ModernisedSocial Security Coordination   New Social Security Regulations       883/2004 & 987/2009              Vit HOLUBE...
Overview Modernised Social Security Coordination Key innovations in the individual sectors• Applicable legislation• Sick...
What is coordination                                                        Ad Hoc groups   organisation                  ...
Over 50 yearsof Social Security Coordination                                                                              ...
Key Themes of the ModernisedRegulations•   Updating•   Simplification•   Improved protection of rights•   Clarification•  ...
Updating to reflect current practicesExamples:• Inclusion of paternity benefits• Explicit provision to take into account c...
Enhanced Cooperation "Clear and more effective cooperation between social security institutions is a key factor in allowin...
Dialogue and conciliation mechanisms           DG Employment, Social Affairs and Equal Opportunities   8   8
Determination of ApplicableLegislation - Key Innovations• Article 11 BR• Principle of “unicity” of applicable legislation ...
Improved protection for individuals  Provisional application of legislation  and provisional granting of benefits 6(1) IR:...
Determination of ApplicableLegislation - Key Innovations         New provisions on posting• Maximum of two years - no exte...
Posting – up to 24 months  A        Legislation applicable = Member State A           Legislation applicable = Member Stat...
Activities in more MS:- for the same employer :    Introduction of a new criterion in Article 13 BR•   The proportion of a...
Activities in 2 or more Member States forthe same employer A                Legislation applicable = Member State A       ...
Activities in 2 or more Member States for 2 or   more employers, with registered offices or place of   business in differe...
Activities in 2 or more Member Statesfor 2 or more employers, includingin the Member State of residence A           Legisl...
Determination of legislationapplicable                      Transitional provisions                            Article 87(...
Sickness and Maternity benefitsTemporary stay outside the State of  insurance: Necessary care – EHIC• Clarification of wh...
Procedures: necessary careA: Member State of residenceB: Member State of stayC: Competent State                           ...
Scheduled treatment Prior authorisation is issued by the institution of the MS bearing the  costs of the scheduled health...
Procedure for scheduled treatment:             general ruleA: Member State ofresidenceB: Member State of stayC: Competent ...
Sickness and Maternity benefitsResidence outside the State of insurance• Entitlement to all benefits in kind – equal  acce...
Sickness benefits for frontier workers                       Frontier workers•   Members of the family of a frontier worke...
Latest developments inAdministrative Commission•   14 new AC Decisions and 3 recommendations adopted    OJ C 106, 24 April...
Decisions and Recommendations ofthe Administrative CommissionA + Number   Applicable LegislationH + Number   Horizontal, c...
Portable documents A document for   individuals           Source: European Commission, DG Employment, Social Affairs and E...
Portable DocumentsPortable   Equivalent E form                              ExplanationdocumentA1         E 101           ...
EESSI (Electronic Exchange ofSocial Security Information)• EESSI is a core element in the new Regulations:   – Enables ins...
Electronic Exchange of SocialSecurity Information                    EESSI                   Network                      ...
EESSI                  AP   AP        I      I              I                          I  I                               ...
EESSI - implementation             Implementation of EESSI               is a twofold activityIdentification of the       ...
EESSI – Overall planning 2009 - 2012                          2010                                                        ...
SEDStructuredElectronicDocument             33   33
Planning business (I)SEDs- First batch of paper SEDs accepted by the Administrative   Commission on 14 April 2010  - famil...
Planning business (II)Second batch of paper SEDs• Accepted by the Administrative Commission in June• In field of recovery ...
Planning business (III)Third and final batch of paper SEDs• On agenda of Administrative Commission meeting of 5th  October...
Public EESSI Directory Interface                                   37
Recent developments in the Council• Proposal for a Regulation extending the provisions  of Regulation 883/04 to nationals ...
Information Sources on the newRegulations• Explanatory Notes on DG EMPL website• New Small Guide• Information campaign for...
New Website on Social Security                        40
Access to national information page                             41
Funding for Transnational ActionsActions:   • Improving information and cooperation between the     institutions of Member...
43
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2010 - New Social Security Regulations

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  • New document certifying the posting – PD A1.
  • 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
  • 2010 - New Social Security Regulations

    1. 1. ModernisedSocial 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. 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. 3. What is coordination Ad Hoc groups organisation Prepare documents and reports Decision Making Administrative Commission Task Force Prepare and coordinate work Technical AdvisoryAudit Board Commission Committee Approve Support AC on Dialogue withaverage costs technical social partnersand accounts aspects DG Employment, Social Affairs and Equal Opportunities 3 3
    4. 4. Over 50 yearsof Social Security Coordination _______________________________ ____________________________ _______________________ ____________________ Reg 883/04 Reg 987/09 (Impl. Reg) Consolid Reg Reg 1408/71 Reg 574/72 (Implementing Reg.) Regulations 3 & 41959 1972 1997 2010 4 4
    5. 5. Key Themes of the ModernisedRegulations• Updating• Simplification• Improved protection of rights• Clarification• Strengthened and Streamlined institutional procedures 5
    6. 6. Updating to reflect current practicesExamples:• 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. 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
    8. 8. Dialogue and conciliation mechanisms DG Employment, Social Affairs and Equal Opportunities 8 8
    9. 9. Determination of ApplicableLegislation - 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. 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. 11. Determination of ApplicableLegislation - 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. 12. Posting – up to 24 months A Legislation applicable = Member State A Legislation applicable = Member State A B 12
    13. 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. 14. Activities in 2 or more Member States forthe 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. 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 BIf 2 or more employers and registered offices/place of business in different member states = Member State of residence 15
    16. 16. Activities in 2 or more Member Statesfor 2 or more employers, includingin 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. 17. Determination of legislationapplicable 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. 18. Sickness and Maternity benefitsTemporary 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) 18
    19. 19. Procedures: necessary careA: Member State of residenceB: Member State of stayC: Competent State C Sickness Insurance InstitutionA B Sickness Insurance Institution 19
    20. 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. 21. Procedure for scheduled treatment: general ruleA: Member State ofresidenceB: Member State of stayC: Competent State C Sickness Insurance InstitutionA B Sickness Insurance Institution Sickness Insurance Institution 21
    22. 22. Sickness and Maternity benefitsResidence 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) 22
    23. 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. 24. Latest developments inAdministrative 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. 25. Decisions and Recommendations ofthe Administrative CommissionA + Number Applicable LegislationH + Number Horizontal, concerning general issues and rules of procedure, and also Financial provisionsE + Number Electronic Data ExchangeF + Number Family BenefitsS + Number Sickness BenefitsU + Number Unemployment BenefitP + Number Pensions 25 25
    26. 26. Portable documents A document for individuals Source: European Commission, DG Employment, Social Affairs and Equal Opportunities 26 26
    27. 27. Portable DocumentsPortable Equivalent E form ExplanationdocumentA1 E 101 Certificate for appl. legislationS1 E 106, E 109, E 120 and E 121 Registration for health care coverS2 E 112 Entitlement to scheduled careS3 - 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 insuranceU1 E 301 Certification of insurance periods for entitlement to UBU2 E 303 Retention of UB entitlementU3 - Change of circumstancesP1 E211 Summary of Pensions Decisions DG Employment, Social Affairs and Equal Opportunities 27 27
    28. 28. EESSI (Electronic Exchange ofSocial 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 28
    29. 29. Electronic Exchange of SocialSecurity Information EESSI Network 29
    30. 30. EESSI AP AP I I I I I I I 30
    31. 31. EESSI - implementation Implementation of EESSI is a twofold activityIdentification of the Creation of a European Business (flows, infrastructure to exchange SEDs the SEDsand data, institution data) Source: European Commission, DG Employment, Social Affairs and Equal Opportunities 31 31
    32. 32. EESSI – Overall planning 2009 - 2012 2010 2011 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4Directory Preparation forServices GO LIVEMessaging system Development by Siemens Flows Preparation of SEDs and flows for upload in EESSI SEDSImplementing EESSI Member States prepare their national applications for connecting to EESSI by 1.5.2012 End of Siemens 32 Contractual term
    33. 33. SEDStructuredElectronicDocument 33 33
    34. 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. 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. 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
    37. 37. Public EESSI Directory Interface 37
    38. 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. 39. Information Sources on the newRegulations• Explanatory Notes on DG EMPL website• New Small Guide• Information campaign for citizens• EESSI newsletter• Updated Website 39
    40. 40. New Website on Social Security 40
    41. 41. Access to national information page 41
    42. 42. Funding for Transnational ActionsActions: • 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
    43. 43. 43
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