTs have issued drafts.
  • 31 Oct 2026: Date by which the Centre expects all states to publish their rules. Final rules for most private employers.
  • Early Nov 2026: Six-month deadline for establishments under the central rules to update existing registrations. Check your details on the Shram Suvidha portal.
  • 1 Jan to 30 Apr 2027: First 120-day check-up window, in states whose rules adopt it. Plan bookings and budget now.
  • 13 May 2027: Core duties under the Digital Personal Data Protection Act take effect. Check-up reports need consent, security and retention limits.

Is the employee annual health check-up mandatory for your company?

The answer depends on your "appropriate government" under the OSH Code. The Centre is the appropriate government for establishments such as mines, major ports, railways, banking and insurance companies, telecom companies and central public sector undertakings. For factories, plantations and most other private workplaces, it is the state.

  • Dock work or building and construction work under the Centre: Mandatory under OSH (Central) Rules, 2026, rule 5. Free, every year, by a qualified medical practitioner, with a certificate (Form VIII) for the employer and the employee. ESIC facilities may be used.
  • Mine: Covered by separate initial and periodic medical examinations under the central rules.
  • Bank, insurer, telecom company or central PSU (general staff): Not required for general staff by the central rules.
  • Factory: Your state’s OSH rules apply. Required for workers aged 40+ in the Karnataka and Maharashtra drafts. Check your state’s final rules.
  • Office, IT or ITeS company, or shop under a state: Your state’s OSH rules apply. Not named in the check-up rule of Karnataka’s draft. Check your state’s final rules.

Why so many sources say "every employer". The draft central rules of December 2025 included factories, and much of what was written early in 2026 describes that draft. The final central rules, notified on 8 May 2026, narrowed the duty to dock work, construction and mines.

What the state drafts say. Karnataka's draft rules of 23 January 2026 require employers of factories, construction work, plantations, beedi and cigar works and motor transport undertakings to arrange a free medical examination every year, within 120 days of the start of the calendar year, for every worker who has completed 40 years of age. The employer gets the certificate and gives a copy to the employee. Maharashtra's draft factory rules of 6 May 2026 use the same age and 120-day window, require the report within 15 days of the examination, and allow ESIC facilities where applicable. Both are drafts and may change when finalised.

Check each site separately. A company with a plant in Karnataka and an office in Delhi can get two different answers. Ask your legal or compliance team to map every site to its appropriate government and to read that state's final rules once they are out.

What non-compliance can cost. Where the OSH Code sets no specific penalty for a contravention, Section 94 provides a penalty of ₹2 lakh to ₹3 lakh.

What to have ready if an inspector asks

Where the duty applies, the rules say the employer "shall arrange to conduct" the examination. Sending a camp invite is not the same as showing the examination happened.

What the rules require

  • A free examination, at no cost to the employee
  • Every year, by a qualified medical practitioner
  • A certificate or report in the prescribed form, with a copy to the employee
  • In the Karnataka and Maharashtra drafts, completion within 120 days of 1 January

What we recommend you keep

  • An up-to-date list of eligible employees aged 40+, by site
  • Dated certificates for every employee examined
  • Consent forms, plus a record of reminders and refusals for anyone who declines
  • Notes of follow-up on abnormal results, such as consultations, referrals and repeat tests

Health data is personal data. Check-up reports are covered by the Digital Personal Data Protection Act, 2023. Its core obligations, including notice and consent, security safeguards and retention limits, take effect on 13 May 2027, two weeks after a 120-day window would close. Collect consent and limit who can see individual reports from the first cycle.

What the check-ups are likely to find

A check-up done for compliance still produces results, and someone has to act on them. ekincare's research across its corporate client base shows what HR teams should expect.

  • More than 1 in 3 people tested show a common risk. In ekincare's 2023 to 2025 national risk assessment, India's Silent Health Crisis, 36.9% of those tested were vitamin D or B12 deficient, 36.2% were obese and 31.7% had abnormal cholesterol markers. Diabetes markers were abnormal for 24.3%.
  • Employees past 35 are the most clinical group for mental health. In ekincare's From Silence to Signal report, 44% of counselling sessions for this group concerned anxiety, depression or mood. A 40+ check-up programme is a natural point to route people to that support.
  • Repeat check-ups are linked to improvement. In ekincare's Young Workforce Heart Health Report 2026, 43.0% of employees under 35 who came back for a second check saw their risk factors fall, and 19.8% saw them rise. The data covers younger employees, but the case for an annual cycle carries over.

Plan the follow-up before the first sample is drawn. Annual health check usage across ekincare's clients grew about 48% year on year, and doctor consultations grew 2.5 times, because check-ups increasingly lead into OPD care.

How to run it without overspending

  • Use ESIC where it applies. The central rules and Maharashtra's draft let employers use ESIC facilities. Since 7 May 2026, ESIC hospitals offer free annual check-ups to ESI beneficiaries aged 40+. This covers only ESI-insured employees, so most salaried staff will need a private programme.
  • Spread it across the window, not one camp. If your state keeps the 120-day window, a network that lets employees book a slot near them avoids lost shift time and reaches plant and remote staff.
  • Match the tests to risk. A basic panel for everyone over 40, with added tests for flagged results or hazardous roles, costs less than a large panel for all.
  • Bundle it with OPD. Check-ups find conditions; OPD treats them. Linking the two means follow-up happens inside a benefit you already pay for, and creates the follow-up record you want to keep.
  • Budget now. Many companies finalise next year's benefits budget between October and January. A line item agreed now costs less than an emergency programme in March.

ekincare runs corporate health checkups and cashless OPD across 90,000+ providers in 500+ cities, with records kept in one place. Talk to us about your 40+ programme.

Your 90-day checklist, October 2026 to January 2027

By 31 October

  • List every site and confirm whether the Centre or the state is its appropriate government.
  • Pull a headcount of employees aged 40+ by site, including contract workers.

November

  • Read each state's final OSH rules: the age threshold, the 120-day window and the forms.
  • Get legal sign-off on which sites must comply from January.
  • Set the 2027 budget line for check-ups and follow-up care.

December

  • Choose a provider that can cover every site within the window, with qualified practitioners and the right forms.
  • Draft the employee notice and consent form, keeping the DPDP Act in mind.
  • Decide how results lead to follow-up: consultations, referrals, OPD.

January

  • Open bookings in the first week so the full window is available.
  • Track participation weekly and send recorded reminders to anyone not yet examined.
  • Store certificates, consent forms and refusal records in one place.

Frequently asked questions

Is a free annual health check-up mandatory for all employees above 40 in India? Not under the central rules alone. The OSH (Central) Rules, 2026 make it mandatory for employees aged 40+ in dock work and construction work, with separate rules for mines. For factories and most other private workplaces, your state's OSH rules decide. Karnataka's and Maharashtra's drafts extend it to factory workers aged 40+.

Does it apply to IT and office-based companies? Not under the central rules. Karnataka's draft names factories, construction, plantations, beedi and cigar works and motor transport undertakings, not offices. Check your own state's final rules after 31 October 2026.

When does the requirement start? The OSH Code came into force on 21 November 2025 and the central rules on 8 May 2026. States are expected to publish their rules by 31 October 2026. Where a state keeps a 120-day window from 1 January, the first full cycle runs from 1 January to 30 April 2027.

Who pays for the check-up? The employer. The rules require it to be free of cost to the employee.

Does group health insurance meet this obligation? No. Group health insurance pays for treatment. The OSH duty is an annual examination by a qualified medical practitioner, with a certificate for the employer and the employee.

Can we use ESIC hospitals? The central rules and Maharashtra's draft allow employers to use ESIC facilities, and ESIC offers free annual check-ups to ESI beneficiaries aged 40+. Employees outside ESI need another arrangement.

What happens if we do not comply? Where the OSH Code sets no specific penalty for a contravention, Section 94 provides a penalty of ₹2 lakh to ₹3 lakh.

What if an employee refuses the check-up? Record the offer, the reminders and the refusal. A documented trail shows you arranged the examination even if the employee declined.

Sources

This article is general information, not legal advice. Rules are changing state by state; confirm your position with your legal or compliance team.

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Jehi Jha
13 Oct 2026 10 min read
Marketing Manager