Social health insurance leave and allowances. Modifications

In the Official Gazette with number 319 of April 16, 2020 was publishedin Emergency Ordinance (OUG) no. 49 of April 15, 2020 for amending and supplementing the Government Emergency Ordinance no. 158/2005 on leave and social health insurance benefits, as well as for regulation social protection measures.

In the case of the persons provided in art. 1, the manner and duration of granting holidays and allowances for temporary incapacity for work caused by infection with COVID-19, under the conditions of paragraph (1), are provided in the application norms approved by order of the Minister of Health and of the President of the National Health Insurance House

The leave and the grants (indemnity) for quarantine are granted to the insured persons who are forbidden to continue the activity due to a contagious disease, for the duration established by the document issued by the public health authorities.

During the emergency situation established under the conditions of the Government Emergency Ordinance no. 1/1999 regarding the state of siege and the state of emergency, approved with modifications and completions by Law no. 453/2004, with the subsequent modifications and completions, the persons provided in art. 1, who are prohibited from continuing their activity and for whom the quarantine measure was instituted as a result of a suspicion of COVID-19 infection, benefit from quarantine leave and allowances, regardless of where it is established or institutionalized, at a location declared by the quarantined person or by isolation, which is granted for the period and on the basis of the documents provided by order of the Minister of Health, depending on the evolution of the epidemiological situation.

For persons being in the situations provided for in paragraph (1), medical leave certificates shall be issued by family doctors after the last day of the quarantine period, but not later than 30 calendar days from the end of the emergency period established, according to par. (1).

The gross monthly amount of the indemnity for the situations provided at paragraph (1) represents 75% of the calculation basis established according to art.10.

The medical leave certificates are issued by the health insurance authorities to which the employer of the insured person submits the declaration provided in art. 147 paragraph (1) of Law no. 227/2015 on the Fiscal Code, with subsequent amendments and completions, or by the one with which it has concluded the insurance contract for holidays and social health insurance benefits, as the case may be, based on the proving documents translated and authenticated, under the conditions and until at the maximum durations provided by this emergency ordinance, but not later than 15 days from the date of return to the country of the persons provided at paragraph (1).

The documents provided in art. 271 par. (2) may be sent to the health insurance authorities that issues the medical leave certificate by the persons provided in par. (1) on paper or by electronic means of remote transmission or, as the case may be, by the persons who authenticate the documents by electronic means of remote transmission, and the insurance company, in turn, may transmit the medical leave certificate, on paper support or by electronic means of remote transmission, to the beneficiaries / legal persons / employers, as the case may be.

The indemnities provided at art. 26 paragraph (1) is granted on the basis of the medical leave certificate issued by the attending physician or, as the case may be, by the health insurance authority provided at art. 271 paragraph (2) and the certificate for the disabled persons, issued in accordance with the law, as the case may be.

The indemnities provided at art. 26 paragraph (11) is granted on the basis of the medical leave certificate issued by the specialist doctor or, as the case may be, by the health insurance house provided in art. 271 paragraph (2).

The duration of granting the indemnity provided at art. 26 paragraph (1) is a maximum of 45 calendar days per year for a child, except in situations where the child is diagnosed with infectious diseases, is immobilized in immobilization systems specific to the musculoskeletal system or is subject to surgery. In these cases, the duration of the medical leave is established by the specialist doctor depending on the evolution of the diseas

The duration of granting the indemnity provided at art. 26 paragraph (11) corresponds to the number of calendar days related to the duration of the medical leave established by the specialist doctor.

The indemnities related to the medical leave certificates granted during the state of emergency established under the conditions of the Government Emergency Ordinance no. 1/1999, approved with modifications and completions by Law no. 453/2004, with the subsequent amendments and completions, may be requested on the basis of the supporting documents by the persons provided in art. 1 paragraph (1) and (2), art. 32 paragraph (1), as well as by the payers provided at art. 36 paragraph (3) lit. a) and b), within 180 days from the date of termination of the emergency period.