Project “Direct Social Insurance Payments” in 2020
The FSS pilot project has currently been introduced in 69 regions of the Russian Federation. The full list of participating entities can be found in this article. From January 2022, it is planned to extend the direct payments project to the entire territory of Russia.
The mechanism of the pilot project is as follows:
- The employee provides the employer with sick leave and all related documents confirming the insured event. The deadline for submitting a certificate of incapacity for work and other documents confirming the occurrence of an insured event is 6 months after the end of the sick leave.
- The employer submits a package of documents to the Social Insurance Fund within 5 days.
- Within 10 days, the Social Insurance Fund checks the papers provided by the employer and issues a decision on the appointment or refusal to pay benefits.
- The benefit is transferred to the employee’s current account or transferred by post. If any documents are missing or are drawn up incorrectly, the FSS will send a notice to the employer. Within 5 days, the policyholder is obliged to replace them or provide the missing documents.
This approach allows you to avoid errors in the assignment and payment of benefits, protect the policyholder from paying benefits on a fake sick leave, and guarantee the insured person timely payment of funds.
The following types of benefits are paid in the “direct payments” system:
- for pregnancy and childbirth (B&C);
- for child care;
- at the birth of a child;
- when registering in the early stages of pregnancy;
- in case of injury at work;
- due to illness.
The algorithm for calculating benefits has not changed: benefits for the first 3 days of an employee’s illness are also paid from the employer’s funds. In addition, the employer pays a funeral benefit and 4 additional days of caring for disabled children. The FSS reimburses the employer for the costs of the last two insured events.
Participation in the Direct Payments pilot project is mandatory for all policyholders registered in this region. The exception is separate divisions that do not have a current account and do not pay wages to employees. Provided that the parent organization is located in a region where the pilot project has not yet been introduced.
Is it possible to do this to an employee who is on sick leave?
Can they be fired while on sick leave? It is possible to carry out dismissal, which is complicated by the employee being on sick leave. The law allows such an action, but only if there is the initiative of the employee himself.
In accordance with Article 81 of the Labor Code, an organization does not have the right to fire a person who has taken leave due to illness . But every rule has its exceptions. It is the cessation of the existence of an organization, for example, its liquidation or bankruptcy.
ATTENTION : The most favorable situation for terminating an employment relationship is the existence of an agreement between two parties who made a mutual decision to dismiss.
What documents are needed for a pilot project?
In case of illness or leave due to employment and labor regulations, request the following package of documents from the employee:
- sick leave: paper or electronic bulletin number;
- certificates of the amount of earnings received from other policyholders for the 2 years preceding the year of the insured event;
- application for payment of benefits (according to the form from Appendix No. 1 of the Order of the Social Insurance Fund of November 24, 2017 No. 578).
The application is filled out by the employee in block letters and with a black pen. The document can be filled out on a computer and printed. An application from the employee is taken in any case.
Application form to the Social Insurance Fund from an employee (pilot project)
Sample application to the Social Insurance Fund from an employee (pilot project)
In certain insurance cases, the following additional documents may be required:
| Benefit, payment | Documentation |
| One-time benefit when registering in the early stages of pregnancy | Certificate from the medical institution that registered the employee |
| One-time benefit for the birth of a child |
If the parents are divorced, a certificate of divorce and a certificate of cohabitation with the child must be submitted |
| Monthly allowance for child care up to 1.5 years |
|
| Accident or injury at work |
|
| To reimburse benefits | |
| Payment for additional days to care for a disabled child | A copy of the order granting additional days off |
| Funeral benefit | Death certificate |
When filling out a sick leave form, do not fill in the following cells:
- “at the expense of the Social Insurance Fund”;
- “Total accrued.”
Sample of filling out a sick leave certificate by an employer (pilot project)
How to submit documents on direct payments to the Social Insurance Fund
The method of transmitting data to the Social Insurance Fund depends on the average number of employees of the employer:
- 25 people or more - documents, including the register of information, are sent to the FSS in electronic form;
- 24 people or less - documents, including an inventory, can be sent to the FSS both electronically and on paper.
Let's consider each of the methods.
Direct payments: electronic register
The register can be filled out in relation to one or more employees who applied for various types of social benefits during the last 5 calendar days. Data for each employee must be indicated in a separate line of the register. If there is no data to fill out any columns, dashes are placed in them.
Fill out the register taking into account the following features:
- If the employee will receive benefits on the Mir card, the address of residence in column 7 does not need to be filled in.
A number of benefits from the Social Insurance Fund are paid only to the Mir card. You can find out more about this here.
- In column 19 “Cause of disability”, transfer the code from the sick leave certificate.
- When replacing years in the billing period, in column 37 “Calculation period”, indicate the date of the employee’s application on the basis of which the replacement is made.
- In columns 39 and 40 “Amount of average earnings for the billing period,” indicate the larger of the values: the base for calculating benefits or 24 times the minimum wage.
- In column 42 “Other information affecting the right to receive benefits or the calculation of its amount,” indicate the details of certificates in Form 182n from previous employers or the size of the coefficient if the employee works in an area where the regional coefficient is applied.
Within 5 calendar days, submit the originals of the above documents to Social Security. The FSS will return them after checking and assigning benefits (refusal to pay).
Registry form in the Social Insurance Fund (pilot project)
Sample of filling out the register in the Social Insurance Fund (pilot project)
Procedure for filling out the register
Inventory of documents in the Social Insurance Fund: pilot project
If the average number of employees is 24 or less, fill out a list of applications and documents instead of a register. The inventory form is given in Appendix No. 2 to Order No. 578 of the Federal Social Insurance Fund of the Russian Federation dated November 24, 2017.
Inventory form in the Social Insurance Fund (pilot project)
Sample of filling out the inventory (pilot project)
Can an employee be fired while he is on sick leave?
The Labor Code prohibits employers from firing employees while they are incapacitated . This is expressly enshrined in Art. 81 Labor Code of the Russian Federation. In this case, dismissal is, in principle, possible only on certain grounds listed in this article:
- insufficient qualifications of the employee;
- systematic failure to fulfill labor duties without significant reasons;
- disclosure of secrets protected by law, etc.
Frequent sick days are not listed in this series (can they be fired for frequent sick days?).
Dismissal of an employee who is on vacation or sick leave will be legal only in one case - liquidation of the enterprise or termination of the activities of an individual entrepreneur.
The ban on dismissal during illness does not apply if the employee wants to leave work himself. That is, it is possible to terminate the employment relationship with a sick employee only with his consent . That is, the basis must be a statement of resignation of one’s own free will or a written agreement of the parties. The same applies to those who have a sick child.
If the employer initiated the termination of the relationship, and the employee brought sick leave, opened by the date of dismissal, then there is no such basis for restoring the employment relationship.
But the date of dismissal must be moved to the first day after sick leave. If a notice of dismissal has already been entered into the employment record, it will need to be corrected.
How to reflect benefits in the calculation of insurance premiums
The calculation of insurance premiums was approved by Order of the Federal Tax Service dated September 18, 2019 No. ММВ-7-11/ [email protected] Fill it out as usual. Prepare Appendix No. 2 to Section 1 taking into account the following features:
- in field 001 “Payer tariff code”, enter code “1”;
- enter zeros on pages 070 and 080.
Do not include Schedules 3 and 4 to Section 1 unless the policyholder paid the benefit before participating in the pilot project. For example, if the region in which the employer is registered joins the project in the middle of the year or the company registered in the region participating in the project after moving. In this case, complete Appendices 3 and 4 only for the benefit costs incurred prior to participating in the pilot project.
Useful information from Consultant+
Question: The organization participating in the pilot project of the Federal Social Insurance Fund of the Russian Federation is in the process of liquidation. One of the employees is disabled and will continue to be sick after dismissal and liquidation of the organization. How can such an employee receive temporary disability benefits? How much is this benefit paid? See the answer here.
Let's sum it up
- In regions that have joined the Direct Payments project, benefits are transferred to the employee directly from the Social Insurance Fund.
- The list of documents submitted by the employer participating in the pilot project to the Social Insurance Fund depends on the insured event.
- If the number of employees is 25 people or more, documents and the register are transferred to the Social Insurance Fund only in electronic form.
- If the average number of employees is 24 people or less, documents and inventory can be submitted to the Social Insurance Fund both on paper and electronically.
Letter of guarantee to the Social Insurance Fund stating that benefits were not assigned or paid: sample
08/18/2021 2 Views
A letter of guarantee to the Social Insurance Fund is a document that must be provided to assign the required type of financial assistance.
About benefits and their recipients Assistance is provided by the state on a one-time basis. The specified nature of support is not provided according to the criteria defined in the legislative document.
In legislative and regulatory acts one can find categories of persons who have the right to receive social assistance from the state.
