Law 255 fz new edition. Law on benefits for temporary disability, pregnancy and childbirth - Russian newspaper. On compulsory social insurance in case of temporary disability and in connection with motherhood
1. Temporary disability benefits, maternity benefits, monthly childcare benefits are calculated on the basis of the average earnings of the insured person calculated for two calendar years preceding the year of temporary disability, maternity leave, maternity leave, including during the time of work (service, other activities) with another policyholder (other policyholders). The average earnings for the time of work (service, other activities) with another policyholder (other policyholders) are not taken into account if, in accordance with Part 2 of Article 13 of this Federal Law, temporary disability benefits, maternity benefits are assigned and paid to the insured for all places of work (service, other activities) based on average earnings for the time of work (service, other activities) of the insured, appointing and paying benefits. In the event that in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the indicated years, the insured person was on maternity leave and (or) on maternity leave, the corresponding calendar year (calendar year) at the request of the insured person, they can be replaced in order to calculate the average earnings in the previous calendar years (calendar year), provided that this leads to an increase in the amount of benefits.
(see text in previous edition)
1.1. If the insured person during the periods specified in Part 1 of this article, had no earnings, and also if the average earnings calculated for these periods, calculated for the full calendar month, are lower than the minimum wage established by federal law on the day of the insured event, the average earnings based on which temporary benefits are calculated disability, maternity leave, a monthly allowance for child care, is taken equal to the minimum wage established by federal law on the day of the insured event. If the insured person is working on a part-time basis (part-time week, part-time day) at the time of the insured event, the average wage based on which benefits are calculated in these cases is determined in proportion to the length of the work time of the insured person. Moreover, in all cases, the calculated monthly allowance for child care cannot be less minimum size monthly allowance childcare established by federal law
2. The average earnings, on the basis of which benefits for temporary disability, pregnancy and childbirth, the monthly allowance for child care are calculated, include all types of payments and other benefits for the benefit of the insured person for which insurance premiums to the Social Insurance Fund Russian Federation in accordance with Federal law dated July 24, 2009 N 212-ФЗ "On insurance premiums in Pension Fund Russian Federation, Social Insurance Fund of the Russian Federation, Federal Mandatory Fund health insurance"(for the period through December 31, 2016 inclusive) and (or) in accordance with the law
(see text in previous edition)
2.1. The insured persons referred to in Part 3 of Article 2 of this Federal Law shall receive the average wage on the basis of which temporary disability benefits, maternity benefits, and the monthly childcare allowance are calculated equal to the minimum wage established by federal law on the day of occurrence insured event. Moreover, the calculated monthly childcare allowance cannot be less than the minimum amount of the monthly childcare allowance established by the Federal Law "On state benefits to citizens with children."
2.2. For insured persons who worked under labor contracts concluded with organizations and individual entrepreneurs, for whom a reduced rate of insurance contributions to the Social Insurance Fund of the Russian Federation was applied in the amount of 0 percent, in the average earnings, on the basis of which benefits for temporary disability, for pregnancy are calculated and maternity leave, a monthly childcare allowance, includes all types of payments and other benefits for the benefit of the insured person, which were included in the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with Federal Law of July 24, 2009 N 212-ФЗ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period through December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from 1 January 2017) in the corresponding calendar year and do not exceed the maximum size of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation established in this calendar year. Information on the specified payments and remuneration in favor of the insured person for the relevant period is indicated in the certificate of the amount of earnings issued by the policyholder in accordance with Clause 3 of Part 2 of Article 4.1 of this Federal Law.
(see text in previous edition)
3. The average daily earnings for calculating temporary disability benefits is determined by dividing the amount of accrued earnings for the period specified in paragraph 1 of this article by 730.
(see text in previous edition)
3.1. The average daily earnings for calculating the maternity allowance, the monthly childcare allowance is determined by dividing the amount of accrued earnings for the period specified in paragraph 1 of this article by the number of calendar days in this period, with the exception of calendar days falling on the following periods :
1) periods of temporary disability, maternity leave, parental leave;
2) the period of release of the employee from work with full or partial retention salary in accordance with the legislation of the Russian Federation, if insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with Federal Law of July 24, 2009 N 212-ФЗ "On Insurance Contributions to the Pension Fund of the Russian Federation, the Fund Social Insurance of the Russian Federation, Federal Compulsory Medical Insurance Fund "(for the period through December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (from January 1, 2017).
(see text in previous edition)
(see text in previous edition)
3.2. Average earnings, on the basis of which temporary disability benefits, maternity benefits and a monthly childcare allowance are calculated, are taken into account for each calendar year in an amount not exceeding that established in accordance with Federal Law of July 24, 2009 N 212-ФЗ " On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund "(for the period through December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from January 1 2017) for the corresponding calendar year, the maximum size of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation. In the event that the assignment and payment of benefits to the insured person for temporary disability, maternity leave is carried out by the territorial bodies of the insurer at the place of registration of several policyholders in accordance with parts 2 and 4 of Article 13 of this Federal Law, the average earnings on the basis of which these benefits are calculated, is taken into account for each calendar year in an amount not exceeding the specified limit value, when calculating these benefits for each of these insurers.
(see text in previous edition)
3.3. The average daily earnings for calculating the maternity allowance, the monthly childcare allowance, determined in accordance with part 3.1 of this article, may not exceed the amount determined by dividing by 730 the sum of the maximum values \u200b\u200bof the base for calculating insurance contributions to the Russian Social Insurance Fund Of the Federation established in accordance with Federal Law of July 24, 2009 N 212-ФЗ "On Insurance Contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Compulsory Medical Insurance Fund" (for the period through December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from January 1, 2017) for two calendar years preceding the year of the beginning of maternity leave, parental leave.
The legislation of the Russian Federation, among social benefits, specifically provides a guarantee to all individuals for which the employer pays mandatory insurance amounts, as well as compensation payments to pregnant women and persons caring for a child until he reaches a certain age. For the most part, all these payments are made at the expense of the funds that the employer transfers for each of its employees.
All the above aspects are considered directly in the Federal Law 255 “On Mandatory social insurance in case of temporary disability and in connection with motherhood ”(hereinafter referred to as the“ Law ”).
Key Points
This Law was adopted on December 29, 2006, replacing the previously effective Federal Law of July 16, 1999 “On the Basics of Mandatory Social Insurance”.
The new law introduced new rules for calculating sick leave and benefits in connection with the onset of pregnancy and childbirth. In particular, the changes affected. Under the new legislation, the billing period now includes not one previous year, but two.
New Law in detail paints the following questions:
Questions to be addressed
Conditionally, in the text of the Law we can distinguish three main areas:
- General cases when temporary disability occurs;
- Maternity benefits;
- Payments for caring for a child who has not yet reached the age of one and a half years.
Also the size of insurance premiums is established for each employee and the procedure for their transfer to the Social Insurance Fund.
Payment of insurance premiums
The law obliges all employers pay insurance premiums for their employees to social insurance bodies. Their size is set as a percentage of the employee’s salary. At present it equals 2.9%.
These contributions transferred monthly after the salary is accrued.
It is from these money transfers that the payment of benefits occurs, with the exception of the first 3 days of the ordinary sick leave (his employer pays at his own expense).
The employer accrues all benefits and then pays from his equity, and only then the FSS reimburses the spent funds by transferring money.
Temporary disability
The law deals with this issue in Chapter 2, articles 5 through 9.
They reveal next questions:
All citizens for whom accrual and transfer will be entitled to benefits insurance amounts to the Social Insurance Fund, and also in some cases, payments will be made to persons who will care, in particular.
Disability any illness or injury that prevents the employee from fulfilling his or her official duties is considered. It can only be installed by a medical institution that issues a certificate of incapacity for work, where the reason and duration will be indicated.
Disability certificate It has uniform form and is a form strict reporting. The Law has clear rules on how to fill out this document. It is filled by employees of medical institutions and employees of the organization where it is provided for payment. The Social Insurance Fund conducts periodic inspections, during which the correctness of the filling and accrual of benefits is checked. In the event that gross mistakes are made when filling out the form of incapacity for work, such a form of social insurance may not be accepted for payment, respectively, the paid sick leave to the employer is not compensated.
The amount of payment depends on the number of years of the employee and is as follows percentages from average earnings:
- 60% - with work experience up to 5 years;
- 80% - with the experience of 5-8 years;
- 100% - with an experience of more than 8 years.
This applies to normal situations when the person who received the leaflet is personally on sick leave. In the case when the sick leave is issued for caring for children or other family members payment is made at a rate of 60%, regardless of the experience.
Payments are held in the following way:
- the employee provides sick leave to the employer;
- accrual;
- benefits are paid at the nearest wage.
Despite the fact that the benefit is accrued only to those for whom insurance premiums are paid, 3 days sick leave the employer pays at his own expense, and the rest of the FSS reimburses him.
Pregnancy and childbirth
Chapter 3 is devoted to this issue; it regulates the size and timing of benefits.
A woman is also issued sick leave for this period, which has strictly set duration. She is:
Since pregnancy and childbirth are registered on the sick leave, then payment and accrual algorithm similar to a regular sick leave, but with a few exceptions:
- this sick leave is paid in full, that is 100%, regardless of the experience of the woman who received it;
- has a minimum and maximum size, which is limited by law. This size changes almost every year and depends on the change.
A sick leave certificate is issued on this basis 70 or 84 days before the date of delivery approximately established in the consultation.
Baby care
According to the Law, anyone who directly cares for a small child can receive monthly benefitsuntil the child is 1.5 years old.
This type of compensation begins to be paid only after the end of the leave given in connection with pregnancy and childbirth.
If a woman simultaneously has the right to receive both types of benefits, then she can choose only one of them, she will not be able to receive two at once. Such a situation can occur when a short time after the first birth.
Calculation principle the benefits are the same as for the accrual of sick leave, but the whole amount is not paid in full, and in installments every month and not in full, but only 40% per child. Accordingly, if there are 2 children, then the allowance will be 80%, if three children were born at the same time, the allowance will be paid at 100%.
The allowance is paid by the employer. And then reimbursed by social insurance.
Benefit calculation methods, payment periods
All benefits are calculated based on average wage, which is defined as the amount of income for the two calendar years that precede when the accrual of benefits is made divided by the number of days in those years, that is, 730 or 731.
Thus, the average wage per day is calculated, then the amount received is multiplied either by the number of sick days or by 30.4, that is, the average number of days in a month. Then, the required percentage is calculated from the amount received.
Benefits are paid in the following terms:
In cases of pregnancy and motherhood, the law allows replacement of billing periods, provided that in this case the amount of the benefit will be greater.
In particular, it is allowed to take into account the periods during which a woman had a vacation in connection with pregnancy and childbirth or with child care. And also if its payment in previous years was higher.
If the person to whom the benefit will be paid is immediately employed two employers, then only one of them, according to the choice of the employee, will accrue benefits, and only the one accrued from this employer will be taken into account. To include in the calculation the entire salary accrued by all employers, you will have to quit from one place.
Last changes
Major changes in 2019:
From February 1, 2019, state benefits for children will be indexed by the inflation rate, which will lead to an increase of 4.3%.
In connection with the increase in the minimum wage from January 1, 2019 to 11,280 rubles, the minimum and maximum payments for compulsory social insurance are indexed, including maternity allowance and monthly childcare benefits up to 1.5 years.
Since 2019, the average daily earnings cannot go beyond the extreme boundaries of 370.85 rubles and 2150.69 rubles (minimum and maximum values). That is, during normal pregnancy, for 140 days, the amount of payment should be not less than 51919 rubles and not more than 301095.2 rubles.
In case of premature pregnancy, B&R leave lasts 156 days, respectively, the minimum will increase to 57,852.6 rubles, the maximum - to 335,506.08 rubles.
For multiple pregnancies, leave for BiR is extended to 194 days, for this period the allowance is provided in the range of 417,231.92 rubles - 71,944.9 rubles.
The rules for calculating disability benefits are described in the following video:
This article will be useful to those who, in addition to the main work, also work part-time.
As you already know from previous materials, the procedure for paying for a certificate of incapacity for work (sick leave) is governed by federal law, namely, Federal Law of 29.12.2006 N 255-ФЗ "On Compulsory Social Insurance for Temporary Disability and in Connection with Maternity".
Starting January 1, 2016, the revision of Federal Law N 255-ФЗ dated December 29, 2015 is in force.
Federal Law of December 29, 2015 N 394-ФЗ "On Amending Certain Legislative Acts of the Russian Federation".
In accordance with this legislation, for the payment of a sick leave certificate (sick leave) to an employee, one of the following insurance events must occur:
illness or injury to the employee;
caring for a family member who is sick;
quarantine of the employee, his child under 7 years old or an incompetent relative;
prosthetics, the basis for which is medical indications;
aftercare in a sanatorium or resort.
Mandatory requirement for the payment of a sick leave certificate (sick leave) to an employee - social insurance of the employee by his employer by transferring insurance contributions to the Social Insurance Fund of the Russian Federation (FSS of the Russian Federation) in the amounts established by Federal Law N 255-ФЗ.
In practice, each officially registered permanent employee is automatically insured by the employer in the Social Insurance Fund of the Russian Federation (FSS of the Russian Federation).
In this material we will not address the issue of how the sick leave certificate (sick leave certificate) is paid to the employee who received injury at work or "earned" an occupational disease.
This is a separate issue and in this material we will not consider this issue in detail. In these situations, the main regulatory document is Federal Law of 07.24.1998 N 125-ФЗ (as amended on December 29, 2015) "On compulsory social insurance against industrial accidents and occupational diseases".
Accidents and compensation for occupational diseases are paid from the funds of the Social Insurance Fund of the Russian Federation (FSS of the Russian Federation) in the usual manner and are identical to how the disability certificate (sick leave) is paid to an employee from 2016 for other insurance cases.
Means for paying a sick leave certificate (sick leave) to regular employees and part-time workers
Consider how the sick leave certificate (sick leave certificate) is paid to regular employees and part-time workers, and from what sources, if the employee took the sick leave certificate (sick leave) after January 1, 2016.
Any insured event what happened to an employee and is subject to the Federal Law N 255-ФЗ (as amended on December 29, 2015) "On compulsory social insurance in case of temporary disability and in connection with motherhood", paid as follows:
the first three days - paid at the expense of the profit of the enterprise;
the rest of the period is reimbursed at the expense of the Social Insurance Fund of the Russian Federation (FSS of the Russian Federation).
Such payment of a sick leave certificate (sick leave) to an employee is established by Article 3, clause 2, and cl. 1 of Federal Law N 255-ФЗ.
Payment of a disability certificate (sick leave) to a child care worker or an incompetent relative
- carried out completely from the budget of the Social Insurance Fund of the Russian Federation (FSS RF).
Payment of a sick leave certificate (sick leave) to an employee after his dismissal
- carried out at a rate of 60% regardless of the duration of the employee's insurance period.
Former employee may claim to pay for such a certificate of incapacity for work (sick leave) upon fulfillment of a number of requirements prescribed in Article 4, Clause 2 of Federal Law No. 255-FZ.
Payment of a sick leave certificate (sick leave) to a permanent employee and an external part-time worker
The general procedure for calculating the disability certificate (sick leave) consists of 4 stages.
Stage 1. The total employee income base for the last 2 calendar years (for example, from January 1, 2014 to December 31, 2015), for which insurance premiums are calculated, is taken.
Stage 2. The amount received is divided into 730 (seven hundred thirty) days.
Stage 3. The calculated value is the average daily earnings.
insurance experience of 8 years or more - 100%;
insurance experience from 5 to 8 years - 80%;
length of service from 3 to 5 years - 60%;
insurance experience less than 6 months. - a disability certificate (sick leave) is calculated on the basis of the minimum wage (minimum wage).
Example. The employee has been working at the enterprise for 5 years, his income base for 2014-2015. equal to 335,200.00 rubles.
This is his first place of work, i.e. insurance experience is in the range from 3 to 5 years, assuming 60% payment daily average earnings:
335200/730 \u003d 459.18 rubles. x 60% \u003d 275.51 rubles.
Thus, for each day of the certificate of incapacity for work (sick leave), the employee will receive 275.51 rubles. The first 3 days the employer pays temporary disability benefit from his own funds - 826.53 rubles, and the remaining days the temporary disability benefit is paid from the funds of the Social Insurance Fund (FSS of the Russian Federation).
When paying for a certificate of incapacity for work (sick leave) to an employee part-time since 2016, there are peculiarities.
Feature 1. When issuing a certificate of incapacity for work (sick leave) to an employee in a medical institution, the employee must say that he has several places of work and the medical officer responsible for issuing certificates of incapacity for work (sick leave), must give several forms - one for each employer.
Moreover, on the certificate of incapacity for work (sick leave), a note is made which place of work is the main, and which (or which, if there are several), concurrently.
Feature 2. If the employee has been working part-time for a long time and the income base for 2014-2015. it turned out that all employers will pay for him sick leave.
Feature 3. If in the 2 calendar years preceding the year of the insured event, the employee had different employers, then he needs to collect certificates from all employers in the form No. 4-n and get paid for the certificate of incapacity for work (sick leave) at the main place of work.
Article 13 “Procedure for the appointment and payment of benefits for temporary disability, maternity, monthly benefits for childcare” of the Federal Law No. 255-FZ “On Compulsory Social Insurance for Temporary Disability and in Connection with Maternity”.
Feature 4. In the event that the part-time employee has not worked anywhere for the past 2 years, temporary disability benefits can be paid to him based on the minimum wage and the length of the insurance period.
The procedure for calculating the average earnings for the payment of a sick leave certificate (sick leave)
As mentioned above, the average daily earnings of an employee to pay for a sick leave certificate (sick leave) is the sum of the income received by the employee in the 2 years preceding the year of applying for temporary disability benefits. In other words, in 2016, the revenue base is taken for 2014 and 2015.
All income received from all employers is considered.
In this case, a prerequisite - contractual relations should be official in nature and from the salary of employees all employers transferred insurance contributions to the Social Insurance Fund of the Russian Federation (FSS of the Russian Federation).
There are situations when in the indicated period the employee has no income base. For example, an employee was on maternity or childcare leave. Then, on the basis of Article 14, Clause 1 of Federal Law No. 255-ФЗ "On Compulsory Social Insurance for Temporary Disability and in Connection with Maternity," she has the right to write a statement and choose the previous calendar years (where the income was) to calculate average daily earnings.
The only condition for such a calculation is the fact that the amount of temporary disability benefit is increased to a greater extent than that calculated according to the minimum wage.
When determining the average earnings for paying the incapacity for work (sick leave) accountants are guided by article 14 of law No. 255-FZ.
At the same time, the result obtained is compared with the minimum wage (minimum wage) at the time of accrual of temporary disability benefits.
Example. The employee has an income base for 2014–2015 of 114,700 rubles.
We determine its average daily earnings: 114,700 / 730 \u003d 157.12 rubles. We calculate the average daily earnings based on the minimum wage: 6,204 (from 01/01/2016) x 24 months \u003d 148,896 / 730 \u003d 203.97 rubles.
A comparison of the two amounts shows that the employee needs to take the second value of the average daily earnings, because it exceeds its actual income for 2014 - 2015.
Amount of disability certificate (sick leave) paid to regular employees and part-time workers since 2016
As already mentioned, the employee receives 100% of his income with insurance experience exceeding 8 years. Experience from 5 to 8 years is paid in the amount of 80%, from 3 to 5 years - 60%, less than 6 months. - based on the minimum wage (6,204 rubles from 01/01/2016).
Dismissed employees are always paid a sick leave certificate (sick leave) in the amount of 60% of the actual average daily earnings (subject to the conditions necessary for payment).
Existing restrictions when paying for a sick leave certificate (sick leave) from January 1, 2016
Payment of a disability certificate (sick leave) to an employee at the enterprise is carried out in accordance with the social legislation of the Russian Federation, which provides for a number of restrictions.
Limitation 1. Income base for 2014-2015. must not be higher than the maximum permissible value.
This provision is spelled out in article 14, clause 3.1 of Federal Law No. 255-FZ.
Article 14. “The procedure for calculating temporary disability benefits, maternity benefits, monthly childcare benefits” of the Federal Law of December 29, 2006 N 255-ФЗ “On compulsory social insurance for temporary disability and in connection with motherhood” .
For 2014, the maximum allowable amount of income for determining the amount of temporary disability benefits is 624,000 rubles, for 2015 - 670,000 rubles. Thus, the upper income limit for any employee (for each place of work) who is accrued for temporary disability benefits in 2016 will be 624,000 + 670,000 \u003d 1294,000 rubles. and average daily earnings - 1773 rubles.
Restriction 2. The presence in the employee's disability certificate (sick leave) of a mark of violation of the patient regimen.
For example, an employee arbitrarily left the hospital. The date of violation of the regime is the moment from which the amount of average daily earnings is calculated from the minimum wage of the minimum wage (6,204 rubles from 01/01/2016).
Limit 3. Limitations related to the length of the insurance period (interest is discussed above).
Restriction 4. The allowance for the care of sick relatives has a number of restrictions on the timing of payment in accordance with article 6, paragraph 5 of Federal Law No. 255-FZ.
Article 6, clause 5, “Temporary disability allowance, if it is necessary to care for a sick family member, is paid to the insured person:” Federal Law of December 29, 2006 N 255-FZ “On Compulsory Social Insurance for Temporary Disability and in Connection with Maternity”.
Dependence of payment of temporary disability benefits on the age of a sick relative.
|
Relative |
The maximum duration of sick leave in days |
The number of paid days during the calendar year |
|
Child under 7 years old |
No restrictions |
|
|
A child under 7 years old with a disease from a special list of the Social Insurance Fund |
No restrictions |
|
|
Child age 7-15 |
||
|
Disabled child up to 15 years old |
No restrictions |
|
|
A child under the age of 15 years with HIV and other diseases according to the list of Federal Law No. 255-ФЗ Article 6, Clause 5, Clauses 4.5 |
No restrictions |
No restrictions |
|
Other relative |
Outpatient care for a sick child is paid to the employee in the following order:
the first 10 days are paid according to the average daily earnings of the employee, adjusted according to the duration of his insurance period in the Social Insurance Fund of the Russian Federation;
the following (from the 11th day) days - 50% of the average daily earnings on the basis of Article 7, Clause 3 of Federal Law No. 255-FZ.
Deadline for disability certificate (sick leave)
The disability certificate (sick leave) calculated in the accounting department is paid to the employee on the day the wage is paid at the enterprise. There should be two such days - advance payment and salary.
On the next date, the employee receives the amount of temporary disability benefits.
The amount of temporary disability benefits is subject to personal income tax.
If the terms of payment of the sick leave certificate (sick leave) by the employer are violated, the employee has the right to file a complaint:
- to the labor inspectorate,
- the prosecutor’s office or
When compiling a complaint, the employee must briefly state the essence of the matter and attach evidence of the unlawfulness of the employer's actions. Confirmation that the terms of payment of the certificate of incapacity for work (sick leave) are violated can be the following documents:
a copy of the certificate of incapacity for work (sick leave);
copy of the employment contract;
payroll with an accrued amount;
copy of statement or account statement plastic cards (for cashless payments with staff).
The document is an amendment to
Changes and Amendments
Chapter 1. GENERAL PROVISIONS
Article 1. Subject of Regulation of this Federal Law
1. This Federal Law regulates legal relations in the system of compulsory social insurance for temporary incapacity for work and in connection with maternity, determines the circle of persons subject to compulsory social insurance for temporary incapacity for work and in connection with maternity, and the types of compulsory insurance provided by it, establishes the rights and obligations of subjects of compulsory social insurance in case of temporary disability and in connection with maternity, and also determines the conditions, sizes and procedure for providing temporary disability benefits, maternity benefits, monthly childcare benefits for citizens subject to compulsory social insurance for temporary disability and in connection with motherhood.
2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an industrial accident or occupational disease, with the exception of the provisions of Articles 12, 13, 14 and 15 of this Federal Law applicable to these relations in part , which does not contradict the Federal Law of July 24, 1998 N 125-ФЗ "On compulsory social insurance against industrial accidents and occupational diseases".
Article 1.1. Legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood
1. The legislation of the Russian Federation on compulsory social insurance for temporary incapacity for work and in connection with motherhood is based on the Constitution of the Russian Federation and consists of this Federal Law, Federal Law of July 16, 1999 N 165-ФЗ "On the Basics of Compulsory Social Insurance", Federal the law "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Fund for Mandatory Medical Insurance and territorial funds of obligatory medical insurance", other federal laws. Relations related to compulsory social insurance for temporary incapacity for work and in connection with motherhood are also regulated by other regulatory legal acts Russian Federation.
2. In cases where an international treaty of the Russian Federation establishes other rules than those provided for by this Federal Law, the rules apply international treaty Russian Federation.
3. In order to uniformly apply this Federal Law, if necessary, relevant explanations may be issued in the manner determined by the Government of the Russian Federation.
Section 1.2. Basic concepts used in this Federal Law
1. For the purposes of this Federal Law, the following basic concepts are used:
1) compulsory social insurance in case of temporary disability and in connection with motherhood - a system of legal, economic and organizational measures created by the state aimed at compensating citizens for lost earnings (payments, remuneration) or additional expenses in connection with the occurrence of an insured event for compulsory social insurance for temporary disability and in connection with motherhood;
2) an insured event for compulsory social insurance for temporary incapacity for work and in connection with motherhood - an accomplished event, upon the occurrence of which the insurer's obligation arises, and in some cases established by this Federal Law, the insured to provide insurance coverage;
3) compulsory insurance coverage for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood (hereinafter also referred to as insurance coverage) - fulfillment by the insurer, and in some cases established by this Federal Law, by the policyholder of his obligations to the insured person upon occurrence of an insured event by payments of benefits established by this Federal Law;
4) means of compulsory social insurance in case of temporary incapacity for work and in connection with maternity - funds generated from the payment of insurance premiums by the insurers for compulsory social insurance in case of temporary incapacity for work and in connection with maternity, as well as property under the operational management of the insurer;
5) insurance contributions for compulsory social insurance in case of temporary incapacity for work and in connection with maternity (hereinafter - insurance contributions) - compulsory payments made by insurers to the Social Insurance Fund of the Russian Federation in order to ensure compulsory social insurance of insured persons in case of temporary incapacity for work and in connection with with motherhood;
6) average earnings - the average amount paid by the policyholder in favor of the insured person in the payroll period, other payments and remuneration, on the basis of which, in accordance with this Federal Law, temporary disability benefits, maternity benefits, a monthly childcare allowance are calculated and for persons who have voluntarily entered into legal social insurance in the event of temporary disability and in connection with motherhood, the minimum wage established by federal law on the day the insured event occurs.
2. Other concepts and terms used in this Federal Law are applied in the sense in which they are used in other legislative acts of the Russian Federation.
Article 1.3. Insurance risks and insurance claims
1. The insurance risks for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood shall be recognized as temporary loss of earnings or other payments, remuneration by the insured person in connection with the occurrence of the insured event or additional expenses of the insured person or his family members in connection with the occurrence of the insured event.
2. The following are recognized as insured events for compulsory social insurance in case of temporary disability and in connection with motherhood:
1) temporary disability of the insured person due to illness or injury (with the exception of temporary disability due to industrial accidents and occupational diseases) and in other cases provided for in Article 5 of this Federal Law;
2) pregnancy and childbirth;
3) the birth of a child (children);
4) caring for a child until he reaches the age of one and a half years;
5) death of the insured person or a minor member of his family.
Section 1.4. Types of insurance coverage
1. The types of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood are the following payments:
1) temporary disability allowance;
2) maternity allowance;
3) a lump sum allowance for women registered in medical institutions in the early stages of pregnancy;
4) lump-sum allowance at birth;
5) monthly childcare allowance;
6) social benefit for burial.
2. The conditions, sizes and procedure for the payment of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood are determined by this Federal Law, Federal Law of May 19, 1995 N 81-ФЗ "On state benefits to citizens with children" (hereinafter - The Federal Law "On state benefits to citizens with children"), the Federal Law of January 12, 1996 N 8-ФЗ "On Burial and Funeral" (hereinafter - the Federal Law "On Burial and Funeral").
Article 2. Persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood
1. Citizens of the Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing in the Russian Federation, shall be subject to compulsory social insurance in case of temporary disability and in connection with motherhood:
1) persons working under labor contracts;
2) state civil servants, municipal employees;
3) persons who fill government posts of the Russian Federation, government posts of a constituent entity of the Russian Federation, as well as municipal posts that are filled on an ongoing basis;
4) members of a production cooperative taking personal labor participation in its activities;
5) clergy;
6) persons sentenced to imprisonment and involved in paid work.
2. Persons subject to compulsory social insurance in case of temporary incapacity for work and in connection with motherhood in accordance with this Federal Law are insured persons.
3. Lawyers, individual entrepreneurs, members of peasant (farmer) households, individuals not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in the manner established by the legislation of the Russian Federation), members of family (clan) indigenous communities The peoples of the North are subject to compulsory social insurance in case of temporary disability and in connection with motherhood if they voluntarily entered into a relationship for compulsory social insurance in case of temporary disability and in connection with motherhood and pay insurance premiums for themselves in accordance with Article 4.5 of this Federal the law.
4. Insured persons are entitled to insurance coverage subject to the conditions provided for by this Federal Law, as well as the Federal Law "On State Benefits to Citizens with Children" and the Federal Law "On Burial and Funeral". Persons who voluntarily entered into relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood acquire the right to receive insurance coverage provided that insurance premiums are paid for the period specified in Section 4.5 of this Federal Law.
5. Persons working under employment contracts for the purposes of this Federal Law shall be recognized as persons who have concluded in the established manner employment contract, from the day from which they were supposed to start work, as well as persons actually admitted to work in accordance with labor legislation.
6. Legislative, regulatory legal acts of the Russian Federation and constituent entities of the Russian Federation may establish other payments for providing federal state civil servants, state civil servants of the constituent entities of the Russian Federation in case of temporary disability and in connection with maternity, financed respectively from the funds federal budgetbudgets of the constituent entities of the Russian Federation.
Article 2.1. Insurers
1. Insurers for compulsory social insurance in case of temporary incapacity for work and in connection with maternity are persons making payments to individuals subject to compulsory social insurance in case of temporary incapacity for work and in connection with maternity in accordance with this Federal Law, including:
1) organizations - legal entities established in accordance with the legislation of the Russian Federation, as well as foreign legal entities, companies and other corporate entities with civil legal capacity, established in accordance with the legislation of foreign states, international organizations, branches and representative offices of these foreign persons and international organizations created on the territory of the Russian Federation;
2) individual entrepreneurs, including heads of peasant (farmer) households;
3) individuals not recognized as individual entrepreneurs.
2. For the purposes of this Federal Law, advocates, individual entrepreneurs, members of peasant (farmer) households, individuals not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in accordance with the legislation of the Russian Federation) are equated with insurers, members of family (clan) communities of the indigenous peoples of the North who voluntarily entered into relations for compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Article 4.5 of this Federal Law. These persons exercise the rights and bear the obligations of policyholders provided for by this Federal Law, with the exception of the rights and obligations related to the payment of insurance coverage to insured persons.
3. If the policyholder simultaneously belongs to several categories of policyholders specified in parts 1 and 2 of this article, the calculation and payment of insurance premiums shall be made by him on each basis.
Article 2.2. Insurer
1. Compulsory social insurance for temporary incapacity for work and in connection with motherhood is carried out by the insurer, which is the Social Insurance Fund of the Russian Federation.
2. The Social Insurance Fund of the Russian Federation and its territorial bodies compose a single centralized system of management bodies for compulsory social insurance funds for temporary incapacity for work and in connection with motherhood.
3. The legal status and procedure for organizing the activities of the Social Insurance Fund of the Russian Federation are determined by federal law.
Section 2.3. Registration and deregistration of policyholders
1. Registration of policyholders is carried out in the territorial bodies of the insurer:
1) policyholders - legal entities within five days from the date of submission to the territorial body of the insurer by the federal executive body that carries out state registration of legal entities, information contained in a single state registry legal entities and represented in the manner determined by the federal executive authority authorized by the Government of the Russian Federation;
2) policyholders - legal entities at the location separate unitshaving a separate balance, settlement account and accruing payments and other remuneration in favor of individuals, on the basis of an application for registration as an insured, submitted no later than 30 days from the date of creation of such a separate unit;
3) insurers - individuals who have concluded an employment contract with an employee, at the place of residence of said individuals on the basis of an application for registration as an insurant, submitted no later than 10 days from the date of conclusion of the employment contract with the first of the employees accepted.
2. De-registration of insurers is carried out at the place of registration in the territorial bodies of the insurer:
1) policyholders - legal entities, within five days from the date of submission to the territorial bodies of the insurer by the federal executive body that carries out the state registration of legal entities, information contained in the unified state register of legal entities, in the manner determined by the federal executive body authorized by the Government of the Russian Federation;
2) insurers - legal entities at the location of separate divisions having a separate balance sheet, current account and accruing payments and other fees to individuals (in case of closing a separate unit or termination of powers to maintain a separate balance sheet, current account or accrual of payments and other fees in favor of individuals), within fourteen days from the day the policyholder submits an application for deregistration at the location of such a unit;
3) insurers - individuals who have concluded an employment contract with an employee (in the event of termination of an employment contract with the last of the accepted employees), within fourteen days from the day the policyholder submits an application for deregistration.
3. The procedure for registration and deregistration of policyholders referred to in Clauses 2 and 3 of Part 1 of this Article and of persons equated with policyholders for the purposes of this Federal Law shall be established by the federal executive body that exercises the functions of public policy and legal regulation in the field of social insurance.
Section 3. Financial Security of Expenses for the Payment of Insurance Security
1. Financial support for the costs of payment of insurance coverage to insured persons shall be carried out at the expense of the budget of the Social Insurance Fund of the Russian Federation, as well as at the expense of the insured in the cases provided for in paragraph 1 of part 2 of this article.
2. The allowance for temporary incapacity for work in the cases specified in Clause 1 of Part 1 of Article 5 of this Federal Law shall be paid:
1) to insured persons (with the exception of insured persons who voluntarily entered into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Article 4.5 of this Federal Law) for the first two days of temporary disability at the expense of the insured, and for the rest the period from the 3rd day of temporary disability at the expense of the budget of the Social Insurance Fund of the Russian Federation;
2) to insured persons who voluntarily entered into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Article 4.5 of this Federal Law, from the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
3. The temporary disability benefit in cases provided for by Clauses 2-5 of Part 1 of Article 5 of this Federal Law shall be paid to insured persons from the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
4. Financial support of additional expenses for the payment of benefits for temporary disability, maternity, related to the offset in the insurance period of the insured person of the periods of service specified in paragraph 1.1 of Article 16 of this Federal Law during which the citizen was not subject to compulsory social insurance for temporary disability and in connection with maternity, is carried out through intergovernmental transfers from the federal budget, provided for the indicated purposes to the budget of the Social Insurance Fund of the Russian Federation. The determination of the amount of inter-budget transfers from the federal budget to the budget of the Social Insurance Fund of the Russian Federation for financing additional expenses, regarding the periods of the specified service that took place before January 1, 2007, is not carried out if these periods are taken into account when determining the length of the insurance period in accordance with Article 17 of this Federal Law.
5. In the cases established by the laws of the Russian Federation, federal laws, financial support for expenses for the payment of insurance coverage in amounts exceeding those established by the legislation of the Russian Federation on compulsory social insurance for temporary incapacity for work and in connection with motherhood is carried out through intergovernmental transfers from the federal budget provided for these purposes, the budget of the Social Insurance Fund of the Russian Federation.
Article 4. Providing insurance coverage to persons sentenced to deprivation of liberty and involved in paid work
The provision of insurance coverage to persons sentenced to imprisonment and involved in paid labor is carried out in the manner determined by the Government of the Russian Federation.
Chapter 1.1. RIGHTS AND OBLIGATIONS
OF OBJECTS OF OBLIGATORY SOCIAL INSURANCE IN THE CASE
OF TEMPORAL DISABILITY AND IN CONNECTION WITH MOTHERHOOD
Section 4.1. Rights and obligations of policyholders
1. Policyholders have the right:
1) contact the insurer for the receipt of funds necessary for the payment of insurance coverage to insured persons, in excess of the assessed insurance premiums;
2) receive free information from the insurer on regulatory legal acts on compulsory social insurance in case of temporary disability and in connection with motherhood;
3) apply to the court to protect their rights.
2. Policyholders are required:
1) register with the territorial body of the insurer in the cases and in the manner established by Article 2.3 of this Federal Law;
2) timely and fully pay insurance premiums to the Social Insurance Fund of the Russian Federation;
3) in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, to pay insurance coverage to insured persons upon occurrence of insurance cases provided for by this Federal Law;
4) keep records and reports on accrued and paid insurance contributions to the Social Insurance Fund of the Russian Federation and the costs of paying insurance coverage to insured persons;
5) comply with the requirements of the territorial bodies of the insurer to eliminate identified violations of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
6) present for verification to the territorial bodies of the insurer documents related to the accrual, payment of insurance contributions to the Social Insurance Fund of the Russian Federation and the costs of paying insurance coverage to insured persons;
7) to inform the territorial bodies of the insurer about the creation, transformation or closure of the separate divisions specified in clause 2 of part 1 of Article 2.3 of this Federal Law, as well as about a change in their location and name;
8) to perform other duties stipulated by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood.
3. The rights and obligations of policyholders as payers of insurance premiums are established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Fund for Mandatory Medical Insurance and Territorial Funds of Mandatory Medical Insurance".
Section 4.2. Rights and obligations of the insurer
1. The insurer has the right:
1) to verify the correctness of the calculation and payment of insurance premiums by policyholders to the Social Insurance Fund of the Russian Federation, as well as the payment of insurance coverage to insured persons, to require and receive from the policyholders the necessary documents and explanations on issues arising during the checks;
2) request from policyholders documents related to the accrual and payment of insurance contributions to the Social Insurance Fund of the Russian Federation, the costs of paying insurance coverage to insured persons, including when allocating funds to the insured for these expenses in excess of assessed insurance contributions;
3) receive information from the Federal Treasury bodies on the amounts of insurance premiums, penalties and fines received by the Social Insurance Fund of the Russian Federation;
4) not to set off against the payment of insurance premiums the costs of insurance coverage to insured persons made by the insured in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and due to motherhood, not confirmed by documents, made on the basis of incorrectly executed or documents issued in violation of the established procedure;
5) apply to the federal executive body, which exercises supervision and control functions in the field of healthcare, with requests for inspections of medical organizations for the organization of an examination of temporary disability, the validity of the issuance and extension of certificates of disability;
6) to sue medical organizations for reimbursement of the amount of expenses for insurance coverage for unreasonably issued or incorrectly issued sick leave certificates;
7) represent the interests of insured persons to policyholders;
8) to exercise other powers established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood.
2. The insurer is obliged:
1) manage the means of compulsory social insurance in case of temporary incapacity for work and in connection with maternity in accordance with the legislation of the Russian Federation on compulsory social insurance for temporary incapacity for work and in connection with maternity and budget legislation of the Russian Federation;
2) draw up a draft budget of the Social Insurance Fund of the Russian Federation and ensure the execution of the budget of the Social Insurance Fund of the Russian Federation in accordance with the budget legislation of the Russian Federation;
3) keep records of compulsory social insurance funds in the event of a temporary disability and in connection with motherhood;
4) draw up a draft report on the budget execution of the Social Insurance Fund of the Russian Federation, as well as the established budget reporting;
5) to monitor the accuracy of the calculation, the completeness and timeliness of payment (transfer) of insurance contributions to the Social Insurance Fund of the Russian Federation (hereinafter - the control of the payment of insurance premiums), as well as the monitoring of compliance by policyholders with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood in the payment of insurance coverage to insured persons;
6) to carry out, in cases established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, the payment of insurance coverage to insured persons;
7) to allocate to the insured in the prescribed manner the necessary funds for the payment of insurance coverage in excess of the premiums accrued by them;
8) carry out registration of policyholders, keep a register of policyholders;
9) keep records of individuals who voluntarily entered into legal social insurance in the event of temporary disability and in connection with motherhood, as well as insurance premiums paid by them and the amount of insurance coverage paid to them;
10) to advise policyholders and insured persons free of charge on issues of applying the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
11) not to disclose without the consent of the insured person information about the results of his medical examinations (diagnosis), his income, except as otherwise provided by the laws of the Russian Federation;
12) comply with other requirements established by the legislation of the Russian Federation.
3. The rights and obligations of the insurer related to the control of the payment of insurance premiums are established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Fund for Mandatory Medical Insurance and Territorial Funds of Mandatory Medical Insurance".
Section 4.3. Rights and obligations of insured persons
1. The insured persons have the right:
1) receive insurance coverage in a timely manner and in full in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
2) to freely receive information from the insured on the calculation of insurance premiums and to control their transfer to the Social Insurance Fund of the Russian Federation;
3) contact the insured and the insurer for advice on the application of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
4) contact the insurer with a request to verify the correctness of the payment of insurance coverage by the insured;
5) to protect their rights in person or through a representative, including in court.
2. The insured persons are obliged:
1) submit to the insured, and in cases established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood, the insurer reliable documents on the basis of which insurance coverage is paid;
2) notify the insured (insurer) of the circumstances affecting the conditions for the provision and size of insurance coverage, within 10 days from the date of their occurrence;
3) comply with the treatment regimen determined for the period of temporary disability, and the rules of conduct of the patient in medical organizations;
4) to fulfill other requirements established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood.
3. In case of default by the insured persons of the obligations established by part 2 of this article, the insurer shall be entitled to recover from them the damage caused in accordance with the legislation of the Russian Federation.
Chapter 1.2. FEATURES OF PAYING INSURANCE CONTRIBUTIONS
Section 4.4. Legal regulation relations related to the payment of insurance premiums
Legal regulation of relations related to the payment of insurance premiums by policyholders specified in Part 1 of Article 2.1 of this Federal Law, including the determination of the object of taxation of insurance premiums, the basis for calculating insurance premiums, amounts not subject to insurance premiums, the establishment of calculation procedures, procedures and deadlines for the payment of insurance premiums, carried out by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds".
Section 4.5. The procedure for voluntary entry into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood
1. Persons specified in Part 3 of Article 2 of this Federal Law shall enter into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood by submitting an application to the territorial body of the insurer at the place of residence.
2. Persons who have voluntarily entered into legal relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood pay insurance premiums to the Social Insurance Fund of the Russian Federation based on the cost insurance yeardetermined in accordance with part 3 of this article.
3. The cost of the insurance year is defined as the product of the minimum wage established by federal law at the beginning fiscal year, for which insurance premiums are paid, and the premium rate established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and Territory Compulsory Medical Insurance Funds" regarding insurance contributions to the Social Fund insurance of the Russian Federation increased by 12 times.
4. Payment of insurance premiums by persons who have voluntarily entered into legal relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood shall be made no later than December 31 current year starting from the year of filing an application for voluntary entry into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood.
5. Persons who voluntarily entered into legal relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood shall transfer insurance premiums to the accounts of the territorial bodies of the insurer by bank transfer, or by depositing cash to a credit institution, or by postal order.
6. Persons who have voluntarily entered into legal relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, acquire the right to receive insurance coverage provided that they pay insurance premiums in accordance with part 4 of this article in the amount determined in accordance with part 3 of this article, for the calendar year preceding the calendar year in which the insured event occurred.
7. In the event that a person who has voluntarily entered into legal relations for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood has not paid insurance premiums for the corresponding calendar year up to December 31 of the current year, there were between him and the insurer legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood are considered to be discontinued.
8. The procedure for paying insurance premiums by persons who voluntarily entered into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood, including the procedure for termination of legal relations with them in compulsory social insurance in case of temporary disability and in connection with motherhood, is determined by the Government Russian Federation.
Section 4.6. Order financial security expenses of policyholders on the payment of insurance coverage at the expense of the budget of the Social Insurance Fund of the Russian Federation
1. The policyholders referred to in Part 1 of Article 2.1 of this Federal Law shall pay insurance coverage to insured persons in payment of insurance premiums to the Social Insurance Fund of the Russian Federation, with the exception of the cases specified in clause 1 of Part 2 of Article 3 of this Federal Law when the insurance is paid collateral is provided at the expense of the insured.
2. The amount of insurance premiums to be transferred by policyholders specified in Part 1 of Article 2.1 of this Federal Law to the Social Insurance Fund of the Russian Federation shall be reduced by the amount of expenses incurred by them for the payment of insurance coverage to insured persons. If the insurance premiums calculated by the policyholder are not enough to pay the full amount of insurance coverage to the insured, the policyholder applies for the necessary funds to the territorial body of the insurer at the place of registration.
In 2010, funds for the payment of compulsory insurance for compulsory social insurance in the event of temporary disability and in connection with motherhood (with the exception of the payment of temporary disability benefits in case of disability due to illness or injury for the first two days of temporary disability) to citizens working under employment contracts concluded with organizations or individual entrepreneurs who have switched to a simplified taxation system or who are payers of a single tax on imputed income for certain types of activities or a single agricultural tax, are allocated to these organizations and individual entrepreneurs territorial bodies of the Social Insurance Fund of the Russian Federation in the manner prescribed by parts 3 to 6 of article 4.6 of this document, at the place of their registration as policyholders.
3. The territorial body of the insurer allocates the necessary funds to the policyholder to pay insurance coverage within 10 calendar days from the date the policyholder submits all the necessary documents, except as otherwise specified in paragraph 4 of this article. The list of documents that must be submitted by the insured is determined by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of social insurance.
4. When considering the insured’s appeal for the allocation of the necessary funds for the payment of insurance coverage, the territorial body of the insurer has the right to verify the correctness and validity of the insurer's expenses for the payment of insurance coverage, including an on-site inspection, in the manner established by Article 4.7 of this Federal Law, and to request policyholder additional information and documents. In this case, the decision to allocate these funds to the policyholder is made based on the results of the audit.
5. In case of refusal to allocate the necessary funds to the policyholder to pay insurance coverage, the territorial body of the insurer shall make a reasoned decision, which shall be sent to the policyholder within three days from the date of the decision.
6. A decision to refuse to provide the insured with the necessary funds for the payment of insurance coverage may be appealed by him to a higher body of the insurer or to a court.
7. Funds for the payment of insurance coverage (except for the payment of temporary disability benefits in case of disability due to illness or injury for the first two days of temporary disability) to citizens who work under labor contracts concluded with organizations that have received the status of participants in a research and development project and commercialization of their results in accordance with the Federal Law "On the Skolkovo Innovation Center", and in respect of which tax authority compliance with the criteria specified in article 145.1 Tax code Of the Russian Federation, are allocated to these organizations by the territorial bodies of the insurer in the manner prescribed by parts 3 to 6 of this article, at the place of their registration as policyholders.
Section 4.7. Carrying out checks by the insurer of the correctness of expenses for the payment of insurance coverage
1. The territorial body of the insurer at the place of registration of the insured conducts desk and field checks of the correctness of the costs of the insurer to pay insurance coverage.
2. Field visits of the policyholder are carried out no more than once every three years, with the exception of cases specified in part 4 of article 4.6 of this Federal law and in part 3 of this article.
3. If the insured person complains about the refusal of the insurer to pay insurance coverage or about the wrong determination of the amount of insurance coverage by the insured, the territorial body of the insurer has the right to conduct an unscheduled on-site inspection of the correctness of the expenses of the insured to pay insurance coverage.
4. In case of revealing the costs of insurance coverage paid by the policyholder in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, not confirmed by documents produced on the basis of documents drawn up incorrectly or issued in violation of the established procedure, the territorial the insurer’s body that conducted the inspection shall decide not to take such expenses into credit against the payment of insurance premiums to the Social Insurance Fund of the Russian Federation.
5. The decision on non-acceptance of the costs of insurance coverage payment along with the claim for their reimbursement shall be sent to the policyholder within three days from the date of the decision. The forms of the decision on non-acceptance of the costs of insurance coverage payment and claims for their reimbursement are approved by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of social insurance.
6. If, within the time period specified in the specified requirement, the policyholder has not made reimbursement of expenses that were not accepted for offset, the decision to not accept for offset the costs of paying insurance coverage is the basis for recovering from the policyholder the arrears of insurance premiums resulting from the implementation of such expenses. The collection of arrears of insurance premiums is carried out by the insurer in the manner prescribed by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and Territorial Mandatory Medical Insurance Funds".
7. On-site inspections of the correctness of the insured's expenses for the payment of insurance coverage are carried out by the insurer at the same time as on-site inspections of the policyholder on the correct calculation, completeness and timeliness of payment (transfer) of insurance contributions to the Social Insurance Fund of the Russian Federation, with the exception of cases specified in paragraph 4 of Article 4.6 of this Federal law and in part 3 of this article.
Section 4.8. Accounting and reporting of policyholders
1. Insurers referred to in Part 1 of Article 2.1 of this Federal Law shall, in the procedure established by the federal executive body performing the functions of developing state policy and legal regulation in the field of social insurance, keep records of:
1) the amount of accrued and paid (listed) insurance premiums, interest and fines;
2) the amount of expenses incurred to pay insurance coverage;
3) settlements on the means of compulsory social insurance in case of temporary disability and in connection with motherhood with the territorial body of the insurer at the place of registration of the insured.
2. On a quarterly basis no later than the 15th day of the month following the expired quarter, policyholders specified in Part 1 of Article 2.1 of this Federal Law shall be obliged to submit reports (calculations) to the insurer's territorial bodies in the form approved by the federal executive body that exercises functions the development of state policy and legal regulation in the field of social insurance, on the amounts:
1) accrued insurance contributions to the Social Insurance Fund of the Russian Federation;
2) the funds they used to pay insurance coverage;
3) expenses for the payment of insurance coverage to be offset against the payment of insurance contributions to the Social Insurance Fund of the Russian Federation;
4) insurance premiums, interest, fines paid to the Social Insurance Fund of the Russian Federation.
3. The forms of reports (calculations) submitted by persons who voluntarily entered into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Article 4.5 of this Federal Law, as well as the timing and procedure for their submission, are approved by the federal executive body, carrying out the functions of developing state policy and legal regulation in the field of social insurance.
Chapter 2. SECURITY ASSISTANCE
ON TEMPORAL DISABILITY
Section 5. Cases of Provision of Temporary Disability Benefit
1. The provision of temporary disability benefits to insured persons is carried out in the following cases:
1) disability due to illness or injury, including in connection with an operation to terminate a pregnancy or in vitro fertilization (hereinafter referred to as a disease or injury);
2) the need to care for a sick family member;
3) the quarantine of the insured person, as well as the quarantine of a child under the age of 7 years, attending a preschool educational institution, or another member of the family, recognized as legally incompetent;
4) performing prosthetics for medical reasons in a stationary specialized institution;
5) aftercare in the prescribed manner in sanatoriums located in the Russian Federation, immediately after inpatient treatment.
2. The temporary disability benefit is paid to insured persons upon the occurrence of the cases specified in paragraph 1 of this article, during the period of work under an employment contract, performance of official or other activities during which they are subject to compulsory social insurance, as well as in cases when the disease or the injury occurred within 30 calendar days from the date of termination of the specified work or activity or from the date of conclusion of the employment contract until the day of its cancellation.
Section 6. Conditions and duration of payment of temporary disability benefits
1. The allowance for temporary disability in the event of disability due to illness or injury shall be paid to the insured person for the entire period of temporary disability until the day of restoration of disability (determination of disability), with the exception of cases specified in parts 3 and 4 of this article.
2. When treating the insured person in a sanatorium-resort institution located on the territory of the Russian Federation, immediately after inpatient treatment, temporary disability benefits are paid for the period of stay in the sanatorium-resort institution, but not more than 24 calendar days (except for tuberculosis) .
3. The insured person, recognized in the established manner as disabled, temporary disability benefits (except for tuberculosis) shall be paid no more than four consecutive months or five months in a calendar year. In case of illness of these persons with tuberculosis, temporary disability benefit is paid until the day of restoration of disability or until the day of revision of the disability group due to tuberculosis.
4. The insured person who entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as to the insured person whose illness or injury occurred from the day the labor contract was concluded until the day of its cancellation, temporary disability benefit (except tuberculosis diseases) is paid for not more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefit is paid until the day of the restoration of disability (determination of disability). In this case, the insured person whose illness or injury occurred from the date of concluding the employment contract until the day of its cancellation, temporary disability benefit is paid from the day from which the employee was supposed to start work.
5. The temporary disability allowance, if necessary, to care for a sick family member is paid to the insured person:
1) in the case of caring for a sick child under the age of 7 years - for the entire period of outpatient treatment or sharing with a child in a hospital, but not more than 60 calendar days in a calendar year for all cases of caring for this child, and in the case of a child’s disease, included in the list of diseases, determined by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of healthcare and social development, no more than 90 calendar days in a calendar year for all cases of care of this child in connection with the specified disease;
2) in the case of caring for a sick child aged 7 to 15 years - for a period of up to 15 calendar days for each case of outpatient treatment or sharing with a child in a hospital, but not more than 45 calendar days in a calendar year in all cases of caring for this child;
3) in the case of caring for a sick child with a disability under the age of 15 years - for the entire period of outpatient treatment or sharing with a child in a hospital, but not more than 120 calendar days in a calendar year for all cases of care for this a child;
4) in the case of caring for a sick child under the age of 15 years who is HIV-infected - for the entire period of joint stay with the child in an inpatient medical institution;
5) in the case of caring for a sick child under the age of 15 years with his illness associated with post-vaccination complications, with malignant neoplasms, including malignant neoplasms of lymphoid, hematopoietic and related tissues, - for the entire period of outpatient treatment or sharing with a child in a hospital medical institution;
6) in other cases of caring for a sick family member with outpatient treatment - no more than 7 calendar days for each case of the disease, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
6. The temporary disability benefit in case of quarantine is paid to the insured person who has been in contact with an infectious patient or who has been diagnosed with bacteriocarrier, for the entire time that he has been suspended from work due to quarantine. If children under 7 years of age attending preschool educational institutions or other family members recognized as legally incapable are quarantined, temporary disability benefits are paid to the insured person (one of the parents, another legal representative or other family member) for the entire quarantine period .
7. The allowance for temporary incapacity for work in the case of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of exemption from work for this reason, including travel time to and from the prosthetics site.
8. The temporary disability benefit is paid to the insured in all cases specified in parts 1 to 7 of this article for calendar days falling on the corresponding period, except for calendar days falling on the periods specified in part 1 of article 9 of this Federal Law.
Section 7. Amount of Temporary Disability Allowance
1. The allowance for temporary disability in the event of disability due to illness or injury, with the exception of cases specified in paragraph 2 of this article, under quarantine, prosthetics for medical reasons and aftercare in sanatoriums immediately after inpatient treatment is paid in the following amount:
1) to the insured person having an insurance experience of 8 years or more - 100 percent of the average earnings;
2) to the insured person having an insurance experience of 5 to 8 years - 80 percent of average earnings;
3) to the insured person with an insurance experience of up to 5 years - 60 percent of average earnings.
2. The allowance for temporary disability in the event of disability due to illness or injury is paid to insured persons in the amount of 60 percent of the average earnings in case of illness or injury that occurred within 30 calendar days after termination of work under an employment contract, official or other activity during which they subject to compulsory social insurance.
3. The allowance for temporary disability, if necessary, to care for a sick child is paid:
1) during outpatient treatment of a child - for the first 10 calendar days in the amount determined depending on the length of the insurance period of the insured person in accordance with part 1 of this article, for the following days in the amount of 50 percent of average earnings;
2) during inpatient treatment of a child - in an amount determined depending on the length of the insurance period of the insured person in accordance with part 1 of this article.
4. The allowance for temporary incapacity for work if it is necessary to care for a sick family member during his outpatient treatment, with the exception of cases of caring for a sick child under the age of 15 years, is paid in an amount determined depending on the length of the insurance period of the insured person in accordance with part 1 of this article.
5. It has expired since January 1, 2010. - Federal Law of 24.07.2009 N 213-ФЗ.
6. The insured person with an insurance experience of less than six months, temporary disability benefit is paid in an amount not exceeding the minimum monthly wage established by federal law for a full calendar month, and in areas and places in which they are applied in the prescribed manner district ratios to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
7. The allowance for temporary incapacity for work for the period of inactivity is paid in the same amount as the salary is maintained during this time, but not higher than the amount of the allowance that the insured would receive according to the general rules.
Article 8. Grounds for reducing the amount of temporary disability benefits
1. The grounds for reducing the amount of temporary disability benefits are:
1) violation by the insured person without good reason during the period of temporary disability of the regime prescribed by the attending physician;
2) failure to appear of the insured person without good reason at the appointed time for a medical examination or for medical and social examination;
3) a disease or injury resulting from alcohol, drug, toxic intoxication or actions related to such intoxication.
2. If there is one or more grounds for reducing temporary disability benefits specified in paragraph 1 of this article, temporary disability benefits are paid to the insured person in an amount not exceeding the minimum monthly wage established by federal law for a full calendar month, and in areas and localities in which the regional coefficients for wages are applied in the prescribed manner - in an amount not exceeding the minimum wage, taking into account these coefficients:
1) if there are grounds specified in clauses 1 and 2 of part 1 of this article, from the day the violation was committed;
2) if there are grounds specified in clause 3 of part 1 of this article, for the entire period of incapacity for work.
Section 9. Periods for which temporary disability benefits are not assigned. Grounds for refusing to assign temporary disability benefits
1. The temporary disability benefit is not assigned to the insured person for the following periods:
1) for the period of exemption of an employee from work with full or partial retention of wages or without payment in accordance with the legislation of the Russian Federation, with the exception of cases of loss of ability to work by an employee due to illness or injury during the period of annual paid leave;
2) for the period of suspension from work in accordance with the legislation of the Russian Federation, if no wages are charged for this period;
3) for the period of detention or administrative arrest;
4) for the period of the forensic medical examination.
2. The grounds for refusing to assign temporary disability benefits to the insured person are:
1) the onset of temporary incapacity for work as a result of the intentional infliction by the court of an insured person harm to his health or attempted suicide;
2) the onset of temporary disability as a result of an intentional crime committed by the insured person.
Chapter 3. MAINTENANCE OF PREGNANCY AND CHILDBIRTH
Section 10. Duration of Maternity Benefit
1. Maternity allowance is paid to the insured woman in total for the entire period of maternity leave lasting 70 (in the case of multiple pregnancy - 84) calendar days before delivery and 70 (in the case of complicated births - 86, at the birth of two or more children - 110) calendar days after delivery.
2. When adopting a child (children) under the age of three months, the maternity allowance shall be paid from the day of its adoption and until the expiration of 70 (in the case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).
3. If a mother takes maternity leave while the mother is on maternity leave until she reaches the age of one and a half years, she has the right to choose one of two types of benefits paid during the periods of the respective leave.
Article 11. Amount of maternity allowance
1. Maternity allowance is paid to the insured woman in the amount of 100 percent of the average earnings.
2. Repealed on January 1, 2010. - Federal Law of 24.07.2009 N 213-ФЗ.
3. An insured woman who has an insurance experience of less than six months, maternity allowance shall be paid in an amount not exceeding the minimum monthly wage established by federal law for a full calendar month, and in areas and localities in which regional coefficients are applied in the established manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
Chapter 3.1. MONTHLY ASSISTANCE
FOR CHILD CARE
Article 11.1. Conditions and duration of the monthly childcare allowance
1. The monthly childcare allowance is paid to insured persons (mother, father, other relatives, guardians) who actually care for the child and are on parental leave from the day the childcare leave is granted until the child reaches the age of one and a half years .
2. The right to a monthly childcare allowance is retained if a person on parental leave works part-time or at home and continues to care for the child.
3. Mothers entitled to maternity benefits in the period after childbirth are entitled from the day of birth of the child to receive either maternity benefits or a monthly maternity allowance, offsetting previously paid maternity benefits if the amount of the monthly maternity allowance is higher than the amount of the maternity allowance.
4. In the event that the care of the child is carried out simultaneously by several persons, the right to receive a monthly allowance for the care of the child is granted to one of these persons.
Article 11.2. Amount of monthly childcare allowance
1. A monthly allowance for child care is paid in the amount of 40 percent of the average earnings of the insured person, but not less than the minimum amount of this allowance established by the Federal Law "On state benefits to citizens with children."
2. In the case of caring for two or more children before they reach the age of one and a half years, the amount of the monthly childcare allowance calculated in accordance with part 1 of this article shall be added up. In this case, the summed benefit amount cannot exceed 100 percent of the average earnings of the insured person, determined in the manner established by Article 14 of this Federal Law, but cannot be less than the summed minimum amount of this benefit.
3. When determining the amount of the monthly allowance for the care of the second child and subsequent children, the previous children born (adopted) by the mother of the child shall be taken into account.
4. In case of caring for a child (s), a born (born) mother deprived of parental rights in relation to previous children, the monthly childcare allowance shall be paid in the amounts established by this article, excluding children for whom she was deprived of parental right
Chapter 4. APPOINTMENT, CALCULATION AND PAYMENT OF ALLOWANCES
BY TEMPORAL DISABILITY, BY PREGNANCY AND BIRTH,
MONTHLY CHILD CARE ASSISTANCE
Article 12. Terms for applying for temporary disability benefits, maternity allowance, monthly childcare allowance
1. The allowance for temporary disability is assigned if the appeal was followed no later than six months from the date of restoration of disability (determination of disability), as well as the end of the period of dismissal from work in cases of caring for a sick family member, quarantine, prosthetics and aftercare.
2. Maternity allowance shall be granted if the appeal has been received no later than six months from the date of termination of the maternity leave.
2.1. A monthly childcare allowance is assigned if an appeal has been received no later than six months from the day the child reaches the age of one and a half years.
3. When applying for temporary disability benefits, maternity allowance, a monthly childcare allowance after a six-month period, the decision to assign benefits is made by the insurer's territorial body if there are good reasons for missing the deadline for applying for benefits. The list of valid reasons for missing the deadline for applying for benefits is determined by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of social insurance.
Article 13. The procedure for the appointment and payment of benefits for temporary disability, maternity, monthly allowance for child care
1. Assignment and payment of benefits for temporary disability, maternity, monthly benefits for child care are carried out by the insured at the place of work (service, other activity) of the insured person (with the exception of cases specified in parts 3 and 4 of this article).
2. If the insured person is employed by several policyholders, temporary disability benefits, maternity benefits are assigned and paid to him by policyholders at all places of work (service, other activities), and the monthly child care allowance is paid by the policyholder in one place work (service, other activity) at the choice of the insured person.
3. The insured person who has lost his ability to work due to illness or injury within 30 calendar days from the date of termination of work under an employment contract, official or other activity during which he was subject to compulsory social insurance in case of temporary disability and in connection with motherhood, a temporary allowance incapacity for work shall be appointed and paid by the insured at his last place of work (service, other activity) or by the territorial body of the insurer in the cases specified in paragraph 4 of this article.
4. To the insured persons specified in Part 3 of Article 2 of this Federal Law, as well as to other categories of insured persons in the event of termination of activity by the insured on the day the insured person applies for temporary disability benefits, maternity benefits, a monthly childcare allowance or in case of impossibility of their payment by the insured due to insufficiency money on his account in credit organization and the application of the priority for debiting funds from the account provided for Civil Code Of the Russian Federation, the appointment and payment of these benefits are carried out by the territorial body of the insurer.
5. For the purpose of assigning and paying temporary disability benefits, maternity leave, the insured person shall submit a disability certificate issued medical organization in the form and in the manner established by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of social insurance, and for the appointment and payment of these benefits by the territorial body of the insurer, also information on average earnings, from which should be calculated allowance, and documents determined by the indicated federal executive body confirming the insurance experience.
6. In order to assign and pay a monthly childcare allowance, the insured person submits an application for the appointment of the specified allowance, a birth certificate (adoption) of the child to be taken care of, and a copy of it or an extract from the decision to establish custody of the child, a birth certificate (adoption, death) of the previous child (s) and its copy, a certificate from the place of work (study, service) of the mother (father, both parents) of the child that she (he, they) does not use parental leave and does not receives a monthly allowance for child care, and if the mother (father, both parents) of the child does not work (does not study, does not serve), a certificate from the social security authorities at the place of residence of the mother (father) of the child on the non-receipt of the monthly allowance for child care. In case of assignment and payment of a monthly childcare allowance by the territorial body of the insurer, the insured person shall also provide information on the average earnings from which the specified benefit should be calculated.
7. An insured person employed by several policyholders, when applying to one of these policyholders of their choice for the appointment and payment of a monthly child care allowance, along with the documents provided for in part 6 of this article, shall submit a certificate (certificates) from the place of work (service) , other activities) with another policyholder (with other policyholders) stating that the assignment and payment of the monthly childcare allowance by this policyholder are not carried out.
8. The policyholder shall pay benefits for temporary disability, maternity leave, monthly childcare benefits to the insured person in the manner prescribed for the payment of wages to the insured persons (other payments, remuneration).
9. In case of assignment and payment of benefits for temporary disability, maternity leave, monthly allowance for childcare by the territorial body of the insurer, provided for in paragraph 4 of this article, payment of benefits for temporary disability, maternity leave, monthly allowance for childcare It is carried out in the established amounts by the territorial body of the insurer that appointed the specified benefits, through the organization of the federal postal service, a credit or other organization at the request of the recipient.
Article 14. The procedure for calculating temporary disability benefits, maternity allowance, monthly childcare benefits
1. Temporary disability benefits, maternity benefits, monthly childcare benefits are calculated on the basis of the average earnings of the insured person calculated for the last 12 calendar months of work (service, other activity) of this policyholder, preceding the month of the onset of temporary disability, vacation maternity leave, parental leave. If the insured person did not have a period of work (service, other activity) immediately before the occurrence of the said insured events due to temporary disability, maternity leave or parental leave, the respective benefits are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months of the work (service, other activity) of this policyholder, preceding the month of the previous insured event.
2. The average earnings, on the basis of which temporary disability benefits, maternity benefits, and the monthly childcare allowance are calculated, include all types of payments and other benefits for the benefit of the employee, which are included in the base for calculating insurance contributions to the Social Insurance Fund Of the Russian Federation in accordance with the Federal Law "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds".
2.1. The insured persons referred to in Part 3 of Article 2 of this Federal Law shall receive the average wage on the basis of which temporary disability benefits, maternity benefits, and the monthly childcare allowance are calculated equal to the minimum wage established by federal law on the day of occurrence insured event. Moreover, the calculated monthly childcare allowance cannot be less than the minimum amount of the monthly childcare allowance established by the Federal Law "On state benefits to citizens with children."
3. The average daily earnings for calculating temporary disability benefits, maternity benefits, monthly childcare benefits is determined by dividing the amount of accrued earnings for the period specified in paragraph 1 of this article by the number of calendar days falling on the period for which wages are taken into account.
3.1. The average daily earnings, from which temporary disability benefits, maternity benefits are calculated, cannot exceed the average daily earnings, determined by dividing the maximum size of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation, established by the Federal Law “On Pension Insurance Payments” Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Fund for Mandatory Health Insurance and territorial funds for obligatory health insurance "on the day of the occurrence of the insured event, by 365. In the event that the assignment and payment of the said benefits to the insured are made by several insurers in accordance with Part 2 Article 13 of this Federal Law, the average daily wage from which these benefits are calculated cannot exceed the average daily wage determined on the basis of the specified ceiling when calculating these benefits to each of these policyholders.
4. The amount of the daily allowance for temporary incapacity for work, for pregnancy and childbirth is calculated by multiplying the average daily wage of the insured person by the amount of the allowance established as a percentage of the average wage in accordance with Articles 7 and 11 of this Federal Law.
5. The size of the allowance for temporary disability, maternity leave is determined by multiplying the size of the daily allowance by the number of calendar days per period of temporary disability, maternity leave.
5.1. The monthly childcare allowance is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings, determined in accordance with part 3 of this article, by 30.4. The average earnings, from which the monthly childcare allowance is calculated, cannot exceed the average earnings, determined by dividing the maximum size of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation, established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Fund social insurance of the Russian Federation, the Federal Fund for Compulsory Medical Insurance and territorial funds of compulsory medical insurance "on the day of the insured event, at 12.
5.2. The amount of the monthly childcare allowance is determined by multiplying the average earnings of the insured person by the amount of the allowance established as a percentage of average earnings in accordance with Article 11.2 of this Federal Law. When caring for a child for an incomplete calendar month, the monthly childcare allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month falling on the period of care.
6. Has expired since January 1, 2010. - Federal Law of 24.07.2009 N 213-ФЗ.
7. Features of the procedure for calculating temporary disability benefits, maternity benefits, monthly childcare benefits, including for certain categories of insured persons, are determined by the Government of the Russian Federation.
Article 15. Terms for the appointment and payment of temporary disability benefits, maternity leave, monthly childcare benefits
1. The policyholder shall assign temporary disability benefits, maternity benefits, a monthly childcare allowance within 10 calendar days from the date the insured person applies for it with necessary documents. The payment of benefits is carried out by the insured on the next day after the appointment of benefits established for the payment of wages.
2. The territorial body of the insurer in the cases provided for by paragraphs 2 and 3 of Article 13 of this Federal Law shall appoint and pay benefits for temporary disability, maternity, a monthly allowance for caring for a child within 10 calendar days from the date the insured person submits the relevant application and necessary documents.
3. Assigned but not received by the insured in a timely manner allowance for temporary disability, maternity leave, a monthly allowance for child care is paid for all the past time, but not more than three years prior to applying for it. The benefit not received by the insured person in whole or in part through the fault of the insured or the territorial body of the insurer is paid for all past time without any time limit.
4. Amounts of temporary disability benefits, maternity allowance, monthly childcare benefits paid excessively to the insured person cannot be collected from him, except in cases counting error and dishonesty on the part of the recipient (presentation of documents with knowingly incorrect information, concealment of data affecting the receipt of the allowance and its size, other cases). The deduction is made in the amount of not more than 20 percent of the amount due to the insured person at each subsequent payment of the benefit, or his salary. Upon termination of the payment of benefits or wages, the remaining debt is recovered in court.
5. The accrued amounts of temporary disability benefits, maternity benefits, monthly childcare benefits not received in connection with the death of the insured person are paid in the manner prescribed by the civil legislation of the Russian Federation.
Article 16. The procedure for calculating the length of insurance to determine the amount of benefits for temporary disability, pregnancy and childbirth
1. The periods of work of the insured person under the employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance, are included in the length of service to determine the amount of benefits for temporary disability, maternity leave (length of service). in case of temporary disability and in connection with motherhood.
1.1. In the insurance period, along with the periods of work and (or) other activity, which are provided for by part 1 of this article, the periods of military service, as well as other service, provided for by the Law of the Russian Federation of February 12, 1993 N 4468-1 "On pension provision of persons passing military service, service in law enforcement bodies, the State Fire Service, drug trafficking and psychotropic substances control bodies, institutions and bodies of the penal system, and their families. "
2. The calculation of the insurance period is carried out in a calendar manner. In case of coincidence in time of several periods counted in the insurance period, one of such periods at the choice of the insured person is taken into account.
3. The rules for calculating and confirming the length of service are established by the federal executive body, which carries out the functions of developing state policy and legal regulation in the field of social insurance.
Chapter 5. ORDER OF ENTRY INTO FORCE
THIS FEDERAL LAW
Article 17. Preservation of previously acquired rights in determining the amount of temporary disability benefits and duration of insurance
1. To establish that citizens who have started work under an employment contract, service or other activity during which they are subject to compulsory social insurance are entitled to receive temporary disability benefits before January 1, 2007 the amount (in percentage terms of average earnings) exceeding the amount of the allowance (in percentages of average earnings), relying in accordance with this Federal Law, temporary disability benefits are assigned and paid in the same higher amount (in percentage terms of average earnings) , but not higher than the maximum amount of temporary disability benefit established in accordance with this Federal Law.
2. If the duration of the insurance period of the insured person, calculated in accordance with this Federal Law for the period until January 1, 2007, turns out to be less than the duration of his continuous period of employment, which is used when assigning temporary disability benefits in accordance with previously existing regulatory legal acts , for the same period, the duration of the insurance period is the duration of the continuous working experience of the insured person.
Article 18. Application of this Federal Law to insurance events occurring before the day and after the day it enters into force
1. This Federal Law applies to insured events that occur after the day this Federal Law comes into force.
2. For insurance events occurring before the day this Federal Law comes into force, the temporary disability, maternity benefit is calculated according to the norms of this Federal law for the period after the day it takes effect, if the amount of the benefit calculated in accordance with this Federal by law, exceeds the amount of the allowance, which relies on the norms of previous legislation.
, 46 Order, approved. By the order of the Ministry of Health and Social Development of 06.29.2011 N 624н):
- illness or injury to the face;
- illness of a family member who needs care;
- pregnancy and childbirth.
An employee who has submitted to his employer a properly executed sick leave is entitled to receive temporary disability benefits (Article 183 of the Labor Code of the Russian Federation, paragraph 1 of article 1 of Article 2 of the Law of December 29, 2006 No. 255-FZ). From the point of view of funding sources, the procedure for paying sick leave is as follows.
| The basis for issuing a disability certificate | At what expense is the benefit paid |
|---|---|
| Disease, injury to the employee | The first 3 days of illness are paid at the expense of the employer, the remaining days starting from the 4th - at the expense of the Social Insurance Fund (Clause 1 of Part 2 of Article 3 of the Law of December 29, 2006 No. 255-FZ) |
| Family member disease that needs care | The period of incapacity for work from the 1st day is paid at the expense of the Social Insurance Fund (part 3 of article 3, paragraph 2 of part 1 of article 5 of the Law of December 29, 2006 N 255-FZ) |
| Pregnancy and childbirth | The benefit is fully paid at the expense of the Social Insurance Fund (part 1 of article 3 of the Law of December 29, 2006 No. 255-FZ, paragraphs “a” of Section 17 of the Procedure, approved by Order of the Ministry of Health and Social Development of December 23, 2009 No. 1012n) |
What period is paid if an employee or a member of his family falls ill
The period for which temporary disability benefits should be paid is determined by those to whom the sick leave was issued and for what reason. Let's start with the situation when the employee falls ill
| Who is given sick leave? | |
|---|---|
| Employee | The whole period of incapacity for work, except as indicated below (Part 1 of Article 6 of the Law of December 29, 2006 N 255-FZ) |
| Disabled worker | Disability period, but not more than 4 consecutive months or 5 months in a calendar year. Other rules are established for tuberculosis (part 3 of article 6 of the Law of December 29, 2006 N 255-FZ) |
| An employee with whom a fixed-term labor contract is concluded for a period of up to 6 months | The period of incapacity for work, but not more than 75 calendar days under this agreement. Other rules are established for tuberculosis (part 4 of article 6 of the Law of December 29, 2006 N 255-FZ) |
The procedure for paying sick leave in 2016, issued in connection with the need to care for a sick child or other family member, depends on who cares for.
| Who needs care | Period for which the allowance is paid |
|---|---|
| Child under 7 years old | The entire period of treatment on an outpatient basis, as well as in a hospital when staying with a child in a medical institution, but not more than 60 calendar days in a calendar year for all cases of caring for this child. For certain diseases included in the list (List approved by Order of the Ministry of Health and Social Development of 02.20.2008 N 84н), no more than 90 calendar days in a calendar year (Clause 1 of Part 5 of Article 6 of the Law of December 29, 2006 N 255-ФЗ ) |
| Child aged 7 to 15 years | The period of treatment on an outpatient basis, as well as in a hospital when sharing with a child in a medical institution within 15 calendar days for each case, but not more than 45 calendar days in a calendar year for all cases of caring for this child (paragraph 2 of article 5 6 of the Law of December 29, 2006 N 255-FZ) |
| Disabled child under the age of 18 | The period of treatment on an outpatient basis, as well as in a hospital when staying with a child in a medical institution, but not more than 120 calendar days in a calendar year for all cases of caring for this child (Clause 3, Part 5, Article 6 of the Law of December 29, 2006 N 255-FZ) |
| Another family member (outpatient treatment) | Not more than 7 calendar days are paid for each disease, but not more than 30 calendar days in a calendar year in total (clause 6, part 5, article 6 of the Law of December 29, 2006 No. 255-FZ) |
Paid period during pregnancy and childbirth
An employee must provide maternity leave to an employee in connection with pregnancy on the basis of her application and the submitted sick leave. As a general rule, the duration of such leave is 140 days: 70 days before delivery and 70 days after delivery. With multiple pregnancies, complicated births, leave of longer duration is provided (Article 255 of the Labor Code of the Russian Federation).
For the entire period of maternity leave, an employee is paid an allowance (part 1 of article 13 of the Law of December 29, 2006 No. 255-FZ).
Billing period for sick leave in 2016
The allowance for temporary disability, as well as for pregnancy and childbirth, is calculated based on the average earnings of the employee. Billing period for sick leave payment, as before, is 2 calendar years preceding the year of the insured event - illness, pregnancy, etc. That is, 2014 and 2015. And if an employee changed his place of work during these 2 years, then when calculating his average earnings, the income received by him from the previous employer should also be taken into account (
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