The Social Insurance Fund of the Russian Federation (hereinafter referred to as the Fund) brings to your attention that on December 8, 2010, the President of the Russian Federation D.A. Medvedev signed Federal Law No. 343-FZ “On Amendments to the Federal Law “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood” (hereinafter Federal Law No. 343-FZ). This federal law came into force on January 1, 2011.
Federal Law No. 343-FZ introduced the following significant changes to Federal Law No. 255-FZ of December 29, 2006 “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood”.
1. In accordance with paragraph 1 of Part 2 of Article 3 of Federal Law No. 255-FZ of December 29, 2006 “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood”, as amended by Federal Law No. 343-FZ (hereinafter referred to as Law No. 255- FZ) the period of payment at the expense of the insured has been increased from two to three days temporary disability benefits in case of illness or injury of the insured person, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization. Currently, the employer pays for the first 2 days of temporary disability (see table No. 1).
2. Changed procedure for calculating benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care (hereinafter referred to as benefits) . At the same time, the changes affected not only the settlement period for which the earnings of the insured person will be taken into account when calculating benefits, but also the procedure for determining the average earnings for their calculation, as well as the procedure for calculating benefits.
So, according to part 1 of article 14 of Law No. 255-FZ, benefits will be calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of occurrence of the insured event, including for the time of work (service, other activities) with another policyholder (other policyholders) (see tables No. 3, 4, 5, 12, 13).
Please note that 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, by virtue of Part 2 of Article 13 of Law No. 255-ФЗ are assigned and are paid to the insured person at all places of work (service, other activities) (see Table No. 3, 5).
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) parental leave , Law No. 255-FZ provides for the possibility of replacing 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 benefits (see table No. 10).
3. 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 previous two 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 who assigns and pays the allowance (without accounting for earnings from another insured) (see tables No. 2, 3);
· a monthly allowance for child care is assigned and paid by the insured at one place of work (service, other activity) at the choice of the insured person (see tables No. 11, 12, 13);
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 (see tables No. 2, 4);
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 by both these and other insurers (another insured), benefits for temporary disability, pregnancy and childbirth are assigned and paid to him (see tables No. 2, 5):
or at 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 (see paragraph 1);
· or by the policyholder at one of the last places of work (service, other activities) at the choice of the insured person (see paragraph 2).
4. Part 1 1 of Article 14 of Law No. 255-FZ provides for a provision on the calculation of benefits based on the minimum wage established by federal law on the day the insured event occurs in cases (see table No. 9):
· 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.
At the same time, it should be borne in mind that if at the time of the occurrence of the insured event the insured person works on a part-time basis, 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 hours (see Table No. 9).
5. According to part 2 of article 14 of Law No. 255-FZ, from 2011, the average earnings, on the basis of which benefits are calculated, will include all types of payments and other remuneration in favor of the insured person, for which insurance contributions to the Fund(in the current year, the average earnings 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 Fund) (see table No. 7).
At the same time, the specified average earnings must be taken into account for each calendar year in an amount not exceeding that established in accordance with Federal Law No. compulsory medical insurance and territorial funds of compulsory medical insurance” for the corresponding calendar year, the maximum amount 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 policyholders applying special tax regimes - for the period up to January 1, 2011, the base limit is 415,000 rubles for each calendar year (Article 2 of Federal Law No. 343-FZ) (see table No. 8).
At the same time, 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 to the Fund on the day of the insured event, by 365 (and for a monthly childcare allowances - 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 to the Fund on the day of the occurrence of the insured event by 12) has been canceled since 2011 (see table No. 6).
Please also note that from next year the average daily earnings of the insured person will be determined by dividing the amount of accrued earnings for the billing period at 730(Part 3 of Article 14 of Law No. 255-FZ). That is, the number of calendar days falling on the period for which wages are taken into account, from 2011 will not matter when calculating benefits (see tables No. 6, 7).
6. Law No. 255-FZ establishes additional rights, duties and responsibilities of policyholders and insured persons.
In particular, 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 the insurance was accrued. contributions (paragraph 3 of part 2 of article 4 1 of Law No. 255-FZ). The form and procedure for issuing this certificate will be approved by the Ministry of Health and Social Development of Russia.
At the same time, the insurers will be 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, which is enshrined in the new article 15 1 of 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 Fund 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 (paragraph 4 part 1 of article 4 1 of Law No. 255-FZ). The form and procedure for sending such requests will be approved by the Russian 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 (paragraph 2 of part 1 of article 4 3 of Law No. 255-FZ). However, insured persons are also liable for submitting documents with knowingly false information, including certificates (certificates) on the amount of earnings from which these benefits are calculated (Part 4 of Article 15 of Law No. 255-FZ).
7. Federal Law No. 343-FZ provides for the possibility of recalculating benefits to insured persons for the period from January 1, 2011 in accordance with the norms of Law No. 255-FZ in a new edition for insured events that occurred in the current year and continued or ended in 2011. Such a recalculation is possible provided that the amount of the benefit calculated in accordance with Law No. 255-FZ in the new version exceeds the amount of the benefit due under the norms of Law No. 255-FZ, as amended, in force before January 1, 2011 (Article 3 of the federal law No. 343-FZ).
In addition, Law No. 255-FZ specifies the rules governing the payment of temporary disability benefits for a period of downtime (part 7 of article 7, paragraph 5 of part 1 of article 9), establishing a list of documents required for the calculation and payment of benefits (parts 5, 5 1, 6, 7 1 of article 13).
In accordance with paragraph 5 of the order of the Fund dated 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 offices of the Fund must conduct organizational measures with employees of the regional branches of the Fund and their branches, as well as with policyholders on the application of new rules established by federal law governing the procedure for calculating and paying benefits for temporary disability and in connection with motherhood from January 1, 2011, to ensure explanatory work in connection with with the implementation of federal law No. 343-FZ.
Federal Law of December 29, 2006 N 255-FZ "On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood" (as amended)
Information about changes:
Federal Law No. 213-FZ of July 24, 2009 reworded the name, which shall enter into force on January 1, 2010.
Federal Law No. 255-FZ of December 29, 2006
"On compulsory social insurance in case of temporary disability and in connection with motherhood"
With changes and additions from:
February 9, July 24, 2009, September 28, December 8, 2010, February 25, July 1, November 28, December 3, 2011, December 29, 2012, April 5, July 2, 23, November 25, 2013 April 2, June 28, July 21, December 1, 31, 2014, December 29, 2015, March 9, July 3, 2016, May 1, 2017, March 7, June 27, 2018
This Federal Law (as amended by Federal Law No. 343-FZ of December 8, 2010) applies when assigning, calculating and paying benefits for temporary disability, for pregnancy and childbirth, and a monthly benefit for caring for a child for insured events that occurred from the date of entry into force. by virtue of the said Federal Law, except for the cases specified in Parts 2 and 3 of Article 3 of the said Federal Law
See comments to this Federal Law
President of Russian Federation
The federal law determines the conditions, amounts and procedure for providing benefits for temporary disability, for pregnancy and childbirth to citizens subject to compulsory social insurance.
Previously, in accordance with paragraph 30 of the Regulations, approved by the Decree of the Presidium of the All-Union Central Council of Trade Unions of November 12, 1984 N 13-6, the amount of the allowance was determined depending on the length of continuous work experience. In accordance with the law, the amount of the benefit depends on the length of the insurance period, which includes periods of work 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. The amount of the temporary disability benefit is: 100% of the average earnings for persons with an insurance record of 8 or more years; 80% - for persons with insurance experience from 5 to 8 years and 60% if the insurance experience is less than 5 years. The benefit for pregnancy and childbirth is paid to an insured woman in the amount of 100% of the average earnings, if she has an insurance period of more than 6 months, otherwise the amount of the benefit should not exceed 1 minimum wage.
It is established that the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year determines the maximum amount of disability benefits, as well as benefits for pregnancy and childbirth.
Temporary disability benefit is granted 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;
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 institution, or another family member recognized as legally incompetent;
4) implementation of prosthetics for medical reasons in a stationary specialized institution;
5) post-treatment in accordance with the established procedure in sanatorium-resort institutions located on the territory of the Russian Federation, immediately after inpatient treatment.
At the same time, temporary disability benefits due to illness or injury are paid for the entire period of disability until the day of restoration of working capacity or the establishment of disability with limited ability to work. Disabled persons are paid temporary disability allowance for no more than four consecutive months or five months in a calendar year, except for the case of tuberculosis. In the event that temporary incapacity for work has occurred as a result of a deliberate infliction of harm to one's health or a suicide attempt established by the court, or as a result of a deliberate crime committed by a person, the award of temporary disability benefits is refused. If temporary disability has occurred due to illness or injury, then the payment of benefits for the first two days of temporary disability is carried out at the expense of the employer, and starting from the third day - at the expense of the Social Insurance Fund. In other cases, the payment of benefits is carried out at the expense of the Fund.
The term for applying for temporary disability benefits, pregnancy and childbirth benefits is six months from the date of restoration of working capacity or the end of maternity leave, respectively. The employer assigns benefits for temporary disability, pregnancy and childbirth within 10 calendar days from the date the person applied for it with the necessary documents and pays benefits on the next day after the appointment, set for the payment of wages.
The federal law comes into force on January 1, 2007 and applies to insured events that occur after the date of its entry into force.
Federal Law of December 29, 2006 N 255-FZ "On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood"
This document has been modified by the following documents:
Federal Law No. 192-FZ of June 28, 2014 (as amended by Federal Law No. 250-FZ of July 3, 2016)
The amendments shall enter into force 10 days after the official publication of the said Federal Law.
The amendments shall enter into force 180 days after the official publication of the said Federal Law.
The amendments shall enter into force on the day of the official publication of the said Federal Law.
The amendments shall enter into force on the day of the official publication of the said Federal Law, with the exception of the addition to Article 14 of Part 3.3, which shall enter into force on January 1, 2013.
The changes come into force on the day of the official publication of the said Federal Law and apply to legal relations that have arisen since January 1, 2011.
Federal Law No. 21-FZ of February 25, 2011 (as amended by Federal Law No. 276-FZ of December 29, 2012)
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Current edition
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 policyholder, 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 insured, preceding the month of the previous insured event.
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".
2.1. For 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, 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”.
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.
3.1. The average daily wage, from which benefits for temporary disability, pregnancy and childbirth are calculated, cannot exceed the average daily wage, 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 occurrence 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.
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 Articles 7 and 11 of 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.
5.2. The amount of the monthly child care allowance 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 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.
Clause 6 - Repealed.
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.
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255-FZ "On compulsory social insurance in case of disability"
Federal Law No. 255 provides disabled citizens with benefits, determines the conditions for receiving and calculates the amount of money. Disabled persons include women in a position who receive monetary compensation for pregnancy and childbirth. Additionally, they are subject to compulsory social insurance under Federal Law-255.
Description of the law
255-FZ on compulsory social insurance in case of disability does not apply to the category of persons with temporary disability received at work. These persons should pay attention to the provisions of the Federal Law on compulsory medical insurance in the Russian Federation.
The law was passed on December 29, 2006. The last changes to FZ-255 were made on May 1, 2017.
Federal Law No. 255 presents the rights of citizens of compulsory insurance. This applies to persons who have received an industrial injury or gone on maternity leave. In case of temporary disability, 255-FZ determines the procedure, amount and conditions of monetary compensation. Depends on the type of grant:
Benefit payment procedure
Article FZ-255 describes the procedure for assigning, the amount and payment of benefits for temporary disability during pregnancy and childbirth, a monthly allowance for child care.
The amount of insurance monetary compensation under Federal Law-255 is determined by the insured, who is assigned to you at the place of work. An insured event has occurred, and the employee is registered in several places of work? The insured person is legally paid benefits for all registered places for the previous two calendar years.
The monthly allowance for child care is paid by the insured only at one place of work.
The payment and amount according to FZ-255 is assigned on the basis of a certificate of incapacity for work. It is issued by a medical institution in the form of a document in writing. It is then legally handed over to the employer for payment. It is possible to transfer in electronic form through the website of the insured.
Sick leave
The procedure for granting a sick leave according to the law is considered in article 13 of the 255-FZ.
When filling out a sick leave, the following points are taken into account:
The doctor fills in the sections and certifies with the seal of the medical institution.
The doctor may not fill in the line - the place of work and the name of the company. The medical worker can independently enter the name of the company with a fountain, black gel or capillary pen. The certificate of incapacity for work cannot be filled in with a ballpoint pen. Ink of a different color is also not allowed.
When filling out a sick leave, according to the law, according to Federal Law-255, the doctor does not have the right to make mistakes. If a discrepancy was found, a duplicate certificate of incapacity for work is issued.
The employer must check the correctness of the form in accordance with FZ-255. If he accepted a sheet with errors, then the FSS of the Russian Federation will not reimburse him for expenses.
Note: The presence in the disability certificate of technical defects in filling out by law is not a basis for creating a duplicate:
Amendments to 255-FZ "On Compulsory Social Insurance in Case of Disability"
Now FZ-255 on compulsory social insurance in case of disability regulates the legal norms on taxes and fees. The law intersects with the Tax Code of the Russian Federation. Federal Law-255 controls the correct calculation, timely and full payment of insurance premiums for reporting periods. Additionally, the following chapters of the law were amended:
Article 3
Article 3 255-FZ states that the provision of insurance payments to insured persons is carried out at the expense of the state budget or at the expense of the insured.
The amount of the allowance is paid according to the law:
Compensation for temporary disability in accordance with paragraphs 2-5 of part 1 of Art. 5 255-FZ is paid from the first day of temporary disability. No changes were made in the latest edition.
Article 5
Temporary disability benefits in FZ-255 are paid in the following cases:
The temporary disability benefit under Federal Law-255 is paid to the insured citizen in accordance with article part 1. Only if he is registered at his official place of work or was injured 30 days after his dismissal.
Article 7
FZ-255 contains the amount of temporary disability benefits in case of a serious illness or injury.
The calculation criteria according to the law are as follows:
- The length of service of the insured person is 8 or more years - the full amount of the average salary is paid (100% of the payment);
- Experience from 5 to 8 years - 80% of the average salary;
- Experience up to five years - 60 percent of the average salary is calculated.
- The prescribed regimen by the doctor was not observed by the patient;
- Non-appearance of the insured person for a scheduled medical examination. Additionally, it was absent during the medical and social research, which is unacceptable in the law;
- The insured person was under the influence of drugs, alcohol or other toxins.
- The employee, by order of the employer, was released from work in whole or in part. The employer continues to calculate the average wage;
- The employee was suspended from service for a good reason for a certain time. In this case, funds for labor activity and disability benefits are not paid;
- The employee tried to commit suicide or caused other harm to his health in accordance with Federal Law-255. Evidence must be presented in court.
The calculation of the allowance under the Nursing Act is as follows:
The first 10 days the amount of the allowance is calculated depending on the length of service in accordance with Federal Law-255. For example, eight years of service provides for 100 percent payment of average earnings. But the health of the patient may not be restored within 10 days. The amount of monetary compensation in this case will be 50 percent of the average wage;
When treating a child in a hospital, the amount of the benefit depends on the length of the insurance period.
Insurance compensation in the amount of the minimum wage is calculated with an official insurance period of less than 6 months in accordance with Federal Law-255. In some regions, coefficients are provided for when calculating by law. For example, the amount of monetary compensation is equal to the size of the average wage + coefficient.
There were no changes in the article in the latest edition.
Article 8
List of grounds for reducing the amount of monetary compensation in FZ-255:
The identification of one or more grounds in the Federal Law-255 helps to reduce the cash benefit to the amount of the minimum wage. The latest version of the law does not contain changes in the article.
Article 9
There are periods for which the amount of monetary compensation for disability is not paid. Payment in accordance with Federal Law-255 may be denied if:
The insured person has committed intentional harm to health at work, which is a criminal offense.
In the latest editions of the law, no changes were made to the article.
Article 11
FZ-255 calculates the amount of insurance monetary compensation for women who go on maternity leave. If she is employed and insured, the amount of the benefit is 100 percent of the average salary.
If women worked less than 6 months at their last job, maternity benefit is also paid. However, the amount is equal to the minimum wage established in the region. In some regions, additional coefficients are added to the minimum wage (according to Federal Law-255). They are also included in the calculation.
Article 12
Article 12 describes the period for applying for temporary disability benefits and maternity benefits.
Part 1 of Article 12 of the 255-FZ states that the amount of monetary compensation for temporary disability is assigned within six months after recovery.
Part 2 of Federal Law-255 states that a pregnancy and childbirth benefit can be received if an application for it was made within six months after the end of the maternity leave. This appeal is accepted by the territorial authority (if the reason for missing the deadline is valid). The list of valid situations is determined by the Federal Law. No changes were made in the latest version of the law.
Article 13
In 2017, the changes affected Part 5 of Article 13 of FZ-255. The sick leave is issued by a medical institution in writing or published in the system of the insured in electronic form. In the second case, an electronic signature of a doctor or medical institution is used.
In order for an officially employed citizen to receive an allowance payment, a receipt on the amount of wages is provided. This document is the basis for calculating the amount of the allowance under FZ-255. Registration of a certificate of incapacity for work is carried out in accordance with the Federal Law of the executive branch. The procedure for issuing and providing sick leave is approved by the Government of the Russian Federation.
Article 14
Cash disability benefit is calculated from the average wage for the last two years in accordance with Federal Law-255. Employment at several employers allows you to receive several payments at the same time. Receipt of monetary compensation occurs upon arrival at work. There were no changes in the latest version of the law.
Attention: Maternity and childcare leave does not stop the accounting of insurance experience. The allowance is paid for the last 24 months, including maternity leave. No changes were made in the latest edition.
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FZ-255 on compulsory social insurance in case of disability was published on December 29, 2006. Contains 5 chapters and 19 articles on the rules for calculating benefits for insured events. In the latest edition of FZ-255 you will find all the changes, additions and amendments to the articles. You can download the law from the following link.
Chapter 1. General Provisions
Article 1. Subject of regulation of this Federal Law
1. This Federal Law determines the conditions, amounts and procedure for providing benefits for temporary disability, pregnancy and childbirth to citizens subject to compulsory social insurance.
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, 13, 14 and 15 of this Federal Law applicable to these relations in part , which does not contradict the Federal Law of July 24, 1998 N 125-FZ "On Compulsory Social Insurance against Industrial Accidents and Occupational Diseases".
Article 2. Persons entitled to benefits for temporary disability, pregnancy and childbirth
1. Citizens who are subject to compulsory social insurance in case of temporary disability and in connection with motherhood (hereinafter referred to as insured persons) are entitled to benefits for temporary disability, pregnancy and childbirth, subject to the conditions provided for by this Federal Law and other federal laws.
2. The insured persons are citizens of the Russian Federation, as well as foreign citizens permanently or temporarily residing on the territory of the Russian Federation and stateless persons:
1) persons working under labor contracts;
2) state civil servants, municipal employees;
3) lawyers, individual entrepreneurs, including members of peasant (farmer) households, individuals who are not recognized as individual entrepreneurs, members of tribal, family communities of the small peoples of the North, who voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with maternity and paying insurance premiums to the Social Insurance Fund of the Russian Federation for themselves in accordance with the Federal Law of December 31, 2002 N 190-FZ "On providing benefits for compulsory social insurance to citizens working in organizations and for individual entrepreneurs applying special tax regimes , and some other categories of citizens" (hereinafter - the Federal Law "On the provision of benefits for compulsory social insurance of citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens en");
4) other categories of persons who are subject to compulsory social insurance in case of temporary disability and in connection with motherhood in accordance with other federal laws, provided that they or for them pay taxes and (or) insurance contributions to the Social Insurance Fund of the Russian Federation.
3. 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 on which they were supposed to start work, or persons actually admitted to work in accordance with labor legislation.
4. 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 connection with temporary disability, pregnancy and childbirth, financed from the federal budget, the budgets of the constituent entities Russian Federation.
Article 3. Financing the payment of benefits for temporary disability, pregnancy and childbirth
1. Financing of the payment of benefits for temporary disability, for pregnancy and childbirth 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 employer in the cases provided for by 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 to insured persons (with the exception of insured persons specified in Part 4 of this Article) for the first two days of temporary disability at the expense of the employer, and for the rest of the period starting from the 3rd day of temporary disability - at the expense of the Social Insurance Fund of the Russian Federation.
3. Temporary disability benefit in the cases provided for in paragraphs 2-5 of Part 1 of Article 5 of this Federal Law shall be paid to insured persons (with the exception of insured persons specified in Part 4 of this Article) at the expense of the Social Insurance Fund of the Russian Federation from the 1st days of temporary disability.
4. Financing the payment of temporary disability benefits to insured persons working under employment contracts concluded with organizations and individual entrepreneurs applying special tax regimes (switched to a simplified taxation system or being payers of a single tax on imputed income for certain types of activities or a single agricultural tax) , as well as persons who have voluntarily entered into relations on compulsory social insurance in case of temporary disability and in connection with motherhood, is carried out in accordance with the Federal Law "On the provision of benefits for compulsory social insurance of citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens".
5. In cases established by the laws of the Russian Federation, federal laws, the financing of expenses related to the payment of benefits for temporary disability, for pregnancy and childbirth in amounts in excess of those established by the legislation of the Russian Federation on compulsory social insurance, is carried out at the expense of federal budget funds transferred for these purposes of the Social Insurance Fund of the Russian Federation.
Article 4
Persons sentenced to deprivation of liberty and involved in paid work are subject to provision with benefits for temporary disability, for pregnancy and childbirth in the manner determined by the Government of the Russian Federation.
Chapter 2. Provision of benefits for temporary disability
Article 5. Cases of providing benefits for temporary disability
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 institution, or another family member recognized as legally incompetent;
4) implementation of prosthetics for medical reasons in a stationary specialized institution;
5) post-treatment in accordance with the established procedure in sanatorium-resort institutions located on the territory of the Russian Federation, immediately after inpatient treatment.
2. Temporary disability benefit shall be paid to insured persons upon the occurrence of the events specified in paragraph 1 of this article, during the period of work under an employment contract, performance of service or other activities, during which they are subject to compulsory social insurance, as well as in cases where illness or the injury occurred within 30 calendar days from the date of termination of the specified work or activity, or from the date of conclusion of the employment contract until the date of its cancellation.
Article 6. Conditions and duration of payment of benefits for temporary disability
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 (establishment of disability with limited ability to work), except for the cases specified in parts 3 and 4 of this article.
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.
3. An insured person recognized as a disabled person in accordance with the established procedure and having limited ability to work, temporary disability benefits (except for tuberculosis) shall be paid for no more than four consecutive months or five months in a calendar year. If these persons become ill with tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity or until the day when the degree of limitation of the ability to work due to tuberculosis increases.
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 (establishment of disability with limited ability to work). 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 - for the entire period of outpatient treatment or joint stay with the child in an inpatient 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 who attend preschool educational institutions 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 .
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 1-7 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
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.
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 duration 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, with the exception of cases of caring for a sick child under the age of 15, is paid in the amount determined depending on the length of the insurance period of the insured person in accordance with part 1 of this article.
5. The amount of temporary disability benefit cannot exceed the maximum amount of temporary disability benefit established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year. If the insured person works for several employers, the amount of the temporary disability benefit cannot exceed the specified maximum amount of the specified benefit for each place of work.
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. Temporary disability benefit for the period of downtime shall be paid in the same amount as wages are maintained during this time, but not higher 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;
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:
1) if there are grounds specified in paragraphs 1 and 2 of 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 section - 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.
Chapter 3. Provision of benefits for pregnancy and childbirth
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. The amount of the maternity benefit may not exceed the maximum amount of the pregnancy and maternity benefit established by the federal law on the budget of the Social Insurance Fund of the Russian Federation for the next financial year. If the insured person works for several employers, the amount of the maternity allowance cannot exceed the specified maximum amount of the specified allowance for each place of work.
3. An insured woman who has an insurance period of less than six months is paid a pregnancy and childbirth allowance in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which regional coefficients are applied in the prescribed manner to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.
Chapter 4. Appointment, calculation and payment of benefits for temporary disability, pregnancy and childbirth
Article 12
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 (establishment of disability with limited ability to work), 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. 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.
3. When applying for benefits for temporary disability, for pregnancy and childbirth after a six-month period, the decision to grant benefits is made by the territorial body of the Social Insurance Fund of the Russian Federation 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 compulsory social insurance.
Article 13
1. Appointment and payment of benefits for temporary disability, pregnancy and childbirth are carried out by the employer at the place of work of the insured person (except for the cases specified in parts 2 and 3 of this article). If the insured person works for several employers, benefits are assigned and paid to him by each employer.
2. 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 is subject to compulsory social insurance, temporary disability benefits are assigned and paid by the employer at his last place work or by a territorial body of the Social Insurance Fund of the Russian Federation.
3. For the insured persons specified in Clause 3 of Part 2 of Article 2 of this Federal Law, as well as for other categories of insured persons in the event of termination of activity by the employer at the time the insured person applies for benefits for temporary disability, for pregnancy and childbirth, the assignment and payment of these benefits are carried out by the territorial body of the Social Insurance Fund of the Russian Federation.
4. 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 compulsory social insurance, and for the appointment and payment of benefits by the territorial body of the Social Insurance Fund of the Russian Federation, also information on earnings (income), from which the benefit should be calculated, and documents confirming the length of service, determined by the specified federal executive body.
5. The employer pays benefits for temporary disability, for pregnancy and childbirth to the insured person in the manner established for the payment of wages to employees.
6. In cases of appointment and payment of benefits for temporary disability, for pregnancy and childbirth by the territorial body of the Social Insurance Fund of the Russian Federation, provided for in parts 2 and 3 of this article, the payment of benefits for temporary disability, for pregnancy and childbirth is made in the prescribed amount directly by the territorial body of the Fund social insurance of the Russian Federation, who appointed the specified allowance, or through the organization of the federal postal service, credit or other organization at the request of the recipient.
Article 14. The procedure for calculating benefits for temporary disability, for pregnancy and childbirth
1. Benefits for temporary disability, pregnancy and childbirth are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months preceding the month of temporary disability, maternity leave.
2. The earnings, on the basis of which benefits for temporary disability, for pregnancy and childbirth are calculated, include all types of payments provided for by the wage system that are taken into account when determining the tax base for the unified social tax credited to the Social Insurance Fund of the Russian Federation, in accordance with Chapter 24 parts of the second Tax Code of the Russian Federation. Earnings for the calculation of benefits for temporary disability, for pregnancy and childbirth for insured persons who voluntarily entered into relations under compulsory social insurance in case of temporary disability and in connection with motherhood, include the income received by them, from which insurance premiums were paid to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law "On providing benefits for compulsory social insurance to citizens working in organizations and for individual entrepreneurs applying special tax regimes, and some other categories of citizens."
3. The average daily earnings for the calculation of benefits for temporary disability, for pregnancy and childbirth 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.
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 Articles 7 and 11 of 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.
6. If the amount of benefits for temporary disability, for pregnancy and childbirth, calculated in the manner established by this article, exceeds the maximum amount of benefits for temporary disability, for pregnancy and childbirth, established in accordance with Articles 7 and 11 of this Federal Law, the said allowances shall be paid at the stated maximum amounts.
7. Features of the procedure for calculating benefits for temporary disability, for pregnancy and childbirth, including for certain categories of insured persons, are determined by the Government of the Russian Federation.
Article 15
1. The employer assigns benefits for temporary disability, for pregnancy and childbirth 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 employer on the next day after the assignment of benefits, set for the payment of wages.
2. The territorial body of the Social Insurance Fund of the Russian Federation, in the cases provided for by Parts 2 and 3 of Article 13 of this Federal Law, assigns and pays benefits for temporary disability, for pregnancy and childbirth within 10 calendar days from the date of submission by the insured person of the relevant application and necessary documents .
3. Assigned, but not received by the insured person in a timely manner, benefits for temporary disability, pregnancy and childbirth are paid for the entire past time, but not more than three years prior to applying for it. A benefit not received by the insured person in whole or in part due to the fault of the employer or the territorial body of the Social Insurance Fund of the Russian Federation is paid for the entire past time without limitation by any period.
4. The amounts of benefits for temporary disability, for pregnancy and childbirth, 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 deliberately incorrect information, concealment of data affecting the receipt of benefits 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 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.
5. Accrued amounts of benefits for temporary disability, for pregnancy and childbirth, not received due to the death of the insured person, are paid in the manner established by the civil legislation of the Russian Federation.
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.
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 compulsory social insurance.
Chapter 5. Procedure for Entry into Force of this Federal Law
Article 17
1. Establish that citizens who have 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 were entitled 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 by law, exceeds the amount of the allowance, which is 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
V. Putin
Note. ed.:
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
Chapter 1. GENERAL PROVISIONS
Article 1. Subject of regulation of this Federal Law
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)
Article 1.1. Legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood
1. The legislation of the Russian Federation on compulsory social insurance 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.
Article 1.2. Basic concepts used in this Federal Law
(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 same sense as they are used in other legislative acts of the Russian Federation.
Article 1.3. Insurance risks and insured events
(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.
Article 1.4. Types of insurance coverage
(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) a one-time allowance for women registered with medical organizations in the early stages of 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").
Article 2. Persons subject to compulsory social insurance in case of temporary disability and in connection with motherhood
1. Citizens of the Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing in the 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 the production cooperative, taking 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 (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 indigenous small The peoples of the North are subject to compulsory social insurance in case of temporary disability and in connection with motherhood, if they have voluntarily entered into relations for 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 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
(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 of foreign states, international organizations, branches and representative offices of these foreign entities 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.
Article 2.2. Insurer
(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 07.08.1992 N 822 and Decree of the Government of the Russian Federation of 12.02.1994 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.
Article 2.3. Registration and de-registration of policyholders
(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 by the federal executive body that carries out state registration of legal entities, the information contained in the unified state register of legal entities and submitted in the manner determined by the authorized Government of the Russian Federation Federation by the federal executive body;
(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, at the e-mail address contained in the information of the unified state register of legal entities (if the e-mail address is indicated in the application for state registration), submitted by the federal executive body in charge of 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 de-registration of the insurers specified in and this article, and persons equated to insurers for the purposes of this Federal Law, is established by the federal executive body responsible for developing state policy and legal regulation in the field of social insurance .
Article 3. Financial support for expenses for the payment of insurance coverage
(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 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 this Federal law.
5. In cases established by the laws of the Russian Federation, federal laws, financial support for the cost of paying 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 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
(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)
Article 4.1. Rights and obligations of policyholders
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 salary retention 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".
Article 4.2. Rights and obligations of the insurer
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) request from the policyholder information on the balances of funds on the accounts of the policyholder with credit institutions and on the insufficiency of funds on the accounts of the policyholder with credit institutions to satisfy all claims against the accounts in the event that the policyholder 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) to receive from the bodies of the 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, the insured or the insured person, if the necessary documents (information) are not at the disposal of state bodies, bodies of state non-budgetary funds, local governments or subordinate state bodies or local self-government bodies of organizations 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 authorities and organizations subordinate to state bodies or local authorities. 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)
Article 4.3. Rights and obligations of the insured persons
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 insured and the insurer for advice on the application of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with motherhood, 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)
Article 4.4. Legal regulation of relations related to the payment of insurance premiums
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)
Article 4.5. The procedure for voluntary entry into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood
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 have voluntarily entered into legal relations on compulsory social insurance in case of temporary disability and in connection with motherhood shall pay insurance premiums to the Social Insurance Fund of the Russian Federation, based on the cost of the insurance year, determined in accordance with this article.
3. The cost of an insurance year is determined as the product of the minimum wage established by federal law at the beginning of the financial year for which insurance premiums are paid and the rate of insurance premiums established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation , Federal Compulsory Medical Insurance Fund" in terms of insurance contributions 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.
Article 4.6. The procedure for financial support of the expenses of policyholders for the payment of insurance coverage at the expense of the budget of the Social Insurance Fund of the 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 insurer 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 insurant'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 insurant 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 reduced tariffs apply 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)
Article 4.7. Carrying out by the insurer of checks of the correctness of expenses for the payment of insurance coverage
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. On-site inspections of the correctness of the insured's expenses for the payment of insurance coverage are carried out by the insurer simultaneously with on-site inspections of the insured regarding 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 of this article.
Article 4.8. Accounting and reporting of insurers
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.
Chapter 2. Provision of benefits for temporary disability
Article 5. Cases of providing benefits for temporary disability
Note:
By the Decree 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 - in the system of current legal regulation - the father of the child is not deprived of the right to raise children, equal to that of the mother, as well as the right to social security for the upbringing of children, carried out, among other things, through the provision of benefits for compulsory social insurance.
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) post-treatment in accordance with the established procedure in sanatorium and resort organizations located on the territory of the Russian Federation, immediately after the provision of medical care in a hospital.
(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)
Article 6. Conditions and duration of payment of benefits for temporary disability
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.
Article 7. The amount of benefits for temporary disability
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 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) 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:
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;
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.
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;
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.
Chapter 3. PROVISION OF PREGNANCY AND MATERNITY BENEFITS
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.
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 allowance in an amount not exceeding the minimum wage established by federal law for a full calendar month, and in areas and localities in which regional 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)
Article 11.1. Conditions and duration of payment of the monthly child care allowance
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.
Article 11.2. Amount of monthly allowance for child care
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.
Chapter 4
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.
Article 12
(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. 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)
Article 13
(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 allowance shall be calculated, from the place (places) of work (service, other activity) 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 temporary disability benefits, pregnancy and childbirth benefits 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. 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 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 child care allowances, and if the mother (father, both parents) of the child does not work (does not serve) or is studying full-time in basic educational programs in organizations engaged in educational activities, a certificate from the social protection authorities at the place of residence (place of stay, actual residence) of the mother (father) of the child on 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 child care allowance 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 the monthly child care allowance 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 from the relevant insurant (relevant insurers) based on the information of individual (personalized) accounting in the system of compulsory 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).
Article 14
(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 the Reference 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 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, The Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund" for the corresponding calendar year, the maximum amount of the base for calculating insurance premiums to the Social Insurance Fund of the Russian Federation. If 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 peculiarity of a leap year, which is 366 calendar days, the calculation period in determining the average daily earnings for calculating maternity benefits, monthly child care benefits 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 pregnancy and childbirth 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 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.
(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)
Article 15
(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 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.
(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, appoints and pays benefits for temporary disability, for pregnancy and childbirth, a 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)
Article 15.1. Responsibility for the accuracy of the information necessary for the appointment, calculation and payment of benefits for temporary disability, for pregnancy and childbirth, monthly allowance for child care
(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.
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 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)
Chapter 5. Procedure for the entry into force of this federal law
Article 17
1. Establish that citizens who have 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 were entitled 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 by law, exceeds the amount of the allowance, which is 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.
President of Russian Federation
V. Putin
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 4 of 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 Article 14 of this Federal Law, for the time of work (service , other activities) from the insured who appoints and pays the allowance.
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 part 2 of 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 part 2.1 of this article by the insurant for one of last places of 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, 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 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 child care, or if it is impossible to pay them by the insured due to insufficient funds on his accounts with 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 if it is impossible to establish the location of the insured and his property, which may be levied, if there is 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, or if, on the day the insured person applies for the specified benefits, procedures are being carried out in relation to the insured, applied in the bankruptcy case of the insured, the assignment and payment of the said benefits, with the exception of temporary disability benefits paid at the expense of the insured in accordance with Clause 1 of Part 2 of Article 3 of this Federal Law, are carried out by the territorial body of the insurer.
5. Appointment and payment of benefits for temporary disability, pregnancy and childbirth are carried out on the basis of a certificate of incapacity for work issued by a medical organization in the form of a document on paper or (with the written consent of the insured person) formed and placed in the information system of the insurer in the form of an electronic document signed using an enhanced qualified electronic signature by a medical worker and a medical organization, if the medical organization and the insured are participants in the information exchange system for the exchange of information in order to generate a certificate of incapacity for work in the form of an electronic document. To assign and pay these benefits, the insured person submits 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 (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 the benefit should be calculated, and determined by 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, documents confirming insurance experience. The form, procedure for issuing and the procedure for issuing sick leave certificates, as well as the procedure for generating sick leave certificates in the form of an electronic document, is 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 , which performs the functions of developing and implementing state policy and legal regulation in the field of labor and social protection of the population, and the Social Insurance Fund of the Russian Federation. The procedure for information interaction between the insurer, policyholders, medical organizations and federal state institutions of medical and social expertise for the exchange of information in order to form a sick leave certificate in the form of an electronic document is approved by the Government of the Russian Federation.
5.1. In the cases specified in parts 2.1 and 2.2 of this article, the insured person, when applying for temporary disability benefits, pregnancy and childbirth benefits 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) with another insurant (with other insurers) that the appointment and payment of benefits by this insurant are not carried out.
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 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 child care allowances, and if the mother (father, both parents) of the child does not work (does not serve) or is studying full-time in basic educational programs in organizations engaged in educational activities, a certificate from the social protection authorities at the place of residence (place of stay, actual residence) of the mother (father) of the child on 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 part 4 of 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 care for a child 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 part 4 of 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.
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.
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.
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 policyholder assigning and paying benefits, or the territorial body of the insurer assigning and paying benefits in the cases specified in Parts 3 and 4 of this Article of this Federal Law, at the request of the insured person, sends a request to the territorial the body of the Pension Fund of the Russian Federation on the provision of information on wages, other payments and remuneration of the insured person from the relevant insurant (relevant insurers) based on the information of individual (personalized) accounting in the system of compulsory 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.
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.
9. Payment of benefits for temporary disability, for pregnancy and childbirth, monthly benefits for caring for a child in the cases provided for in paragraph 4 of this article, 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 beneficiary's request.
10. Information on the appointment and payment to insured persons in the cases provided for in paragraph 4 of this article, temporary disability benefits, benefits for pregnancy and childbirth, monthly childcare benefits is posted in the Unified State Social Security Information System. The placement and receipt of this information in the Unified State Social Security Information System is carried out in accordance with the Federal Law of July 17, 1999 N 178-FZ "On State Social Assistance".
