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

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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

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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

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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]

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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

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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

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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

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BA Legislation applicable = Member State ALegislation applicable = Member State A

Posting – up to 24 months

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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

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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

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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

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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

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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

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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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Procedures: necessary care

CBA

Sickness InsuranceInstitution

Sickness InsuranceInstitution

A: Member State of residenceB: Member State of stay C: Competent State

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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

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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

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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

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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

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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

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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

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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

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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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EESSI

Network

Electronic Exchange of Social Security Information

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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

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EESSI – Overall planning 2009 - 2012

2010

1 2 312 1 2 3 4 5 6 7 8 9 10 11 12

2011

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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

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SED

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Structured

Electronic

Document

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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

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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

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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

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Public EESSI Directory Interface

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Recent developments in the Council

• Proposal for a Regulation extending the provisions of Regulation 883/04 to nationals third country nationals

• Association Council Decisions

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Information Sources on the new Regulations

• Explanatory Notes on DG EMPL website

• New Small Guide

• Information campaign for citizens

• EESSI newsletter

• Updated Website

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New Website on Social Security

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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

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