2010 - C.N.P.A.S. Accidente de Muncă şi Boli Profesionale
2010 - New Social Security Regulations
1. Modernised
Social Security Coordination
New Social Security Regulations
883/2004 & 987/2009
Vit HOLUBEC
trESS seminar: Riga 28/9/2010
DG Employment,
Social Affairs and
Equal Opportunities
2. Overview
Modernised Social Security Coordination
Key innovations in the individual sectors
• Applicable legislation
• Sickness and maternity
Recent and future developments
DG Employment, Social Affairs and Equal Opportunities 2 2
3. What is coordination Ad Hoc groups
organisation Prepare
documents and
reports
Decision
Making Administrative Commission Task Force
Prepare and
coordinate work
Technical Advisory
Audit Board
Commission Committee
Approve Support AC on Dialogue with
average costs technical social partners
and accounts aspects
DG Employment, Social Affairs and Equal Opportunities 3 3
4. Over 50 years
of Social Security Coordination
_______________________________
____________________________
_______________________
____________________
Reg 883/04
Reg 987/09 (Impl. Reg)
Consolid Reg
Reg 1408/71
Reg 574/72 (Implementing Reg.)
Regulations 3 & 4
1959 1972 1997 2010
4 4
5. Key Themes of the Modernised
Regulations
• Updating
• Simplification
• Improved protection of rights
• Clarification
• Strengthened and Streamlined institutional
procedures
5
6. Updating to reflect current practices
Examples:
• Inclusion of paternity benefits
• Explicit provision to take into account credits
for child-raising periods
• New provisions on posting
• New procedures for recovery
• Improved and speedier procedures for reimbursement
of healthcare costs
• Requirement for data to be exchanged electronically
DG Employment, Social Affairs and Equal Opportunities 6 6
7. Enhanced Cooperation
"Clear and more effective cooperation between social security
institutions is a key factor in allowing the persons covered by
regulation (EC) 883/2004 to access their rights as quickly as
possible and under optimum conditions"
[Preamble of the IR, para. 2]
7
9. Determination of Applicable
Legislation - Key Innovations
• Article 11 BR
• Principle of “unicity” of applicable legislation
strengthened
no exceptions as it was under art 14c (Annex VII) and Art. 14f of
Reg 1408
• Strengthening of “lex loci laboris” principle
• Residence for non-active persons
DG Employment, Social Affairs and Equal Opportunities 9 9
10. Improved protection for individuals
Provisional application of legislation
and provisional granting of benefits
6(1) IR:
Divergence of views about the legislation applicable:
person provisionally subject to one legislation identified
with an order of priority
6(2) IR:
Divergence of views about which institution should provide
the benefits: institution identified with an order of priority
10
11. Determination of Applicable
Legislation - Key Innovations
New provisions on posting
• Maximum of two years - no extension of
period
• Main conditions remain applicable
– Definitions in article 14 Implementing Regulation
– New Decision A2 on posting adopted by
Administrative Commission on 12 June 2009
– Revised posting guide
DG Employment, Social Affairs and Equal Opportunities 11 11
12. Posting – up to 24 months
A Legislation applicable = Member State A
Legislation applicable = Member State A
B
12
13. Activities in more MS:
- for the same employer :
Introduction of a new criterion in Article 13 BR
• The proportion of activity in the Member State of residence
has to be substantial for the legislation of residence to apply
• Otherwise: legislation of MS of employer applies
- for more employers in different Member States:
• Legislation of MS of residence applies
13
14. Activities in 2 or more Member States for
the same employer
A Legislation applicable = Member State A
Legislation applicable = Member State A
B
Only if substantial part of activities in the Member State of residence
14
15. Activities in 2 or more Member States for 2 or
more employers, with registered offices or place of
business in different Member States
A C
Legislation applicable = Member State A
Legislation applicable = Member State A
B
If 2 or more employers and registered offices/place of business in different member states
= Member State of residence
15
16. Activities in 2 or more Member States
for 2 or more employers, including
in the Member State of residence
A Legislation applicable = Member State A
Legislation applicable = Member State A
B
If 2 or more employers, Member State of residence
16
17. Determination of legislation
applicable
Transitional provisions
Article 87(7) BR
• Legislation determined under 1408/71 continues to apply
– if as a result of application of 883 person would become subject
to different legislation
– as long as relevant situation remains unchanged
– For a maximum period of 10 years
• Person can request to become subject to the legislation
applicable under Regulation 883/2004.
DG Employment, Social Affairs and Equal Opportunities 17 17
18. Sickness and Maternity benefits
Temporary stay outside the State of
insurance:
Necessary care – EHIC
• Clarification of who is responsible
for providing EHIC to persons
not residing in competent State
(Article 27 BR)
Scheduled treatment – requires
authorisation
• New procedures and rules
for scheduled treatment – PD S2
(Article 26 IR)
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19. Procedures: necessary care
A: Member State of residence
B: Member State of stay
C: Competent State
C
Sickness Insurance
Institution
A B
Sickness Insurance
Institution
19
20. Scheduled treatment
Prior authorisation is issued by the institution of the MS bearing the
costs of the scheduled health care, namely:
• the competent institution
• institution of the MS of residence when the reimbursement between
institutions is based on a lump sum
The application is made with the institution of the place of
residence, which forwards it to the competent institution (after
verifying whether the conditions are met in the State of residence)
Incorporation of the case-law:
- Keller (C-145/03): vitally necessary treatment
- Vanbraekel (C-368/98): additional reimbursement
- Herrera (C-466/04): travel and accomodation costs
20
21. Procedure for scheduled treatment:
general rule
A: Member State of
residence
B: Member State of stay
C: Competent State
C
Sickness Insurance
Institution
A B
Sickness Insurance
Institution
Sickness Insurance
Institution
21
22. Sickness and Maternity benefits
Residence outside the State of insurance
• Entitlement to all benefits in kind – equal
access to healthcare
• Registration with the sickness insurance
institution (Portable document S1)
Reimbursements between institutions
• Primarily on basis of Actual costs
• In MSs listed in Annex 3 on the basis of
new Average costs
• New procedures and time limits
(Art. 67 IR, Decisions S4, S5, S6)
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23. Sickness benefits for frontier workers
Frontier workers
• Members of the family of a frontier worker are entitled to
benefits in kind while staying in the competent state UNLESS
the latter is listed in Annex III
• Retired frontier workers and family are entitled to benefits in
kind in the Member State where they used to work as a
frontier workers if this MS as well as the MS which is
financially responsible are both listed in Annex V
23
24. Latest developments in
Administrative Commission
• 14 new AC Decisions and 3 recommendations adopted
OJ C 106, 24 April 2010, p. 1
• Adoption of new Posting guide (part I)
• Adoption of Portable Documents
• Structured Electronic Documents (SEDs)
• Miscellaneous Amendments 2010
DG Employment, Social Affairs and Equal Opportunities 24 24
25. Decisions and Recommendations of
the Administrative Commission
A + Number Applicable Legislation
H + Number Horizontal, concerning general issues and rules of
procedure, and also Financial provisions
E + Number Electronic Data Exchange
F + Number Family Benefits
S + Number Sickness Benefits
U + Number Unemployment Benefit
P + Number Pensions
25 25
26. Portable documents
A document for
individuals
Source: European Commission, DG Employment, Social Affairs and Equal
Opportunities 26 26
27. Portable Documents
Portable Equivalent E form Explanation
document
A1 E 101 Certificate for appl. legislation
S1 E 106, E 109, E 120 and E 121 Registration for health care cover
S2 E 112 Entitlement to scheduled care
S3 - Medical treatment for former cross-
border worker in former country of
work (new or continued treatment)
DA1 E 123 Entitlement to health care cover
under accident insurance
U1 E 301 Certification of insurance periods
for entitlement to UB
U2 E 303 Retention of UB entitlement
U3 - Change of circumstances
P1 E211 Summary of Pensions Decisions
DG Employment, Social Affairs and Equal Opportunities 27 27
28. EESSI (Electronic Exchange of
Social Security Information)
• EESSI is a core element in the new Regulations:
– Enables institutions to exchange information electronically
under a common secure network
– Gives effect to the principle of enhanced cooperation
between the Member States
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31. EESSI - implementation
Implementation of EESSI
is a twofold activity
Identification of the Creation of a European
Business (flows, infrastructure to exchange
SEDs the SEDs
and data, institution
data)
Source: European Commission, DG Employment, Social Affairs and Equal
Opportunities 31 31
32. EESSI – Overall planning 2009 - 2012
2010 2011
12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4
Directory Preparation for
Services GO LIVE
Messaging
system
Development by Siemens
Flows
Preparation of SEDs and flows for upload in EESSI
SEDS
Implementing
EESSI
Member States prepare their national applications for connecting to EESSI by 1.5.2012
End of Siemens
32
Contractual term
34. Planning business (I)
SEDs
- First batch of paper SEDs accepted by the Administrative
Commission on 14 April 2010
- family benefits (all)
- unemployment benefits (majority)
- sickness benefits (50%)
- pensions (SED on child raising periods)
• First batch of SEDs will be ready in all languages end
September
34
35. Planning business (II)
Second batch of paper SEDs
• Accepted by the Administrative Commission in June
• In field of recovery (50% of SEDs) and pensions (7 SEDs)
• Second batch will be available in all languages by mid-
October
35
36. Planning business (III)
Third and final batch of paper SEDs
• On agenda of Administrative Commission meeting of 5th
October
• All remaining SEDs (70%)
• SEDs will be available in all languages Spring 2010
36
38. Recent developments in the Council
• Proposal for a Regulation extending the provisions
of Regulation 883/04 to nationals third country
nationals
• Association Council Decisions
38 38
39. Information Sources on the new
Regulations
• Explanatory Notes on DG EMPL website
• New Small Guide
• Information campaign for citizens
• EESSI newsletter
• Updated Website
39
42. Funding for Transnational Actions
Actions:
• Improving information and cooperation between the
institutions of Member States, and/or
• Improving citizens’ knowledge on their rights
• Subsidy up to 80%
• Call for proposal VP/2010/004 (deadline 17/05/2010)
• Published on DG EMPL website
• Publication again in 2011
DG Employment, Social Affairs and Equal Opportunities 42 42
Interpretation guidelines are currently discussed in the Administrative Commission as Part II of Practical guide on applicable legislation
If there is not substantial part of activities in the MS of residence – the legislation of the MS where the employer has registered office or place of business applies.
in the future: only if substantive activity
Point 15 of Part II of the Pracical guide on Applicable legislation (subject to the approval of the Admin Com)
The European Health Insurance Card : always issued by the Member State which is responsible for the costs of the benefits in kind provided. Pensioners are entitled to go back to the Member State which is financial responsible for the costs of the health care in order to receive health care if Member State concerned is listed in Annex IV (BE, DE, GR, ES, FR, LU, NL, AUT, SE).(Article 27 (2) BR))
vitally necessary treatment : prior autorisation may be issued by the institution of the MS of residence when the conditions of the BR are met competent institution shall accept findings and treatment options of the doctor approved by the institution of the place of residence ( Keller judgement ) Reimbursement of the costs Additional reimbursement upon request by competent institution (Van Braekel judgement) Reimbursement of travel and accomodation costs if the legislation of the competent MS provides for such a reimbursement.
1st May 2010 is also the start of a two year transition period during which Member States with the support of DG EMPL will have to prepare their national applications for the this changeover to the new electronic data exchange of social security information.
What lies ahead? Training Experiencing Adapting Making new system work to the citizen's benefit