Фз n 255 tests according to the law. New rules for calculating temporary disability benefits, pregnancy and childbirth benefits, monthly childcare benefits
1. The policyholder shall assign temporary disability benefits, maternity benefits, a monthly childcare allowance within 10 calendar days from the date the insured person applies for it with the necessary documents. The payment of benefits is carried out by the insured on the next day after the appointment of benefits established for the payment of wages.
2. The territorial body of the insurer in the cases provided for by parts 3 and 4 of Article 13 of this Federal Law, appoints and pays benefits for temporary disability, pregnancy and childbirth, a monthly allowance for caring for a child within 10 calendar days from the date of receipt by the territorial body of the insurer relevant statement and necessary documents.
2.1. If the insured person does not have on the day of applying for temporary disability benefits, maternity benefits, a monthly childcare allowance certificate (certificates) on the amount of earnings required to assign these benefits in accordance with parts 5 and 6 of Article 13 of this Federal of the law, the corresponding benefit is assigned on the basis of information and documents provided by the insured and available to the insured (territorial body of the insurer). After the insured person submits the indicated certificate (s) 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 are submitted.
3. Assigned but not received by the insured person in a timely manner allowance for temporary disability, maternity leave, a monthly allowance for child care is paid for all the past time, but not more than three years prior to applying for it. The benefit not received by the insured person in whole or in part through the fault of the insured or the territorial body of the insurer is paid for all past time without any time limit.
4. Amounts of temporary disability benefits, maternity allowance, monthly childcare benefits paid excessively to the insured person cannot be collected from him, except for cases of a counting 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 the specified benefits are calculated, concealment of data affecting the receipt of the benefit and its size, other cases). The deduction is made in the amount of not more than 20 percent of the amount due to the insured person at each subsequent payment of the benefit, or his salary. Upon termination of the payment of benefits or wages, the remaining debt is recovered in court.
5. The accrued amounts of temporary disability benefits, maternity benefits, and monthly childcare benefits not received in connection with the death of the insured person are paid in accordance with the procedure established by the civil legislation of the Russian Federation.
1. Temporary disability benefits, maternity benefits, monthly childcare benefits are calculated on the basis of the average earnings of the insured person calculated for two calendar years preceding the year of the onset of temporary disability, maternity leave, maternity leave, including during the time of work (service, other activities) with another policyholder (other policyholders). The average earnings for the time of work (service, other activities) with another insurer (other insurers) are not taken into account if, in accordance with Part 2 of Article 13 of this Federal Law, temporary disability benefits, maternity benefits are assigned and paid to the insured person for all places of work (service, other activities) based on average earnings for the time of work (service, other activities) of the insured, appointing and paying benefits. In the event that in two calendar years immediately preceding the year of occurrence of the specified insured events, or in one of the indicated years, the insured person was on maternity leave and (or) on maternity leave, the corresponding calendar year (calendar year) at the request of the insured person, they may be replaced in order to calculate the average earnings in the previous calendar years (calendar year), provided that this will lead to an increase in the amount of benefits.
1.1. In the event that the insured person had no earnings during the periods specified in Part 1 of this Article, as well as if the average earnings calculated for these periods per full calendar month are lower than the minimum wage established by federal law by the day of the occurrence of the insured event, the average earnings, on the basis of which the benefits for temporary disability, maternity, the monthly allowance for child care are calculated, are taken equal to the minimum wage, mouth copulating federal law on the day of the insured event. If the insured person is working on a part-time basis (part-time week, part-time day) at the time of the insured event, the average earnings, based on which benefits are calculated in these cases, are determined in proportion to the length of the work time of the insured person. Moreover, 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 to citizens with children."
2. The average earnings, on the basis of which temporary disability benefits, maternity benefits, and the monthly childcare allowance are calculated, include all types of payments and other benefits for the benefit of the insured, for which insurance contributions to the Social Insurance Fund of the Russian Federation are charged in accordance with the Federal Law of July 24, 2009 N 212-ФЗ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Fund for Mandatory Medical Health Insurance "(for the period ending December 31, 2016 inclusive) and (or) in accordance with the Russian legislation on taxes and fees (since 1 January 2017).
2.1. To the 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, maternity leave, and a monthly allowance for caring for a child are calculated, are taken equal to the minimum wage established by federal law on the day of occurrence 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 to citizens with children."
2.2. For insured persons who worked under employment contracts concluded with organizations and individual entrepreneurs, for whom a reduced rate of insurance contributions to the Social Insurance Fund of the Russian Federation was applied in the amount of 0 percent, in the average earnings, on the basis of which benefits for temporary disability, for pregnancy are calculated and maternity leave, a monthly allowance for child care, all types of payments and other benefits for the benefit of the insured person are included, which are included in the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with Federal Law of July 24, 2009 N 212-ФЗ "On Insurance Contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Compulsory Medical Insurance Fund" (for the period of 31 December 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (starting from January 1, 2017) in the corresponding calendar year and do not exceed the maximum base for the number of insurance contributions to the Social Insurance Fund of the Russian Federation established in this calendar year. Information on the specified payments and remuneration in favor of the insured person for the relevant period is indicated in the certificate of the amount of earnings issued by the policyholder in accordance with Clause 3 of Part 2 of Article 4.1 of this Federal Law.
3. The average daily earnings for calculating temporary disability benefits is determined by dividing the amount of accrued earnings for the period specified in paragraph 1 of this article by 730.
3.1. The average daily earnings for calculating the maternity allowance, the monthly childcare allowance is determined by dividing the amount of accrued earnings for the period specified in paragraph 1 of this article by the number of calendar days in this period, with the exception of calendar days falling on the following periods :
1) periods of temporary disability, maternity leave, parental leave;
2) the period of the employee’s exemption from work with full or partial retention of wages 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 of July 24, 2009 N 212-ФЗ "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" (for the period of 31 December In 2016, inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (from January 1, 2017).
3.2. Average earnings, on the basis of which temporary disability benefits, maternity benefits and a monthly childcare allowance are calculated, are taken into account for each calendar year in an amount not exceeding that established in accordance with Federal Law of July 24, 2009 N 212-ФЗ " On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund "(for the period through December 31, 2016 inclusive) and (or) in accordance with the law atelstvom the Russian Federation on taxes and fees (since 1 January 2017) for the relevant calendar year, the limit value base for calculating premiums to the Fund of the Russian Social Insurance. In the event that the assignment and payment of benefits to the insured person for temporary disability, pregnancy and childbirth are carried out by the territorial bodies of the insurer at the place of registration of several policyholders in accordance with parts 2 and 4 of Article 13 of this Federal Law, the average earnings on the basis of which these benefits are calculated, is taken into account for each calendar year in an amount not exceeding the specified limit value, when calculating these benefits for each of these insurers.
3.3. The average daily earnings for calculating the maternity allowance, the monthly childcare allowance, determined in accordance with part 3.1 of this article, cannot exceed the amount determined by dividing by 730 the sum of the maximum values \u200b\u200bof the base for calculating insurance contributions to the Russian Social Insurance Fund Federation established in accordance with Federal Law of July 24, 2009 N 212-ФЗ "On insurance contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Ф Integral Compulsory Medical Insurance Fund "(for the period through December 31, 2016 inclusive) and (or) in accordance with the legislation of the Russian Federation on taxes and fees (from January 1, 2017) for two calendar years preceding the year of the start of maternity leave and childbirth, parental leave.
4. The amount of the daily allowance for temporary incapacity for work, for pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the allowance established as a percentage of average earnings in accordance with Articles 7 and 11 of this Federal Law.
5. The amount of the allowance for temporary disability, maternity leave is determined by multiplying the size of the daily allowance by the number of calendar days per period of temporary disability, maternity leave.
5.1. The monthly childcare allowance is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings, determined in accordance with parts 3.1 and 3.2 of this article, by 30.4.
5.2. The amount of the monthly childcare allowance is determined by multiplying the average earnings of the insured person by the amount of the allowance established as a percentage of average earnings in accordance with Article 11.2 of this Federal Law. When caring for a child for an incomplete calendar month, the monthly childcare allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month falling on the period of care.
6. Has lost force.
7. Features of the procedure for calculating temporary disability benefits, maternity benefits, monthly childcare benefits, including for certain categories of insured persons, are determined by the Government of the Russian Federation.
255-FZ of December 29, 2006 regulates relations in the field of material support for women in the postpartum period and other needy persons on sick leave. The regulatory act establishes the circle of citizens with the right to cash payments. Consider the main provisions of the document.
Action specifics
Law 255-FZ defines:
- Types of material support.
- Obligations and legal possibilities of subjects of law.
- Sizes, procedure, conditions for the provision of material support.
The normative act "does not apply to relations relating to money transfers to citizens who are unable to perform professional tasks due to work-related injuries or occupational diseases. There are a number of exceptions to this rule. They are determined by the provisions of Articles 12-15 of the act in question, to the extent not inconsistent with Federal Law No. 125.
Subject of regulation
Normative act " On compulsory social insurance in case of temporary disability and in connection with motherhood " defines situations in which subjects can rely on material support. The document provides primarily a definition of risk. It refers to a temporary loss of earnings or other income, compensation to a citizen due to the occurrence of an insured event. The risks are also equivalent to the costs incurred by the subject or his relatives if it is impossible to perform their professional tasks in accordance with the job description.
When does material support depend?
Temporary disability it is made at:
- Inability to carry out work due to injury or illness. The exception is the receipt or occupational disease, as well as other circumstances specified in Article 5 of the normative act under consideration.
- Pregnancy and childbirth.
- Care for minors up to 1.5 years.
- The birth of children (baby).
- The death of a subject or minor family member.
Types of collateral
These include payments:
The sizes, conditions, and procedure for providing security are established by regulatory acts No. 81 of May 19, 1995, No. 8 of January 12. 1996 as well Federal Law 255-FZ.
Subjects of law
Law 255-FZ applies to:
Changes
Consider some provisions Adjustments to the normative act were made several times. The changes, in particular, related to the procedure for calculating the amount of payments for caring for minors, R&D, as well as for temporary incapacity for work. The rules are established by article 14 of the normative act in question. In 2016, the amendments introduced by Federal Law No. 213 dated July 24, 2009 are in force. This article determines that the average citizen's earnings are used in the calculation of amounts. It, in turn, is established for 2 years (calendar) that preceded the period of disability, leave associated with the antenatal and labor periods, as well as care for the young. The term includes all periods of professional activity, even if it was conducted at other enterprises.
A comment
Federal Law 255 provides these rules only for situations in which the subject of law, who has worked in different organizations for the previous two years, receives collateral at one enterprise. If he is accrued amounts in each institution in which he is in the state, the average earnings are not taken into account. If in both or in one of the two calendar years a citizen was on maternity leave or pregnancy / childbirth leave, the corresponding periods can be replaced for calculation, provided that this operation leads to an increase in the amount of security. For this, the person concerned writes a written statement.
Calculation of the average salary
255-FZ in the new edition of 2016 establishes that all amounts transferred in favor of a citizen are included in earnings. Moreover, they must be deducted contributions to the FSS, FFOMS, PFR. Amounts sent to these funds up to December 31 are taken into account. 2016. When determining the average earnings, deductions established by the Tax Code may also be taken into account. The latter provision will be enforced from Jan 1. 2017. The scheme for calculating earnings is defined as follows. The amount of the calculated salary for the one established in the first part of article 14 is divided by the number of calendar days in it. In this case, days that relate to periods are excluded from the calculation:
Maternity Benefit Calculator
First of all, it should be said that until 2013, 2 methods of calculation were used. Currently, the determination of the amount is carried out in one way. The following information is entered into the maternity allowance calculator:
- Duration of vacation. It depends on the number of children and the presence / absence of complications. 140 days are set for a single, unproblematic pregnancy, 156 for a problematic and 194 for a multiple.
- Earnings for 2 years. As mentioned above, this period is the years preceding the period of going on vacation. At the same time, the date of the hospital, and not the birth, is of importance. Only a full year can be taken into account - from January 1 to December 31. The amount of earnings is taken full, without deduction of personal income tax.
- Settlement days. Their number is 730 or 731 (depending on whether the period is a leap year or not). From the number of days it should be deducted: the period of illness, leave for biomedical care or care for the young, as well as the period of exemption from the performance of professional duties with the preservation of salaries and without deduction of contributions to funds.
One nuance should be noted here. No other periods may reduce the number of billing days. So, if a woman worked directly for only 1 year for 2 years, and the rest of the time she was unemployed, the number 730 (731) will be used in determining the amount.
Calculation Formulas
Establishes the following calculation rules. To determine the amount of daily support in case of loss of ability to perform professional duties, BiR average earnings are multiplied by the coefficient established by Art. 7 and 11.2. The following formula is used to calculate the monthly amount. When determining it, it is necessary to calculate the average value of earnings. It is calculated by multiplying the daily payment by 30.4. It, in turn, is determined by the rules of article 14 (parts 3.1 and 3.2). The amount of the monthly child care payment is calculated by multiplying the average earnings by a coefficient, in accordance with Art. 11.2.
Bets
Law 255-FZ sets the coefficients in Art. 7 and 11.2. Calculation of amounts in case of loss of ability to perform professional tasks due to injury or illness is carried out using interest rates on average earnings. They are set depending on the duration of the insurance period:
- 8 years or more - 100%.
- 5-8 years - 80%.
- Up to 5 years - 60%.
The exception is situations when an injury or illness occurred within a month from the date of termination of employment. In these cases, a rate of 60% of the average salary is used.
Care for a sick child
In the case of outpatient treatment during the first 10 days (calendar), the amount is calculated in accordance with the rates specified in article 7 (part 1), at a rate of 50% on the following days. When a child is in the hospital, the order of the first part of article 7 is used. Similar rules apply in cases of the need to care for a sick relative, except for children under 15 years of age, with outpatient treatment.
Monthly security
Child care allowance is charged at 40% of the average earnings. In this case, the amount of the resulting amount should not be lower than established by regulatory enactments for persons with children. When caring for two or more minors who have reached 1.5 years, the amount of security is added up. Moreover, its value cannot be more than 100% of the average citizen's earnings, established in accordance with Art. 14. When calculating the monthly amounts for the second and subsequent children, the previous minors, including those adopted, are taken into account. The exception is cases when, in relation to the latter, the mother is deprived of parental rights.
1. The allowance for temporary disability in the event of disability due to illness or injury shall be paid to the insured person for the entire period of temporary disability until the day of the restoration of disability (determination of disability), with the exception of cases specified in parts 3 and 4 of this article.
2. When treating the insured person in a sanatorium-resort organization located on the territory of the Russian Federation, immediately after rendering medical care in stationary conditions, temporary disability benefits are paid for the period of stay in the sanatorium-resort organization, but not more than 24 calendar days (for except for tuberculosis).
3. The insured person, recognized in the established manner as a disabled person, temporary disability benefits (except for tuberculosis disease) shall be paid no more than four consecutive months or five months in a calendar year. In case of illness of these persons with tuberculosis, temporary disability benefit is paid until the day of restoration of disability or until the day of revision of the disability group due to tuberculosis.
4. The insured person who entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as to the insured person whose illness or injury occurred from the day the labor contract was concluded until the day of its cancellation, temporary disability benefit (except tuberculosis diseases) is paid for not more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefit is paid until the day of the restoration of disability (determination of disability). At the same time, the insured person whose illness or injury occurred from the day the labor contract was concluded until the day it was canceled, temporary disability benefit is paid from the day from which the employee was supposed to start work.
5. The temporary disability allowance, if necessary, to care for a sick family member is paid to the insured person:
1) in the case of caring for a sick child under the age of 7 years - for the entire period of treatment of the child on an outpatient basis or joint stay with the child in a medical organization while providing him with medical care in stationary conditions, but not more than 60 calendar days in a calendar year in all cases of caring for this child, and in the case of a child’s disease, included in the list of diseases determined by the federal executive body, which carries out the functions of developing and implementing state policy and standards VNO-legal regulation in the sphere of public health, not more than 90 calendar days per calendar year for all cases of care for this child in connection with the said 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 treating a child on an outpatient basis or staying with a child in a medical organization while providing him with medical care in stationary conditions, but no more than 45 calendar days in a calendar year for all cases of caring for this child;
3) in the case of caring for a sick disabled child under the age of 18 years - for the entire period of treatment of the child on an outpatient basis or joint stay with the child in a medical organization while providing him with medical care in stationary conditions, but not more than 120 calendar days in calendar year for all cases of care for this child;
4) in the case of caring for a sick child under the age of 18 who is HIV-infected - for the entire period of joint stay with the child in a medical organization while providing him with medical care in stationary conditions;
5) in the case of caring for a sick child under the age of 18 years with his illness associated with 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 shared with a child in a medical organization while providing him with medical care in stationary conditions;
6) in other cases of caring for a sick family member during outpatient treatment - no more than 7 calendar days for each case of the disease, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.
6. The temporary disability benefit in case of quarantine is paid to the insured person who has been in contact with an infectious patient or who has been diagnosed with bacteriocarrier, for the entire time that he has been suspended from work due to quarantine. If children under the age of 7 years attending preschool educational institutions or other family members recognized as legally incapable are quarantined, temporary disability benefits are paid to the insured person (one of the parents, another legal representative or another family member) for the entire quarantine period .
7. The allowance for temporary incapacity for work in the case of prosthetics for medical reasons in a stationary specialized institution is paid to the insured person for the entire period of exemption from work for this reason, including travel time to the place of prosthetics and vice versa.
8. The temporary disability benefit is paid to the insured in all cases specified in parts 1 to 7 of this article for calendar days falling on the corresponding period, with the exception of calendar days falling on the periods specified in part 1 of article 9 of this Federal Law.
