1. This Federal Law regulates legal relations in the system of compulsory social insurance in case of temporary disability and in connection with motherhood, determines the circle of persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood, and the types of compulsory insurance coverage provided to them, establishes the rights and obligations of subjects of compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, and also determines the conditions, amounts and procedure for providing benefits for temporary incapacity for work, for pregnancy and childbirth, a monthly allowance for caring for a child of citizens subject to compulsory social insurance in case of 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 accident at work or an occupational disease, with the exception of the provisions of , and this federal law applied to the specified relations in the part that does not contradict No. 125-FZ of July 24, 1998 "On mandatory social insurance from accidents at work and occupational diseases.
1. Legislation Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood is based on the Russian Federation and consists of this Federal Law, of July 16, 1999 N 165-FZ "On the Basics of Compulsory Social Insurance", of July 24, 2009 N 212-FZ "On insurance premiums in Pension Fund Russian Federation, Social Insurance Fund of the Russian Federation, Federal Compulsory Fund health insurance"(hereinafter referred to as 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"), other federal laws. Relations related to compulsory social insurance in case of temporary disability and in connection with motherhood are also regulated by other regulatory legal acts of the 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 of the international treaty of the Russian Federation shall apply.
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, rewards) or additional expenses in connection with the onset of insured event on compulsory social insurance in case of temporary disability and in connection with motherhood;
2) an insured event under compulsory social insurance in case of temporary disability and in connection with motherhood - an accomplished event, with the occurrence of which the obligation of the insurer arises, and in individual cases established by this Federal Law, the insured to carry out insurance coverage;
3) compulsory insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter also referred to as insurance coverage) - the fulfillment by the insurer, and in some cases established by this Federal Law, by the insured of his obligations to the insured person upon the occurrence of an insured event through payment of benefits established by this Federal Law;
4) means of compulsory social insurance in case of temporary incapacity for work and in connection with motherhood - funds generated by the payment of insurance premiums by insurers for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, as well as property under the operational management of the insurer;
5) insurance premiums for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter referred to as insurance premiums) - mandatory payments made by policyholders to the Social Insurance Fund of the Russian Federation in order to ensure compulsory social insurance of insured persons in case of temporary disability and in connection with motherhood;
6) average earnings- the average amount of wages, other payments and remunerations paid by the insured in favor of the insured person in the billing period, on the basis of which, in accordance with this Federal Law, benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care are calculated, and for persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood, - established by federal law on the day of the insured event.
2. Other concepts and terms used in this Federal Law shall be applied in the sense in which they are used in other legislative acts of the Russian Federation.
1. Insurance risks under compulsory social insurance in case of temporary disability and in connection with motherhood are recognized as temporary loss of earnings or other payments, remuneration by the insured person in connection with the occurrence of an insured event or additional expenses of the insured person or members of his family in connection with the occurrence of an insured event.
1) temporary disability of the insured person due to illness or injury (with the exception of temporary disability due to accidents at work and occupational diseases) and in other cases provided for by this Federal Law;
1. The types of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood are the following payments:
2. The conditions, amounts 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, dated May 19, 1995 N 81-FZ "On State Benefits to Citizens with Children" Law "On State Benefits to Citizens with Children"), dated January 12, 1996 N 8-ФЗ "On Burial and Funeral Business" (hereinafter - the Federal Law "On Burial and Funeral Business").
1. Citizens of the Russian Federation permanently or temporarily residing on the territory of the Russian Federation are subject to compulsory social insurance in case of temporary disability and in connection with motherhood. Foreign citizens and stateless persons, as well as foreign citizens and stateless persons temporarily residing in the Russian Federation (with the exception of highly qualified specialists in accordance with N 115-FZ of July 25, 2002 "On the legal status of foreign citizens in the Russian Federation"):
1) persons working on employment contracts, including heads of organizations that are the sole participants (founders), members of organizations, owners of their property;
Federal Law of the Russian Federation
"On compulsory social insurance in case of temporary disability and in connection with motherhood"
Adopted by the State Duma on December 20, 2006
Approved by the Federation Council on December 27, 2006
Published on 06/30/2014
As amended by: 09.02.2009 N 13-FZ;
07/24/2009 N 213-FZ; 09/28/2010 N 243-FZ;
08.12.2010 N 343-FZ; 25.02.2011 N 21-FZ;
07/01/2011 N 169-FZ; November 28, 2011 N 339-FZ;
03.12.2011 N 379-FZ; December 29, 2012 N 276-FZ;
04/05/2013 N 36-FZ; 02.07.2013 N 185-FZ;
07/23/2013 N 243-FZ; November 25, 2013 N 317-FZ;
04/02/2014 N 59-FZ; 07/28/2014 N 192-FZ
Note:
On the issue of providing benefits for pregnancy and childbirth, see also Federal Law No. 81-FZ of May 19, 1995.
1. This Federal Law regulates legal relations in the system of compulsory social insurance in case of temporary disability and in connection with motherhood, determines the circle of persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood, and the types of compulsory insurance coverage provided to them, establishes the rights and obligations of subjects of compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, and also determines the conditions, amounts and procedure for providing benefits for temporary incapacity for work, for pregnancy and childbirth, a monthly allowance for caring for a child of citizens subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
(part one as amended by Federal Law No. 213-FZ of July 24, 2009)
2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an accident at work or an occupational disease, with the exception of the provisions Federal Law of July 24, 1998 N 125-FZ "On Compulsory Social Insurance against Industrial Accidents and Occupational Diseases".
(as amended by Federal Law No. 36-FZ of April 5, 2013)
1. The legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood is based on the Constitution of the Russian Federation and consists of this Federal Law, Federal Law No. 165-FZ of July 16, 1999 "On the Basics of Compulsory Social Insurance", Federal of July 24, 2009 N 212-FZ "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" (hereinafter - 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"), other federal laws. Relations related to compulsory social insurance in case of temporary disability and in connection with motherhood are also regulated by other regulatory legal acts of the Russian Federation.
(as amended by Federal Laws No. 343-FZ of 08.12.2010, No. 276-FZ of 29.12.2012)
2. In cases where an international treaty of the Russian Federation establishes other rules than those provided for by this Federal Law, the rules of the international treaty of the Russian Federation shall apply.
3. For the purpose of the uniform application of this Federal Law, appropriate explanations may be issued, if necessary, in the manner determined by the Government of the Russian Federation.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
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, remunerations) or additional expenses in connection with the occurrence of an insured event under compulsory social insurance for a case of temporary disability and in connection with motherhood;
2) an insured event under compulsory social insurance in case of temporary disability and in connection with motherhood - an accomplished event, upon the occurrence of which the obligation of the insurer arises, and in certain cases established by this Federal Law, the insured to provide insurance coverage;
3) compulsory insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter also referred to as insurance coverage) - the fulfillment by the insurer, and in some cases established by this Federal Law, by the insured of his obligations to the insured person upon the occurrence of an insured event through payment of benefits established by this Federal Law;
4) means of compulsory social insurance in case of temporary incapacity for work and in connection with motherhood - funds generated by the payment of insurance premiums by insurers for compulsory social insurance in case of temporary incapacity for work and in connection with motherhood, as well as property under the operational management of the insurer;
5) insurance premiums for compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter - insurance premiums) - mandatory payments made by policyholders to the Social Insurance Fund of the Russian Federation in order to ensure compulsory social insurance of insured persons in case of temporary disability and in connection with with motherhood;
6) average earnings - the average amount of wages, other payments and remunerations paid by the insured in favor of the insured person in the billing period, on the basis of which, in accordance with this Federal Law, benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care are calculated , and for persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with motherhood, the minimum wage established by federal law on the day of the insured event.
2. Other concepts and terms used in this Federal Law shall be applied in the sense in which they are used in other legislative acts of the Russian Federation.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Insurance risks under compulsory social insurance in case of temporary disability and in connection with motherhood are recognized as temporary loss of earnings or other payments, remuneration by the insured person in connection with the occurrence of an insured event or additional expenses of the insured person or members of his family in connection with the occurrence of an insured event.
2. Insured events for compulsory social insurance in case of temporary disability and in connection with motherhood are recognized:
1) temporary disability of the insured person due to illness or injury (with the exception of temporary disability due to accidents at work and occupational diseases) and in other cases provided for by 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.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
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) allowance for temporary disability;
2) allowance for pregnancy and childbirth;
3) lump sum women registered with medical organizations in early dates pregnancy;
4) a one-time allowance for the birth of a child;
5) monthly allowance for child care;
6) social benefit for burial.
2. The conditions, amounts 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-FZ "On State Benefits to Citizens with Children" (hereinafter - Federal Law "On State Benefits to Citizens with Children"), Federal Law of January 12, 1996 N 8-FZ "On Burial and Funeral Business" (hereinafter - the Federal Law "On Burial and Funeral Business").
1. Citizens of the Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing in the territory of the Russian Federation, are subject to compulsory social insurance in case of temporary disability and in connection with motherhood:
1) persons working under labor contracts, including heads of organizations who are the sole participants (founders), members of organizations, owners of their property;
(as amended by Federal Law No. 379-FZ of December 3, 2011)
2) state civil servants, municipal employees;
3) persons holding public positions of the Russian Federation, public positions of a constituent entity of the Russian Federation, as well as municipal positions filled on a permanent basis;
4) members of a production cooperative who take personal labor participation in its activities;
5) clergy;
6) persons sentenced to deprivation of liberty and involved in paid work.
2. Persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law are insured persons.
3. Lawyers, individual entrepreneurs, members of peasant (farm) households, individuals, not recognized individual entrepreneurs(notaries engaged in private practice, other persons engaged in private practice in accordance with the procedure established by the legislation of the Russian Federation), members of family (tribal) communities of indigenous peoples of the North are subject to compulsory social insurance in case of temporary disability and in connection with motherhood if they voluntarily have entered into relations on compulsory social insurance in case of temporary disability and in connection with motherhood and pay insurance premiums for themselves in accordance with this Federal Law.
4. Insured persons are entitled to receive 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 Business". Persons who voluntarily entered into relations under compulsory social insurance in case of temporary disability and in connection with motherhood acquire the right to receive insurance coverage, subject to payment of insurance premiums within the period specified by this Federal Law.
5. Persons working under labor contracts, for the purposes of this Federal Law, are recognized as persons who have duly entered into an employment contract from the day on 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, constituent entities of the Russian Federation may also establish other payments to provide for federal state civil servants, state civil servants of the constituent entities of the Russian Federation in case of temporary disability and in connection with motherhood, financed, respectively, at the expense of federal budget, budgets of subjects of the Russian Federation.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Insurers under compulsory social insurance in case of temporary disability and in connection with motherhood are persons making payments to individuals subject to compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law, including:
1) organizations - legal entities, formed 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 foreign countries, international organizations, branches and representative offices of these foreign persons and international organizations established on the territory of the Russian Federation;
2) individual entrepreneurs, including heads of peasant (farmer) households;
3) individuals who are not recognized as individual entrepreneurs.
2. For the purposes of this Federal Law, lawyers, individual entrepreneurs, members of peasant (farmer) households, individuals who are not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in accordance with the procedure established by the legislation of the Russian Federation), members of family (tribal) communities of the indigenous peoples of the North who voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law. These persons shall exercise the rights and bear the obligations of policyholders provided for by this Federal Law, with the exception of the rights and obligations associated with the payment of insurance coverage to insured persons.
3. If the insured simultaneously belongs to several categories of insureds specified in and this article, the calculation and payment of insurance premiums are made by him on each basis.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Compulsory social insurance in case of temporary disability 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 constitute a single centralized system of bodies for managing the means of compulsory social insurance in case of temporary disability and in connection with motherhood.
Note:
On the Social Insurance Fund of the Russian Federation, see Decree of the President of the Russian Federation of 08/07/1992 N 822 and Decree of the Government of the Russian Federation of 02/12/1994 N 101.
3. The legal status and procedure for organizing the activities of the Social Insurance Fund of the Russian Federation are determined by federal law.
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Registration of policyholders is carried out in the territorial bodies of the insurer:
1) policyholders - legal entities within a period not exceeding three working days from the date of submission to the territorial body of the insurer federal agency executive power, exercising state registration legal entities, information contained in a unified state register legal entities and represented in the manner determined by the federal executive body authorized by the Government of the Russian Federation;
(as amended by Federal Law No. 59-FZ of April 2, 2014)
2) policyholders - legal entities at the location of separate subdivisions that have a separate balance sheet, current account and accrue payments and other remuneration in favor of individuals, on the basis of an application for registration as an insurant, submitted no later than 30 days from the date of creation of such a separate divisions;
3) policyholders - individuals who have concluded an employment contract with an employee, at the place of residence of these individuals on the basis of an application for registration as an insurant, submitted no later than 10 days from the date of conclusion of an employment contract with the first of the hired employees.
1.1. A document confirming the fact of registration of the insurers specified in this article shall be sent by the territorial body of the insurer to the insurer using public information and telecommunication networks, including the Internet, including a single portal of state and municipal services, in the form of an electronic document signed by an enhanced qualified electronic signature, by the address Email, contained in the information of the unified state register of legal entities (if an e-mail address is indicated in the application for state registration), submitted by the federal executive body carrying out state registration of legal entities, to the territorial bodies of the insurer. It is not obligatory for the policyholder to receive a written confirmation of the fact of this registration on paper. Such a document is issued at the request of the insured by the territorial body of the insurer within a period not exceeding three working days from the date of receipt of the relevant request.
(Part 1.1 was introduced by Federal Law No. 59-FZ of April 2, 2014)
2. Deregistration of policyholders 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 carrying out state registration of legal entities, the 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) policyholders - legal entities at the location of separate subdivisions that have a separate balance sheet, current account and accrue payments and other remuneration in favor of individuals (in the event of the closure of a separate subdivision or the termination of powers to maintain a separate balance sheet, current account or accrue payments and other remunerations in favor of individuals), within fourteen days from the date of submission by the insured of an application for deregistration at the location of such a unit;
3) policyholders - individuals who have concluded an employment contract with an employee (in the event of termination of the employment contract with the last of the hired employees), within fourteen days from the date of filing by the insurant of an application for deregistration.
3. The procedure for registration and deregistration of the insurers specified in this Article and persons equated to insurers for the purposes of this Federal Law shall be established by the federal executive body responsible for the development of public policy and legal regulation in the field of social insurance.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. Financial support for expenses for the payment of insurance coverage to insured persons is 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 this article.
2. Temporary disability benefit in the cases specified in this Federal Law shall be paid:
1) to insured persons (with the exception of insured persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law) for the first three days of temporary disability at the expense of the insured, and for the rest of the period starting from the 4th day of temporary disability at the expense of the budget of the Social Insurance Fund of the Russian Federation;
(Clause 1 as amended by Federal Law No. 343-FZ of 08.12.2010)
2) to insured persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law, at the expense of the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
3. Temporary disability benefits in the cases provided for by this Federal Law shall be paid to insured persons at the expense of the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
4. Financial support for additional expenses for the payment of benefits for temporary disability, for pregnancy and childbirth, related to the offset in the insurance record of the insured person of the periods of service specified in this Federal Law, during which the citizen was not subject to compulsory social insurance in case of temporary disability and in connection with with motherhood, is carried out at the expense of intergovernmental transfers from the federal budget provided for the specified purposes to the budget of the Social Insurance Fund of the Russian Federation. Determination of the volume of interbudgetary transfers from the federal budget provided to the budget of the Social Insurance Fund of the Russian Federation to finance additional expenses, in terms of the periods of the specified service that took place before January 1, 2007, is not made if these periods are taken into account when determining the duration of the insurance period in accordance with this Federal law.
5. In cases established by the laws of the Russian Federation, federal laws, financial support expenses for the payment of insurance coverage in excess of those established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood are carried out at the expense of interbudgetary transfers from the federal budget provided for these purposes to the budget of the Social Insurance Fund of the Russian Federation.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
The provision of insurance coverage to persons sentenced to deprivation of liberty and involved in paid work is carried out in the manner determined by the Government of the Russian Federation.
Chapter 1.1. RIGHTS AND OBLIGATIONS OF SUBJECTS OF COMPULSORY SOCIAL INSURANCE IN THE CASE OF TEMPORARY DISABILITY AND IN CONNECTION WITH MOTHERHOOD
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Policyholders have the right:
1) apply to the insurer for obtaining the funds necessary for the payment of insurance coverage to insured persons, in excess of the accrued insurance premiums;
2) to receive free information from the insurer on normative legal acts on compulsory social insurance in case of temporary disability and in connection with motherhood;
3) go to court to protect their rights;
4) verify information about the insured (insured) who issued (have issued) to the insured person a certificate (certificates) on the amount of wages, other payments and remunerations (hereinafter referred to as the certificate of the amount of earnings) for calculating benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care, by sending a request to the territorial body of the insurer in the form and in the manner established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance.
(Clause 4 was introduced by Federal Law No. 343-FZ of 08.12.2010)
2. Policyholders are obliged:
1) register with the territorial office of the insurer in the cases and in the manner established by this Federal Law;
2) pay insurance contributions to the Social Insurance Fund of the Russian Federation in a timely manner and in full;
3) in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood, pay out insurance coverage to insured persons upon the occurrence of insured events provided for by this Federal Law, and also issue to the insured person on the day of termination of work (service, other activity) or at the written request of the insured person after the termination of work (service, other activity) with this policyholder no later than three working days from the date of submission of this application, a certificate of the amount of earnings for two calendar years preceding the year of termination of work (service, other activity) or the year of applying for a certificate of the amount of earnings, and the current calendar year for which insurance premiums were accrued, and the number of calendar days falling in the specified period for periods of temporary disability, maternity leave, parental leave, period e release of the employee from work with full or partial pay in accordance with the legislation of the Russian Federation, if 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" were not accrued, in the form and in the manner established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance;
(Clause 3 as amended by the Federal Law of December 29, 2012 N 276-FZ)
4) keep records and reports on accrued and paid insurance premiums to the Social Insurance Fund of the Russian Federation and expenses for the payment of insurance coverage to insured persons;
5) comply with the requirements of the territorial bodies of the insurer to eliminate the identified violations of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
6) submit for verification to the territorial bodies of the insurer documents related to the accrual, payment of insurance premiums to the Social Insurance Fund of the Russian Federation and the costs of paying insurance coverage to insured persons;
7) inform the territorial bodies of the insurer about the creation, transformation or closure of separate subdivisions specified in this Federal Law, as well as about changes in their location and name;
8) fulfill other obligations 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 premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund".
1. The insurer has the right:
1) conduct checks on the correctness of the accrual 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, require and receive from 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 premiums to the Social Insurance Fund of the Russian Federation, the costs of paying insurance coverage to insured persons, including when funds are allocated to the policyholder for these expenses in excess of the accrued insurance premiums;
2.1) ask the policyholder for information about the balances Money on the accounts of the insured with credit institutions and about the insufficiency of funds on the accounts of the insured with credit institutions to satisfy all claims against the accounts in the event that the insured applies to the territorial body of the insurer in accordance with this Federal Law;
(Clause 2.1 was introduced by Federal Law No. 243-FZ of July 23, 2013)
3) receive from organs Federal Treasury information on the amounts of insurance premiums, penalties, fines received by the Social Insurance Fund of the Russian Federation;
4) not to accept for offset against the payment of insurance premiums the expenses for the payment of insurance coverage to insured persons, incurred by the insured in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood, not supported by documents, made on the basis of incorrectly executed or documents issued in violation of the established procedure;
5) to carry out, in the manner established by the federal executive body authorized by the Government of the Russian Federation, verification of compliance with the procedure for issuing, extending and issuing sick leave certificates;
6) to file claims against medical organizations for reimbursement of the amount of expenses for insurance coverage for unreasonably issued or incorrectly issued certificates of incapacity for work;
7) represent the interests of the insured persons before the policyholders;
7.1) in the cases specified in this Federal Law, request documents (information) necessary to provide free assistance to the insured person in the form of drawing up applications, complaints, petitions and other documents of a legal nature, as well as in the form of representing the interests of the insured person in courts, appointing and payment of benefits, and documents (information) confirming the existence of the grounds provided for by this Federal Law with the insured or the insured person, if the necessary documents (information) are not at the disposal of state bodies, state bodies off-budget funds, local self-government bodies or organizations subordinate to state bodies or local self-government bodies, or if the necessary documents (information) are included in the list of documents determined by Federal Law of July 27, 2010 N 210-FZ "On the organization of the provision of state and municipal services". Other necessary documents (information) are requested by the insurer from state bodies, local governments and subordinate government bodies or local government organizations. In the cases provided for by this Federal Law, the policyholder or the insured person has the right to submit the documents necessary for the appointment and payment of benefits in full on their own initiative;
(Clause 7.1 was introduced by Federal Law No. 169-FZ of July 1, 2011. As amended by Federal Law No. 192-FZ of July 28, 2014)
7.2) request from credit institutions information on the balances of funds on the accounts of the insured and on the insufficiency of funds on the accounts of the insured to satisfy all claims against the accounts, if the specified information was not submitted by the insured to the territorial body of the insurer, when deciding on the appointment and payment of benefits by the territorial body of the insurer in accordance with the Federal Law if it is impossible to pay them by the insured due to the insufficiency of funds on his accounts with credit institutions to satisfy all claims against the accounts;
(Clause 7.2 was introduced by Federal Law No. 243-FZ of July 23, 2013)
8) 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) to manage the funds of compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood and the budgetary legislation of the Russian Federation;
2) draft the budget of the Social Insurance Fund of the Russian Federation and ensure the implementation of the budget of the Social Insurance Fund of the Russian Federation in accordance with the budgetary legislation of the Russian Federation;
3) keep, in accordance with the established procedure, accounting of the funds of compulsory social insurance in case of temporary disability and in connection with motherhood;
4) draw up a draft report on the execution of the budget of the Social Insurance Fund of the Russian Federation, as well as the established budget reporting;
5) exercise control over the correct calculation, completeness and timeliness of payment (transfer) of insurance premiums to the Social Insurance Fund of the Russian Federation (hereinafter referred to as control over the payment of insurance premiums), as well as control over compliance by policyholders with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood when paying 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 motherhood, the payment of insurance coverage to insured persons;
7) to allocate to the insured the necessary funds for the payment of insurance coverage in excess of the insurance premiums accrued by them;
8) carry out registration of policyholders, maintain a register of policyholders;
9) keep records of individuals who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood, as well as the insurance premiums paid by them and the amounts of insurance coverage paid to them;
10) to advise policyholders and insured persons free of charge on the application of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood;
10 1) provide the insured person with free assistance necessary to obtain insurance coverage in accordance with Part 4 of Article 13 of this Federal Law, in the manner established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance, in the form of drawing up applications, complaints, petitions and other documents of a legal nature, as well as in the form of representing the interests of the insured person in courts if the insured person declares in writing the need to provide him with the specified assistance and consents to the receipt and processing of his personal data;
(Clause 10 1 was introduced by Federal Law No. 192-FZ of July 28, 2014)
11) not to disclose, without the consent of the insured person, information about the results of his medical examinations (diagnosis), income received by him, with the exception of cases provided for by the legislation 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 over the payment of insurance premiums are established by the Federal Law "On insurance premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund".
(as amended by Federal Law No. 276-FZ of December 29, 2012)
1. Insured persons have the right to:
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) freely receive from the insured a certificate of the amount of earnings, as well as information on the calculation of insurance premiums and exercise control over their transfer to the Social Insurance Fund of the Russian Federation;
3) contact the policyholder 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, as well as contact the insurer for free assistance necessary to obtain insurance coverage in accordance with part 4 of article 13 of this Federal law, in the form of drawing up applications, complaints, petitions and other documents of a legal nature, as well as in the form of representing the interests of the insured person in courts;
(as amended by Federal Law No. 192-FZ of July 28, 2014)
4) apply to the insurer with a request to verify the correctness of the payment of insurance coverage by the insured;
5) protect their rights personally or through a representative, including in court.
2. The insured persons are obliged to:
1) present 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, to the insurer, reliable documents (information), on the basis of which insurance coverage is paid and (or) the insurer provides free assistance to the insured person in the form of drawing up applications, complaints, petitions and other documents of a legal nature, as well as in the form of representing the interests of the insured person in courts, necessary to obtain insurance coverage in accordance with Part 4 of Article 13 of this Federal Law;
2) notify the policyholder (insurer) of the circumstances affecting the terms of provision and the amount 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 the patient's behavior in medical organizations;
4) 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. If the insured persons fail to fulfill the obligations established by this article, the insurer shall have the right to recover from them the damage caused in accordance with the legislation of the Russian Federation.
Chapter 1.2. Features of payment of insurance premiums
(introduced by Federal Law No. 213-FZ of July 24, 2009)
Legal regulation of relations related to the payment of insurance premiums by insurers specified in 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, establishing the procedure for calculating, the procedure and terms for paying insurance premiums , is 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".
(as amended by Federal Law No. 276-FZ of December 29, 2012)
1. The persons specified in this Federal Law enter into legal relations on 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 voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood pay insurance premiums to the Social Insurance Fund of the Russian Federation, based on the cost insurance year determined in accordance with this article.
3. The cost of an insurance year is determined as the product of minimum size wages established by federal law at the beginning fiscal year, for which insurance premiums are paid, and the rate of insurance premiums established by the Federal Law "On insurance premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" in terms of insurance premiums to the Social Insurance Fund of the Russian Federation, increased by 12 times.
(as amended by Federal Law No. 276-FZ of December 29, 2012)
4. Payment of insurance premiums by persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood, is made no later than December 31 of the current year, starting from the year of filing an application for voluntary entry into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood.
5. Persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood transfer insurance premiums to the accounts of the territorial bodies of the insurer by non-cash payments, or by depositing cash in a credit institution, or by postal order.
6. Persons who have voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood shall acquire the right to receive insurance coverage provided that they pay insurance premiums in accordance with this Article in the amount determined in accordance with this Article, for the calendar year preceding the calendar year in which the insured event occurred.
7. In the event that a person who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood did not pay insurance premiums for the corresponding calendar year before December 31 of the current year, the legal relations between him and the insurer on compulsory social insurance in case of temporary disability and in connection with motherhood are considered terminated.
8. The procedure for paying insurance premiums by persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood, including the procedure for terminating legal relations with them on compulsory social insurance in case of temporary disability and in connection with motherhood, is determined by the Government Russian Federation.
1. The insurers specified in this Federal Law shall pay insurance coverage to the insured persons on account of the payment of insurance premiums to the Social Insurance Fund of the Russian Federation, except for the cases specified in this Federal Law, when the payment of insurance coverage is carried out at the expense of the insurers.
2. The amount of insurance premiums to be transferred by the insurers specified in 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 accrued by the insured are not enough to pay the insurance coverage to the insured persons in full, the insured applies for the necessary funds to the territorial body of the insurer at the place of his registration.
2.1. If the territorial body of the insurer, in accordance with this Federal Law, appointed and paid benefits to the insured person for temporary disability, pregnancy and childbirth, monthly childcare benefits, then when the insured person receives the amounts of these benefits from the insured in connection with the termination of circumstances, the existence which was the basis for the appointment and payment of the relevant benefits by the territorial body of the insurer, the amount of insurance premiums payable by such an insurant to the Social Insurance Fund of the Russian Federation shall not be reduced by the amount of expenses incurred by the insured to pay benefits to the insured person to whom the territorial body of the insurer paid this benefit .
(Part 2.1 was introduced by Federal Law No. 276-FZ of December 29, 2012)
3. The territorial body of the insurer shall allocate to the insured the necessary funds for the payment of insurance coverage within 10 calendar days from the date of submission by the insured of all necessary documents, except for the cases specified in this article. The list of documents to be submitted by the insured is determined by the federal executive body responsible for the development of state policy and legal regulation in the field of social insurance.
3.1. In case of insufficiency of funds on the accounts of the insured in credit institutions to satisfy all the claims presented to the accounts, the territorial body of the insurer decides to refuse to allocate the necessary funds to the insured for the payment of insurance coverage.
(Part 3.1 was introduced by Federal Law No. 243-FZ of July 23, 2013)
4. When considering the insured's application for the allocation of the necessary funds for the payment of insurance coverage, the territorial body of the insurer shall have the right to verify the correctness and validity of the insured's expenses for the payment of insurance coverage, including an on-site inspection, in the manner established by this Federal Law, and also to request from the insured additional information and documents. In this case, the decision to allocate these funds to the insured is made based on the results of the audit.
5. In case of refusal to allocate to the insured the necessary funds for the payment of insurance coverage, the territorial body of the insurer shall issue a reasoned decision, which shall be sent to the insured within three days from the date of the decision.
6. The decision to refuse to allocate the necessary funds to the insured for the payment of insurance coverage may be appealed by him to the superior body of the insurer or to the court.
7. Funds for the payment of insurance coverage (with the exception of the payment of temporary disability benefits in case of disability due to illness or injury for the first three days of temporary disability) to insured persons who work under employment contracts concluded with organizations and individual entrepreneurs, for whom apply reduced rates insurance premiums in accordance with Parts 3.3 and 3.4 of Article 58 and Article 58.1 of 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", are allocated to these organizations and individual entrepreneurs by the territorial bodies of the insurer in in the manner prescribed by this article, at the place of their registration as insurers.
(Part 7 as amended by Federal Law No. 276-FZ of December 29, 2012)
Note:
Order of the FSS of Russia dated 09.03.2010 N 37 approved the recommended forms of documents when checking the correctness of the expenses of insurers for the payment of insurance coverage for compulsory social insurance in case of temporary disability and in connection with motherhood.
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 insured's expenses for the payment of insurance coverage.
2. On-site inspections of the insured are carried out no more than once every three years, except for the cases specified in this Federal Law and in this article.
3. In case of receipt of a complaint by the insured person against the policyholder's refusal to pay insurance coverage or for the incorrect determination by the policyholder of the amount of insurance coverage, the territorial body of the insurer shall have the right to conduct an unscheduled on-site verification of the correctness of the policyholder's expenses for the payment of insurance coverage.
4. In case of detection of expenses for the payment of insurance coverage incurred by the insured in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood, not supported by documents, incurred on the basis of incorrectly executed or issued documents in violation of the established procedure, the territorial the body of the insurer that conducted the inspection shall make a decision not to accept such expenses as offset against the payment of insurance premiums to the Social Insurance Fund of the Russian Federation.
5. The decision on non-acceptance of expenses for the payment of insurance coverage, together with the claim for their reimbursement, shall be sent to the insured within three days from the date of the decision. Forms of the decision on non-acceptance of expenses for the payment of insurance coverage and claims for their reimbursement are approved by the federal executive body responsible for the development of state policy and legal regulation in the field of social insurance.
6. If, within the period specified in the specified requirement, the insured did not reimburse the expenses that were not accepted for offset, the decision to not accept the expenses for the payment of insurance coverage for offset is the basis for collecting from the insurant the arrears in insurance premiums resulting from the implementation such expenses. The collection of arrears on insurance premiums is carried out by the insurer in the manner prescribed by the Federal Law "On insurance premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund".
(as amended by Federal Law No. 276-FZ of December 29, 2012)
7. Field checks of the correctness of the insured's expenses for the payment of insurance coverage are carried out by the insurer simultaneously with field checks the insured on the correctness of the calculation, completeness and timeliness of payment (transfer) of insurance premiums to the Social Insurance Fund of the Russian Federation, except for the cases specified in this Federal Law and in this article.
1. The insurers specified in this Federal Law are obliged, in accordance with the procedure established by the federal executive body responsible for the development of state policy and legal regulation in the field of social insurance, to keep records of:
1) the amounts of accrued and paid (transferred) insurance premiums, penalties and fines;
2) the amounts of expenses incurred for the payment of 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 previous quarter, the insurers specified in this Federal Law are required to submit reports (calculations) to the territorial bodies of the insurer in the form approved by the federal executive body responsible for 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) funds used by them for the payment of insurance coverage;
3) expenses for the payment of insurance coverage subject to offset against the payment of insurance premiums to the Social Insurance Fund of the Russian Federation;
4) insurance premiums, penalties, fines paid to the Social Insurance Fund of the Russian Federation.
3. Forms of reports (calculations) submitted by persons who have voluntarily entered into legal relations for compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law, as well as the timing and procedure for their submission are approved by the federal executive body exercising the functions on the development of state policy and legal regulation in the field of social insurance.
Note:
By the Resolution of the Constitutional Court of the Russian Federation of 06.02.2009 N 3-P, Part 1 of Article 5 is recognized as not contradicting the Constitution of the Russian Federation, since the provisions contained in it are in the system of the current legal regulation- the father of the child is not deprived of the same right as the mother to raise children, as well as the right to social security for the upbringing of children, carried out, among other things, through the provision of mandatory social insurance benefits.
1. Provision of insured persons with benefits for temporary disability is carried out in the following cases:
1) disability due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization (hereinafter referred to as disease or injury);
2) the need to care for a sick family member;
3) quarantine of the insured person, as well as the quarantine of a child under the age of 7 attending a preschool educational organization, or another family member recognized as legally incompetent;
4) implementation of prosthetics for medical reasons in a stationary specialized institution;
5) aftercare in the prescribed manner in sanatorium organizations located on the territory of the Russian Federation, immediately after the provision medical care in stationary conditions.
(Clause 5 as amended by Federal Law No. 317-FZ of November 25, 2013)
2. Temporary disability benefit shall be paid to insured persons upon the occurrence of the events specified in 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 in case of temporary disability and in connection with motherhood, and also in cases where the disease or injury occurred within 30 calendar days from the date of termination of the specified work or activity, or in the period from the day the employment contract was concluded until the day it was cancelled.
(as amended by Federal Law No. 343-FZ of 08.12.2010)
1. Temporary disability benefit in case of disability due to illness or injury is paid to the insured person for the entire period of temporary disability until the day of restoration of working capacity (disability establishment), except for the cases specified in and this article.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
2. When the insured person receives aftercare in a sanatorium and resort organization located on the territory of the Russian Federation, immediately after the provision of medical care in a hospital, temporary disability benefits are paid for the period of stay in a sanatorium and resort organization, but not more than 24 calendar days (for excluding tuberculosis).
(Part 2 as amended by Federal Law No. 317-FZ of November 25, 2013)
3. An insured person recognized as a disabled person in accordance with the established procedure is paid temporary disability benefits (except for tuberculosis) for no more than four consecutive months or five months in a calendar year. If these persons fall ill with tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity or until the day the disability group is reviewed due to tuberculosis.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
4. An insured person who has entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as an insured person whose illness or injury occurred in the period from the date of conclusion of the employment contract until the day of its cancellation, temporary disability benefits (except for tuberculosis) is paid for no more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity (disability determination). In this case, the insured person, whose illness or injury occurred in the period from the date of conclusion of the employment contract until the day of its cancellation, is paid temporary disability benefits from the day from which the employee was supposed to start work.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
5. Temporary disability benefit, if it is necessary to take care of 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 treatment of the child on an outpatient basis or joint stay with the child in a medical organization when providing medical care to him in an inpatient setting, but not more than 60 calendar days in a calendar year in all cases of care for this child, and in the event of a child falling ill, included in the list of diseases determined by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of healthcare, no more than 90 calendar days in calendar year for all cases of care for this child in connection with the specified disease;
(as amended by Federal Law No. 317-FZ of November 25, 2013)
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 treatment of a child on an outpatient basis or joint stay with a child in a medical organization when providing medical care to him in an inpatient setting, but no more than 45 calendar days in a calendar year for all cases of care for this child;
(as amended by Federal Law No. 317-FZ of November 25, 2013)
3) in the case of caring for a sick disabled child under the age of 15 years - for the entire period of treatment of the child on an outpatient basis or joint stay with the child in a medical organization when providing medical care to him in a hospital, but not more than 120 calendar days in calendar year for all cases of care for this child;
(as amended by Federal Law No. 317-FZ of November 25, 2013)
4) in the case of caring for a sick child under the age of 15 who is HIV-infected - for the entire period of joint stay with the child in a medical organization when providing him with medical care in a hospital;
(as amended by Federal Law No. 317-FZ of November 25, 2013)
5) in the case of caring for a sick child under the age of 15 with his illness associated with a post-vaccination complication, with malignant neoplasms, including malignant neoplasms of lymphoid, hematopoietic and related tissues - for the entire period of treatment of the child on an outpatient basis or joint stay with a child in a medical organization when providing him with medical care in a hospital;
(as amended by Federal Laws No. 13-FZ of February 9, 2009, No. 317-FZ of November 25, 2013)
6) in other cases of caring for a sick family member during outpatient treatment - no more than 7 calendar days for each case of illness, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
(as amended by Federal Law No. 317-FZ of November 25, 2013)
6. 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 found to be carrying bacteria, for the entire time of his suspension from work due to quarantine. If children under the age of 7 who attend preschool educational organizations or other family members who are duly recognized as incapacitated are subject to quarantine, temporary disability benefits are paid to the insured person (one of the parents, other legal representative or other family member) for the entire period of quarantine .
(as amended by the Federal Law of 02.07.2013 N 185-FZ)
7. Temporary disability benefit in the event of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of release from work for this reason, including the travel time to the place of prosthetics and back.
8. Temporary disability benefit is paid to the insured person in all cases specified in - this article, for the calendar days falling on the relevant period, with the exception of calendar days falling on the periods specified in this Federal Law.
Note:
Benefits for the payment of temporary disability benefits were established by Federal Law No. 2-FZ of 10.01.2002 and Federal Law No. 157-FZ of 17.09.1998.
1. Temporary disability benefit in case of disability due to illness or injury, with the exception of cases specified in this article, during quarantine, prosthetics for medical reasons and aftercare in sanatorium organizations immediately after the provision of medical care in a hospital is paid in the following amount:
(as amended by Federal Law No. 317-FZ of November 25, 2013)
1) for an insured person with an insurance record of 8 or more years - 100 percent of average earnings;
2) for an insured person with an insurance record of 5 to 8 years - 80 per cent of average earnings;
3) for an insured person with an insurance record of up to 5 years - 60 per cent of average earnings.
2. Temporary disability benefit in case 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 occurring within 30 calendar days after the termination of work under an employment contract, official or other activity during which they are subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
(as amended by Federal Law No. 343-FZ of 08.12.2010)
Note:
Benefits for the payment of allowance for the care of a sick child were established as follows regulations: Federal Law of 01/10/2002 N 2-FZ, Federal Law of 09/17/1998 N 157-FZ, Law of the Russian Federation of 05/15/1991 N 1244-1.
3. Temporary disability allowance, if it is necessary to care for a sick child, is paid:
1) when treating a child on an outpatient basis - 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 this article, for the following days in the amount of 50 percent of the average earnings;
(as amended by Federal Law No. 317-FZ of November 25, 2013)
2) when treating a child in a hospital - in the amount determined depending on the duration of the insurance period of the insured person in accordance with this article.
(as amended by Federal Law No. 317-FZ of November 25, 2013)
4. Temporary disability benefit if it is necessary to care for a sick family member during his treatment on an outpatient basis, with the exception of cases of caring for a sick child under the age of 15, is paid in an amount determined depending on the length of the insurance period of the insured person in accordance with of this article.
(as amended by Federal Law No. 317-FZ of November 25, 2013)
Note:
6. An insured person who has an insurance period of less than six months is paid temporary disability benefits in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which district coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
7. In case of temporary disability that occurred before the downtime period and continues during the downtime period, the temporary disability benefit for the downtime period is paid in the same amount in which the salary is maintained during this time, but not higher than the amount of the temporary disability benefit, which the insured a person would receive according to the general rules.
(Part 7 as amended by Federal Law No. 343-FZ of 08.12.2010)
Note:
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 incapacity for work of the regimen prescribed by the attending physician;
2) non-appearance of the insured person without good reason at the appointed time for a medical examination or for a medical and social examination;
Note:
On the issue concerning the procedure for establishing a causal relationship between alcohol consumption and injury and disease, see letter of the FSS of the Russian Federation dated 04/15/2004 N 02-10 / 07-1843.
3) illness or injury resulting from alcohol, narcotic, toxic intoxication or actions related to such intoxication.
2. If there are one or more grounds for reducing temporary disability benefits specified in this article, temporary disability benefits are paid to the insured person in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in regions and localities , in which regional coefficients for wages are applied in accordance with the established procedure - in an amount not exceeding the minimum wage, taking into account these coefficients:
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1) if there are grounds specified in paragraph 1 of this article - from the day when the violation was committed;
2) if there are grounds specified in paragraph 3 of part 1 of this - for the entire period of incapacity for work.
1. Temporary disability benefit is not assigned to the insured person for the following periods:
1) for the period of the employee's release from work with full or partial pay or without pay in accordance with the legislation of the Russian Federation, except for cases of disability by the 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 accrued for this period;
3) for the period of detention or administrative arrest;
4) for the period of the forensic medical examination;
5) for the period of downtime, except for the cases provided for by this Federal Law.
(Clause 5 was introduced by Federal Law No. 343-FZ of December 8, 2010)
2. The grounds for refusing to grant an insured person temporary disability benefits are:
1) the onset of temporary incapacity for work as a result of the intentional infliction by the insured person of harm to his health or a suicide attempt established by the court;
2) the onset of temporary disability due to the commission of an intentional crime by the insured person.
1. The benefit for pregnancy and childbirth is paid to the insured woman in total for the entire period of maternity leave lasting 70 (in case of multiple pregnancy - 84) calendar days before childbirth and 70 (in case of complicated childbirth - 86, in case of birth of two or more children - 110) calendar days after childbirth.
2. When adopting a child (children) under the age of three months, the pregnancy and childbirth allowance shall be paid from the date of its adoption until the expiration of 70 (in case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).
3. If during the period of a mother's leave to care for a child until the child reaches the age of one and a half years, she has a maternity leave, she has the right to choose one of the two types of benefits paid during the periods of the corresponding holidays.
1. The benefit for pregnancy and childbirth is paid to an insured woman in the amount of 100 percent of the average earnings.
Note:
On the issue concerning the application of district coefficients in determining the amount of benefits for compulsory social insurance, see Letter of the FSS of the Russian Federation dated 02.12.2002 N 02-18 / 05-8417.
3. An insured woman who has an insurance period of less than six months is paid a pregnancy and childbirth benefit in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which district coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
Chapter 3.1. Provision of a monthly allowance for child care
(introduced by Federal Law No. 213-FZ of July 24, 2009)
1. Monthly child care 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 parental leave is granted until the child reaches the age of one and a half years .
2. The right to a monthly child care allowance is retained if the person on parental leave works part-time or at home and continues to care for the child.
3. Mothers who are entitled to a pregnancy and childbirth allowance, in the period after childbirth, are entitled to receive either a pregnancy and childbirth allowance or a monthly childcare allowance, offset by the previously paid pregnancy and childbirth allowance, from the date of the birth of the child, if the amount of the monthly child care allowance is higher than the amount of the maternity allowance.
4. If the child is cared for by several persons at the same time, the right to receive a monthly allowance for child care shall be granted to one of these persons.
1. 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 until they reach the age of one and a half years, the amount of the monthly allowance for caring for a child, calculated in accordance with this article, is summed up. At the same time, the summed amount of the benefit may not exceed 100 percent of the average earnings of the insured person, determined in accordance with the procedure established by this Federal Law, but may not 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 this child are taken into account.
4. In the case of caring for a child (children) born (born) by a mother deprived of parental rights in relation to previous children, the monthly child care allowance shall be paid in the amounts established by this article, excluding children in respect of whom she was deprived of parental rights. rights.
Note:
Provisions - of this Federal Law to relations related to the provision of citizens with temporary disability benefits in connection with an accident at work or an occupational disease, to the extent that does not contradict Federal Law No. 125-FZ of July 24, 1998.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. Temporary disability benefit is granted if the application for it was followed no later than six months from the date of restoration of working capacity (disability determination), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and aftercare.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
2. The benefit for pregnancy and childbirth is assigned if the application was followed no later than six months from the date of the end of the maternity leave.
2.1. Monthly allowance for child care is assigned if the application was followed no later than six months from the day the child reaches the age of one and a half years.
3. When applying for a benefit for temporary disability, for pregnancy and childbirth, a monthly benefit for caring for a child after a six-month period, the decision to grant the benefit is made by the territorial body of the insurer 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 responsible for developing state policy and legal regulation in the field of social insurance.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. Appointment and payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care are carried out by the insured at the place of work (service, other activity) of the insured person (except for the cases specified in and this article).
2. If the insured person at the time of the occurrence of the insured event is employed by several insurers and in the two previous calendar years was employed by the same insurers, benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by the insurers at all places of work (service , other activities), and the monthly allowance for the care of a child - the insured at one place of work (service, other activity) at the choice of the insured person and are calculated based on the average earnings determined in accordance with this Federal Law, for the time of work (service, other activities) from the insured who appoints and pays the benefit.
(Part 2 as amended by Federal Law No. 343-FZ of 08.12.2010)
2.1. If the insured person at the time of the occurrence of the insured event is employed by several insurers, and in the previous two calendar years was employed by other insurers (another insured), temporary disability benefits, pregnancy and childbirth benefits, monthly allowance for child care are assigned and paid to him by the insurant at one of the last places of work (service, other activity) at the choice of the insured person.
2.2. If the insured person at the time of the occurrence of the insured event is employed by several insurers, and in the two previous calendar years was employed by both these and other insurers (another insured), temporary disability benefits, pregnancy and childbirth benefits are assigned and paid to him either in in accordance with this article by insurers at all places of work (service, other activity) based on the average earnings for the time of work (service, other activity) with the insured assigning and paying benefits, or in accordance with this article by the insurant at one of the last places of work ( services, other activities) at the choice of the insured person.
(Part 2.2 was introduced by Federal Law No. 343-FZ of December 8, 2010)
3. An insured person who 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, service or other activities, during which he was subject to compulsory social insurance in case of temporary disability and in connection with motherhood, temporary allowance disability is assigned 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 this article.
Note:
The provisions of Part 4 of Article 13 (as amended by the Federal Law of December 29, 2012 N 276-FZ) apply to insured persons on the facts of non-payment of benefits by insurers for temporary disability, pregnancy and childbirth and monthly childcare benefits established by court decisions , which entered into force before the date of entry into force of the Federal Law of December 29, 2012 N 276-FZ, but not executed on the day of entry into force of the said Federal Law.
4. To the insured persons specified in 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 benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for child care, or in the absence of the possibility their payment by the insured due to the insufficiency of funds on his accounts in credit institutions and the application of the order of debiting funds from the account provided for by the Civil Code of the Russian Federation, or in the absence of the possibility of establishing the location of the insured and his property, which may be levied, if the presence of a court decision that has entered into legal force establishing the fact of non-payment of benefits by such an insurant to the insured person, the appointment and payment of these benefits, with the exception of temporary disability benefits paid at the expense of the insured person in accordance with pursuant to this Federal Law, are carried out by the territorial body of the insurer.
(as amended by Federal Laws No. 276-FZ of December 29, 2012, No. 243-FZ of July 23, 2013)
5. To assign and pay benefits for temporary disability, for pregnancy and childbirth, the insured person submits a certificate of incapacity for work issued by a medical organization in the form and in the manner established by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of healthcare, in agreement with the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of labor and social protection of the population, the Social Insurance Fund of the Russian Federation, a certificate (certificates) on the amount of earnings, from which be calculated allowance, from the place (places) of work (service, other activities) with another insurant (with other insurers), and for the appointment and payment of these benefits by the territorial body of the insurer - a certificate (certificates) on the amount of earnings, from which should be the allowance has been calculated, and the documents confirming the insurance period determined by the indicated federal executive body.
(as amended by Federal Laws No. 343-FZ of 08.12.2010, No. 317-FZ of 25.11.2013)
5.1. In the cases specified in and this article, the insured person, when applying for the appointment of benefits for temporary disability, pregnancy and childbirth to the insured at one of the last places of work (service, other activity), at the choice of the insured person, also submits a certificate (certificates) from the place work (service, other activities) with another insurant (with other insurers) that the appointment and payment of benefits by this insurant are not carried out.
(Part 5.1 was introduced by Federal Law No. 343-FZ of 08.12.2010)
6. To assign and pay a monthly allowance for child care, the insured person submits an application for the assignment of the specified allowance, a birth (adoption) certificate of the child being cared for, and a copy of it or an extract from the decision on establishing custody of the child, a birth certificate (adoption, death) of the previous child (children) and a copy of it, a certificate from the place of work (service) of the mother (father, both parents) of the child that she (he, they) does not use parental leave and does not receive a monthly childcare benefits, and if the mother (father, both parents) of the child does not work (does not serve) or is studying full-time on basic educational programs in organizations engaged in educational activities, a certificate from the bodies of social protection of the population at the place of residence (place of stay, actual residence) mother (father) of the child about non-receipt of the monthly allowance for child care. In order to assign and pay a monthly child care allowance, the insured person shall also submit, if necessary, a certificate (certificates) on the amount of earnings from which the allowance is to be calculated. For the appointment and payment of a monthly allowance for child care in accordance with this article, a certificate (information) from the social protection authorities at the place of residence (place of stay, actual residence) of the father, mother (both parents) of the child on non-receipt of a monthly allowance for child care is requested by the insurer from the authorized executive body of the subject of the Russian Federation, which has such information at its disposal. The insured person has the right, on his own initiative, to submit the specified certificate for the appointment and payment of benefits. The interdepartmental request of the insurer for the submission of documents (information) shall be sent within three calendar days from the date of receipt of the application for the payment of a monthly allowance for child care in accordance with this article. The term for preparing and sending by the authorized executive body of the subject of the Russian Federation a response to the said interdepartmental request may not exceed five calendar days from the date of receipt of the interdepartmental request by the said bodies.
(as amended by Federal Laws No. 169-FZ of 01.07.2011, No. 185-FZ of 02.07.2013)
7. An insured person employed by several insurers, when applying to one of the indicated insurers of his choice for the appointment and payment of a monthly child care allowance, along with the documents provided for in this article, shall submit a certificate (certificates) from the place of work (service, other activities) from another insurant (from other insurers) that the appointment and payment of a monthly allowance for child care by this insurant is not carried out.
7.1. The insured person, instead of the original certificate of the amount of earnings, from which benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care must be calculated, may submit a copy of the certificate of the amount of earnings, certified in the prescribed manner.
(Part 7.1 was introduced by Federal Law No. 343-FZ of December 8, 2010)
7.2. If the insured person is unable to submit a certificate (certificates) on the amount of earnings from which the allowance should be calculated from the place (places) of work (service, other activities) with another insured (with other insurers) in connection with the termination of activities by this policyholder (these policyholders) or for other reasons, the insurer assigning and paying benefits, or the territorial body of the insurer assigning and paying benefits in the cases specified in and this article of this Federal Law, at the request of the insured person, sends a request to the territorial body of the Pension Fund of the Russian Federation on the provision of information on the salary, other payments and remuneration of the insured person with the relevant insured (relevant insurers) on the basis of information on individual (personalized) accounting in the system of mandatory pension insurance. The form of the said application of the insured person, the form and procedure for sending a request, the form, procedure and terms for submitting the requested information by the territorial body of the Pension Fund of the Russian Federation are established by the federal executive body responsible for the development of state policy and legal regulation in the field of social insurance.
(Part 7.2 was introduced by Federal Law No. 343-FZ of December 8, 2010)
8. The insured pays benefits for temporary disability, for pregnancy and childbirth, monthly childcare benefits to the insured person in the manner established for the payment of wages (other payments, remuneration) to insured persons.
Note:
The provisions of Part 9 of Article 13 (as amended by the Federal Law of December 29, 2012 N 276-FZ) apply to insured persons on the facts of non-payment of benefits by insurers for temporary disability, pregnancy and childbirth and monthly childcare benefits established by court decisions , which entered into force before the date of entry into force of the Federal Law of December 29, 2012 N 276-FZ, but not executed on the day of entry into force of the said Federal Law.
9. Payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care in the cases provided for in this article, is carried out in the established amounts by the territorial body of the insurer that appointed these benefits, through the organization of the federal postal service, credit or other organization upon application recipient.
(Part 9 as amended by Federal Law No. 276-FZ of December 29, 2012)
Note:
For insured events that occurred before January 1, 2011, the benefit for the period after January 1, 2011 is calculated according to the new rules, if its amount calculated in this way exceeds the amount of the corresponding benefit calculated according to the old procedure (paragraph 3 of Article 3 of the Federal Law of 08.12 .2010 N 343-FZ).
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. Benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of temporary disability, maternity leave, parental leave, including for 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 insurant (other insurers) are not taken into account in cases where, in accordance with this Federal Law, benefits for temporary disability, pregnancy and childbirth are assigned and paid to the insured person at all places of work (service , other activities) based on the average earnings for the time of work (service, other activities) with the insured assigning and paying benefits. If in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the specified years, the insured person was on maternity leave and (or) on parental leave, the corresponding calendar years (calendar year) at the request of the insured person, they can be replaced for the purpose of calculating the average earnings by the previous calendar years (calendar year), provided that this leads to an increase in the amount of the benefit.
(Part 1 as amended by Federal Law No. 343-FZ of 08.12.2010)
1.1. If the insured person had no earnings during the periods specified in this Article, and also if the average earnings calculated for these periods, calculated for a full calendar month, are lower than the minimum wage established by federal law on the day of the onset of of an insured event, the average earnings, on the basis of which benefits for temporary disability, pregnancy and childbirth, and the monthly allowance for child care are calculated, are taken equal to the minimum wage established by federal law on the day of the insured event. If the insured person at the time of the occurrence of the insured event works part-time (part-time work week, part-time work), the average earnings, on the basis of which benefits are calculated in these cases, is determined in proportion to the duration of the insured person's working time. At the same time, in all cases, 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 for Citizens with Children".
(Part 1.1 was introduced by Federal Law No. 343-FZ of 08.12.2010)
2. The average earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth, and the monthly allowance for child care are calculated, include all types of payments and other remuneration in favor of the insured person, for which insurance premiums to the Social Insurance Fund of the Russian Federation are accrued 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".
(as amended by Federal Laws No. 213-FZ of 24.07.2009, No. 343-FZ of 08.12.2010, No. 276-FZ of 29.12.2012)
2.1. For the insured persons specified in this Federal Law, the average earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth, and the monthly allowance for child care are calculated, are taken equal to the minimum wage established by federal law on the day of the insured event. At the same time, 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 for Citizens with Children".
(Part two.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
2.2. For insured persons who work under employment contracts concluded with organizations and individual entrepreneurs, for whom reduced rates of insurance premiums are applied in accordance with parts 3.3 and 3.4 of Article 58 and with Article 58.1 of the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Fund Social Insurance of the Russian Federation, the Federal Compulsory Medical Insurance Fund", the average earnings, on the basis of which benefits for temporary disability, pregnancy and childbirth, and the monthly allowance for child care are calculated, include all types of payments and other remuneration in favor of the insured person, which included in the base for calculating insurance premiums to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law "On insurance premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" in the corresponding calendar year and do not exceed the maximum value of the base for calculating insurance premiums to the Social Insurance Fund of the Russian Federation, established in this calendar year. Information about 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 submitted by the insured in accordance with this Federal Law.
(Part 2.2 was introduced by Federal Law No. 276-FZ of December 29, 2012)
3. The average daily earnings for calculating temporary disability benefits are determined by dividing the amount of accrued earnings for the period specified in this article by 730.
(as amended by Federal Laws No. 213-FZ of 24.07.2009, No. 343-FZ of 08.12.2010, No. 21-FZ of 25.02.2011)
Note:
For the calculation of the maximum average daily earnings for calculating benefits for temporary disability, for pregnancy and childbirth, see background information.
3.1. The average daily earnings for the calculation of the maternity allowance, the monthly allowance for child care is determined by dividing the amount of accrued earnings for the period specified in 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 pay in accordance with the legislation of the Russian Federation, if insurance contributions to the Social Insurance Fund of the Russian Federation are paid for this period in accordance with the Federal Law "On insurance contributions to the Pension Fund of the Russian Federation Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" were not charged.
(Part 3.1 as amended by Federal Law No. 21-FZ of February 25, 2011 (as amended on December 29, 2012))
3.2. Average earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth and a monthly allowance for child care are calculated, are taken into account for each calendar year in an amount not exceeding that established in accordance with the Federal Law "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 corresponding calendar year limit value bases for calculating insurance premiums to the Social Insurance Fund of the Russian Federation. In the event that the appointment and payment of benefits to the insured person for temporary disability, pregnancy and childbirth are carried out by several insurers in accordance with this Federal Law, the average earnings on the basis of which these benefits are calculated are taken into account for each calendar year in an amount not exceeding the specified limit amount, when calculating these benefits by each of these insurers.
(Part 3.2 was introduced by Federal Law No. 21-FZ of February 25, 2011 (as amended on December 29, 2012))
Note:
Taking into account the features leap year, which is 366 calendar days, billing period when determining the average daily earnings for calculating the maternity allowance, the monthly allowance for child care can be 730 calendar days, 731 calendar days, 732 calendar days (Information from the FSS of the Russian Federation).
3.3. The average daily earnings for calculating the maternity allowance, the monthly allowance for child care, determined in accordance with this article, cannot exceed the amount determined by dividing by 730 the sum of the marginal values of the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation, established 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" for two calendar years preceding the year of maternity leave, parental leave.
(Part 3.3 was introduced by Federal Law No. 276-FZ of December 29, 2012)
4. The amount of the daily allowance for temporary disability, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the benefit, established as a percentage of the average earnings in accordance with this Federal Law.
5. The amount of benefits for temporary disability, for pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary disability, maternity leave.
5.1. The monthly child care allowance is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings determined in accordance with this Article by 30.4.
(Part Five.1 was introduced by Federal Law No. 213-FZ of 24.07.2009, as amended by Federal Laws No. 343-FZ of 08.12.2010, No. 21-FZ of 25.02.2011)
5.2. The amount of the monthly allowance for child care is determined by multiplying the average earnings of the insured person by the amount of the allowance established as a percentage of the average earnings in accordance with this Federal Law. When caring for a child during an incomplete calendar month, the monthly child care allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month falling on the period of care.
(Part Five.2 was introduced by Federal Law No. 213-FZ of July 24, 2009)
7. Features of the procedure for calculating benefits for temporary disability, for pregnancy and childbirth, monthly benefits for caring for a child, including for certain categories of insured persons, are determined by the Government of the Russian Federation.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. The insured assigns benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for child care within 10 calendar days from the date of the insured person's application for its receipt with necessary documents. Payment of benefits is carried out by the insured on the next day after the assignment of benefits, set for the payment of wages.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
2. The territorial body of the insurer, in the cases provided for by this Federal Law, assigns and pays benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care within 10 calendar days from the date of receipt of the relevant application and necessary documents by the territorial body of the insurer .
(as amended by Federal Laws No. 213-FZ of 24.07.2009, No. 343-FZ of 08.12.2010, No. 169-FZ of 01.07.2011)
2.1. If the insured person does not have a certificate (certificates) on the amount of earnings necessary for the assignment of these benefits in accordance with this Federal Law on the day of applying for benefits for temporary disability, pregnancy and childbirth, monthly childcare benefits, the corresponding benefit is assigned on the basis of information and documents provided by the insured person and available to the insured (the territorial body of the insurer). After the insured person submits the specified certificate (certificates) on the amount of earnings, the assigned benefit is recalculated for the entire past time, but not more than three years preceding the day the certificate (certificates) on the amount of earnings is submitted.
(Part 2.1 was introduced by Federal Law No. 343-FZ of December 8, 2010)
3. Assigned, but not received by the insured person in a timely manner, benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care is paid for the entire past time, but not more than three years prior to applying for it. Benefit not received by the insured person in whole or in part due to the fault of the insured or the territorial body of the insurer, is paid for the entire past time without limitation by any period.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
4. The amounts of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care, overpaid to the insured person, cannot be recovered from him, except for cases of accounting error and dishonesty on the part of the recipient (submission of documents with knowingly incorrect information, including certificates (certificates) on the amount of earnings from which these benefits are calculated, concealment of data affecting the receipt of benefits and its amount, other cases). The deduction is made in the amount of not more than 20 percent of the amount due to the insured person for each subsequent payment of benefits or his salary. When the payment of benefits or wages is terminated, the remaining debt is collected in court.
(as amended by Federal Laws No. 213-FZ of 24.07.2009, No. 343-FZ of 08.12.2010)
5. Accrued amounts of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care, not received due to the death of the insured person, are paid in the manner prescribed by the civil legislation of the Russian Federation.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
(introduced by Federal Law No. 343-FZ of 08.12.2010)
1. Individuals and legal entities are responsible for the accuracy of the information contained in the documents issued by them to the insured person and necessary for the appointment, calculation and payment of benefits for temporary disability, for pregnancy and childbirth, and the monthly allowance for child care.
2. If the submission of false information entailed the payment of excessive amounts of benefits for temporary disability, pregnancy and childbirth, monthly childcare benefits, the guilty persons compensate the insurer for the damage caused in the manner established by the legislation of the Russian Federation.
1. The insurance period for determining the amount of benefits for temporary disability, for pregnancy and childbirth (insurance period) includes periods of work of the insured person under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
1.1. The length of service, along with the periods of work and (or) other activities that are provided for in this article, includes 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 the pension provision of persons who underwent military service, service in the internal affairs bodies, the State Fire Service, bodies for the control of the circulation of narcotic drugs and psychotropic substances, institutions and bodies of the penitentiary system, and their families.
(part one.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
2. Calculation of the insurance experience is made in calendar order. In the event of coincidence in time of several periods counted in the length of service, one of such periods is taken into account at the choice of the insured person.
3. The rules for calculating and confirming the insurance period are established by the federal executive body, which performs the functions of developing state policy and legal regulation in the field of social insurance.
(as amended by Federal Law No. 213-FZ of July 24, 2009)
1. Establish that citizens who started work under an employment contract, official or other activities during which they are subject to compulsory social insurance, before January 1, 2007 and who before January 1, 2007 had the right to receive temporary disability benefits in in the amount (as a percentage of average earnings) exceeding the amount of the benefit (as a percentage of average earnings) due in accordance with this Federal Law, temporary disability benefits are assigned and paid in the same higher amount (as a percentage of average earnings) , but not higher than established in accordance with this Federal Law maximum size temporary disability benefits.
2. In the event that the duration of the insurance experience of the insured person, calculated in accordance with this Federal Law for the period before January 1, 2007, turns out to be less than the duration of its continuous seniority applied in the appointment of benefits for temporary disability in accordance with the previous regulatory legal acts, for the same period, the duration of the insurance period is taken as the duration of the continuous work experience of the insured person.
1. This Federal Law applies to insured events that occur after the day this Federal Law enters into force.
2. For insured events that occurred before the day this Federal Law came into force, benefits for temporary disability, for pregnancy and childbirth are calculated in accordance with the norms of this Federal Law for the period after the day it comes into force, if the amount of the benefit calculated in accordance with this Federal Law by law, exceeds the amount of benefits due under the norms of the previous legislation.
2. From January 1, 2007, legislative acts and other regulatory legal acts of the Russian Federation, which provide for the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance, are applied to the extent that they do not contradict this Federal Law.
President of Russian Federation
V. Putin
This document, as amended by the Federal Law of July 24, 2009 N 213-FZ, is applied when assigning, calculating and paying benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for caring for a child for insured events that occurred after the date of entry into force of the Federal Law of 07/24/2009 N 213-FZ See help
| December 29, 2006 | N 255-FZ |
State Duma
Federation Council
(as amended by Federal Laws of February 9, 2009 N 13-FZ,
2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an accident at work or an occupational disease, with the exception of the provisions of Articles 12, , and this Federal Law applicable to these relations in the part that does not contradict Federal Law of July 24, 1998 N 125-FZ "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. Citizens of the Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing in the territory of the Russian Federation, are 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 holding public positions of the Russian Federation, public positions of a constituent entity of the Russian Federation, as well as municipal positions filled on a permanent basis;
4) members of a production cooperative who take personal labor participation in its activities;
5) clergy;
6) persons sentenced to deprivation of liberty and involved in paid work.
2. Persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with this Federal Law are insured persons.
3. Lawyers, individual entrepreneurs, members of peasant (farm) households, individuals who are not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in accordance with the procedure established by the legislation of the Russian Federation), members of family (tribal) communities of indigenous small 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 of 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
4. Insured persons are entitled to receive 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 Business". Persons who voluntarily entered into relations under compulsory social insurance in case of temporary disability and in connection with motherhood acquire the right to receive insurance coverage, subject to the payment of insurance premiums within the period specified in Article 4.5 of this Federal Law.
5. Persons working under labor contracts, for the purposes of this Federal Law, shall be recognized as persons who have concluded an employment contract in accordance with the established procedure, 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, constituent entities of the Russian Federation may also establish other payments for the provision of federal state civil servants, state civil servants of the constituent entities of the Russian Federation in case of temporary disability and in connection with motherhood, financed accordingly at the expense of the federal budget, budgets subjects of the Russian Federation.
Article 2.1. Policyholders
1. Financial support for expenses for the payment of insurance coverage to insured persons is 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 clause 1 of part 2 of this article.
2. Temporary disability benefit 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 under 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 starting 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 on compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Article 4.5 of this Federal Law, at the expense of the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
3. Temporary disability benefit in the cases provided for in clauses 2-5 of part 1 of Article 5 of this Federal Law shall be paid to insured persons at the expense of the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.
4. Financial support for additional expenses for the payment of benefits for temporary disability, for pregnancy and childbirth, related to the offset in the insurance record of the insured person of the periods of service specified in Part 1.1 of Article 16 of this Federal Law, during which the citizen was not subject to compulsory social insurance in case of temporary disability and in connection with motherhood, is carried out at the expense of interbudgetary transfers from the federal budget, provided for these purposes to the budget of the Social Insurance Fund of the Russian Federation. Determination of the volume of interbudgetary transfers from the federal budget provided to the budget of the Social Insurance Fund of the Russian Federation to finance additional expenses, in terms of the periods of the specified service that took place before January 1, 2007, is not made if these periods are taken into account when determining the duration of the insurance period in accordance with article 17 of this Federal Law.
5. In cases established by the laws of the Russian Federation, federal laws, financial support for the costs of paying insurance coverage in amounts in excess of those established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood is carried out at the expense of interbudgetary transfers from the federal budget provided by for the specified purposes to 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 deprivation of liberty and involved in paid work is carried out in the manner determined by the Government of the Russian Federation.
2. When the insured person receives aftercare in a sanatorium and resort facility located on the territory of the Russian Federation, immediately after inpatient treatment, temporary disability benefits are paid for the period of stay in a sanatorium and resort facility, but not more than 24 calendar days (with the exception of tuberculosis) .
3. An insured person recognized as a disabled person in accordance with the established procedure is paid temporary disability benefits (except for tuberculosis) for no more than four consecutive months or five months in a calendar year. If these persons fall ill with tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity or until the day the disability group is reviewed due to tuberculosis.
4. An insured person who has entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as an insured person whose illness or injury occurred in the period from the date of conclusion of the employment contract until the day of its cancellation, temporary disability benefits (except for tuberculosis) is paid for no more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity (disability determination). In this case, the insured person, whose illness or injury occurred in the period from the date of conclusion of the employment contract until the day of its cancellation, is paid temporary disability benefits from the day from which the employee was supposed to start work.
5. Temporary disability benefit, if it is necessary to take care of 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 joint stay with the child in an inpatient medical institution, but not more than 60 calendar days in a calendar year for all cases of caring for this child, and in case of illness of a child included in the list of diseases determined by the federal executive body responsible for the development of 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 for 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 joint stay with a child in an inpatient medical institution, but not more than 45 calendar days in a calendar year in all cases of care for this child;
3) in the case of caring for a sick disabled child under the age of 15 - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical institution, but not more than 120 calendar days in a calendar year for all cases of care for this child;
4) in the case of caring for a sick child under the age of 15 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 with his illness associated with a post-vaccination complication, with malignant neoplasms, including malignant neoplasms of lymphoid, hematopoietic and related tissues - for the entire period of outpatient treatment or joint stay with the child in a hospital medical institution;
6) in other cases of caring for a sick family member in outpatient treatment - no more than 7 calendar days for each case of illness, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
6. 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 found to be carrying bacteria, for the entire time of his suspension from work due to quarantine. If children under the age of 7 attending preschools are subject to quarantine educational institutions, or other family members recognized as legally incompetent, temporary disability benefits are paid to the insured person (one of the parents, other legal representative or other family member) for the entire quarantine period.
7. Temporary disability benefit in the event of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of release from work for this reason, including the travel time to the place of prosthetics and back.
8. Temporary disability benefit is paid to the insured person in all cases specified in parts 1 - of this article, for the calendar days falling on the relevant period, with the exception of calendar days falling on the periods specified in part 1 of article 9 of this Federal Law.
Article 7. The amount of benefits for temporary disability
ConsultantPlus: note.
Benefits for the payment of temporary disability benefits were established by the following regulations: Federal Law of 10.01.2002 N 2-FZ, Federal Law of 07.11.2000 N 136-FZ, Federal Law of 17.09.1998 N 157-FZ, Federal Law of 12.01 .1995 N 5-FZ, Law of the Russian Federation of 06/09/1993 N 5142-1, Law of the Russian Federation of 02/19/1993 N 4520-1, Law of the Russian Federation of 05/15/1991 N 1244-1.
1. Temporary disability benefit in case of disability due to illness or injury, with the exception of cases specified in paragraph 2 of this article, during quarantine, prosthetics for medical reasons and aftercare in sanatorium-resort institutions immediately after inpatient treatment is paid in the following amount:
1) for an insured person with an insurance record of 8 or more years - 100 percent of average earnings;
2) for an insured person with an insurance record of 5 to 8 years - 80 per cent of average earnings;
3) for an insured person with an insurance record of up to 5 years - 60 per cent of average earnings.
2. Temporary disability benefit in case 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 occurring within 30 calendar days after the termination of work under an employment contract, official or other activity during which they are subject to compulsory social insurance.
ConsultantPlus: note.
Benefits for the payment of benefits for the care of a sick child were established by the following regulations: Federal Law of 10.01.2002 N 2-FZ, Federal Law of 17.09.1998 N 157-FZ, Law of the Russian Federation of 15.05.1991 N 1244-1.
3. Temporary disability allowance, if it is necessary to care for a sick child, is paid:
1) in case of 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 paragraph 1 of this Article, for the following days in the amount of 50 percent of the average earnings;
2) in case of inpatient treatment of a child - in the amount determined depending on the duration of the insurance period of the insured person in accordance with paragraph 1 of this article.
4. Temporary disability benefit, if it is necessary to care for a sick family member during his outpatient treatment, except for cases of caring for a sick child under the age of 15, 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. Has become invalid since January 1, 2010. - Federal Law of July 24, 2009 N 213-FZ.
ConsultantPlus: note.
<О ПРИМЕНЕНИИ РАЙОННЫХ КОЭФФИЦИЕНТОВ К ЗАРАБОТНОЙ ПЛАТЕ ПРИ ОПРЕДЕЛЕНИИ РАЗМЕРОВ ПОСОБИЙ ПО ОБЯЗАТЕЛЬНОМУ СОЦИАЛЬНОМУ СТРАХОВАНИЮ>">Letter
6. An insured person who has an insurance period of less than six months is paid a temporary disability benefit in an amount not exceeding the minimum amount for a full calendar month.
7. Temporary disability benefit for the period of downtime is paid in the same amount in which wages are maintained during this time, but not more than the amount of benefit that the insured person would receive under 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 incapacity for work of the regimen prescribed by the attending physician;
2) non-appearance of the insured person without good reason at the appointed time for a medical examination or for a medical and social examination;
ConsultantPlus: note.
On the issue concerning the procedure for establishing a causal relationship between alcohol consumption and injury and disease, see the FSS of the Russian Federation of 04/15/2004 N 02-10 / 07-1843<О ПОРЯДКЕ ПРИМЕНЕНИЯ ПП. Б П. 27 ПОЛОЖЕНИЯ О ПОРЯДКЕ ОБЕСПЕЧЕНИЯ ПОСОБИЯМИ ПО ГОСУДАРСТВЕННОМУ СОЦИАЛЬНОМУ СТРАХОВАНИЮ, УТВ. ПОСТАНОВЛЕНИЕМ ПРЕЗИДИУМА ВЦСПС ОТ 12.11.1984 N 13-6>"> letter of the FSS of the Russian Federation dated 04/15/2004 N 02-10 / 07-1843.
3) illness or injury resulting from alcohol, narcotic, toxic intoxication or actions related to such intoxication.
2. If there are one or more grounds for reducing the temporary disability benefit specified in Part 1 of this article, the temporary disability benefit is paid to the insured person in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in districts and localities in which, in accordance with the established procedure, regional coefficients for wages are applied - in an amount not exceeding the minimum wage, taking into account these coefficients:
1) if there are grounds specified in paragraphs 1 and part 1 of this article - from the day when the violation was committed;
2) if there are grounds specified in paragraph 3 of paragraph 1 of this article - for the entire period of incapacity for work.
Article 9 Grounds for refusing to grant temporary disability benefits
1. Temporary disability benefit is not assigned to the insured person for the following periods:
1) for the period of the employee's release from work with full or partial pay or without pay in accordance with the legislation of the Russian Federation, except for cases of disability by the 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 accrued 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 grant an insured person temporary disability benefits are:
1) the onset of temporary incapacity for work as a result of the intentional infliction by the insured person of harm to his health or a suicide attempt established by the court;
2) the onset of temporary disability due to the commission of an intentional crime by the insured person.
Article 10. Duration of payment of benefits for pregnancy and childbirth
1. The benefit for pregnancy and childbirth is paid to the insured woman in total for the entire period of maternity leave lasting 70 (in case of multiple pregnancy - 84) calendar days before childbirth and 70 (in case of complicated childbirth - 86, in case of birth of two or more children - 110) calendar days after childbirth.
2. When adopting a child (children) under the age of three months, the pregnancy and childbirth allowance shall be paid from the date of its adoption until the expiration of 70 (in case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).
3. If during the period of a mother's leave to care for a child until the child reaches the age of one and a half years, she has a maternity leave, she has the right to choose one of the two types of benefits paid during the periods of the corresponding holidays.
Article 11. The amount of benefits for pregnancy and childbirth
1. The benefit for pregnancy and childbirth is paid to an insured woman in the amount of 100 percent of the average earnings.
2. Has become invalid since January 1, 2010. - Federal Law of July 24, 2009 N 213-FZ.
ConsultantPlus: note.
On the issue concerning the application of district coefficients in determining the amount of benefits for compulsory social insurance, see the FSS of the Russian Federation dated 02.12.2002 N 02-18 / 05-8417<О ПРИМЕНЕНИИ РАЙОННЫХ КОЭФФИЦИЕНТОВ К ЗАРАБОТНОЙ ПЛАТЕ ПРИ ОПРЕДЕЛЕНИИ РАЗМЕРОВ ПОСОБИЙ ПО ОБЯЗАТЕЛЬНОМУ СОЦИАЛЬНОМУ СТРАХОВАНИЮ>"> Letter of the FSS of the Russian Federation dated 02.12.2002 N 02-18 / 05-8417.
3. An insured woman who has an insurance period of less than six months is paid a pregnancy and childbirth benefit in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which district coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
1. Temporary disability benefit is granted if the application for it was followed no later than six months from the date of restoration of working capacity (disability determination), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and aftercare.
2. The benefit for pregnancy and childbirth is assigned if the application was followed no later than six months from the date of the end of the maternity leave.
2.1. Monthly allowance for child care is assigned if the application was followed no later than six months from the day the child reaches the age of one and a half years.
Law of July 24, 2009 N 213-FZ)
3. When applying for a benefit for temporary disability, for pregnancy and childbirth, a monthly benefit for caring for a child after a six-month period, the decision to grant the benefit is made by the territorial body of the insurer 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 responsible for developing state policy and legal regulation in the field of social insurance.
Article 13
1. Appointment and payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care are carried out by the insured at the place of work (service, other activity) of the insured person (except for the cases specified in parts 3 and this article).
2. If the insured person is employed by several insurers, benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by the insurers at all places of work (service, other activities), and the monthly allowance for child care - by the insurant at one place work (service, other activities) at the choice of the insured person.
3. An insured person who 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 activities, during which he was subject to compulsory social insurance in case of temporary disability and in connection with motherhood, temporary allowance disability is assigned 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 part 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 benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for caring for a child, or in if it is impossible to pay them by the insured due to insufficient funds in his account in credit institution and applying the order of debiting funds from the account provided for by the Civil Code of the Russian Federation, the appointment and payment of these benefits are carried out by the territorial body of the insurer.
5. To assign and pay benefits for temporary disability, for pregnancy and childbirth, the insured person submits a certificate of incapacity for work issued by a medical organization in the form and in the manner established by the federal executive body that performs 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 the average earnings from which the benefit should be calculated, and documents, determined by the specified federal executive body, confirming the insurance record.
6. In order to assign and pay a monthly allowance for child care, the insured person submits an application for the assignment of the said allowance, a birth (adoption) certificate of the child being cared for, and a copy of it or an extract from the decision on establishing custody of the child, a birth certificate (adoption, death) of the previous child (children) 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 protection authorities at the place of residence of the mother (father) of the child on non-receipt of a monthly allowance for child care. If a monthly child care allowance is assigned and paid by the insurer's territorial body, the insured person shall also provide information on average earnings from which the specified allowance must be calculated.
7. An insured person employed by several insurers, when applying to one of the indicated insurers of his choice for the appointment and payment of a monthly child care allowance, along with the documents provided for in paragraph 6 of this article, submits a certificate (certificates) from the place of work (service , other activities) from another insurant (from other insurers) that the appointment and payment of a monthly allowance for child care by this insurant is not carried out.
8. The insured pays benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care to the insured person in the manner established for the payment of wages (other payments, remuneration) to insured persons.
9. In case of appointment and payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care by the territorial body of the insurer, provided for in paragraph 4 of this article, payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care is carried out in the established amounts by the territorial body of the insurer that assigned these benefits, through the organization of the federal postal service, credit or other organization at the request of the recipient.
Article 14
1. Benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months of work (service, other activities) with this insured, preceding the month of temporary disability, vacation maternity leave, parental leave. If the insured person did not have a period of work (service, other activities) immediately before the onset of the specified insured events due to temporary disability, maternity leave or parental leave, the relevant benefits are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months of work (service, other activities) with this policyholder, preceding the month of the previous insured event.
(part one as amended by Federal Law No. 213-FZ of July 24, 2009)
2. The average earnings, on the basis of which benefits for temporary disability, pregnancy and childbirth, and the monthly allowance for child care are calculated, include all types of payments and other remuneration in favor of the employee, which are included in the base for calculating insurance premiums 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".
(Part two as amended by Federal Law No. 213-FZ of July 24, 2009)
2.1. For insured persons specified in Part 3 of Article 2 of this Federal Law, the average earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth, and the monthly allowance for child care are calculated, are taken equal to the minimum wage established by federal law on the day of the onset of insured event. At the same time, 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 for Citizens with Children".
(Part two.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
3. The average daily earnings for the calculation of benefits for temporary disability, for pregnancy and childbirth, the monthly allowance for child care is determined by dividing the amount of accrued earnings for the period specified in part 1 of this article by the number of calendar days falling on the period for which wages are taken into account.
ConsultantPlus: note.
For the calculation of the maximum average daily earnings for calculating benefits for temporary disability, for pregnancy and childbirth, see Reference Information.
3.1. The average daily earnings from which benefits for temporary disability, pregnancy and childbirth are calculated cannot exceed the average daily earnings, determined by dividing the maximum value 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". 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 "on the day of the insured event, by 365. If the appointment and payment of the specified benefits to the insured person are carried out by several insurers in accordance with part 2 Article 13 of this Federal Law, the average daily earnings from which these benefits are calculated may not exceed the average daily earnings determined on the basis of the specified limit, when calculating these benefits to each of these insurers.
(Part three.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
4. The amount of the daily allowance for temporary disability, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the benefit, established as a percentage of the average earnings in accordance with this Federal Law.
5. The amount of benefits for temporary disability, for pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary disability, maternity leave.
5.1. The monthly child care allowance is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings determined in accordance with paragraph 3 of this article by 30.4. The average earnings from which the monthly allowance for child care is calculated cannot exceed the average earnings, determined by dividing the maximum value 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 Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds" on the day of the occurrence of the insured event, on 12.
(Part Five.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
5.2. The amount of the monthly allowance for child care is determined by multiplying the average earnings of the insured person by the amount of the allowance established as a percentage of the average earnings in accordance with Article 11.2 of this Federal Law. When caring for a child during an incomplete calendar month, the monthly child care allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month falling on the period of care.
(Part Five.2 was introduced by Federal Law No. 213-FZ of July 24, 2009))
Article 15
1. The insured assigns benefits for temporary disability, for pregnancy and childbirth, a monthly allowance for caring for a child within 10 calendar days from the date of the insured person's application for receiving it with the necessary documents. Payment of benefits is carried out by the insured on the next day after the assignment of benefits, set for the payment of wages.
4. The amounts of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care, overpaid to the insured person, cannot be recovered from him, except for cases of accounting error and dishonesty on the part of the recipient (submission of documents with knowingly incorrect information, concealment of data affecting the receipt of benefits and its amount, other cases). The deduction is made in the amount of not more than 20 percent of the amount due to the insured person for each subsequent payment of benefits or his salary. When the payment of benefits or wages is terminated, the remaining debt is collected in court.
Article 16
1. The insurance period for determining the amount of benefits for temporary disability, for pregnancy and childbirth (insurance period) includes periods of work of the insured person under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with motherhood.
1.1. The length of service, along with the periods of work and (or) other activities that are provided for in part 1 of this article, includes 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 pensions for persons who served in the military, served in the internal affairs bodies, the State Fire Service, bodies for the control of the circulation of narcotic drugs and psychotropic substances, institutions and bodies of the penitentiary system, and their families.
(part one.1 was introduced by Federal Law No. 213-FZ of July 24, 2009)
2. Calculation of the insurance experience is made in calendar order. In the event of coincidence in time of several periods counted in the length of service, one of such periods is taken into account at the choice of the insured person.
Article 17
1. Establish that citizens who started work under an employment contract, official or other activities during which they are subject to compulsory social insurance, before January 1, 2007 and who before January 1, 2007 had the right to receive temporary disability benefits in in the amount (as a percentage of average earnings) exceeding the amount of the benefit (as a percentage of average earnings) due in accordance with this Federal Law, temporary disability benefits are assigned and paid in the same higher amount (as a percentage of average earnings) , but not higher than the maximum amount of temporary disability benefits established in accordance with this Federal Law.
2. In the event that the duration of the insurance period of the insured person, calculated in accordance with this Federal Law for the period before January 1, 2007, turns out to be less than the duration of his continuous work experience used when assigning benefits for temporary disability in accordance with the previous regulatory legal acts , for the same period, the length of the insurance period is taken as the duration of the continuous work experience of the insured person.
Article 18
1. This Federal Law applies to insured events that occur after the day this Federal Law enters into force.
2. For insured events that occurred before the day this Federal Law came into force, benefits for temporary disability, for pregnancy and childbirth are calculated in accordance with the norms of this Federal Law for the period after the day it comes into force, if the amount of the benefit calculated in accordance with this Federal Law law, exceeds the amount of benefits due under the norms of the previous legislation.
Article 19. Entry into force of this Federal Law
2. From January 1, 2007, legislative acts and other regulatory legal acts of the Russian Federation providing for the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance, shall be applied to the extent that does not contradict this Federal Law.
The president
Russian Federation
Moscow Kremlin
1. Benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care are calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of temporary disability, maternity leave, parental leave, including for 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 insurant (other insurers) are not taken into account in cases where, in accordance with Part 2 of Article 13 of this Federal Law, benefits for temporary disability, pregnancy and childbirth are assigned and paid to the insured person for all places of work (service, other activities) based on the average earnings for the time of work (service, other activities) with the insured assigning and paying benefits. If in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the specified years, the insured person was on maternity leave and (or) on parental leave, the corresponding calendar years (calendar year) at the request of the insured person, they can be replaced for the purpose of calculating the average earnings by the previous calendar years (calendar year), provided that this leads to an increase in the amount of the benefit.
Arbitration Court of Primorsky Territory (AC Primorsky Territory)
The insured was assigned and paid a pregnancy and childbirth allowance, an allowance for caring for a second child in an overestimated amount. In violation of h. 3.1 .Art. 14 of the Federal Law of December 29, 2006 No. 255-FZ “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood”, Inopt No. 1 LLC unreasonably underestimated the number ...
Arbitration Court of the Kamchatka Territory (AC of the Kamchatka Territory)
When calculating the maternity allowance Safronova E.Yu., and it was established that the calculation of the amount of this allowance was made in violation of part 1.1 of Article 14 of the Federal Law of December 29, 2006 No. 255-ФЗ “On Compulsory Social Insurance in Case of Temporary Disability and connection with motherhood ”(hereinafter - Law No. 255-FZ), since Safonova ...
Arbitration Court of the Republic of Tyva (AC of the Republic of Tyva)
Child care is carried out simultaneously by several persons, the right to receive a monthly allowance for child care is granted to one of these persons. Articles 11.2, 13, 14 of Federal Law No. 255-FZ establish the amount, procedure for assigning, paying and calculating the monthly child care allowance. By virtue of Article 256 of the Labor Code of the Russian Federation, upon application ...
Arbitration Court of the Ulyanovsk Region (AC of the Ulyanovsk Region)
2016 -145,002.81 rubles). As the fund pointed out, the monthly allowance for child care is calculated in accordance with parts 3.1 and 3.2 of Art. 14, h.h. 5.1, 5.2 Art. 14, part 1, art. 11.2 of Law No. 255-FZ. The amount of the monthly allowance for child care Bashaeva A.A. in...
E. L. Jabazyan, Chief Editor
Amendments made Federal Law No. 343-FZ dated 08.12.2010, changed the rules for calculating benefits for temporary disability, pregnancy and childbirth, as well as the monthly allowance for child care. In the material presented, we answered the main questions related to the payment of benefits.
How are benefits calculated in 2011?
Changes made Federal Law No. 343-FZ, touched upon the procedure for calculating benefits for temporary disability, for pregnancy and childbirth, and the monthly allowance for child care. At the same time, the following has changed:
– settlement period for which the earnings of the insured person are taken into account when calculating benefits;
- the procedure for determining the average earnings for the calculation of benefits;
– Benefit calculation procedures.
Definition of the billing period. Yes, according to Part 1 Art. 14 of the Federal Law of December 29, 2006 No. 255-FZ benefits will be calculated on the basis of the average earnings of the insured person, calculated for two calendar years preceding the year of the occurrence of the insured event, including for the time of work (service, other activities) with another insurant (other insurers).
For persons who, in the two calendar years immediately preceding the year of temporary disability, maternity leave, parental leave, or in one of the indicated years, were on maternity leave and (or) on maternity leave child, Federal Law No. 255-FZ it is possible to replace the corresponding calendar years (calendar year) with the previous calendar years (calendar year) at the request of the insured person, provided that this will lead to an increase in the amount of the benefit.
Calculation of average earnings. According to Part 2 Art. fourteen in the new edition from 2011, the average earnings, based on which benefits are calculated, will include all types of payments and other remunerations in favor of the insured person, which are accrued in the FSS (this year, the average earnings include all types of payments and other remunerations in favor of employee, which are included in the base for calculating insurance premiums to the FSS). At the same time, the specified average earnings must be taken into account for each calendar year in an amount not exceeding the amount established in accordance with Federal Law No. 212-FZ for the corresponding calendar year, the maximum value of the base for calculating insurance premiums to the fund. For the period up to January 1, 2010, and for persons working under employment contracts with insurers applying special tax regimes, - for the period up to January 1, 2011, the maximum value of the base is 415,000 rubles. for each calendar year Art. 2 Federal Law No. 343-FZ).
It should be noted that since 2011, the norm on limiting the average daily earnings of the insured person when calculating benefits for temporary disability, pregnancy and childbirth by the average daily earnings, determined by dividing the maximum value of the base for calculating insurance premiums by 365 (for the monthly allowance for child care - the rule on limiting the average earnings of the insured person by the average earnings, determined by dividing the maximum value of the base for calculating insurance premiums by 12).
The average daily earnings of the insured person is determined by dividing the amount of accrued earnings for the billing period by 730 (Part 3, Article 14 of Federal Law No. 255-FZ). That is, the number of calendar days falling on the period for which it is taken into account, from 2011 will not matter when calculating benefits.
Benefit Calculation Procedure. For clarity, we present the algorithm for calculating benefits before and after the entry into force of the amendments made Federal Law No. 343-FZ.
The procedure for calculating benefits |
The procedure for calculating benefits |
1. Definition of average earnings |
|
Average earnings are calculated for last 12 calendar months work (service, other activities) with this insured preceding the month of temporary disability, maternity leave, parental leave |
Average earnings are calculated for the two calendar years preceding the year temporary disability, maternity leave, parental leave, including for the time of work (service, other activities) with another policyholder (other policyholders) |
2. Determination of the average daily earnings
|
|
Average daily earnings are determined by dividing the amount of total earnings by the number of calendar days falling on the period for which wages are taken into account. |
Average daily earnings are determined by dividing the amount of accrued earnings by 730 |
We determine the average earnings based on the maximum value of the base for calculating insurance premiums (415,000 rubles / 365) |
|
We compare the average earnings calculated on the basis of the actual salary and the marginal value of the base. The indicator with a lower value is used to determine the amount of the daily allowance |
|
3. Determining the amount of daily allowance |
|
The amount of the daily allowance for temporary disability, pregnancy and childbirth allowance is calculated by multiplying the average daily earnings of the insured person by the amount of the allowance, set as a percentage of the average earnings in accordance with Art. 7 and 11 of Federal Law No.255-FZ |
|
4. Determining the amount of the benefit |
|
The amount of benefits for temporary disability, pregnancy and childbirth is determined by multiplying the amount of the daily allowance by the number of calendar days falling on the period of temporary disability, maternity leave |
|
Who to apply for benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care?
Federal Law No. 343-FZ the approach to determining the insured who appoints and pays insurance coverage to the insured person has been changed in the following cases.
1. If the insured person is employed by several policyholders at the time of the insured event and was employed by the same policyholders in the two previous calendar years:
- allowances for temporary disability, pregnancy and childbirth are assigned and paid to him by insurers at all places of work (service, other activity) and are calculated based on the average earnings for the time of work (service, other activity) with the insured assigning and paying the allowance (excluding earnings from another insured);
- monthly is assigned and paid by the insured at one place of work (service, other activity) at the choice of the insured person.
2. If the insured person at the time of the insured event is employed by several policyholders, and in the previous two calendar years was employed by other policyholders (another policyholder), the above benefits are assigned and paid to him by the policyholder at one of the last places of work (service, other activity) at the choice of the insured person.
3. If the insured person at the time of the occurrence of the insured event is employed by several insurers, and in the two previous calendar years was employed both by these and other insurers (another insured), benefits for temporary disability, for pregnancy and childbirth are assigned and paid to him :
- or for all places of work (service, other activity) based on the average earnings for the time of work (service, other activity) with the insured who assigns and pays the allowance;
- or by the insured at one of the last places of work (service, other activities) at the choice of the insured person.
For convenience, we will present all the options for assigning and paying benefits to insured persons in the table.
Option |
|||
Base |
Part 2 Art. 13 Federal Law No. 255-FZ |
Part 2.1 Art. 13 Federal Law No. 255-FZ |
Part 2.2 Art. 13 Federal Law No. 255-FZ |
What benefits? |
temporary disability benefit, maternity allowance, monthly child care allowance |
temporary disability benefit, maternity allowance |
|
Where is the payment made? |
For each place of work (service, other activity) |
One place of work (service, other activity) |
Either for each place of work (service, other activity), or for one place of work |
What are the conditions for choosing an option? |
At the time of the occurrence of the insured event, the insured person is employed by several employers who were also employed in the previous two calendar years |
At the time of the insured event, the insured person is employed by several employers, and in the previous two calendar years was employed by other employers (another employer) |
At the time of the occurrence of the insured event, the insured person is employed by several employers, and in the previous two calendar years was employed both by the same and other employers (another employer) |
Potapov D. M. works at Organization A LLC and part-time at Organization B LLC. On February 7, 2011, he submitted a disability certificate to Organization A LLC from 01/27/2011 to 02/04/2011. D. M. Potapov’s insurance experience is 3 years 8 months, and he is entitled to a 60% allowance. The following income information is available for the two years prior to the onset of disability.
In accordance with the norm h. 2 Article. 13 of Federal Law No. 255-FZ D. M. Potapov applied for benefits for each place of work.
Calculation of benefits in organization A:
- average daily earnings - 684.93 rubles. ((210,000 + 290,000) rubles / 730);
- daily allowance - 410.96 rubles. (684.93 rubles x 60%);
- the amount of the benefit - 7,388.64 rubles. (410.96 rubles x 9 days).
Calculation of benefits in organization B:
- average daily earnings - 321.92 rubles. ((95,000 + 140,000) rubles / 730);
- daily allowance - 193.15 rubles. (321.92 rubles x 60%);
- the amount of the benefit - 1,738.35 rubles.
The average earnings for the time of work (service, other activities) with another insurant (other insurers) should not be taken into account in cases where benefits for temporary disability, pregnancy and childbirth are in force Part 2 Art. 13 Federal Law No. 255-FZ are assigned and paid to the insured person at all places of work (service, other activities). At the same time, the average earnings are taken into account for each calendar year in an amount not exceeding the maximum base for calculating insurance premiums to the FSS for the corresponding calendar year by each insured (for 2009 and 2010 - 415,000 rubles for each specified calendar year) ( Part 3.1 of Art. 14 of Federal Law No. 255-FZ).
Let's change and supplement the conditions of example 1. At the choice of the employee, the allowance is assigned and paid by Organization A LLC. Suppose that in 2009 D. M. Potapov also worked at Organization B LLC, while the information on his income is as follows.
The average salary must include:
- for 2009 - 305,000 rubles. (210,000 + 95,000);
- for 2010 - 415,000 rubles. (415,000 rubles.< 430 000 руб. (290 000 + 140 000)).
First, let's determine the average daily earnings. It will amount to 986.30 rubles. ((305,000 + 415,000) rubles / 730).
In what cases is the calculation of benefits based on the minimum wage?
Article 14 of the Federal Law No. 255-FZ was supplemented by part 1.1 (paragraph “b”, paragraph 9 of Article 1 of the Federal Law No. 343-FZ). This part provides for the rule on the calculation of benefits based on the minimum wage established by federal law on the day of the insured event, in the following situations:
– if the insured person had no earnings during the above periods;
- if the average earnings calculated for the above periods, calculated for a full calendar month, are lower than the minimum wage established by federal law on the day of the insured event.
If at the time of the insured event the insured person works part-time, the average earnings, on the basis of which benefits are calculated in these cases, is determined in proportion to the duration of the insured person's working time.
It should be noted that in all cases the calculated monthly childcare allowance cannot be less than the minimum amount of the monthly childcare allowance established by Federal Law No. 81-FZ of May 19, 1995"On State Benefits for Citizens with Children".
According from part 1.1 of Art. 14 Federal Law No. 255-FZ Minimum wage applied without taking into account the regional coefficient.
How many days of disability are paid at the expense of the employer?
In 2010, the insured paid at his own expense only the first two days of temporary disability. Now the burden on policyholders has increased - they will have to pay for the first three days of sick leave. Item 2 tbsp. 1 Federal Law No. 343-FZ changes have been made to p. 1 h. 2 art. 3 Federal Law No. 255-FZ. According to the new wording of this paragraph, temporary disability benefits are paid to insured persons (with the exception of insured persons who voluntarily entered into legal relations under 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 three days of temporary disability at the expense of the insured, and for the rest of the period starting from the 4th day of temporary disability at the expense of the budget of the Social Insurance Fund of the Russian Federation.
Recall that insured persons who voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with Art. 4.5 Federal Law No. 255-FZ, the payment of benefits is made at the expense of the FSS budget from the 1st day of temporary disability.
Payment of benefits for temporary disability at the expense of the insured is carried out in the cases specified in p. 1 h. 1 art. 5 Federal Law No. 255-FZ, namely in case of disability due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization.
What rules of law should be followed during the transition period?
Federal Law No. 343-FZ provides for the possibility of recalculating benefits to insured persons for the period from January 1, 2011 according to the norms Federal Law No. 255-FZ in a new edition for insured events that occurred in 2010 and continued or ended in 2011. Such a recalculation is possible provided that the amount of the benefit calculated in accordance with Federal Law No. 255-FZ in the new edition, will exceed the amount of the allowance, which is due according to the norms Federal Law No. 255-FZ as amended until January 1, 2011 ( Art. 3 Federal Law No. 343-FZ).
What to pay attention to when paying temporary disability benefits for a period of downtime?
Paragraph 6 of Art. 1 Federal Law No. 343-FZ changes have been made to Art. 7"Amount of temporary disability benefit" Federal Law No. 255-FZ. In particular, the new edition contains part 7 of this article. According to the new rules, in case of temporary disability that occurred before the downtime period and continues during the downtime period, the temporary disability benefit for the downtime period is paid in the same amount as wages are maintained during this time, but not more than the amount of the temporary disability benefit, which the insured person would receive according to the general rules.
Besides, Part 1 Art. 9“Periods for which temporary disability benefits are not assigned. Grounds for refusing to grant temporary disability benefits Federal Law No. 255-FZ supplemented by clause 5 (clause 7, article 1 of Federal Law No. 343-FZ). In accordance with the newly introduced norm, temporary disability benefits are not assigned to the insured person for the period of downtime, with the exception of cases provided for Part 7 of Article 7 of this Federal Law.
What is included in the list of documents required for the calculation and payment of benefits?
In accordance with Part 5 Art. 13 Federal Law No. 255-FZ(before changes Federal Law No. 343-FZ) in order to assign and pay benefits for temporary disability, pregnancy and childbirth, the insured person had to submit to the employer a certificate of incapacity for work issued by a medical organization.
subparagraph "c" paragraph 8 of Art. 1 Federal Law No. 343-FZ named part Federal Law No. 255-FZ presented in a new edition. Now, if the insured person is employed by several employers, it is additionally necessary to submit a certificate (certificates) on the amount of earnings from which the allowance should be calculated from the place (s) of work (service, other activity) from another insurant (from other insurers) .
In addition, in the cases referred to in Parts 2.1 and 2.2 of Art. 13 Federal Law No. 255-FZ, the insured person, when applying for benefits for temporary disability, pregnancy and childbirth to the insured at one of the last places of work (service, other activity), at the choice of the insured person, also submits a certificate (certificates) from the place of work (service, other activity) from another policyholder (from other policyholders) that the appointment and payment of benefits by this policyholder are not carried out ( Part 5.1 Art. 13 Federal Law No. 255-FZ).
In order to assign and pay a monthly child care allowance in accordance with the insured person, the insured person submits an application for the assignment of the specified allowance, a birth (adoption) certificate of the child being cared for, and a copy of it or an extract from the decision on establishing custody of the child, a certificate of birth (adoption, death) of the previous child (children) 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 receive 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 protection authorities at the place of residence of the mother (father) of the child on non-receipt of a monthly childcare benefits. In the event that a monthly child care allowance is assigned and paid by the insurer's territorial body, the insured person shall also provide information on average earnings, on the basis of which the specified allowance should be calculated.
Subparagraph "e" of paragraph 8 of Art. 1 Federal Law No. 343-FZ second sentence Part 6 Art. 13 Federal Law No. 255-FZ is set out as follows: in order to assign and pay a monthly allowance for child care, the insured person also, if necessary, submits a certificate (certificates) on the amount of earnings from which the allowance should be calculated.
The insured person, instead of the original certificate of the amount of earnings, on the basis of which benefits for temporary disability, pregnancy and childbirth, monthly allowance for child care, may be submitted a copy of the certificate of the amount of earnings, certified in the prescribed manner ( Part 7.1 of Art. 13 of Federal Law No. 255-FZ).
According to Part 7.2 Art. 13 Federal Law No. 255-FZ in the event that the insured person is unable to submit a certificate (certificates) on the amount of earnings, on the basis of which the allowance should be calculated, from the place (places) of work (service, other activity) with another insurant (with other insurers) in connection with the termination activity by this policyholder (these policyholders) or for other reasons, the policyholder appointing and paying the benefit, at the request of the insured person, sends a request to the territorial body of the Pension Fund of the Russian Federation for the provision of information on wages, other payments and remunerations of the insured person from the relevant policyholder (relevant policyholders) on the basis of information of individual (personalized) accounting in the system of compulsory pension insurance.
The form of the specified application of the insured person, the form and procedure for sending a request, the form, procedure and terms for submitting the requested information by the territorial body of the Pension Fund of the Russian Federation are established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance.
Policyholders and insured persons: what additional rights, duties and responsibilities are established for them by Federal Law No. 255-FZ?
From 2011, policyholders will be required to issue to the insured person on the day of termination of work or upon his written application a certificate of the amount of earnings for two calendar years preceding the year of termination of work or the year of applying for a certificate, and the current calendar year for which insurance premiums were accrued (Clause 3, Part 2, Article 4.1 of Federal Law No. 255-FZ). The form and procedure for issuing this certificate must be approved by the Ministry of Health and Social Development.
For the accuracy of the information contained in the documents issued to the insured person and necessary for the appointment, calculation and payment of benefits, the insurers will be responsible ( Art. 15.1 of Federal Law No. 255-FZ).
The insured who appoints and pays benefits to the insured person is also entitled to send requests to the territorial bodies of the FSS in order to verify information about the insured person (insured persons) who issued (have issued) to the insured person a certificate (certificates) on the amount of earnings necessary for calculating benefits ( p. 4 h. 1 art. 4.1 Federal Law No. 255-FZ). The form and procedure for sending such requests will be approved by the Ministry of Health and Social Development.
In turn, the insured person has the right to receive from the insured a certificate of the amount of earnings necessary for calculating benefits. (Clause 2, Part 1, Article 4.3 of Federal Law No. 255-FZ). For insured persons, liability is provided for the submission of documents with knowingly false information, including certificates (certificates) on the amount of earnings, on the basis of which these benefits are calculated ( Part 4 Art. 15 of Federal Law No. 255-FZ).
In conclusion, we note that according to clause 5 of the Order of the FSS of the Russian Federation of December 14, 2010 No. 269"On the organization of work on the implementation of the Federal Law" On Amendments to the Federal Law "On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity", the managers of the regional branches of the FSS should take organizational measures with employees of the regional branches of the fund and their branches, as well as with policyholders on the application of new norms established by federal legislation governing the procedure for calculating and paying temporary disability and maternity benefits from January 1, 2011, to ensure explanatory work in connection with the implementation Federal Law No. 343-FZ. In particular, the FSS issued Letter dated December 14, 2010 No. 02 03 17/05-13765, in which officials of the department listed the main changes that come into force in the new year. Unfortunately, additional explanations and comments on the law were not given in the said letter.
