India's Health Checkup Mandate: What HRs Must Do Now

On November 21, 2025, India implemented four Labour Codes that fundamentally changed employer obligations. Buried in these reforms is a game-changing requirement: mandatory annual health checkups for all employees over 40.

Not optional. Not recommended. Mandatory.

This means every company with employees over 40 must now provide free annual health screenings—and most companies are completely unprepared. The industry standard for health checkup utilization is 35%. That's not going to cut it when the government audits your compliance.

Here's what changed, why preventive healthcare just became your most important employee benefit, and how to actually make it work.

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What Changed: 29 Labour Laws Became 4

India's labour regulations were built in the pre-Independence era, most from the 1930s through 1950s. They were fragmented, complex, and struggled to keep pace with how work actually happens today.

The four new codes are:

1. Code on Wages, 2019 - Universal minimum wages, timely payment, gender equality
2. Industrial Relations Code, 2020 - Trade unions, fixed-term employment, faster dispute resolution
3. Code on Social Security, 2020 - EPF, ESIC, gratuity, maternity benefits for all workers
4. Occupational Safety, Health and Working Conditions Code, 2020 - Workplace safety, migrant worker protections, health requirements

The consolidation means: one registration instead of six, one license, one return filing. Compliance gets simpler. Worker protections get stronger.

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The Mandate That Changes Everything: Annual Health Checkups

The Occupational Safety, Health and Working Conditions Code includes a requirement that will affect every HR decision you make in 2026: mandatory free annual health checkups for all employees above age 40.

This isn't buried in fine print. It's enforceable law.

What the code requires: According to the government's official announcement: Employers must provide all workers above the age of 40 years with a free annual health check-up.

The execution challenge: Industry data shows that only 35% of employees use health checkup benefits. The other 65%? Never book and never engage.

The law says employers must "provide" health checkups — not "offer" them. When two-thirds of your eligible workforce never participates, execution becomes the real compliance question.

You need a prevention system built for scale, not a benefit that collects dust.

What the Health Checkup Mandate Means for Employers

If your employees are over 40, here's what you must provide under the Occupational Safety, Health and Working Conditions Code:

• Annual health screening - Free for all employees above 40
• At no cost to employees - Employer-funded
• Actual health checkups delivered - Not just offering the benefit

Here's the challenge most companies face:

The industry standard for health checkup utilization is 35%. That means 65% of employees never book, never engage, never participate, even when the benefit is available.

The law requires employers to "provide" health checkups, not just "offer" them. This shift in language matters. When participation is low, can you genuinely say you've "provided" the benefit?

Companies that achieve high utilization (70-80%+) demonstrate that they've built systems to make health checkups accessible, convenient, and integrated with follow-up care. Companies stuck at 35% are essentially leaving a legal mandate unfulfilled for most of their eligible workforce.

The mandate creates both a compliance requirement and an execution challenge. You need infrastructure that makes participation the default, not the exception.

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Why Smart Companies Are Treating This as Opportunity, Not Obligation

The health checkup mandate does something most HR initiatives can't: it forces you to build prevention infrastructure.

And prevention infrastructure is what separates companies with rising insurance claims from companies that keep employees healthy and productive for decades.

Here's what happens when you get preventive health checkups right:

You catch problems before they become crises
Blood pressure of 200. Pre-diabetic blood sugar. Cardiac risk markers. These show up in health checkups months or years before the ₹20 lakh insurance claim. A ₹15,000 health checkup prevents a ₹20 lakh emergency—the math is simple.

You get intelligence that HR teams never had
Right now, you have three metrics: NPS (rarely tracked), sick days (too early), and insurance claims (way too late). Health checkups fill the massive gap between "employees seem okay" and "major health crisis just happened." You can finally see workforce risks and take action before they explode.

You build cultures where health is infrastructure
When 80% of your workforce gets annual health checkups, understands their results, and takes action—that's not wellness theater. That's infrastructure. That's the 20-year health gap closing in real-time.

Companies treating this as compliance overhead will spend money and get 35% engagement.

Companies treating this as a strategic advantage will build healthier workforces and watch insurance premiums stabilize while competitors' skyrocket.

Social Security: Coverage Expands to All Workers

The Code on Social Security brings major changes to EPF and ESIC coverage:

ESIC now covers all of India
Previously limited to "notified areas," ESIC medical facilities will expand from 566 districts to all 740 districts. If you employ even a single person in hazardous work, ESIC coverage becomes mandatory.

Gratuity after one year for fixed-term employees
Previously five years. This makes project-based hiring more attractive for employees and removes barriers for employers.

Gig and platform workers get coverage
The codes define "aggregator," "gig worker," and "platform worker" for the first time, requiring 1-2% contribution from aggregators toward social security funds.

Universal Account Number (UAN)
Aadhaar-based UAN ensures portability across states and employers. When employees move, their benefits move with them.

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Women in the Workforce: New Rights and Protections

The codes explicitly enable women to work in all establishments, including night shifts (before 6 AM, after 7 PM) and previously restricted roles like underground mining and heavy machinery operation.

Requirements:

• Written consent from the employee
• Safety measures in place (transportation, security, CCTV where needed)
• Women's representation on grievance committees
• Equal pay for equal work across all roles

The 2017 Maternity Benefit Amendment already increased paid leave from 12 to 26 weeks and mandated crèche facilities for establishments with 50+ workers. These codes reinforce and expand those protections.

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Fixed-Term Employment: Flexibility with Full Protection

The Industrial Relations Code formally recognizes fixed-term employment (FTE)—a game-changer for companies that need project-based talent.

What fixed-term employees get:

• All benefits of permanent workers (wages, leave, medical, and social security)
• Gratuity after one year instead of five
• Legal recognition and protection
• Re-skilling fund (15 days' wages) if retrenched, credited within 45 days

What employers get:

• Flexibility to hire for specific projects or timelines
• Cost efficiency compared to contractor arrangements
• Reduced compliance burden
• Clear legal framework for time-bound roles

This reduces excessive contractualization while giving companies the flexibility modern business requires.

Migrant Workers: Real Protections This Time

The Occupational Safety, Health, and Working Conditions Code completely rewrites protection for inter-state migrant workers:

• Self-registration. Workers can register themselves on a national portal—they don't need a contractor to have a legal identity.
• Annual travel allowance. Employers must provide allowance for a to-and-fro journey to the native place per year.
• Portability of benefits. One Nation One Ration Card means workers get ration in the state where they work, while family members access benefits in their home state.
• Mandatory appointment letters. Every worker gets written proof of employment, wages, and social security entitlements.
• Mandatory helpline. Every state must maintain a toll-free helpline for migrant worker grievances.

India's migrant workforce has long been invisible in official systems. These changes create legal identity and portable benefits, which means better retention for employers who treat workers well.

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Compliance Simplified: One Registration, One License, One Return

• One registration. Instead of registering under six different acts, you register once electronically.
• One license. Valid across India for five years. Auto-generated after prescribed period.
• One return. Single filing replaces multiple overlapping submissions.
• Inspector-cum-Facilitator system. Inspectors shift from enforcement-only to guidance and advisory roles. Randomized, web-based algorithm-driven inspections reduce harassment.
• Compounding of offenses. First-time, non-imprisonable offenses can be settled with monetary fines (50% of maximum for fine-only offenses, 75% for fine/imprisonment cases). Repeat offenses within five years cannot be compounded.

Small and medium businesses benefit most from reduced paperwork and clearer processes. The focus shifts from catching violations to preventing them.

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What HR Needs to Do Right Now

Priority #1: Fix Your Health Checkup System Before Audit Season

If your current health checkup provider has 35% utilization, you're not ready for mandatory compliance. You need a system that achieves 80%+ participation.

Ask yourself:

• Can employees book a health checkup in under 90 seconds?
• Do they get results in under 12 hours with actionable insights they actually understand?
• Is there immediate access to doctors to discuss findings?
• Can healthcare come to your office instead of asking employees to find time?

If the answer to any of these is "no," you need a new approach. Loop's health checkup system achieves 80% utilization within 12 months—more than double the industry standard—because it removes every barrier that traditionally keeps engagement low.

Other immediate actions:

2. Review fixed-term employment policies. If you use contractors or project-based workers, FTE designation might be more beneficial. Calculate the cost of providing gratuity after one year versus contractor margins.

3. Update appointment letters. Every employee needs written documentation of role, wages, and social security benefits. Migrant workers especially need this protection.

4. Register women employees for night shifts. If you have operations that require evening or early morning work, formalize consent and safety protocols now.

5. Check ESIC applicability. If you operate in areas that weren't previously "notified" for ESIC, you may now need to register. Hazardous operations need coverage regardless of location.

Strategic actions for 2026:

1. Build health intelligence, not just data collection. The health checkup mandate creates a goldmine of workforce health data. Track high-prevalence conditions (diabetes, hypertension, cardiac risk), identify patterns by department or location, and design interventions based on actual evidence. Companies that turn health checkup data into action will see claims reduction within 18 months.

2. Integrate prevention with care. A health checkup that discovers elevated blood sugar is useless without immediate access to doctors, nutritionists, and diabetes management programs. Loop's integrated approach means every health checkup becomes the first step in a continuous care journey, not an isolated data point.

3. Train managers on health as infrastructure. Managers need to understand that mandatory health checkups aren't paperwork—they're the foundation of workforce resilience. When managers support prevention, participation goes from 35% to 80%.

4. Budget for prevention ROI, not just compliance costs. Yes, universal health checkups cost money. But catching 10 employees with undiagnosed hypertension prevents multiple cardiac events down the line. The companies that see prevention as investment, not expense, will dominate talent markets.

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How Loop Health Solves the Mandatory Health Checkup Problem

Here's the reality: when health checkups become mandatory, 35% engagement means you're non-compliant.

You need 80%+ participation. You need fast execution. You need actionable insights that lead to doctor consultations, not PDF files that employees ignore.

Loop achieves 80% health checkup utilization within 12 months—more than double the industry standard. This isn't luck. Its infrastructure is designed specifically to make prevention work at scale.

Why Loop's health checkup system works

90-second booking. 70% of employees complete the entire booking process in under 90 seconds. No complicated forms. No back-and-forth messaging. No friction.

Results in 12 hours, not 5 days. 90% of health checkup reports are deployed within 12 hours. At-home sample collection means employees don't need to take time off or find a diagnostic center.

Care Plans, not confusing jargon. Every health checkup generates a personalized Care Plan that translates medical parameters into actions employees actually understand. "Your HbA1c is 6.2%" becomes "You're pre-diabetic—here are 3 specific dietary changes and your next steps."

Integrated doctor access. Health checkup → Care Plan → free doctor consultation in one seamless journey. No 2-week wait to discuss results. No hunting for specialists. When an employee discovers cardiac risk markers, they're talking to a cardiologist within 24 hours through the Loop app.

Base Camps bring healthcare to your office. Loop doctors visit your workplace with vision screening, dental checks, and phlebotomists. Employees spend 5-10 minutes getting vitals checked, risk assessments completed, and lifestyle guidance—all without leaving the office. App activation doubles overnight after a Base Camp.

Health Index for organizational intelligence. Loop's Health Index shows concrete workforce health data: cardiac risk prevalence, diabetes rates, and high blood pressure cases. You get year-over-year tracking to see if interventions actually work. This bridges the gap between sick days (too early) and insurance claims (too late).

This matters because the labour codes don't just require health checkups—they require you to demonstrate that prevention is actually happening. Loop gives you the utilization rates, the data, and the care pathways to prove it.

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Prevention Is Now Infrastructure. Loop Makes It Work.

The labour code reforms signal a fundamental shift in how India thinks about worker welfare.

For decades, employer obligations focused on wages, hours, and basic safety. Health was something you addressed after it became a problem—through insurance claims and sick leave.

The mandatory health checkup requirement says: prevention is infrastructure, not luxury.

This aligns with everything Loop has built. India's workforce faces a 20-year health gap compared to developed nations. Japanese executives stay sharp and productive into their 70s, while many Indian professionals battle chronic illness by their 50s.

This gap isn't genetic. It's infrastructure.

Japanese executives aren't healthier because of superior DNA—they have superior preventive healthcare systems that catch problems early, provide immediate access to care, and make prevention practical instead of aspirational.

India is building that infrastructure now. The question for employers: will you be compliance-focused or outcome-focused?

Compliance-focused companies:

• Pay for health checkups, get 35% engagement, file paperwork
• Check the box for audits while health risks compound silently
• Watch insurance claims rise 25-50% annually
• Treat prevention as a cost center

Outcome-focused companies:

• Build systems that achieve 80%+ health checkup participation
• Turn health checkup data into actionable care pathways
• Catch cardiac risks, diabetes, and hypertension before they become ₹20 lakh claims
• See insurance premiums stabilize while competitors' explode
• Treat prevention as a competitive advantage

The labour codes create the mandate. Loop provides the infrastructure to actually execute it.

What Companies Should Consider

The labour codes became effective on November 21, 2025. The health checkup mandate is the law.

Here's what we know for certain: employers must provide free annual health checkups to all workers above 40. How this gets enforced, audited, or penalized remains to be seen as implementation rules get finalized.

What smart companies are doing right now:

Building infrastructure before it's urgent. Companies that wait for enforcement notices will scramble. Companies building health checkup systems now have time to test providers, compare engagement rates, train managers, and refine processes.

Asking the utilization question. If your current health checkup provider delivers 35% participation, is that "providing" health checkups to your workforce? Or just to a minority? Companies are evaluating whether their current approach actually fulfills the mandate.

Thinking beyond compliance. The mandate creates legal obligation. But the opportunity is workforce health. Companies investing in preventive infrastructure (high-utilization health checkups, integrated doctor access, care pathways for identified risks) are betting that prevention reduces claims, improves retention, and builds competitive advantage.

The known outcome from preventive health checkups:

When employees discover elevated blood pressure, pre-diabetic markers, or cardiac risk factors early — and when they have immediate access to doctors and management programs — health outcomes improve. This isn't speculation. It's established medical evidence.

What remains unknown: how long it takes for prevention infrastructure to show ROI in insurance premiums, how enforcement will work, what documentation will be required.

What is known: the mandate exists. Execution separates companies.

Build Your Prevention Infrastructure

The labour codes are effective. Your compliance clock started on November 21, 2025. Mid-2026 audits are 6 months away.

You need a health checkup system that:

• Achieves 80%+ participation (not 35%)
• Delivers results in hours (not days)
• Provides actionable insights that employees understand
• Integrates with immediate doctor access
• Generates organizational health intelligence

Loop's preventive health checkup infrastructure does all of this:

✓ 80% utilization within 12 months - Proven across hundreds of companies
✓ 90-second booking - 70% of employees complete the process in under 90 seconds
✓ 12-hour results with Care Plans - Actionable insights, not confusing medical jargon
✓ Integrated doctor consultations - Free, unlimited access to specialists
✓ Base Camps at your office - Healthcare comes to employees
✓ Health Index dashboard - Track workforce risks, measure intervention impact

See how Loop's health checkup system works and why companies achieve 2x industry-standard utilization.

The law now requires annual health checkups.

But the opportunity is building a workforce that's 20 years healthier.

Loop provides the infrastructure to make prevention actually work—at the scale and speed compliance demands.

Also Read: India's New Labour Codes: HR Compliance Guide for 2026