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DG Employment, Social Affairs and
Equal Opportunities
Modernised Social Security Coordination
New Social Security Regulations883/2004 & 987/2009
Vit HOLUBEC
trESS seminar: Riga 28/9/2010
2DG 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
3DG Employment, Social Affairs and Equal Opportunities 3
What is coordination organisation
Decision Making Administrative Commission Task Force
Ad Hoc groups
Prepare documents and reports
Technical Commission
Audit Board
Prepare and coordinate work
Approve average costs and accounts
Support AC on technical
aspects
Advisory Committee
Dialogue with social partners
44
_________
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Reg 1408/71
Reg 574/72 (Implementing Reg.)
Consolid Reg
Reg 987/09 (Impl. Reg)
Reg 883/04
Regulations 3 & 4
Over 50 years of Social Security Coordination
19591959 19721972 19971997 20102010
5
Key Themes of the Modernised Regulations
• Updating • Simplification • Improved protection of rights • Clarification • Strengthened and Streamlined institutional
procedures
6DG Employment, Social Affairs and Equal Opportunities 6
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
Updating to reflect current practices
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]
8
Dialogue and conciliation mechanisms
DG Employment, Social Affairs and Equal Opportunities 8
9DG Employment, Social Affairs and Equal Opportunities 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
10
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
Provisional application of legislation and provisional granting of benefits
Improved protection for individuals
11
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
Determination of Applicable Legislation - Key Innovations
12
BA Legislation applicable = Member State ALegislation applicable = Member State A
Posting – up to 24 months
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
14
B
Activities in 2 or more Member States for the same employer
AOnly if substantial part of activities in the Member State of residence
Legislation applicable = Member State ALegislation applicable = Member State A
15
C B
Activities in 2 or more Member States for 2 or more employers, with registered offices or place of business in different Member States
AIf 2 or more employers and registered offices/place of business in different member states
= Member State of residence
Legislation applicable = Member State ALegislation applicable = Member State A
16
B
Activities in 2 or more Member Statesfor 2 or more employers, including in the Member State of residence
AIf 2 or more employers, Member State of residence
Legislation applicable = Member State ALegislation applicable = Member State A
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
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)
19
Procedures: necessary care
CBA
Sickness InsuranceInstitution
Sickness InsuranceInstitution
A: Member State of residenceB: Member State of stay C: Competent State
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
21
Procedure for scheduled treatment: general rule
CBA
Sickness InsuranceInstitution
Sickness InsuranceInstitution
Sickness InsuranceInstitution
A: Member State of residenceB: Member State of stay C: Competent State
22
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)
Sickness and Maternity benefits
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
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
2525
Decisions and Recommendations of the Administrative CommissionA + 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
26Source: European Commission, DG Employment, Social Affairs and Equal
Opportunities 26
A document for individuals
Portable documents
27
Portable Documents Portable document
Equivalent E form Explanation
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
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
29
EESSI
Network
Electronic Exchange of Social Security Information
30
I
II
I
I
I
AP AP
I
EESSI
31Source: European Commission, DG Employment, Social Affairs and Equal
Opportunities 31
EESSI - implementation
Implementation of EESSI
is a twofold activity
Identification of the Business (flows,
SEDs and data, institution
data)
Creation of a Europeaninfrastructure to exchange
the SEDs
32
EESSI – Overall planning 2009 - 2012
2010
1 2 312 1 2 3 4 5 6 7 8 9 10 11 12
2011
4
Preparation of SEDs and flows for upload in EESSI
Preparation for GO LIVE
End of SiemensContractual term
Directory Services
Flows SEDS
Messaging system Development by Siemens
Implementing EESSI Member States prepare their national applications for connecting to EESSI by 1.5.2012
33
SED
33
Structured
Electronic
Document
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
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
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
37
Public EESSI Directory Interface
383838
Recent developments in the Council
• Proposal for a Regulation extending the provisions of Regulation 883/04 to nationals third country nationals
• Association Council Decisions
39
Information Sources on the new Regulations
• Explanatory Notes on DG EMPL website
• New Small Guide
• Information campaign for citizens
• EESSI newsletter
• Updated Website
40
New Website on Social Security
41
Access to national information page
42DG Employment, Social Affairs and Equal Opportunities 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
43