DECISION No 109 of 18 November 1977 amending Decision No 92 of 22 November 1973 concerning the concept of sickness and maternity insurance benefits in kind referred to in Article 19 (1) and (2), 22, 25 (1), (3) and (4), 26, 28 (1) and 28a, 29 and 31 of Council Regulation (EEC) No 1408/71 and the determination of the amounts to be refunded under Articles 93, 94 and 95 of Council Regulation (EEC) No 574/72, as well as the advances to be paid in pursuance of Article 102 (4) of the same Regulation

THE ADMINISTRATIVE COMMISSION OF THE EUROPEAN COMMUNITIES ON SOCIAL SECURITY FOR MIGRANT WORKERS,

Having regard to Article 81 (a) of Council Regulation (EEC) No 1408/71 under which it is made responsible for dealing with all administrative questions and questions of interpretation arising from Council Regulation (EEC) No 1408/71 and (EEC) No 574/72,

Having regard to Decision No 92 of 22 November 1973, published in the Official Journal of the European Communities No C 99 of 23 August 1974,

Having regard to Article 36 (2) of Council Regulation (EEC) No 1408/71,

Whereas it is necessary to revise the abovementioned Decision No 92 to take account of: (a) amendments to German legislation, namely the abolition with effect from 1 January 1974, of payments provided under Article 188 (2) and (3) of the German insurance code (Reichsversicherungsordnung, RVO) and the introduction, with effect from the same date, of a new benefit (Haushaltshilfe), which is provided for in the new Article 185 (b) of the German insurance code and under Article 35 of the Law on sickness insurance for farmers (Gesetz über die Krankenversicherung der Landwirte, KVLG);

(b) amendments introduced by the Luxembourg Law on the reform of sickness insurance, in this case the conversion of the cash allowance for nursing mothers (allocation pécuniaire d'allaitement) into a benefit of another nature;

(c) special features of United Kingdom and Irish legislations;

Whereas for the application of Articles 19 (1) and (2), 22, 25 (1), (3) and (4), 26, 28 (1), 28a, 29 and 31 of Regulation (EEC) No 1408/71 there are grounds for giving a precise definition of sickness and maternity insurance benefits in kind in all the Member States;

Acting in accordance with the provisions of Article 80 (3) of Regulation (EEC) No 1408/71;

HAS DECIDED AS FOLLOWS:

1. The sickness and maternity benefits in kind to be considered for the determination of refunds, referred to in Articles 93, 94 and 95 of Regulation (EEC) No 574/72, shall be the benefits considered as benefits in kind under the national legislation administered by the institution which has provided the benefits, in so far as they can be acquired in accordance with the provisions of Articles 19 (1) and (2), 22, 25 (1), (3) and (4), 26, 28 (1), 28a, 29 and 31 of Regulation (EEC) No 1408/71.

2. The benefits provided under German legislation and set out in Article 185 (b) of the German insurance code (Haushaltshilfe) and in Article 35 of the Law on sickness insurance for farmers (Haushaltshilfe) shall be regarded as benefits in kind within the meaning of the aforesaid Articles of Regulation (EEC) No 1408/71 even though they may be provided in cash. These benefits shall he included in the expenditure referred to in (1) above.

3. The refunds provided for in Articles 93, 94 and 95 of Regulation (EEC) No 574/72 shall be determined exclusive of administrative costs, costs of administrative and medical supervision and without taking account of any amounts contributed individually by the persons concerned.

4. For the calculation of the average costs mentioned in Articles 94 and 95 of Regulation (EEC) No 574/72, the additional benefits specified in the statutes or rules of procedure of the institutions shall be included in total annual expenditure on sickness and maternity benefits in kind.

5. Expenditure incurred in respect of the provision of home help and meals on wheels, the supply of milk, maintenance in old people's welfare homes, fluoridation of water supplies, medical research and subsidies to institutions for preventive medicine, granted for a general campaign for health protection not sponsored by social security institutions, shall not be included in total annual expenditure on sickness and maternity benefits in kind.

6. The amounts refunded to other Member States in accordance with the Regulations or bilateral or multilateral agreements shall not be taken into consideration for the calculation of average costs.

7. The calculation of the amounts to be refunded shall as far as possible be based on the official statistics and accounts of the place of stay or residence, and preferably on the published official data. The sources of the statistics used should be indicated.

8. The amount of the advances to be paid under Article 102 (4) of Regulation (EEC) No 574/72 shall be calculated by multiplying the last approved average cost by the last known number of persons concerned, as obtained from the data established by the institutions responsible for the lists.

9. This Decision shall be published in the Official Journal of the European Communities.

It shall replace Decision No 92 of 22 November 1973.

For the purpose of determining amounts to be reimbursed pursuant to Articles 94 and 95 of Regulation (EEC) No 574/72, it shall apply from 1 January 1974.

The Chairman of the Administrative Commission for the Social Security of Migrant Workers

J. DONIS