Source: http://www.noi.bg/en/faqs
Timestamp: 2018-12-19 14:13:05
Document Index: 430731397

Matched Legal Cases: ['Art. 114', '§1', 'Art. 26', 'Art. 41', 'Art. 41', 'Art. 41', 'Art. 41', '§ 2', 'art. 167', 'art. 50', 'art. 167', '§ 2', 'Art. 26', '§ 1', 'art. 5', '§ 4', 'art. 6', '§ 9', 'art. 114']

What kinds of benefits and allowances are paid from the State Social Security Fund?
Temporary disability due to sickness, accidents at work and occupational disease, sanatorium rehabilitation or treatment, medical examination, quarantine, removal from the office appealed by the medical expertise, caring for a sick family member or family member under quarantine, necessary accompanying of a family member for medical examination or treatment, as well as care for a child back from kindergarten because of quarantine;
Reajustment because of temporary disability due to sickness, accidents at work or occupational disease;
Readjustment due to pregnancy and breastfeeding;
Child-raising;
Adoption of a 2-5 year old child.
disability due to sickness, in case the insured hasn't got the needed period of insurable service to be granted disability pension for sickness;
death of an insured person.
Who has the right to a benefit for temporary disability and reajustment?
The right for temporary disability benefit have the insured for sickness and maternity with at least 6 months of insurance record for this risk. This requirement does not apply to persons under 18 years of age and for the entitlement to benefits for accidents at work and occupational diseases or reajustment.
The insurer pays the insured person for the first three days of the temporary disability 70% of the average gross salary for the month in which the temporary disability has occured, but not less than 70% of the average remuneration contracted between them.
Benefits for temporary disability are reimbursed by persons for the period for which they were granted a disability pension for the same condition, with the exception when the sick leave was issued upon objective data of exacerbation of the condition and with interventions related to treatment of chronic disease.
What are the documents needed for temporary disability or readjustment benefits to be paid?
Benefits for temporary disability and reajustment are paid based on the sick leave document from the hospital presented by the insured to the insurer.
The data from the medical certificates/sick leave document from the hospital, adopted under the Ordinance on the Procedure on the Submission of Data of Issued Medical Certificates to the National Social Security Institute and Decisions on Their Appeal (OPSDIMCNSSIDTA), as well as data used from the Register of the Insurers and the Self-insured, the Register of Revenue from the Social Security Contributions to the State Social Security Fund, the Register "Labour Contracts", the Register "Pensions", the Register "Accidents at Work", the Register "Occupational Diseases" the Register "Cash Allowances for Prophylaxis and Rehabilitation" and the Register "Cash Benefits and Allowances from the State Social Security Fund".
A declaration form in accordance with Annex № 1 of the Ordinance on Benefits and Allowances from the State Social Security Fund (OBASSSF) presented by the insured to the insurer, in which he just once declares data, regarding the bank account for payment benefits together with his first sick leave.
A certificate from the insurer, the insurance funds or data by the self-employed concerning the right to benefits, which is presented in NSSI for each sick leave document - Annex № 9 OCBBSSSF.
What is the remuneration/salary that is considered for the calculation of the temporary disability benefit?
The daily benefit for temporary disability due to sickness is calculated at the rate of 80 % and for temporary disability due to accident at work or occupational disease – at 90 % of the average daily gross salary or the average daily insurable income for which the due insurance contributions are paid, and for the self-employed – paid insurance contributions for sickness and maternity leave for the period of 18 calendar months preceding the month of the occurrence of the disability.
The daily benefit for temporary disability due to sickness may not exceed the average daily net remuneration for the period from which the benefit is calculated.
For the days in the 18-month period preceding the month of the occurrence of the disability the average daily minimum wage for the country in the same period is taken into account if the person:
 was not insured for sickness and maternity;
 was in unpaid leave, which is recognized for length of insurable service;
 used a leave for child-raising;
 has been insured under the legislation of another country under the terms of an international regulation to which Bulgaria is a party.
For the days in the 18-month period during which a person has received benefit from the social security for temporary disability, for pregnancy and birth, the income from which the benefit was calculated is taken into account.
The amount from which the benefit is calculated cannot be more than the maximum monthly insurance income as defined by the State Social Security Budget Act (SSSBA) for the period of which the benefits are calculated. For 2016 it is 2600 BGN.
How long the temporary disability benefit is paid?
The benefit for temporary disability due to sickness, accident at work and occupational disease is paid from the first day of the event up to the recovery from the disability or a statement of long-term disability.
In case the temporary disability due to sickness, accident at work or occupational disease occurred within 30 calendar days after the termination of the employment contract or insurance, the cash benefit is payable for the period of the disability, but not more than 30 calendar days. In these cases, the benefit is not paid to persons receiving a pension or compensation for remaining without work, determined in accordance with a legislative act.
The paid cash benefits for temporary disability are reimbursed by persons for the period for which they were granted a pension or unemployment benefit was paid.
In case the temporary disability occurred before the termination of term labour and official contracts, contracts for military service, management and control of companies’ contracts, the cash benefit is paid for not more than 30 calendar days after the termination of the legal relation or contract.
If the temporary disability is due to accident at work or occupational disease the cash benefit is paid until the recovery of the ability or a statement of long-term disability.
Benefits for temporary disability due to accidents at work and
occupational disease of people employed under a contract for short-term seasonal agricultural work for a day (Art. 114a §1 of the Labour Code) can be paid for a period of incapacity but not more than for 90 calendar days.
How long benefits under quarantine or removal from work are paid?
Benefits for temporary disability due to quarantine or removal from the office as prescribed by the health authorities are paid respectively:
the time for which the insured is under quarantine;
the time of removal from the office if the insured cannot be reassigned to another job during that time, but not more than 90 calendar days in one calendar year.
Have the individuals got the right to benefits for sanatorium treatment?
The disabled individual sent to sanatorium treatment from the health authorities, the benefit is paid for the entire stay, including up to three calendar days travel in the amounts defined for sickness or accident at work and occupational diseases.
In what cases and for how long benefits for caring of a sick member of the family can be obtained?
Cash benefit under the conditions and in the amount of cash compensation for temporary disability due to sickness are paid for:
care or necessary accompanying for medical examination or treatment in the country or abroad of an ill family member over the age of 18 – ten calendar days in one calendar year for each insured;
care or necessary accompanying for medical examination or treatment in the country or abroad of an ill child under the age of 18 – up to 60 calendar days per calendar year for all insured family members total; in this period the time for a child under items 3-5 is not included;
care of a quarantined child under the age of 18, suffering from a contagious disease – till the end of the quarantine;
care of a sick child under the age of 3, accommodated at a hospital together with the insured – for the time during which the insured was in the hospital;
care for a child back from a kindergarten due to quarantine – as long as the quarantine is.
Benefit according to the above items 2, 3, 4 and 5 to be paid for child care, accommodated with relatives or foster family under Art. 26 of the Child Protection Law.
For one and the same contingency, for the same time period, cash benefit for caring for a sick family member can be paid to only one member of the insured family.
Caring of a chronically ill family member cash benefit is paid only in case of exacerbation of the disease.
For family members of the insured person are considered the direct descending and ascending line of kinship, the husband and the wife.
In which cases benefits will not be paid?
Benefit for temporary disability is not payable to insured persons who:
deliberately damage their health in order to obtain leave or a benefit;
violate the regime established by the health authorities – only for the days of the violation;
have become disabled due to drinking alcohol, taking an anaesthetic without curative intent or for activities carried out under the impact of such stuff;
have become unable to work due to hooliganism and other antisocial behaviour, these events determined accordingly;
have become unable to work due to non-compliance of the rules for safety at work, identified as appropriate.
In the above cases 3 and 4, the period for which the benefit is not paid cannot be longer than 15 calendar days in the case of item 5 – not longer than 3 days.
Benefits for temporary disability and for pregnancy and birth are not paid to persons engaged in work that is the basis for insurance for sickness and maternity leave during the periods for which acts by the health authorities were issued.
In which cases, how much and how long a benefit for labour readjustment is paid?
In the case of readjustment due to temporarily reduced capacity because of a general illness, accident at work or occupational disease, the insured is paid benefit if the new work is with reduced renumeration.
The daily cash benefit is equal to the difference between the average daily gross salary during the 18 calendar months preceding the month of the reajustment, but not more than the average daily amount of the maximum monthly insurable earnings and the average daily gross salary after the reajustment. If the insured person has worked less than 18 months to the day of the reajustment, the compensation is defined as the difference between the average daily remuneration determined under Art. 41 of the SIC and the average daily gross salary after the reajustment.
The benefit is paid for the time of the job transfer, but not more than 6 months.
Who and under what conditions can get an allowance for disability due to illness and an allowance for death of an insured person?
Right for benefits for disability due to illness have persons who were refused for granting disability pension due to sickness, because of shortage of insurance record if insured for illness and maternity, disability due to sickness, old age and death, accident at work and occupational disease and unemployment. The allowance is paid at the rate of 60-day compensation for temporary disability, calculated as a benefit for temporary disability to work due to sickness.
- To be paid, the application – declaration according to Annex № 16 of the OBASSSF in paper form and ID must be submitted.
Right for a one-time allowance at death of an insured person have husband/wife, children and parents. The total amount is divided equally between the beneficiaries and is determined annually by the State Social Security Budget Act (SSSBA). For 2016 it is determined in the amount of 540 BGN total.
- To be paid the application– declaration according to Annex № 17 of the OBASSSF in paper form and ID must be submitted.
What should we know about benefits for temporary disability due to pregnancy or breast-feeding, or advanced stage of IVF treatment?
In case of readjustment due to pregnancy or nursing a child or an advanced stage of IVF the insured woman is paid benefits if the new job is with a reduced remuneration.
The daily benefit is at the amount of the difference between the average daily gross salary income during the 24 calendar months preceding the month of the job transfer, but not more than the average daily maximum amount of the monthly income and the average daily gross salary income after the job readjustment. When the insured woman has worked less than 24 months to the day of the job transfer, the benefit is defined as the difference between the average salary as in Art. 41 of the Social Insurance Code and the average daily gross salary after the labour readjustment.
In case at the new job the woman gets average gross salary less than the minimum daily wage established for the country or if the average daily remuneration determined under Art. 41 is less than the minimum salary established for the country, the daily benefit is equal to the difference between the average daily gross wage before the job transfer and the minimum daily wage established for the country. From 1st January 2016 the minimum of the monthly salary is 420 BGN.
What is the requirement to get the right to benefits for pregnancy and childbirth?
The insured for sickness and maternity have the right to get benefits for pregnancy and birth instead of their job salary if they have 12 months of insurance service as required for this risk.
What is the amount of the benefit for pregnancy and childbirth?
The daily benefit for pregnancy and birth is set at 90% of the average daily gross remuneration or the average daily insurable income on which the due contributions are paid and for the self-employed the contributions for sickness and maternity benefits must be paid for the period of 24 calendar months preceding the month of the occurrence of the temporary disability because of pregnancy and childbirth.
The daily benefit cannot be larger than the average daily net wage for the period for which the benefit is calculated, and less than the minimum daily wage established for the country and it is determined in accordance with Art. 41, § 2-5 from the Social Insurance Code.
When acquiring the right to benefit for pregnancy and birth during the payment of benefit for pregnancy and birth or parental leave for the previous child the benefit is in the above amounts if it is more favourable for the insured.
When the person is insured for more than one ground, the total daily benefit cannot be less than the minimum daily wage established for the country.
How long the cash benefit for pregnancy and childbirth is to be paid?
The insured for sickness and maternity mother has the right to get benefits for pregnancy and birth for a period of 410 calendar days, 45 days of which before the birth.
If the childbirth occurs before the expiration of these 45 days from the initial use of the benefit, the remaining days from these 45 are used after the birth.
When the child is stillborn, dies or is given to a kindergarten with a full support from the state or for adoption, the mother has the right to get benefit until 42 days from the birth. If the ability of the mother following the birth is not restored after 42 days, the duration of the benefit is extended with the discretion of the health authorities till her full recovery for work. Until the expiry of the 410 days the benefit is paid as benefit for pregnancy and childbirth.
When the child is given up for adoption, placed in a kindergarten with full support from the state or dies after the 42 days of the birth, the benefit for pregnancy and birth is terminated from the next day. In these cases, if the ability of the mother following the birth is not restored, the duration of the benefit is extended with the discretion of the health authorities till her full recovery for work. Until the expiry of the 410 days the benefit is paid as compensation for pregnancy and childbirth.
The insured for sickness and maternity, who adopt a child have the right to get benefits for the birth of the child in the amount within the time margin from the day of the adoption till the expiry date due for a benefit for child-birth.
The insured for sickness and paternity father has the right to get benefit for childbirth in the amount determined for pregnancy and childbirth, up to 15 calendar days during the relevant leave according to the Labour Code, if he has 12 months of insurance record as insured for this risk.
The insured for sickness and paternity adoptive parent/father has the right to get benefit after the childbirth at the amount determined for pregnancy and birth after the age of 6 months of the child for the remaining up to 410 calendar days during the relevant leave according to the Labour Code, if he has 12 months of insurance service as insured for this risk. The father can use this leave with the consent of the mother.
Who can receive benefits in case of death or illness of the mother and/or the father?
In case of serious illness of the mother (adoptive mother), which prevents her to take care of her child, or death of the mother and/or the father, the person who uses leave under art. 167 of the Labour Code has the right to get benefits for childbirth or child-raising. The benefit is paid also to the self-employed who are insured for sickness and maternity.
Does the person when her/his insurance is terminated have the right to get pregnancy and birth benefits?
When the termination of the insurance for sickness and maternity is during the receipt of the pregnancy and birth benefits, the insured person is paid the benefits till the expiry of the period for pregnancy and birth according to art. 50 of the Social Insurance Code or till the expiration of the 410 days.
What is the condition to get the right for a little child-raising benefit?
The insured for sickness and maternity have the right to get benefit for raising a child if they have 12 months of insurance service as insured for this risk.
What is the amount of the benefits during the additional leave for raising a little child and under what conditions it is obtained?
After the expiry of the benefits for pregnancy and childbirth, during the additionally paid leave for raising a child, the mother (the adoptive mother) is paid a monthly benefit in the amount determined by the State Social Security Budget Act (SSSBA). For 2016 it is 340 BGN.
Where the additional paid leave for raising a child is used by the father (adoptive father), rather than the mother (adoptive mother) or the person who has taken care of the child, he/she will be paid a monthly benefit in the amount determined by the Budget Act of the State Social Insurance. This benefit is paid to the guardian when he/she uses a leave under art. 167, § 2 of the Labour Code.
Benefit for raising a child is paid also to those who use parental leave for raising a child up to the age of two, who is placed in accordance with Art. 26, § 1 of the Child Protection Law.
The benefit for raising a child is not paid in the cases of death of the child, giving the child for adoption or placing the child in childcare institutions, including nurseries, as well giving the child to a person involved in programmes giving support to motherhood.
Self-employed who are insured for sickness and maternity have also the right to get benefits for raising a child.
What is the amount of the benefit for those who don’t use additional paid leave for raising a little child and under what conditions it is obtained?
The mother (the adoptive mother) which is insured for sickness and maternity, and has the right to get benefit for raising a child receives a 50% benefit for raising a child if:
She doesn’t use an additional paid leave for raising a child or the person using such leave, terminates using it;
If the self-insured with the right for a benefit for raising a child gets employed and insured for sickness and maternity.
If the mother (adoptive mother) has died, if she is deprived from parental rights or if these rights are granted to the father (adoptive father), this benefit is paid to the father (adoptive father), and if he has died – to the guardian. The benefit is paid if the person taking care of the child is insured for sickness and maternity.
The benefit in the amount of 50 % for raising a child will not be paid if the child is placed in childcare institutions with full state support, as well as given to a person involved in programmes giving support to motherhood.
What is the condition for child-raising benefit upon adoption of a child from 2 to 5 years old?
The insured for sickness and maternity person who has 12 months of insurance service as provided for this risk and uses leave at adoption of a child from 2 to 5 years old in terms of full adoption, is entitled to the compensation amount determined as benefit for pregnancy and birth for a period of 365 days but no later than the completion of the 5-year age.
This benefit is not payable at death of the child, if the adoption is terminated and if the child attends kindergarten, nursery or school including.
The self-employed individuals who are insured for sickness and maternity and have 12 months of service insured for this risk are entitled to cash benefit upon adoption of a child from 2 to 5 years old in the terms in the above conditions.
What documents are needed, so that a benefit for pregnancy and birth, for raising a little child or adopting a 2-5-year old child to be granted?
Medical certificates for a period of 135 calendar days for sick leaves submitted from the insured to the insurer.
The data from the medical certificates for the period up to 135 calendar days, submitted according to the НРПНОИДИБЛРО.
A declaration according to Annex № 1 of OBASSSF, submitted from the insured to the insurer – about the medical certificates of the mother after the 42nd day of the child-birth.
A certificate from the insurer, the insurance funds or the self-employed with data on the right to the benefit, which is presented in NSSI for each of the sick leaves documents from the hospital - Annex № 9 OBASSSF.
An Application-Declaration by the insured to the insurer for the payment of benefits for pregnancy and birth for the remaining up to 410 calendar days in the form Annex № 2 of OBASSSF.
An Application-Declaration by the insured to the insurer for the payment of benefits to the father for time of 15-day leave for childbirth in the form Annex № 3 of OBASSSF.
An Application-Declaration from the insured to the insurer for payment of benefits for childbirth after the age of 6 months of the child for the remaining up to 410 calendar days to the father/adoptive father in the form of Annex № 4 to OBASSSF.
An Application-Declaration from the insured to the insurer for payment of benefits for 2 to 5- year old child adoption for a period of 365 days in the form of Annex № 5 to OBASSSF.
An Application-Declaration from the insured to the insurer for payment benefits for 2 to 5- year old child adoption after the expiry of six months from the date of the child adoption for the remaining 365 days in the form of Annex № 6 of OBASSSF.
An Application-Declaration from the insured to the insurer for payment benefits for parental leave for raising a little child and benefits when not using the additional paid leave for raising a little child in the forms № 7 and № 8 of OBASSSF.
A Certificate in the form of Annex № 10 of OBASSSF – about the insured at an insurer individuals or Annex № 11 of OBASSSF – about the self-insured with data on the right to benefits.
How the data from the medical certificates is submitted to the NSSI?
The data contained in the issued medical certificates must be submitted to NSSI from:
1. doctors/dentists – in person or by the medical institutions in which they operate;
2. The medical advisory committee (LKK) - by the medical institutions at which they are founded.
The data contained in the decisions on appeals of medical certificates shall be submitted to NSSI from:
The medical advisory committee (LKK) - by the medical institutions at which they are founded.
Territorial expert medical commissions (TELK) - through the regional indexes of the medical expertise (RKME);
The National Expert Medical Commission (NELK).
The submission of data contained in the issued medical certificates and in the decisions on appeals (with the exception of the data contained in the expert decisions TELK/ NELK given on the occasion of appeals on medical certificates) is processed electronically via the web services provided by the Institute. The filled in data is sent to NSSI and is transferred to the Electronic Register of the Medical Certificates and the Decisions on Their Appeals at the same time with their issuing or if technical feasibility lacks – within 7 days of the issue.
How to submit to NSSI the necessary documents and data for payment of benefits for temporary disability, reajustment, pregnancy and childbirth, raising a little child and at adoption of a 2 – 5-year old child?
The certificates Annex № 9, Annex № 10 and Annex № 11 are to be presented either on paper or on a CD or electronically by use of a qualified electronic signature of the sender.
· More than two certificates are to be submitted only on a CD or electronically using a qualified electronic signature of the sender.
· More than ten certificates are to be submitted only electronically using a qualified electronic signature of the sender.
· The insurance funds submit certificates only electronically using a qualified electronic signature of the sender.
Documents on paper or on a CD shall be submitted to the relevant local office of NSSI together with a cover letter in accordance with Annex № 12, signed and stamped by the person to present them according to OBASSSF or their representative, and for the self-insured - signed and stamped by the person if the self-insured person has a seal.
When a CD is submitted, the Unified Identification Code (UIC) under the Register of Companies/BULSTAT has to be written on it. The cover letter is submitted on paper in 2 copies, one of the copies remains in the NSSI's local office and the other is given to the bearer.
The certificates, Annex № 9, Annex № 10 and Annex № 11 are submitted electronically via the web application accessible via the Internet site of NSSI or using the software distributed freely by NSSI or any other software product meeting the functional requirements, structure and format of the data, established by an order of the Governor of NSSI, by a qualified electronic signature of the sender.
After receiving the certificates NSSI issues a reference about the accepted and the returned documents in a form according to Annex № 14.
Upon receipt of the documents electronically, to the e-mail address of the registered user a message is sent with access to the content of the report.
Upon receipt of the documents on paper or a CD, the report is issued sealed and signed by the official in the respective local office of NSSI and is given to the person submitting the documents.
What are the time limits for the certificates № 9 - № 11 for payment of benefits to be submitted in NSSI?
The insurers and their branches and subsidiaries and the insurance funds - up to the 10th of the month after the month in which the insured has presented the needed documents for payment of the benefit to the insurer (medical certificate from the hospital for the sick leave and/or an application-declaration);
The self-employed - up to the 10th of the month after the month in which the medical certificate was issued by the hospital and respectively up to the 10th of the month after the month in which the payment of a benefit for pregnancy and birth, little child raising and adopting a 2 – 5-year old child is required;
What kind of registration is due to be made after 1st December 2015 by persons who will perform electronically submission of documents for payment of benefits for temporary disability, readjustment, pregnancy and birth, little child raising and adoption of a 2 – 5-year old child according to the Ordinance for the Benefits and Allowances from the State Social Security Fund (OBASSSF)?
Persons who will submit documents for payment of benefits electronically or persons authorized by them are to be registered as users of the Web services of NSSI. The registration is done online via a web application accessible through the website of NSSI.
The registration of a Company or of an Insurance Fund is done by means of a valid qualified electronic signature, containing UIC according to the Commercial Register Act/UIC - BULSTAT and the name of the legal entity or the insurance fund.
The registration of an individual is performed by means of a valid qualified electronic signature containing the personal identification number/personal number of a foreigner and the full name of the person.
The registration of a sole trader is done by means of a valid qualified electronic signature, containing UIC according to the Commercial Register Act/UIC - BULSTAT and the name of the sole trader or a personal identification number/personal number of a foreigner and the full name of the person.
A person required to submit the documents under OBASSSF can authorize with an application form another person holding a qualified electronic signature, to submit electronically documents on his behalf. The authorized person is to present the application electronically with the qualified electronic signature via the web application in the website of NSSI. The authorizer presents the signed and stamped paper application in person or through an authorized agent in the corresponding local office of NSSI within 3 working days of the authorization.
Upon withdrawal of the authorization, the person required to submit the documents
in the corresponding NSSI's local office presents a new application form not later than 3 working days prior to the date of the withdrawal.
How and in what time limits are the benefits and allowances paid by NSSI?
Benefits and allowances are paid by NSSI's to the entitled persons within 15 working days (after 30th June 2016 within 10 working days) after the receipt of the data from the issued hospital certificates on sick leaves and submission of the certificates in the forms of the Annexes № 9 - № 11 of OBASSSF.
Benefits for a period covering more than one calendar month are paid within 15 working days (after 30th June 2016 within 10 working days) for the first month of the period and for the remaining calendar months – up to 5 working days after the end of the month to which they relate, and for the last month – up to 5 working days after the expiry of the benefit.
The local offices of NSSI pay to the eligible persons the benefits to their declared personal current or savings bank accounts (such transfers are performed twice weekly).
If the person is not entitled to benefit or allowance, the official responsible for the management of the payment of benefits and allowances or other official appointed by the head of the local office of NSSI, issues an order for refusal within 15 working days (after 30th June 2016 within 10 working days) from the receipt of the the data from the issued hospital certificates on sick leaves and submission of the certificates in the forms of the Annexes № 9 - № 11 or the application-declarations in the form of the Annexes №15 - №18. A copy of the order for the refusal is sent to the person within 3 days of the issuance of the order and he may appeal in front of the Head of the local office in a 14- day period after its receipt.
The order is cancelled if in the three-year limitation period under SIC the insured person or the insurer present new or additional evidence demonstrating the right to a benefit or allowance. The due by the State Social Security Fund claims expire in a three-year period as from 1st January of the year following the year to which they relate.
The official of the local office of the Institute issues an order to stop the payment of the temporary disability benefits for accident at work and occupational disease, labour reajustment, pregnancy and birth, and child-raising in case of appealed acts of the medical expertise or when evidence leading to the issuance of a refusal order or suspension of the benefit payments, or cancellation of the benefit or when no data from medical certificates was provided and the decisions on their appeal issued in the Electronic Register of the Medical Certificates and the Decisions on Their Appeals.
What are the time limits for a local office of NSSI to notify the persons about submitted incorrect or missing documents according to OBASSSF, as well as to clarify facts and circumstances related to the calculation and payment of the benefits and allowances?
Within 7 working days of the submission of the documents NSSI informs the persons due to submit documents according to OBASSSF, giving them the necessary instructions on rectification or clarification of facts and circumstances.
The informing is made by a licensed postal operator to the indicated particular address or electronically to the specified e-mail address, or the phone, which is certified by the signature of the executive officer.
Within 7 working days from the notification the persons submit in the corresponding local office of NSSI the corrected or missing documents.
What are the time limits to submit documents and data in case of change of the circumstances leading to terminating the payment of benefits and allowances?
The insured submits a new declaration to the insurer (Annex № 1) of OCPBASSSF or a new application-declaration Annexes № 2 - № 8 of OCPBASSSF within 3 working days of the change of the circumstances concerning the payment of cash benefits, change of the bank account including and the related evidence.
Within 3 working days of their receipt, the insurers, their branches or subsidies and the insurance funds submit new certificates at the local offices of NSSI with data about the changes of the circumstances according to Annexes № 9, 10 and 11.
Within 3 working days from the change in the circumstances related to the payment of the benefit - self-insured, entities, companies, through which shareholders are being insured, owners of Ltd., individuals - members of unincorporated associations and insurance funds submit new certificates in Annexes № 9, 10 and 11 with data on changes in circumstances.
How long must insurers keep the documents for granting benefits for temporary disability, reajustment, for pregnancy and birth, child raising and adoption of a 2 - 5-year old child?
The documents for payment of the benefits and the relevant evidence are presented by the insured to the insurer who keeps them in a separate record book and stores them for a period of five years as from 1st January of the year following the year of their submission.
The self-insured, the insurance funds, entities, companies, through which shareholders are being insured, owners of Ltd., individuals - members of unincorporated associations store these documents for a period of 5 years from 1st January of the year following the year in which the payment of the benefit was requested.
When and how are the benefits (for temporary disability, reajustment, pregnancy and childbirth and adoption of a 2 – 5-year old child) recalculated?
Benefits and allowances paid to the insured are automatically recalculated according to the data of art. 5 § 4 pt. 1 of SIC up to 30th June of the year following the year to which they relate.
Benefits and allowances paid to the self-employed for the previous calendar year are automatically recalculated up to 30th June of the current year, based on the final insurance record, determined in accordance with art. 6 § 9 of SIC. If the payments were bigger than the amount due, the benefits are to be reimbursed by the self-employed persons pursuant to art. 114 of SIC.
Where the cash benefits and allowances are paid in an amount less than the due, the difference is paid up to 30th June of the year following the year for which refer.
Last update: 12.01.2016
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