Study of Social Security in the partner countries European Workshop More Than Neighbours

Ferrol (A Corua) Senior University 2011-2012

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Index
Introduction Social Security: Definition and Brief History The Welfare State Social Security in Belgium Social Security in Czech Republic Social Security in Germany Social Security in Italy Social Security in Poland Social Security in Spain Conclusions Team work Bibliography

Social Security .dont cut it

Introduction The title of this work makes an explicit reference to Social Security, inseparable from the extraordinary conquest that the Welfare State is, and that constitutes an unquestionable mark of our identity. The Welfare State provides a management model that in regime of freedom and democratic participation tends to equalize all citizens in the enjoyment of essential services, by establishing legal equality and opportunities, the principle of solidarity and the distribution of wealth through a fair and equitable tax policy and ensuring a minimum level of essential resources that base the worthy exercise of citizenship and the satisfaction of basic needs which define that dignity. It is convenient to emphasize that the improved levels of welfare also include other aspects such as housing, quality public spaces, leisure and culture. The economic activity in developed countries is now undergoing a process of globalization and internationalization, whose greatest exponent is the current economic crisis, in which the public debt situation of the euro area countries has been the main trigger of debate on the sustainability of the Welfare State. Nowadays, States do not hold the reins of their monetary policy and the debt is designed and decided on an internationalized world that has no rules. Rating agencies control the markets and make the prices of debt go up and down, causing major conflicts. The population pyramid in the different states of the European Union has changed since the time in which the formula that supports the Welfare State was created, increasing life expectancy, growing a lot
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the spending on health, retirement and dependency. It is said over and over again that the Welfare State is in crisis, but what is in crisis is the logic on which it was created, a model of society that no longer exists, the citizens began to work at twenty , quoted over forty and had a short life expectancy from the time of retirement. We are in a time of revision, adjustment and redistribution of all aspects of financing the Welfare State that should not suppose the dismantling. The challenge is to get a balance between efficiency and welfare, since what is in play, is the political and social future of mankind.

Social Security: Definition and Brief History

The concept of Social Security mainly arises in the twentieth century, as the result of several situations of generalized social and politic crisis that seek to be solved by the State. Social Security is the set of actions that individual States can carry out to eliminate problems such as poverty, misery, unemployment etc and ensure the members of society permanent access to the most important rights. In short, Social Security is a term referred to the welfare of citizens that make up a community. The most recent definition and accepted by all economies, is the one defined by the International Labor Organization in 1991. It is the protection that society provides for its members through a series of public measures against economic and social deprivation that otherwise would cause the disappearance or a strong reduction in income due to illness, maternity, accident at work or occupational disease, unemployment, invalidity, old age and death; and also in medical protection and assistance to families with children. This definition accepted by all economies, is adapted to each area according to their own economic and social development, being the Spanish Social Security one of the most complete compared with other advanced economies.

Brief History

Social Security is the result of a long historical process, due to the state of insecurity in which man lives from the down of mankind. Social Security was born in Germany at the time of Kaiser William I as a product of the industrialization process, the fierce struggles of the workers, pressure of churches, some political groups and academic circles of the time. Driven by the Iron Chancellor, Otto von Bismarck, three social laws were endorsed, which represent till now, the basis of the Universal Social Security System: Sickness Insurance Accident Disability

The results of applying this model were so effective that quickly spread through Europe and later to other parts of the world. In 1919, by the Treaty of Versailles, political leaders put an end to the First World War. In the wake of this historic treaty, the International Labor Organization (ILO) was created. The term Social Security is used for first time in a law of the United States, specifically The Social Security Act in 1935. Later, from England, the concept is expanded in 1942 by Sir William Beveridge. The Beveridge Report (Social Insurance and Allied Services Report) sought to extend the Social Security benefits to the entire population with an integral and universal character. With respect to integrity, this plan proposed the
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construction of a welfare system that was capable of protecting citizens from the cradle to the grave and to attack the five giant evils of modern society.

Poverty Disease Ignorance Dirt Idleness

This plan included a Social Security Unitary System that would handle: Pensions: sickness, maternity, old age, widowhood and unemployment. National Health Service: free medical care. National Support Service: complementary allowances when they were insufficient. Universal family allowances. Full employment.

The benefits were extended to education, housing and specialized care for children. All this conformed what became known as the British Welfare State. England was the first country where compulsory unemployment insurance was established, in 1911. The English model was extended to other Western European countries that were incorporating the commitments of welfare in their legislation. In all advanced Constitutions were ratified as basic social rights of all citizens, access to education, health, social security, housing and work.

Spain The starting point of protection policies could be situated in the Social Reforms Commission, in 1883. The first social insurance is created in 1900: the Law of Accidents at work and in 1908 the National Institute of Social Welfare in which the emerging social insurances are integrated. Later, the protection mechanisms lead to a number of social insurances, among them the Workers Retirement in 1919.Compulsory Maternity Insurance in 1923, Unemployment Insurance in 1931, Health Insurance in 1942 and Old Age and Disability in 1947. All this was insufficient and Mutual Labor appeared. They were organized by sectors, whose aim was to complete the existing protection. Given their multiplicity, employment discrimination and financial imbalances happened, what made a very difficult rational and effective management. In 1963 the Social Security Basis Law is published, whose main purpose was the implantation of an integrated unitary model of social protection. In 1966 the General Law of Social Security appeared. The tendency to unit did not materialize because old systems of quoting survived, absence of periodic revaluations etc. In 1972 the Law of Financing and Improving of the Protective Action, tried to correct the financial problems, without success. With the advent of Democracy and the approval of the Constitution, there will be a series of reforms covering many fields that make up the Social Security System today. The article 41 of the Constitution establishes that public authorities will maintain a public system of Social Security for all citizens guaranteeing adequate social assistance and benefits in situations
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of need, especially in unemployment cases, indicating that complementary assistance and benefits will be free. The first major reform occurs in 1978 with the publication of the Royal Decree Law 36/1978, November 16, according to the agreement of the Moncloa Pacts. It creates a system of institutional participation by promoting transparency and rationalization of Social Security, as well as a new management system carried out by the following organizations: The National Institute of Social Security, for the management of the economic benefits of the system. The National Institute of Health, for health benefits. Later called the National Institute of Health Management. The National Institute of Social Services, for the management of Social Services. Later called Elderly and Social Services. The Social Marine Institute, for the management of maritime workers The General Treasury of Social Security, as a single box of the system, acting under the principle of financial solidarity.

Throughout the eighties, steps are taken to extend benefits to groups not covered yet and provide greater economic stability to the system, for example:-Gradual equalization of contribution bases with real salaries. -Revaluation of pensions according to the variation in the consumer prices index. -Extension of necessary periods to access the benefits and the pension calculation. -Simplification of the Social Security structure. -Start of financing functions separation, so that, contributory benefits would be financed by social contributions, while non-contributed, would find their financial coverage in the general extension. This process, will allow the gradual spread of health care. Also at this time, the IT Management Department of Social Security is created, to coordinate and control the computer services and data processing of the various managing bodies.

In the nineties there were a series of social changes that have had a great influence in the Social Security system: greater mobility, womens integration into the labor market etc. have made necessary to adapt the protection to the new needs. In 1995 with the support of all political and social forces, the Pact of Toledo was signed. It brought significant changes and the establishment of a roadmap to ensure financial stability and future benefits of Social Security. Among others we can cite: -Implantation of non-contributive pensions. -Rationalization of the Social Security legislation. -Better adaptation between benefits received and exemption of contribution previously made. -Creation of the Reserve Fund of Social Security -Introduction of flexible retirement arrangements. -Incentives for prolonging the working life. -Measures to improve protection in cases of minor pension. In recent years Social Security has been adapted to new technologies with the development of its website and the optimization of services via Internet. As a reward for the work carried out since its origins, both Social Security and the organisms which it is made of, have been awarded with several prizes and awards that reinforce the great social work done over its history.

The Welfare State

The Welfare State is a concept of Political and Economic Sciences that designate a political proposal or general model of State and social organization under which the State provides certain services or social guarantees to all the inhabitants of a country. That is to say, it is up to the State and Society to assume the responsibility of the social and economic welfare of their members. Being understood this responsibility as universal and that welfare is a broad concept to be applied to everybody.
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Although other terms had been used previously to express the same aspirations, the current concept corresponds to the English term Welfare State, whose use was coined since 1945, as a consequence of the traumatic experience of the general crisis product of the Great Depression that culminated in World War II. It is a kind of social pact that established a more equitable distribution of the benefits and richness among all the population, a socially balanced economic development and full employment. It is a combination of democracy, social welfare and capitalism. It has been the combined result of various factors: The Social Democratic Reformism, the Christian socialism, liberalism, Christian democracy, certain political economical conservative and illustrated elites and the big industrial unions. These were the most important forces in its favor and granted wider and wider schemes of compulsory insurance, labor protection laws, minimum wage, expansion of health and education services, housing subsidized by the State as well as the recognition of unions as legitimate economic and political representatives of workers. By means of social cooperation some problems could be solved: Poverty. Unemployment and similar forms of social security. Sickness and pain. Criminal Cruelty. Slavery and other forms of servitude. Racial and religious discrimination. Lack of educational opportunities. Rigid class differences. War

Although England was the great promoter of these improvements, as time passing by it is clear that the policies practiced in Western European countries converge and it is also evident that both the progress and stability of each European country depend on their neighbors. So, a consensus is created that include from the most leftists sectors of Social Democratic parties to the most rightist of Democrat Christians.

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Nowadays, it is frequent to hear that there is a unique European social model. The fact is that reality is much more complex and in the UE there are several social models. Despite of each country has its own particularities, we can distinguish four models: The Nordic, of Denmark, Norway, Island, Finland and Holland. The Continental, of Austria, Belgium, France, Germany and Luxemburg. The Anglo-Saxon, of Ireland and Great Britain. The Mediterranean, of Greece, Portugal and Spain.

As a way of general evaluation, the social models of the different types of Welfare State, has been valued according to two criteria: Efficiency: it allows work to the greatest number of people and has high rates of activity and occupation. Equity, keeps the risk of poverty relatively low. TIPOLOGY OF THE VARIOUS SOCIAL EUROPEAN MODELS

Efficiency High High Equity Low ANGLO-SAXON MEDITERRANEAN NORDIC Low CONTINENTAL

Definitively, the main criteria of Welfare State are: Globalization: The Welfare State is directed to the entire population, both active and passive and it is extended to all basic social needs of people Active policy against exclusion: Margined people and marginal groups will be able to find the conditions which gave them the possibility of exercising their rights legally recognized, for all citizens. Prevention: This actuation tries to know the problems, giving them a previous solution.

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Generalization: Without taking account the differences based in their social status, cultural resources, economic, health etc. Autonomy: The Autonomic Bodies or Federal States have their own capacity of planning in their territories. Participation: The user of the services must also participate in the solution of their own problems. Coordination: Solidarity policies should act coordinately, so that the different political ambits could not interfere in the donation of service

It is truth that the concept of Welfare State has been polemic and the discussion about the responsibility of governments to maintain its sustainability has strongly increased, as a direct consequence of the global crisis that affects the Western World, but it is also evident that nations must try to find reasonable solutions to keep and improve the benefits achieved during such a long way.

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Belgium

Social Security in Belgium Introduction, organisation and financing Introduction The Belgian social security system for employed persons comprises the following branches: Sickness benefits; and maternity

Benefits for accidents at work and occupational diseases; Death benefits; Invalidity benefits; Old-age benefits; and survivors'

Unemployment benefits; Family benefits.

For self-employed persons, special provisions may apply. How to register for social security? As soon as you take up employment in Belgium, your employer must register you with the social security system. You yourself need not apply to any institution. The only exception to this rule concerns insurance for health care and benefits. In order to be covered against these risks, you must join a mutual insurance fund (mutualit/ziekenfonds) of your own choice or register with a regional office of the Auxiliary Fund for Sickness & Invalidity Insurance (Caisse auxiliaire dassurance maladieinvalidit/Hulpkas voor ziekte- en invaliditeitsverzekering/Hilfskasse fr Kranken- undInvalidenversicherung CAAMI/HZIV/HKIV). In Belgium, the mutual insurance funds are grouped together in the national unions of Christian, socialist, neutral, free and liberal mutual insurance funds. You are free to change to a different mutual insurance fund on the first day of any calendar quarter. The new fund you wish to join may refuse your application, however,
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especially if you have been insured for less than 12 months, but it will give you all the information you need in this regard. In the following, mutual insurance funds and the regional offices of the Auxiliary Fund will be referred to as health insurance funds. The mutual insurance funds are nonprofit making associations of individuals aimed at promoting physical, psychological and social well-being. The Auxiliary Fund for Sickness & Invalidity Insurance is a public social security institution. Appeals If you disagree with a decision taken by a social security institution, you can lodge a written appeal within three months from the date on which you were notified of the decision. If you live in Belgium, you must either send your appeal by registered letter to the clerk of the labour court (Greffe du Tribunal du travail, Griffie van de Arbeidsrechtbank) in your district of residence or personally present it to that office. If you live outside the country, you must send your appeal to the labour court of the district of your last place of residence in Belgium or, if you have never lived or been resident in the country, to the labour court of the district where you last worked in Belgium. Organisation of social protection In proper terms social security is a federal affair which is subject to the competence of the Minister in charge of social affairs (Ministre des Affaires sociales), of the Minister of Employment (Ministre de l'Emploi), of the Minister of Public Service (Ministre de la Fonction publique), the Minister of Pensions and Large Cities (Ministre des Pensions et des Grandes villes), of the Minister dealing with Middle Classes questions (Ministre des Classes moyennes), of the Secretary of State of social affairs in charge of people with disabilities (Secrtaire d'Etat aux Affaires sociales charg des personnes handicapes) and of the Secretary of State of Social Integration and of the fight against poverty (Secrtaire dEtat l'Intgration sociale et la Lutte contre la Pauvret). The National Social Security Office (Office national de Scurit sociale) is a public institution of social security which has the task of collecting contributions (with the exception of employment injuries) and allocating the funds between the central institutions responsible for the administration of the different branches of social security through the so-called Global Management. Sickness, maternity, invalidity The fields of sickness, maternity and invalidity are run by the National Institute for Sickness and Invalidity Insurance (Institut national d'assurance maladie-invalidit, INAMI), which above all distributes the financial resources between the different insurance funds responsible for the benefits (mutual insurance funds, which are affiliated to one of the five national unions, regional offices of the Auxiliary Fund for
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Sickness and Invalidity Insurance or the Health Insurance Fund of the Belgian National Railway Company Holding, SNCB Holding). The choice of insurance fund is free with the exception of the employees of the National Railway Company of Belgium. Old-age and survivors The fields of old-age and survivors pensions are run by the National Pension Office (Office national des pensions), which is in charge of the assessment and payment of pensions. The application for a pension will be made via the local administration of the town in which the applicant is resident. Employment injuries and occupational diseases The field of employment injuries is run by the Employment Injuries Fund, whose main task is to grant benefits in the form of damage compensation to sailors, seamen and employees whose employers do not meet their obligations. The Employment Injuries Fund carries out technical and medical control, and ratifies the agreement settling the employment injury between the victim and the insurance fund. The employers have to take out insurance against the risks of accidents at work with a registered insurance fund or a common insurance fund to the benefit of their staff. The Occupational Diseases Fund is a public social security institution which is solely responsible for administering the whole field of insurance against occupational diseases. This fund also implements the legal regulations in the field of prevention. This institution comprises also the Asbestos Funds for the payment of indemnities to victims of asbestos. Family benefits The implementation of legislation is carried out on the one hand by the National Family Benefits Offices for Employees (Office national d'allocations familiales pour travailleurs salaris) and the special Compensation Funds for Family Benefits and, on the other hand, by the independent Compensation Funds. The main tasks of the National Office are to distribute the financial resources between the different compensation funds and to act as a compensation fund for employers insured with the Office. Furthermore the Office has been allocated the supervision of the compensation funds. For some occupations special funds have been created (public funds), which the corresponding employers should join. The independent Compensation Funds are institutions which have been set up on the employers' initiative and are managed by them. They are approved by the King and can only be responsible for the granting of statutorily provided benefits. Unemployment

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The field of unemployment is run by the National Employment Office (Office national de l'emploi) and its regional units, which will decide on the concerned person's entitlement. The payment of benefits is made either by the registered trade union organisation of which the employee is member or by the auxiliary fund for payment of unemployment benefit that has received the application. Financing Most of the social security branches are financed through the overall financial management (gestion globale), i.e. a part of the overall social security contribution, of the overall State subsidies and of the alternative financing (VAT) is allocated to the branches according to their treasury needs. You will have to pay a percentage of your salary as your social security contribution. Your employer will withhold this from your salary and pay it to the National Office of Social Security (Office national de scurit sociale/, Rijksdienst voor sociale zekerheid/Landesamt fr Soziale Sicherheit ONSS/RSZ/LSS). The only contribution that you may have to pay yourself is whatever your health insurance fund may charge for certain supplementary benefits. There will be no supplementary contributions if you join the Auxiliary fund for Sickness and Invalidity Insurance, since it provides compulsory insurance only. The basic contribution paid by employers and employees amounts to 37.84 percent, next to a wage moderation contribution which may vary. The sickness and maternity, invalidity, old-age and survivors, and unemployment schemes are also financed through other special contributions. Employment injuries are covered through insurance paid by the employers. Healthcare When are you entitled to healthcare? The health insurance system covers everyone who is legally in Belgium: employees, the unemployed, pensioners, the self-employed, civil servants, the disabled, domestic workers, students, individuals registered in Belgium and their dependants. To be entitled to healthcare: you must be registered with a health insurance fund; contributions may not be lower than a fixed minimum amount.

The eligible dependants are the spouse, cohabitant, children under 25 years of age (6 categories) and ascendants (in some cases parents-in-law) whose professional or replacement income is lower than 2,191.85 per quarter. For self-employed persons, special provisions may apply.
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What is covered? Benefits for preventive care and treatment are reimbursed according to a schedule of pre-set statutory rates. Medical and dental care In principle, your health insurance fund will reimburse 60-75 percent of the fees charged for healthcare services, such as for GP or specialists' consultations or visits. Dental care comprises preventive and conservative treatment, extractions, dental prosthesis and orthodontic treatment. There is a refund of the cost of treatment, the cost of dental plates, etc., Medicines For prescription drugs, you will have to pay a certain amount per prescription. This will vary depending on the product. The portion of the price covered by your health insurance depends on the category to which the specific drug belongs (A, B, C, Cs, Cx or dispenser's preparation). Normally, if you have a prescription, all you will have to pay the pharmacist is that portion of the price not covered by your health insurance fund. Patients in a general hospital pay 0.62 per day for medicines. For a refund of the cost of preparations by a pharmacist, a maximum share of 1.10 or 2.20 per insured person is set. The charge is reduced for those benefiting from the preferential scheme. Hospitalisation On admission to hospital, you will have to make a flat-rate prepayment, followed by a per diem charge for each day as an inpatient ( 14.14 per day). You will also be charged a flat-rate daily amount for the drugs used during your hospital stay. Where the patient is hospitalised within a psychiatric home for more than five years, the charge is 23.57 per day. There is a fixed contribution by the insurance fund for approved homes for the aged, protected homes, nursing homes, psychiatric homes, and day-care centres. The admission fee is 41.41. There is a reduction for dependent children of ordinary beneficiaries, those benefitting from the preferential scheme and the unemployed found to qualify for 12 months as an unemployed single or as an unemployed with a dependant, including their dependants. Physiotherapy and nursing care Physiotherapy is reimbursed only if prescribed by a doctor. Then, generally, your health insurance will cover up to 60 percent of a physiotherapists charges. Health insurance covers 75 percent of the cost of nursing care for recipients not benefitting from the preferential scheme who call on a non-contracted care provider.
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Prostheses, spectacles, hearing-aids A full refund of fees is fixed by agreement. Other benefits Other benefits may be provided as laid down in byelaws of an insurance fund. A flat-rate contribution from a special solidarity fund of the National Institute for sickness and invalidity insurance (Institut National d'Assurance Maladie-Invalidit, INAMI, Rijksinstituut voor ziekte- en invaliditeitsverzekering), is charged for certain expensive treatments not provided in the official list of reimbursable services. Increased reimbursement Some insured persons and their dependants are entitled to a higher reimbursement rate because of their financial situation. These include pensioners, widows, orphans, people on disability allowances or social assistance, etc. How is healthcare accessed? Medical and dental care As a general rule, you may go directly to the doctor or dentist of your choice, to whom you must pay the required fees yourself. The doctors can be registered with the College of Physicians (Ordre des mdecins/Orde der geneesheren) and approved by the Minister of Public Health (Ministre de la Sant publique/Minister van Volksgezondheid). However, there is a free choice of doctor, just as there is free access to specialists. The fees will be reimbursed on production of a certificate from the doctor or dentist attesting to the treatment provided. If you choose to go to a doctor or dentist who is not bound by the statutory rates, you yourself must pay any amount charged in excess of those rates. Your health insurance fund will be able to give you a list of the practitioners who charge the statutory rates. Medicines For medicines, you will have to pay the pharmacist that portion of the price not covered by your health insurance fund. Hospitalisation If you have to be hospitalised, you must first consult your health insurance fund, which will tell you what to do. This is not necessary for emergency hospitalisation. Old-age pensions and benefits When are you entitled to old-age benefits? In principle, everyone who has worked in Belgium under an employment contract is insured for old-age benefits. There are special rules for part-time domestic staff.
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All employed persons are entitled to an early retirement pension on reaching the age of 60, provided they have an adequate insurance history and after 35 years of professional activity. Normal retirement age for men and women is 65. An exception to this rule is made for miners, seamen and aircrew of civil aviation who can retire earlier. Men in receipt of a contractual pre-retirement pension are not entitled to a retirement pension before the age of 65. Women in the same situation are currently not entitled to claim their retirement pension before the age of 65 as well. You will not receive a retirement pension if you are already receiving sickness, invalidity or involuntary unemployment benefit under Belgian or foreign social security legislation, or if you are receiving an allowance for cessation of work or a supplementary allowance under contractual pre-retirement arrangements. Pensioners are entitled to work, subject to an earnings ceiling. For people under 65, when the pension has started from 2009, accumulation with income from work is authorised if annual professional earnings do not exceed 7.421,57 per year for an employee (gross wage). This amount is increased to 11.132,37 where there is a dependent child. Before beginning work as a pensioner you must notify the National Pension Office (Office national des pensions, Rijksdienst voor Pensioenen/Landespensionsamt, ONP/RVP/LPA), by registered letter. And you must inform your employer, also by registered letter, that you are receiving a pension. For more information, contact the National Pension Office. For self-employed persons, special provisions may apply. What is covered? The benefits comprise: a retirement pension for employed persons; a heating allowance for retired miners; a holiday allowance and supplementary holiday allowance.

The amount of your retirement pension depends both on your period of employment in Belgium (including paid leave, sickness absence and any periods of unemployment) and on your earnings during that time, adjusted for the cost of living at the time when the pension is calculated. For both men and women, the retirement pension is calculated by applying, for each year worked, one forty-fifth of the full pension rate. Special conditions apply to seamen and miners. The pension amounts to up to 60 percent of your average pay over your working life, and 75 percent if you have a dependent spouse.
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The guaranteed minimum old-age pension for a complete career is 15,369.88 (household) or 12,299.77 (single) per year, calculated pro rata if the career is at least equivalent to two-thirds of a complete career. The maximum pension depends on annual earnings ceiling. On 1 September 2010, the maximum pension for an employee (single person) amounts to 22,956.00. How old-age benefits are accessed? Pension applications must be submitted to the municipal administration at your place of residence. If you live in another EU Member State, you must send your application to the local pension institution in that country. To avoid delays in the processing of your file, you are advised to submit your application one year before reaching retirement age. Your pension can be paid either by postal order, which can be sent to you at home, or by transfer into your post office or bank account.

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Czeck Republic

Social Security in Czeck Republic

Introduction, organization and financing Introduction The social security system in the Czech Republic comprises the pension, sickness and health insurance systems, as well as national employment policy system and the non

contributory social benefit system. The health insurance system is financed via health insurance funds. Other components of the system are financed from the State budget. Premiums are paid by employers and employees or by self-employed persons. The health insurance, pension insurance and national employment policy system are mandatory for every economically active individual; the sickness insurance scheme is obligatory for employees and voluntary for self-employed people. In addition, some groups are considered to be insured without having to pay any premiums (students, women on maternity leave, etc.) if certain conditions are met. Health insurance is compulsory for anyone who resides permanently and is working for an employer located in the Czech Republic. EU citizens who hold a job or are self-employed in the Czech Republic are also covered. For certain categories of people, such as children (up to 26 years old) with no financial resources, pensioners, recipients of parental allowance, women on maternity leave, jobseekers and so on, the insurance premiums are paid by the State. Unemployment insurance is a compulsory social insurance scheme financed by contributions covering the active population (including self-employed persons) and providing earningsrelated benefits. The State social support system is a non-contributory system which is financed from the State budget and administered by the assigned state bodies. By means of the State social support system, the State contributes in particular to families with dependent children in the case of an acknowledged social situation which the family is unable to resolve using its own funds and abilities. Tax-financed social assistance benefits include, alongside the social services system, certain one-off benefits provided to persons with disabilities and the system of assistance in material Senior Ferrol 2011-2012-

need. This latter system is aimed at people with insufficient income. Its fundamental goal is to ensure basic needs for living and housing. The principal condition is low income and the impossibility to improve it by ones own effort (work, use of property and other priority claims). Organisation of social protection Healthcare The central authority of the State healthcare administration is the Ministry of Health (Ministerstvo zdravotnictv), which, inter alia, prepares the legislative framework in this field. Health insurance is compulsory for all persons with permanent residence or employment by an employer with a registered office in the territory of the Czech Republic as well as those covered by EU regulations or bilateral agreements. The insurance is provided by nine health insurance companies as independent legal entities. The entitled persons have the right of free choice among the health insurance companies and also among the healthcare providers that have a contract with his/her health insurance company. The Law guarantees the contracting rules and the accessibility and quality of healthcare. Old-Age, Invalidity, Survivors, Sickness Benefits in Cash The Ministry of Labour and Social Affairs (MOLSA) draws up legislation for the whole sphere of social security (except health insurance). The administration is dealt with by offices of the Czech Administration of Social Security (CSSZ), which is subordinated to and supervised by the Ministry. The Centre of the Czech Administration of Social Security supervises 76 District Social Security Administrations. The main task of the CSSZ is to collect contributions for the basic pension insurance system, the sickness insurance scheme, and the national employment policy system (unemployment insurance and employment policy programmes). The CSSZ is also responsible for the calculation and payment of benefits from pensions and sickness schemes as well as the keeping of records on insured individuals (excluding the system of national employment policy). Unemployment District Labour Offices operate in the individual regions and are subordinated to MOLSA's Section of Employment Policies and Labour Market. Their main activities are the payment of unemployment benefits, keeping records on job applicants and promoting and creating employment opportunities. They also develop and organise employment programmes (placement, vocational guidance, resettlement, etc). Family The schemes of State social support, which cover family benefits and a funeral grant, are administrated by Labour Offices. These offices are responsible for all activities related to the administration of State social support benefits, in particular, collecting applications, registering applicants, compiling the necessary data, operating the nationwide information system, decision-making concerning benefits and issuing of official decisions. In order to make it easier for citizens to apply, District Labour Offices have established contact places in some small towns. Social assistance 22

One-off or recurrent benefits are provided by municipal authorities and financed from the State budget (general taxation). These are obligatory or facultative benefits for the acquisition of special aids, apartment modification, the purchase, special modification and operation of a motor vehicle, individual transport and for feeding a guide dog. Under the system of assistance in material need, the following recurrent or one-off benefits are provided: allowance for living, supplement for housing and extraordinary immediate assistance. Benefits are designated for persons with low incomes or in the event of an emergency situation. Municipal authorities administer Assistance in Material Need at the expense of the central budget (general taxation). Social services provide assistance and support to persons in adverse social situations and care allowance. The latter is a recurrent monthly allowance provided to persons who are dependent on the assistance of a third person due to long-term adverse health conditions. Care Allowance is administered by the municipal authorities at the expense of the State budget (general taxation). Long-term care Long-term care is not ensured by a single system, but it is partially included in the healthcare system, which is the responsibility of the Ministry of Health, and in the social services system, which is run by the Ministry of Labour and Social Affairs. Financing The social insurance system and unemployment benefits are financed by contributions from employees and employers. The healthcare system is funded by contributions and taxation. Family benefits and social assistance are tax-financed. Healthcare When are you entitled to healthcare? All permanent residents and employees of companies with a registered office in the Czech Republic are eligible for public healthcare. What is covered? Insured persons are entitled to free choice of a primary healthcare physician who has a contract with his/her insurance company. They can re-register with a new physician every three months. There are no restrictions on the patient's choice of healthcare provider. There are charges of CZK 30 ( 1.14) for a visit to a practitioner, a specialist or a dentist where a clinical examination was carried out, and of CZK 90 ( 3.42) for a visit to an emergency service doctor. Several categories of persons are exempted from regulatory charges, notably: persons placed in childrens homes; persons placed in homes for disabled persons or for elderly persons if their minimum income remainder (as specified by another legal provision) is less than CZK 800 ( 30); persons ordered a protective treatment by the court; those proved to be in material need;

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persons obliged to be treated for an infectious disease.

These charges are also not applicable in cases of preventive examination, dispensary care provided to selected patients (including pregnant women), haemodialysis, laboratory or diagnostic examination, examination by a blood transfusion doctor and for children up to age of 18. Charges for out-patient healthcare consist of co-payments for medication and medical devices. A regulatory charge of CZK 30 ( 1.14) is made for each prescribed medication which is fully or partially reimbursed by the public health insurance system. Exemptions from these charges are the same as above. Dental services are reimbursed according to a special price list, and a patient does not bear the costs himself, unless the law provides otherwise. How is healthcare accessed? Patients are given direct access, which is not restricted by a gate-keeping system. The only restriction is in cases where they want to have a non-urgent treatment covered by public health insurance: the provider must have a contract with the health insurance company of the person concerned. There is free choice of contracted hospitals after referral by a primary doctor or a specialist. Old-age pensions and benefits When are you entitled to old-age benefits? A minimum of 16 years membership of the insurance scheme is required if the claimant has already reached the age of 65. To retire at the statutory age, a minimum of 26 years insurance is required. The retirement age is different for men and women. Men may retire at the age of 62 years and two months, while for women the time of retirement depends upon the number of children raised: no children: 60 years and eight months; one child: 59 years and eight months; two children: 58 years and eight months; three or four children: 57 years and eight months; five or more children: 56 years and eight months.

The retirement age will be gradually increased by two months for men and four months for women each year until it reaches 65 years for men and women with one or no children, and from 62 to 64 years for women with two or more children. What is covered? Amounts The value of the pension depends on earnings and the insurance period. The pension is calculated from the following two elements: a basic amount of CZK 2,170 ( 83) per month, to which is added a percentage amount tied to earnings and calculated from the personal assessment base and the number of years of contributions (1.5 percent of the personal

24

assessment base per year of insurance). The minimum value of the percentage amount is set at CZK 770 ( 29) per month. The personal assessment base is based on the average gross earnings over the years preceding retirement. This period was initially ten years and is extended by one year every year until it reaches a total of 30 calendar years. Currently this period covers all earnings since 1985. All earnings which are taken into account are indexed in relation to the average wage. The personal assessment base is calculated from these gross earning using the following formula: up to CZK 10,500 ( 399): 100 percent incorporation; from CZK 10,500 ( 399) to CZK 27,000 ( 1,027): 30 percent incorporation; over CZK 27,000 ( 1,027): ten percent incorporation.

Adjustment Pensions are adjusted regularly, every January, by a minimum of 100 percent of inflation (in the 12-month period running to July of the previous year) and by at least one-third of the average growth in real wages (in the 12-month period running to January 1 of the previous year). Pensions may be adjusted by government decree to speed up the legislative process and to ensure that the value of the pension continually reflects growth in prices and wages. The thresholds for the personal assessment base are also adjusted regularly so that the ratio between existing and newly-granted pensions and between pensions and earnings is maintained. There are no limits on income. All earnings are permitted. Early and deferred pension The earnings-related amount of pensions is reduced by 0.9 percent for every (even incomplete) period of 90 days that the pension is received within a 720-day reference period before normal retirement age, and by 1.5 percent for every period of 90 days of pension receipt preceding this reference period, up to a maximum of three additional years. A minimum limit of 90 days after normal retirement age is stipulated for deferred pensions. For every 90 days of economic activity during which the claim for an old-age pension is postponed, an increase of 1.5 percent of the reference value is provided for. As long as an old-age beneficiary works (and has only half of his/her pension), his/her pension is increased about 1.5 percent for every period of 180 calendar days, or 0.4 percent for every 360 days if the beneficiary works and has whole pension. How are old-age benefits accessed? In the Czech Republic, there is a compulsory social insurance system financed by contributions from employers and employees and providing earnings-related benefits according to the length of insurance. Pensions in general are granted by the system of social insurance. It pays out earnings-related benefits linked to the period of insurance coverage. Participation is mandatory for employees, assimilated groups (for example students at secondary school or university in respect of periods of studies before 2009, the unemployed, people caring for children/the disabled, people in military service etc.), and the self-employed. The Pension Senior Ferrol 2011-2012-

Insurance Act lists those required to join the pension insurance scheme provided they meet the conditions stipulated in the Act. Most people become members in the insurance scheme by law, without having to sign up. There are exceptions for people personally caring for a dependent child (younger than ten years) in the first to the fourth level of dependence, or the older dependent person in the second to the fourth level of dependence, provided that they are part of the same household (in the case of a close relative, the household condition will not be required). People in this case can join the pension insurance scheme by submitting an application for evaluation of the care period after or during the care period in connection with a request for any kind of pension. Applications are to be submitted to the Social Security Administration for the district where the care-giver resides permanently. Self-employed workers Self-employed people must inform the Social Security Administration for the district in which they reside permanently (or, if they do not have a permanent residence in the Czech Republic, the Social Security Administration for the district in which they are self employed) that they have commenced or re-commenced self-employment or cooperation in the self-employment of another person, or that they have terminated their self-employment, by the eighth day of the calendar month following the month in which the event to be reported occurred. Voluntary insurance People over 18 may apply to join the pension insurance scheme voluntarily, provided the application concerns a period where: they are registered as jobseekers who are not entitled to unemployment benefit, where this period exceeds the one (three) year(s) referred to in the Act; they are studying at a secondary school, higher specialised school or university, with the exception of the first six years of study after the age of 18, which are covered by law (if acquired before 2009); they are staying abroad as a spouse of a person working in the diplomatic service of the Czech Republic; they are engaged in a gainful activity abroad; they are performing voluntary work on the basis of an agreement signed with the posting organisation under the Volunteer Service Act.

In the first three cases above, an application for participation in the insurance scheme may be submitted and premiums paid at any time prior to the submission of an application for a pension. In the case of a gainful activity abroad, or of voluntary services, premiums may be paid retrospectively for a period equivalent to up to two years before the application to join the insurance scheme was submitted. Anyone else over 18 may choose to participate in a pension insurance scheme. They may, however, only make retrospective payments covering up to one year before they applied to join the insurance scheme. Up to ten years of pension insurance may be acquired in this way. Applications are to be submitted to the Social Security Administration for the district where the applicant resides permanently. Pension insurance covers the following: old-age pension; 26

disability pension; widows and widowers pensions and orphans pension .

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Germany

Social Security in Germany

Introduction, organisation and financing Introduction

The German social security system comprises five statutory types: sickness insurance, long term care insurance, pension insurance, accident insurance and unemployment insurance. This chapter explains for each type who is the insurers and the insured, and sets out the registration and contribution procedures. Old-age insurance for farmers, insurance for craftsmen and social insurance for artists and publicists are not included in this guide. Further information concerning these types of insurance can be obtained from the competent insurance institutions. The insurance institutions have set up liaison bodies for dealings in the field of social security with the other EU Member States. If you have problems or questions concerning social security in Germany and one or more other Member States, you should get in touch with the competent liaison body. With the exception of a few professions (for example, civil servants, judges and military personnel), all workers are subject to compulsory insurance, unless their salary exceeds the fixed ceiling for compulsory insurance. Conversely, those in marginal employment who earn no more than 400 per month are exempted from insurance. Unemployment insurance may in principle be extended on a voluntary basis by making a request to the Federal Employment Agency, provided that, in the 24 months prior to taking up a self-employed activity, the interested party has for a period of 12 months been subject to compulsory insurance or received unemployment benefit. You may contact your local employment agency for information or advice. In addition to the above-mentioned types of social security, there is also State social support, basic provision for jobseekers and various family benefits and housing allowances The registration procedure

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As soon as you have taken up employment, your employer will take the necessary steps to register you for social security. You will first be registered with the sickness insurance fund (Krankenkasse), which will then inform the competent pension and unemployment insurance bodies. You will be given an insurance number (Versicherungsnummer), under which the pension insurance institution will record your periods of insurance and your contributable income. Upon taking up employment for the first time, you will receive a social insurance identity card (Sozialversicherungsausweis or SV-Ausweis) from the pension insurance institution. This contains your surname, maiden name (where appropriate), given name and your insurance number. For some professions (e.g. construction), the identity card must have a photo and must be carried during working hours. All persons to whom a new insurance number is allocated immediately receive notification of which pension insurance body is competent in their case. Self-employed persons must register themselves with the competent sickness insurance fund. Organisation of social protection Statutory pension insurance The statutory pension insurance (Gesetzliche Rentenversicherung) is organised by the Federal Institution for German Pension Insurance (Deutsche Rentenversicherung Bund), the Regional Institutions of the German Pension Insurance (Regionaltrger der Deutschen Rentenversicherung), the German Pension Insurance for Mining, Railways, Marine (Deutsche Rentenversicherung Knappschaft-Bahn- See) and the old-age pension funds for farmers (Landwirtschaftliche Alterskassen). Statutory sickness insurance The statutory sickness insurance (Gesetzliche Krankenversicherung) is in the hands of roughly 196 insurance funds, some of which operate regionally (e.g. local sickness insurance funds, Ortskrankenkassen) and some of which operate at a national level (e.g. most of the substitute funds, Ersatzkassen). These funds are open to all members regardless of occupation or employment in a company (exceptions are the fund for seamen and the agricultural funds for farmers). Apart from a few special categories (e.g. civil servants, judges, soldiers) all employees are subject to compulsory insurance, unless the remuneration is above the annual assessment ceiling in three consecutive years. For minor employment, special rules are applied. The sickness insurance funds administer the collection of the overall social insurance contributions for all branches. Statutory long-term care insurance Each statutory sickness insurance fund has established a long-term care insurance fund which is responsible for granting benefits to beneficiaries who are in need of long-term care. All persons who are members of a statutory sickness insurance fund are covered against the risk of need for long-term care in the same fund. Persons with private sickness insurance coverage must correspondingly conclude a private long-term care insurance contract. Statutory accident insurance Senior Ferrol 2011-2012-

The relevant organisations of the statutory accident insurance (Gesetzliche Unfallversicherung) are the accident insurance institutions for the industrial sector (Berufsgenossenschaften) and the accident insurance institutions of the public sector. Statutory unemployment insurance Statutory unemployment insurance (Gesetzliche Arbeitslosenversicherung) is implemented by the Federal Employment Agency (Bundesagentur fr Arbeit). It is divided into the main office, the regional directorates and the local agencies. All employees are covered (manual workers, white-collar workers, trainees including young disabled persons). Self-administration The individual branches of social insurance are self-governed by representatives meetings and board meetings or administrative boards which consist of the same number of representatives of the employers and the insured persons. In the field of unemployment insurance, representatives of the public sector are included as a third party. The selfadministration of substitute funds consists only of the representatives of the persons insured. Supervision As regards supervision, the Federal Ministry of Health (Bundesministerium fr Gesundheit) is responsible for the branches of sickness and long-term care insurance. The Federal Ministry of Labour and Social Affairs (Bundesministerium fr Arbeit und Soziales) is responsible for (oldage, survivors' and invalidity) pension, accident, and unemployment insurance. As regards the competence of the supervisory authorities, the important factor is whether the insurance fund is a Lnder or a federal institution. An insurance fund qualifies as a Lnder institution when its responsibilities do not extend beyond its Land. Furthermore, a fund whose responsibilities stretch over more than one Land (max. three), is also to be considered a Lnder institution, provided the Lnder involved stipulate one supervising Land. In such a case, supervision falls under the responsibility of the highest social insurance administrative body at a Lnder level, or the authority stipulated by the Land's legislation. This is also the case for associations at a Lnder level. In all other cases, the insurance fund qualifies as a federal institution (as for instance the Federal Institution for German Pension Insurance (Deutsche Rentenversicherung Bund), the German Pension Insurance for Mining - Railway - Sea (Deutsche Rentenversicherung Knappschaft - Bahn - See) and the Substitute Health Insurance Funds (Ersatzkrankenkassen). The Federal Insurance Office (Bundesversicherungsamt) is the competent supervisory body. Financing The social security system is financed from national insurance contributions paid by employers and employees, and from general tax revenue. If as a worker you earn more than a minimum income, you are obliged to pay contributions to sickness insurance, long-term care insurance, unemployment insurance and pension insurance. The level of your contribution is a fixed percentage of your earnings. In principle, half of the contribution has to be paid by you while your employer pays the other half. However, selfemployed persons pay their full contribution to statutory sickness insurance, long-term care insurance and pension insurance.

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Employers are exclusively responsible for accident insurance contributions. Your employer is responsible for the actual payment of contributions every time your wage or salary is paid. The statutory sickness insurance funds manage the collection of the total amount of contributions for all types of social security. The total contribution to the sickness insurance scheme currently represents an average of 14.9 percent of your earnings up to an amount determined on an annual basis (ceiling for the calculation of contributions for 2010: 45,000 annually). Half of the contribution is borne by the employer. You are solely responsible for an additional contribution to statutory sickness insurance at a rate of one percent (as at 2010). The contribution rate for long-term care insurance (Pflegeversicherung) is 1.95 percent. Insured persons born since 1940 without children pay an additional contribution of 0.25 percent once they reach the age of 23. The ceiling for statutory sickness insurance and long-term care insurance was 45,000 annually in 2010. For general pension insurance, the total amount in 2010 was 19.90 percent of earnings up to the contribution ceiling (in 2010, this was 66,000 annually in the old Lnder and 55,800 annually in the new Lnder). Half of the contribution is borne by the employer. In 2010, the rate of contribution to unemployment insurance was 2.8 percent of earnings up to the contribution ceiling applicable to pension insurance. Half of the contribution is borne by the employer. No contributions are payable for family allowances (which are financed by public funds). Healthcare When are you entitled to healthcare? There is a general obligation for the entire population (unless their income exceeds a ceiling of 49,950) to become affiliated with the statutory or private health insurance. The following are entitled to benefits: persons in paid employment and those receiving vocational training, including trainees; pensioners with a sufficient period of insurance; unemployed persons receiving unemployment insurance benefits; disabled persons in sheltered employment; persons participating in vocational rehabilitation and people being trained for some form of employment in special training institutions for youth assistance (Jugendhilfe); students in recognised higher education; farmers and helping members of their family; artists and writers; persons having no other right to the provision of healthcare services (under certain conditions).

Senior Ferrol 2011-2012-

No qualifying period is required. What is covered? Preventive examinations For the early detection of diseases, you and the members of your family are entitled to the following preventive medical examinations: screening examinations for children's diseases up to the age of six and from the age of ten; yearly screening examination for cancer for women from the age of 20 and men from he age of 45; every two years, a general medical screening examination for, in particular, heart, circulatory and kidney diseases or diabetes for insured persons from the age of 35.

Medical care For as long as you are insured, you and the members of your family are entitled to treatment by general practitioners, specialists and dentists. Per quarter, and for each initial consultation of a doctor or dentist which has not been requested by another practitioner during the same quarter, you must pay a special tax (Praxisgebhr) of 10. Medicines, therapeutic aids and appliances Medicines are available on prescription from a sickness insurance fund doctor and may be obtained from all pharmacies. As a general rule, every medicine bought in a pharmacy entails an extra charge corresponding to ten percent of the sale price, with a minimum of 5 and a maximum of 10. The extra charge may not, however, exceed the price of the medicine. You must pay the full cost of medicines taken for certain illnesses such as a common cold or influenza and for other minor ailments. There is, however, an exemption to the fact that overthe-counter drugs are not paid for by the insurance fund. For example, medicines for children up to the age of 12 showing developmental disability, as well as pharmaceuticals which, according to the guidelines of the Joint Federal Committee (Gemeinsamer Bundesausschuss) constitute the therapy standard for the treatment of serious diseases, are (partially) refunded. Insured persons are also entitled to therapy (physiotherapy, massage, etc.). From the age of 18, insured persons are obliged to pay an additional charge of ten percent of the sale price, plus 10 per prescription, but not exceeding the cost of the treatment. The sickness insurance fund normally assumes financial responsibility for the cost of spectacle lenses, prostheses and other aids and appliances up to a fixed amount. The relevant prescriptions must first be submitted to the sickness insurance fund for approval. Here too, an extra charge corresponding to ten percent of the sale price must be paid, with a minimum of 5 and a maximum of 10. The extra charge may not, however, exceed the price of the product purchased. Dental services

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Insured persons pay 50 percent of the approved rates for dentures and crowns. There is full compensation of medically necessary conservative and surgical dental treatment. Insured persons pay 20 percent of the cost of orthodontic treatment (the prevention and correction of irregularities of the teeth). They are only refunded this 20 percent after the treatment has been completed. There is full compensation of necessary orthodontist care for insured persons aged less than 18. Domestic nursing care and domestic help If the circumstances in your household are such that you cannot be given the necessary care and attention by a person living in your household when you are ill, the sickness insurance fund will pay not only for the medical treatment but also for the necessary domestic nursing care by qualified nursing staff. However, this right exists only where hospital treatment is required but is not possible, or where this treatment can be avoided or shortened by care at home. In principle, entitlement to domestic care is limited to four weeks per case of sickness. You may also receive domestic help when, as a result of your illness, you cannot carry out your household duties. This benefit, however, is provided only if your household includes a child who is below the age of 12 or is disabled, and who cannot be looked after by another person at home. In-patient treatment You are entitled to any form of hospital treatment you may require. The need for hospital treatment must be confirmed in a certificate from the doctor. Except in the case of emergencies, an application must be made before hand to the sickness insurance fund for coverage of the costs. For up to 28 days per calendar year, you must pay a contribution of 10 for each day in hospital. Travel expenses Under certain conditions, travel expenses incurred for the purpose of obtaining medical treatment may be partially or wholly paid for by the sickness insurance fund. Insured persons pay ten percent of the travel expenses themselves, with a minimum of 5 and maximum of 10 per journey. How is healthcare accessed? Before any medical treatment, you must present the doctor concerned with a health insurance card (Krankenversichertenkarte). In an emergency, the doctor will treat you without requiring this card; in this case, you should provide him or her with the name and address of the sickness insurance fund with which you are insured. Treatment is provided by doctors or dentists who have contracts with the sickness insurance funds more than 90 percent of all established medical practitioners between whom you may choose at the commencement of treatment or at the beginning of each calendar quarter. A list of these practitioners is available from your sickness insurance institution. If your doctor considers it necessary to refer you to a specialist, a polyclinic or a similar institution, s/he will give you a referral note (berweisungsschein). Senior Ferrol 2011-2012-

Old-age pensions and benefits When are you entitled to old-age benefits? Everybody who is subject to compulsory pension insurance (i.e. all employees and certain groups of self-employed people, earning more than a minimum income) is covered by old-age insurance. An old-age pension is seen as a reward for the work you have done in the course of your working life. To receive it, you must have reached a certain age and completed a minimum period of insurance (the general qualifying period is five years of contribution and substitute periods). All calendar months in which you paid contributions or were rearing a child under three years of age are taken into account for qualifying periods of five, 15 and 25 years. For the qualifying period of 35 years, the periods taken into account are all pensionable periods. This includes, for example, training periods and periods of rearing a child below the age of ten. If, on reaching pensionable age, you wish to cut back on your professional activity without stopping completely, you may opt for partial retirement, i.e. to receive your old-age pension in the form of a partial pension (one-third, one-half or two-thirds of the full pension). You may also decide not to claim your pension for the time being. If, on reaching the age of 65, you do not claim an old-age pension or only claim a partial pension, your final full pension will be increased by 0.5 percent per month (6 percent per year) of the amount of pension you did not claim before. Normal retirement pension (Regelaltersrente) The legislation provides for the standard retirement age to be gradually increased to 67 years from 2012 to 2029, starting with those born in 1947. For all those born after 1963, the standard retirement age of 67 years will apply. It will still be possible for insured persons to retire at the age of 65 years without having their pensions reduced if they completed 45 years of compulsory contributions from employment and care and from child-raising periods up to the age of ten. There are no limits to the amount of income you may receive in addition to your normal retirement pension. Early pension The retirement age for early pensions will be adjusted to the new standard retirement age. However, there is no adjustment for pension types which are being phased out; for these pensions, the standard retirement age remains 65 years of age. An early pension (at reduced rate) may be claimed from the age of 63 after 35 years of pension insurance periods. The old-age pension for the severely disabled may be claimed by insured persons who have reached the age of 65, are recognised as severely disabled when the pension is first paid, and have completed a qualifying period of 35 years. Early payment of this kind of old-age pension is possible at a reduced rate from the age of 62.

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Insured persons born before 1 January 1952 may claim a reduced old-age pension at the age of 63 if they: have completed a qualifying period of 15 years; have paid compulsory contributions for an insured occupation for eight years out of the last ten preceding the start of the pension; are unemployed at the start of the pension; have been unemployed from the age of fifty-eight and a half for a total of 52 weeks or have worked part-time on the grounds of age (Altersteilzeitarbeit) for at least 24 months before the start of the pension.

As a compensation for the longer duration of pension payments, the pension is reduced by 0.3 percent for each month of drawing a pension prior to the standard retirement age (in case of old-age pension for persons with severe disability before the age of 65). There are special rules for miners. They are entitled to an old-age pension on reaching the age of 60, provided that they have completed a qualifying period of 25 years. Old-age pension for women Women are entitled to an old-age pension at the age of 60 if they can produce evidence of more than ten years of compulsory contributions after reaching the age of 40. The qualifying period is 15 years. Insured women born from 1952 onwards are not entitled to claim this oldage pension. The standard retirement age remains the age of What is covered? The amount of your pension will depend on the amount of social security contributions paid by you in the course of your entire 'insurance life'. In addition to contribution periods, other periods exempt from contributions or with reduced contributions may increase the pension. How are old-age benefits accessed? As a matter of principle, pensions are awarded only if applied for. The application should be made to the competent social insurance institution.

Senior Ferrol 2011-2012-

Italy
Social Security in Italy Introduction, organisation and financing Introduction The social security system in Italy provides benefits to employees and the selfemployed in case of illness, maternity and unemployment. It also offers family allowances and provides benefits for the elderly and disabled people. There are important distinctions between insurance-based, categoryand income/asset-related benefits. It is possible to receive any one or more type of benefit according to applicant and family circumstances. Registering for compulsory social and health insurance If you are a salaried employee or wage earner, your employer will take care of all the formalities. If you are self-employed, you are responsible for registering with the National Social Security Institute (Instituto Nazionale Previdenza Sociale, INPS Employed persons Contributions are calculated as a percentage of pay. The schedule of rates is fixed by legislative provision. The rate applicable in each case depends on the sector (industry, commerce, craft industry, credit, insurance, etc.), the professional qualification of the individual, the number of employees, the location of the business, etc. For the purpose of determining the contribution base, pay is considered to cover everything the worker receives from his or her employer, in cash or in kind, as a result of their employment relationship, before deductions. Only items formally exempted by the applicable legislation are excluded. The unit pay (hourly, daily, monthly, depending on the type of work) cannot be less than the threshold set for the category the worker belongs to. The employer is responsible for paying both his own and the employees contributions to the National Social Security Institute (INPS). The contributions are paid monthly using a special form (F24) and are declared to the INPS on the electronic monthly statement UNIEMENS. Self-employed workers 36

Contributions are calculated on the total earned income declared on the income tax return for the relevant year. Members of the self-employed workers family who provide assistance also have to pay contributions, although these are charged a lower rate if they are under the age of 21. There is also an annual income criterion, with minimum and maximum limits. For farmers, sharecroppers and smallholders, the contribution is exclusively pro rata the average traditional taxable income (set each year by special ministerial decree), for each of the four income brackets into which farms are divided, depending on their agricultural income. The standard rate is reduced for farms in mountain regions and disadvantaged rural regions. National Health Service (Servizio Sanitario Nazionale) contributions are paid directly to the State Treasury, with the annual income tax return. Voluntary contributions Insured persons who interrupt or cease their salaried or independent activity can continue to pay contributions voluntarily in order to preserve or improve their pension and disability insurance rights; these payments are treated as compulsory contributions. To qualify for this right the person must have paid real contributions for at least five years over his or her working life or three years out of the five preceding his or her application. For certain categories of workers (seasonal, part-time, parasubordinati), the payment of contributions for one year in the five years preceding the application is required. The necessary contributions can be paid either as an employed or a self-employed person or as a combination of the two. Parasubordinati may be permitted to continue to pay contributions voluntarily as part of the same separate administration during periods when they are not practising the activity in question. Voluntary contributions to top up the necessary nominal contributions can also be paid by: persons who choose to stop working while their child is between the ages of three and eight; Women who take legal leave to nurse an infant or care for a sick child (between the ages of three and eight).

Authorisation to pay voluntary contributions is valid from the first Saturday following the date of submission of the application, for independent workers, and is permanent. The amount of the contribution is based on average pay in the last year before the authorisation was given; a minimum amount is set, which corresponds to 40 percent of the basic pension in effect on 1 January each year. Payments made for a lower class than the beneficiary belongs to entail a proportional reduction in the number of weeks recognised. Contributions are paid quarterly by postal cheque, or by direct deposit at authorised banks. Redemption of non-insured periods In certain conditions, you can pay a special contribution to redeem periods when you were not insured. This applies, for example, to years of university studies and to periods spent working in a country with which Italy does not have a social security agreement. If you have already paid insurance contributions for a minimum period of five years, you can also redeem Senior Ferrol 2011-2012-

non-insured periods when you were not working in order to look after a child or a person with disabilities. Nominal contributions In certain cases, contributions that you have not actually paid can be credited to your account. Nominal contributions can be used both to top up your years of insurance service for pension entitlement and to increase the amount of the pension. Periods of sickness and/or unemployment benefit cannot be used to complete pension entitlement for retirement pensions based on fewer than forty years of contributions. Nominal contributions may be credited for: military service and redeployment; political or racial persecution; occupational injury or disease; unemployment; tuberculosis; pregnancy and childbirth; parental leave; natural disasters; activity performed by disabled workers; assistance to members of the family who are severely disabled; Solidarity contracts; voluntary blood donations; special leave for public or union business; socially useful and public service work.

Organisation of social protection The Italian Social Security system (Previdenza Sociale) is managed by the National Social Security Institute (Instituto Nazionale Previdenza Sociale, INPS). It does not administer the national health system, which is under the competence of separate entities. With the exception of healthcare, the Italian system of social protection is not organised according to one universal criterion. For each branch there is one special administration which is responsible for the collection of contributions and the provision of benefits. The implementation and supervision of the legislation fall within the competence of the Ministry of Labour and Social Policies (Ministero del Lavoro e delle Politiche Sociali). Healthcare and sickness benefits in kind The Ministry of Health (Ministero della Salute) is the competent institution for this field. It administers the resources, allocating them to the regions and municipal authorities that are in charge of benefit provision through the local health centres (Azienda sanitaria locale). Sickness and maternity - benefits in cash The Ministry of Labour and Social Policies is competent for sickness cash benefits for employees of the private sector. The administration of contributions and benefits has been assigned to the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS) by means of an ad hoc administration. Civil servants do not receive cash benefits for sickness and maternity; however, the State does continue to pay their salaries. Invalidity benefits, old-age and survivors pensions

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Almost all employees in the private sector and certain categories in the public sector have compulsory insurance coverage through INAIL against old age, invalidity, death, unemployment, tuberculosis and sickness. Domestic workers enjoy the same protection as employees (except for cash sickness benefits), as do those working at home, save for unemployment benefit (trattamento di integrazione salariale). INAIL also covers the following categories of independent workers, but only for old age, invalidity and death: farmers, sharecroppers and smallholders, tradespersons and shopkeepers, registered midwives practising independently, and farm owners for whom farming is their principal activity. The INPS manages a number of special provident funds for certain categories of workers, including railway and tramway workers, tax, licensing, telephone and private gas company employees, and ministers of religion. Private sector employee pensions The competent institution is the Ministry of Labour and Social Policies. Implementation is carried out by the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS) for general employment, as well as two special schemes for which an ad hoc administration is provided: 1. National Institute for Social Security of the Italian Journalists (Istituto nazionale di previdenza dei giornalisti italiani, INPGI) for journalists. The system has been private since 1 January 1995; 2. National Institute for Social Security of Show Business Workers (Ente nazionale previdenza ed assistenza lavoratori spettacolo, ENPALS) for artists and soccer players. Public sector employees The administration of the pensions for civil servants and the benefits for employees of the local authorities falls within the responsibility of the National Institute for Social Security of Employees of Public Authorities (Istituto nazionale di previdenza per i dipendenti dell'amministrazione pubblica, INPDAP). Self-employed persons For farmers, craftsmen and persons engaged in business or trade, there are special schemes within the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). Private ad hoc schemes exist for the liberal professions. Employment injuries and occupational diseases The competent institution is the Ministry of Labour and Social Policies. The collection of contributions and provision of benefits are carried out by the National Institute for Insurance against Employment Injuries (Istituto nazionale contro gli infortuni sul lavoro, INAIL). Family benefits The competent institution is the Ministry of Labour and Social Policies. The collection of contributions and provision of benefits falls to an ad hoc administration within the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). Part of the financing of benefits is made directly at the States expense. Senior Ferrol 2011-2012-

Unemployment The competent institution is the Ministry of Labour and Social Policies. The collection of contributions and provision of benefits has been entrusted to an ad hoc administration within the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). This also includes all non-contributory benefits granted by the INPS: early retirement pensions, social pensions, minimum pensions. Guaranteeing sufficient resources The competent institution is the Ministry of the Interior (Ministero dell'Interno). Benefits are granted at local level and administered by the regional and/or the local authorities and the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). Financing The Italian social security system is financed from national insurance contributions paid by employers and employees, as well as from general tax revenue. Healthcare When are you entitled to healthcare? The public health service is based on residence. Healthcare is provided to all those registered with the local health centres (Azienda sanitaria locale) and all those who are eligible under the applicable national and Community legislation. Each Italian national resident in Italy and everyone affiliated to the health insurance system of another Member State of the European Union working in Italy and their dependants are covered for medical assistance. What is covered? The treatment or medicine may be supplied free of charge by the local health centre or by doctors or pharmacists attached to the health system, or the patient may pay the cost of the benefits received and be reimbursed. Most medicines are listed in the pharmacists schedule, which divides them into two categories. Drugs in the first category, which are intended for emergency care and for the treatment of high risk, chronic and disabling diseases, are wholly free of charge. For the second category, you pay part of the cost directly to the pharmacist who fills your prescription. There is a minimum charge for every prescription. If the doctor prescribes a drug that is not on the schedule, you will have to pay the full cost yourself. There is a user fee for diagnostic and laboratory tests. However, hospital care is free of charge in public hospitals and in private clinics that are attached to the National Health Service (Servizio sanitario nazionale, SSN). You have to be referred by your GP, except in emergencies. Admission to accredited institutions has to be approved by your local health centre. Hospitalisation is free, but you have to pay for any extras (private room, telephone, television). Although the guaranteed minimum benefits are the same everywhere in Italy, since the Italian regions have considerable autonomy in this domain there may be slight regional variation in the conditions and methods of payment of medical, pharmaceutical and supplementary benefits. Available medical assistance includes: 40

the services of a general practitioner outside a hospital; paediatric, obstetric and gynaecological care; the services of a specialist (including dental care) in public and private dispensaries that have contracts with the national health service; hospitalisation (including for childbirth) in public hospitals, clinics, etc. and private institutions that have contracted with the national health service; medicine and pharmaceutical products, on prescription by general practitioner or specialist who is employed in or accredited by the National Health Service.

Benefits for tuberculosis patients Persons suffering from tuberculosis are covered by special provisions; they are also insured for sickness and maternity benefits. The special regime includes medical assistance and cash benefits. Workers and family members who suffer from tuberculosis are entitled to certain conditional cash benefits as long as the insured has paid at least one year of contributions over the course of his or her working life. Other supplementary benefits The national health system offers special supplementary benefits. Supplementary benefits are for the most part indirect, and only part of their cost is refunded. Paediatric care is free up to the age of twelve. These include thermal cures, special orthopaedic treatments, prostheses and certain key diagnostic benefits. To receive these benefits you must apply to your local health centre with a recommendation from your consulting physician. How is healthcare accessed? General medical assistance is provided by local health centres (Azienda sanitaria locale). These are part of the National Health Service (Servizio sanitario nazionale, SSN). You must visit your local health centre to enrol in the National Health Service and obtain a health insurance card (Tessera Sanitaria). Those who are employed or self-employed can enrol as soon as contributions are paid into the Italian National Insurance system. When you are registered, you can freely choose a doctor in your region from the list of those attached to the National Health Service. For general medical assistance, you go directly to the National Health Service doctor in your local health centre or in another service accredited by the National Health Service. You have to go to the doctor on whose list you are registered, or the locum if s/he is absent. If you are temporarily away from your place of residence or stay, you can in an emergency visit any National Health Service doctor. In these cases you pay the cost of treatment, which will be refunded according to the health service schedule. There is an on-call service for emergency treatment at night and on Sundays and holidays. Any time you move, you must register with the local health centre in your new locality. For seamen and civil aviation flight crews, health care benefits are administered by a special Ministry of Health service (Ufficio di sanit marittima ed aerea). Old-age pensions and benefits Senior Ferrol 2011-2012-

When are you entitled to old-age benefits? The 1995 pension reform introduced a new system for calculating the old-age pension in respect of contributions. This Defined Contribution System (Sistema Contributivo) applies to all workers insured for the first time after 1 January 1996. Under this system: contributions are paid into each workers account, calculated on the basis of a defined rate; this is 33 percent of the assessable base for employed persons, 20 percent for independent workers and 26.72 percent for parasubordinati; the provisional contributions are adjusted annually by a factor equal to the average five-year variation in GDP, specially calculated by ISTAT (the Italian Statistics Institute) in reference to the five years preceding the adjustment year; the amount thus obtained (paid-in capital plus revaluation) is multiplied by a conversion coefficient linked to the age of the worker when the pension is drawn. The conversion coefficient for the years between the ages of 57 and 65 is linked to the waiting period for entitlement to the pension and varies from 4.720 to 6.136 percent.

For those whose pension is based exclusively on the defined contribution system, the contribution and pension base is limited to 92,147 a year. Pensions paid under this system cannot be topped up by the minimum pension supplement. The Defined Benefits System (Sistema Retributivo) is for persons who had accumulated at least 18 years of insurance contributions on 31 December 1995. The pension will continue to be calculated on the basis of the Defined Benefits System, partially modified by Law 335 of 8 August 1995 on reform of the compulsory and supplementary pension system in respect of the reference period for earnings. The maximum pension is based on forty years of contributions, and for each year of payment there is an increment of 2 percent of the average pay that is taken into account for the pension. Regressive rates are applied to pay above a certain ceiling. A Hybrid system (Sistema Misto) runs in parallel. For persons who had not accumulated 18 years of insurance contributions on 31 December 1995, the pension is calculated according to the Defined Benefits System for the portion corresponding to this period and according to the Defined Contributions System for the portion corresponding to the oldage pension contributions accumulated since 1 January 1996. Early retirement Insured persons who have reached coefficient 95 (sum of their age plus their contributions) for 2010 or coefficient 96 for 2011 are entitled to claim early retirement at the age of 59 in 2010 and 60 in 2011. Early retirement is also available to employees in enterprises experiencing economic difficulties and mothers at home. Any missing contribution years up to the normal retirement age are calculated as if they were covered by contributions. What is covered? All employed persons and certain categories of independent workers (farmers, sharecroppers and smallholders, tradesmen and merchants) are conditionally entitled to an old-age pension. Self-employed professionals (doctors, etc.), are also entitled to a European Commission , but the rules governing this sector vary considerably, depending on the insurance category. If you are an employee, you must stop working in order to receive the pension.

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Since 1 January 2000, the old-age pension is paid when you reach statutory retirement age, i.e. 65 for men and 60 for women, if you are employed or self-employed and have been insured and have paid contributions for at least twenty years. The conditions for drawing a full pension are 40 years of insurance and contributions. Minimum pension To be entitled to the minimum pension, your income and that of your spouse must not exceed certain limits, which are set annually. The personal income limit for 2010 is 5,992.61. If your income is between 5,460.25 and 11,985.22, you are entitled to a reduced supplement. If your income is over 11,985.22, you are not entitled to any supplement. The combined income limit for a couple, again for 2010, is 17,977.83. If your income is between 17,977.83 and 23,970.44, you are entitled to a reduced supplement. If your combined income is more than 23,970.44, you are not entitled to any supplement. For pensions that were claimed before 1994, only the retired persons income is taken into account with regard to the supplement; for pensions due in 1994, the combined income of the two spouses are taken into account as well as the income of the retired person; this combined income must be less than five times the annual amount of the minimum pension. For married persons, the minimum pension supplement can in no case be paid if the personal income is over the prescribed limit, even if the combined income is less. Similarly, the supplement cannot be paid if the retired persons personal income is below the limit but the combined income is above it. How are old-age benefits accessed? Application for retirement benefits must be made directly to the competent Cassa or to the INPS. Many forms can be obtained from the INPS website.

Senior Ferrol 2011-2012-

Poland

Social Security in Poland Introduction, organisation and financing Introduction In Poland, social security consists of: old-age pension; disability pension;

sickness and insurance;

maternity

insurance against accidents at work and occupational diseases; Health insurance.

In addition to this, Poland has a system of family benefits, social assistance benefits and unemployment benefits. The Polish social security system covers practically all people in active employment, i.e. employees, self-employed people and their family members. Social insurance may be mandatory or voluntary. All people in active employment, that is, employees, the self-employed and farmers, are covered by mandatory insurance. Reporting these people to social insurance is the responsibility of either those who pay the contributions (employers), or, for the self-employed and clergy, of the individuals themselves. Organisation of social protection The social security system is contained within the general framework of the Ministry of Labour and Social Policy (Ministerstwo Pracy i Polityki Spoecznej) and the Ministry of Health (Ministerstwo Zdrowia) but the system's legal, administrative and financial organisation is independent from that of these Ministries. The following institutions administer the social security schemes: The Social Insurance Institute (Zakad Ubezpiecze Spoecznych, ZUS) and its regional services, which are responsible for sickness and maternity cash benefits and pensions for retirement, invalidity, survivors, employment injuries and occupational diseases. The Social Insurance Institute collects all social security contributions and transfers them to the appropriate organisations.

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At the same time, the general mandatory pension system in Poland also comprises open pension funds managed by private financial institutions. However these are subject to a strict monitoring and supervision of the State. The insured persons do not pay the contributions directly to pension funds but rather to ZUS, along with other social insurance contributions. ZUS is responsible for transferring the part of a pension insurance contribution to the pension fund chosen by the insured individual; Regional health funds, which are responsible for providing sickness and maternity healthcare benefits; Community Social Policy Centres, providing family benefits; Local and Regional Labour offices, providing unemployment benefits; The State Fund for the Rehabilitation of Disabled Persons (Pastwowy Fundusz Rehabilitacji Osb Niepenosprawnych, PFRON), which controls disabled persons' access to employment and rehabilitation. All rehabilitation and employment programmes, including sheltered work, are financed from levies on employers not meeting the disability quota.

In Poland, the healthcare system is managed within the health insurance framework by the National Health Fund (Narodowy Fundusz Zdrowia - NFZ) and its local branches. The NFZ signs contracts with service providers to set up a network of bodies available to provide healthcare services. It finances healthcare benefits and pays the refunds of medicines from its own budget. Financing The Social Insurance Institute (Zakad Ubezpiecze Spoecznych - ZUS) is largely responsible for collecting contributions to social insurance (old-age pension, sickness, accident and health insurance) for people employed outside agriculture. It is also in charge of paying benefits. Contributions are the main source of financing for benefits. The rates of contributions are the same for all insured people and are as follows: 19.52 percent of the calculation basis for old-age pension; 6.00 percent of the calculation basis for disability pension; 2.45 percent of the calculation basis for sickness insurance; 0.67 percent to 3.33 percent of the calculation basis for accident insurance; 9.00 percent for health insurance; 2.45 percent for the Labour Fund.

Contributions to old-age pensions are financed in equal parts by the beneficiaries and employers, i.e. each of these two groups pays 9.76 percent of the calculation basis, totalling 19.52 percent. Contributions to disability pensions are financed by the beneficiaries (1.5 percent of the calculation basis) and by the employers (4.5 percent of the calculation basis). Contributions to sickness and health insurance are financed in full by the insured people themselves. Contributions to accident insurance and the Labour Fund are financed in full by the employers. Employees contributions are determined on the basis of income from employment, as defined in the provisions on personal income tax. Senior Ferrol 2011-2012-

There are open pension funds managed by private financial institutions operating within the general and mandatory employee old-age pension system in Poland. ZUS is responsible for transferring a portion of the old-age pension contribution (one third, i.e. 7.3 percent) to the open pension fund selected by insured people. For insured people who have not joined any open pension fund, the entire old-age pension contribution is transferred to the Social Insurance Fund, which covers old-age pension, disability pension, sickness and accident benefits. Healthcare When are you entitled to healthcare? You are entitled to receive free healthcare benefits in Poland if: you are covered by general health insurance (either mandatory or voluntary); you are not directly insured, but you live in Poland and meet the income criterion set by the Act on Social Assistance.

Access to healthcare during a temporary stay in Poland Eligible people who are temporarily staying in Poland may receive healthcare benefits on equal terms with Polish citizens. During a temporary stay in Poland, any eligible person is entitled to health services in the following areas: primary healthcare, specialist out-patient care, hospital treatment, dental treatment, Rescue and medical transport services.

What is covered? Entitlement to free healthcare benefits entitles you to use the services of those providers who have concluded contracts with NFZ and who are therefore required to provide such services. Healthcare providers include doctors who practise within the health insurance system (GPs, dentists), healthcare establishments (hospitals, first-aid services, dispensaries, health centres, out-patient clinics, etc.), and private surgeries (individual, specialist, group). Primary healthcare Primary healthcare includes examinations and advice provided by a general practitioner. GPs may then refer patients to a specialist or a hospital for diagnostic tests to confirm the preliminary diagnosis. Dental care Most fees for dental care provided by dentists who have concluded contracts with NFZ have to be paid directly by the patient. Free dental benefits within the general health insurance system are very limited and are specified in a regulation issued by the Minister of Health. Any services and materials other than these are at the patients own cost. 46

Hospital care Throughout a stay in the hospital, all procedures, examinations and medicines are provided free of charge. Medicines and medical devices Beneficiaries or eligible people are entitled to the provision of medicines or medical devices on the basis of a prescription issued by a doctor who practises within the health insurance system or by a doctor who does not practise within this system, but has concluded a contract with NFZ authorising him/her to issue prescriptions. The official list of medicines divides pharmaceuticals into three categories: for basic medicines, patients pay a fixed cost (standard price) determined by the Minister of Health (Minister Zdrowia), which cannot exceed 0.5 percent of the minimum wage; for special additional medicines, insured persons pay 30 percent to 50 percent of the cost; for other medicines, insured persons pay 100 percent of the cost.

Medicines are free of charge in hospitals. How is healthcare accessed? Patients can register with a general practitioner of their choice. Out-patient clinics (dispensaries) are open Monday to Friday from 8 a.m. to 6 p.m. After 6 p.m. on weekdays, and on Saturdays, Sundays and holidays, 24-hour assistance is provided by those establishments which have concluded contracts for such services. These include out-patient care and home visits for patients who are not able to travel. Addresses and telephone numbers of establishments which provide 24-hour care services are available from primary healthcare providers. If you need to consult a specialist, you will generally need a referral from a doctor who practises within the health insurance system. However, no referral is required for the following specialists: gynaecologists, obstetricians, dentists, dermatologists, venereologists, oncologists, ophthalmologists or psychiatrists. A referral is also not required for people suffering from tuberculosis, people infected with HIV, war invalids and victims of political persecution, and people addicted to alcohol, narcotics or psychoactive substances who are undergoing rehabilitation. Any beneficiary who has suffered an accident, injury, poisoning, or whose life is threatened, will also receive the medical care needed without a referral. If you need hospital care, a doctors referral is required. Old-age pensions and benefits When are you entitled to old-age benefits? The reform of the social insurance system in Poland in 1999 introduced different eligibility criteria for old-age pension (emerytura) according to the age of the insured person. Thus, the rules differ somewhat for the following three age groups: Senior Ferrol 2011-2012-

people born before 1 January 1949; people born between 1 January 1949 and 31 December 1968; people born after 31 December 1968.

People born before 1 January 1949 become eligible for the old-age pension once the following conditions are met: the retirement age is reached, i.e. 60 years of age for women and 65 for men; the required insurance period can be documented, i.e. 20 years for women and 25 years for men.

Entitlement to an old-age pension may also be acquired after an insurance period of 15 years for women and 20 years for men. However, if the old-age pension of such people is lower than the minimum retirement benefit guaranteed by the insurance system, it will not be increased to the amount of the minimum benefit. People born before 1 January 1949 may also be eligible for old-age pension earlier if they meet the following conditions: any woman who has reached the age of 55 and can show that she has at least 30 years of contributory and non-contributory periods, or at least 20 years of contributory and non-contributory periods, if she is declared totally unable to work; any man who has reached the age of 60 and can show that he has at least 25 years of contributory and non-contributory periods, if he is declared totally unable to work.

Old-age pensions may also be obtained earlier by individuals who can show that they have at least 20 years (for women) and 25 years (for men) of insurance periods, including at least 15 (and in some cases, 10) years of work under unusual conditions or of a special nature. People who meet these conditions may retire at the age defined for particular occupational groups and jobs under the Regulation on the retirement age of employees working in unusual conditions or performing work of a special nature. More favourable conditions for eligibility for the old-age pension are also enjoyed by some special groups, such as war invalids or the military, public sector employees, teachers, miners and railway employees. People born between 1 January 1949 and 31 December 1968 may retire earlier on similar terms to those described above, provided that they fulfil both of the following conditions: they have not joined any open pension fund; the statutory conditions for qualifying for the old-age pension was met by 31 December 2006.

Insured people born after 31 December 1948 and who, by 31 December 2006, did not reach the retirement age needed to qualify for the old-age pension (because their work was performed under special conditions or was of a special nature, or because their activity was creative or artistic), miners old-age pension, old-age pension for some periods of miners work, or railway employees old-age pension, may retire at the age of 60 (for women) and 65 (for men), provided that on 1 January 1999, they could document:

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a period of employment under special conditions or of a special nature guaranteeing the right to the old-age pension at the age of 60 (for women) and 65 (for men); contributory and non-contributory periods totalling at least 20 years for women and 25 years for men.

As of 2009 some employees who have been employed before 1 January 1999 and/or after 31 December 2008 under special conditions or in work of a special nature may also be entitled to the bridge pension (emerytura pomostowa). The bridge pension may be claimed by persons who, among other things, have reached the age of 55 years for women and 60 years for men, and have completed an insurance period of no less than 20 years for women and 25 years for men, including at least a 15-year period of employment under special conditions or in work of a special nature. Termination of the employment relationship is a supplementary condition to be awarded the pension. The pension amount is calculated in a similar way as the amount of the new old-age pension. However, irrespective of the actual age of retirement of a given person, the average life expectancy for persons aged 60 years is always taken into account. The right to the bridge pension expires on the day preceding the day of acquiring the right to the old-age pension or, if the person concerned does not have the right to the old-age pension, on the day preceding the statutory retirement age. People born after 31 December 1968 become eligible for old-age pension once they reach the minimum retirement age of 60 for women and 65 for men. In this case, entitlement to the oldage pension does not depend on documenting any specified minimum insurance period. For this group of insured people, the amount of the old-age pension will determined by dividing the calculation basis by the average life expectancy for people of the age at which the insured person decides to retire. What is covered? The amount of the abovementioned old-age pensions depends on the following: the basic amount for the assessment; the number of contributory and non-contributory periods that the insured person can demonstrate; the base amount effective as at the date on which the person became eligible for the pension.

Old-age pensions are assessed on the basis of contributions to social security or old-age insurance under Polish law paid during 10 consecutive calendar years within the 20 calendar years directly preceding the year the application for the benefit was submitted. An insured person may also opt for the average of contributions to social insurance from 20 freely-selected calendar years out of the full period of insurance to be used as the basis for calculating the old-age pension. The basis for calculating the old-age pension is set by multiplying the individual calculation basis rate by the base amount. The base amount is 100 percent of average pay minus the social insurance contributions deducted in the previous calendar year. The base amount is established annually and is valid from 1 March of each calendar year until the end of February of the next calendar year. Senior Ferrol 2011-2012-

The amount of the old-age pension is equal to: 24 percent of the base amount as referred to above; 1.3 percent of its basis of assessment for each year of contributory periods; 0.7 percent of its basis of assessment for each year of non-contributory periods taking account of special regulations.

The statutory minimum pension is PLN 706.29 and the maximum is 100 percent of the reference wage. Non-contributory periods are taken into account to a maximum of 1/3 of the contributory periods considered. For people born after 31 December 1968, the basis of assessment for the old-age pension is the total value of contributions paid by the insured person up to the end of the month preceding the one in which they become eligible for the old-age pension. This amount includes contributions to old-age pension insurance, the annual indexation and the initial capital, duly indexed (where the insured person was covered before 1 January 1999). The age of the insured person on the day of retirement will be expressed in years and months. Average life expectancy is a statistical figure which will be used to establish the number of months during which, on average, any new old-age pension will be paid out. Exceeding this number of months will not in any way affect the amount or the indexation of the pension paid in the future. How are old-age benefits accessed? Anyone who pays contributions must submit an application for social insurance coverage within seven days of the event which creates the obligation to be insured (i.e. the conclusion of the employment contract or the establishment of one's own economic activity). Everyone who is required to have old-age and disability pension insurance must submit this application. Anyone covered by social insurance on a voluntary basis may apply for social insurance coverage any time they choose to do so. Applications to ZUS for social insurance coverage can be made using a special electronic form created by ZUS which is available to contribution payers, or a good quality print-out of this same form.

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Spain

Social Security in Spain Introduction, organisation and financing Introduction The social security system in Spain has two levels or types of protection: the contributory system and the noncontributory system.

Contributory system There are two types of contributory schemes in the Spanish social security system: a general scheme applicable to all employed persons who are not covered by special schemes, plus certain categories of civil servants; and Five special schemes, for: agricultural workers, the self-employed, domestic servants, coal miners and sea workers (sailors and fishermen).

Students are covered by a special protection plan (school insurance). There is also a special contributory scheme for civil servants. Non-contributory system Persons who face a specific situation of need, and whose income is below a certain legally prescribed level, are eligible for non-contributory benefits. They may be entitled to this even if they have never paid social security contributions, or have done so but are not entitled to the resulting benefits under the contributory system. Non-contributory benefits include: medical assistance; retirement and disability allowances; special assistance for the unemployed (subsidio por desempleo); family allowances.

non-contributory maternity allowance (subsidio por maternidad de naturaleza no contributiva) Senior Ferrol 2011-2012-

In addition, certain limited categories of persons may claim supplementary benefits from the central or local government. This social assistance is provided primarily to elderly and handicapped persons. Voluntary insurance The Spanish system provides for the possibility of concluding special voluntary agreements with the social security services for the purpose of maintaining, or in certain specific cases extending, an entitlement to social security benefits. In certain situations this may mean subscribing to the corresponding social protection scheme, depending on the persons occupation. In such cases the insurance contribution is paid entirely by the subscriber. Registration In Spain, a person entering the labour market for the first time has to register with the social security service and join the insurance scheme for his type of occupation. This must be done within certain time limits. The self-employed person must do this themselves; otherwise, it is the employers responsibility. Registration with the social security service is compulsory. It is done once only, when the person begins to work for the first time, and is valid for his entire working life. Once a person has registered he is given a registration card with his personal details and a personal social security identification number. This card is valid for his whole lifetime and is used for all dealings with the social security system, and so must be kept very carefully. No-one may be insured simultaneously under two social security schemes for the same occupation. Once a person has registered with the appropriate social security scheme and started to work, he begins to pay social security contributions and is automatically insured. Changes in a persons employment situation for instance, change of jobs, or a period of unemployment affect the insurance status. Periods when a person is working and paying contributions are called altas, and those when a person is not working are called bajas. As a general rule a person must be employed and paying contributions in order to be entitled to benefits. There are, however, several situations that are treated as insurance contribution periods (alta asimilada), even if the person is not actively employed. Similarly, provided certain conditions have been met, a person who is not paying contributions may still be entitled to an old age pension, a permanent incapacity (absolute permanent incapacity or severe incapacity) pension, and death and survivor's benefits (except the funeral expenses grant). Special regime for civil servants Civil service personnel, military personnel and other public employees are insured under a special social security regime, although certain categories of civil servants belong to the general social security regime. This special regime covers: career civil service personnel; career military personnel; 52

officials of the courts, the legislature and other State or constitutional bodies, if the applicable legislation so provides.

Organisation of social protection The Spanish social security system is administered by the following organisations: The General Social Security Revenue Office (Tesorera General de la Seguridad Social TGSS) keeps the registration records of companies, employees and self-employed persons, monitors their employment status and social security contributions, collects social security contributions and pays out all benefits. It also manages the Social Security Reserve Fund. The National Social Security Institute (Instituto Nacional de la Seguridad Social - INSS) is responsible for granting and calculating all the cash benefits provided for by all the schemes (except for the special scheme for sea workers, non-contributory old age and disability allowances and unemployment benefits) and all family benefits (in all schemes, including the special scheme for sea workers). The Social Institute for Sea workers (Instituto Social de la Marina - ISM) has a double function. It is responsible both for the social problems of the maritime and fishing sector and for administering the special social security scheme for sea workers. Healthcare is administered by the health services of the Autonomous Communities and, in Ceuta and Melilla, by the National Institute for Health Management (Instituto Nacional de Gestion Sanitaria - INGESA). The Institute for Elderly and Social Services (Instituto de Mayores y Servicios Sociales IMSERSO) administers, with the Autonomous Communities, pensions paid under the noncontributory system, benefits for the elderly and the disabled and related social services. Italso administers long-term care schemes. The State Public Employment Service (Servicio Pblico de Empleo Estatal - SPEE) administers and checks unemployment benefits. It is also responsible for developing employment policies, in co-operation with the Autonomous Communities, through the employment offices (Oficinas de Empleo).

The specific schemes for civil servants are administered by special public organisations. Appeals Anyone who disagrees with the decision of a social security organisation can submit a complaint to that organisation, within thirty days from the time of notification of the decision. If the organisation rejects the complaint, an appeal to the local social security tribunal (Juzgado de lo social) is available. As a further step, a claim can be lodged at the Higher Court of Justice of the Autonomous Community to which the social security tribunal belongs. Financing As soon as a person begins to work he or she begins to pay social security contributions. They are calculated as a percentage (contribution rate) of the contribution base. These contribution bases and rates are determined by the government each year. In the general insurance scheme, the contribution base corresponds roughly to the employees real salary. There is, however, a floor rate, which is equivalent to the guaranteed minimum Senior Ferrol 2011-2012-

wage (SMI) increased by one sixth for full-time employment, and a ceiling, which is equivalent to a little more than five times the guaranteed minimum wage. For the self-employed, there are fixed floor and ceiling contribution bases, and they have to pay contributions calculated on at least the minimum level. They can, however, choose a higher level, up to the prescribed maximum, and can later change it within the set limits. Under certain conditions, they can also voluntarily upgrade their protection in order to include insurance against accidents at work and occupational diseases. Self-employed persons are responsible for paying their own social security contributions. For employed persons, their contributions are withheld from their pay, and transferred to the General Social Security Revenue Office by their employer together with his own contributions. Contributions for accidents at work and occupational diseases are paid solely by the employer. Long-term care benefits are financed by the State, the Autonomous Communities (Comunidades Autnomas), with the collaboration of Local Institutions and the participation of beneficiaries where appropriate. Family benefits are also financed out of taxes. Civil servants have to pay contributions to the corresponding insurance programme and pension fund. Healthcare When are you entitled to healthcare? Who is insured? Registered workers who are affiliated to a social protection scheme or who are in an equivalent position. For the purposes of these benefits, workers are held to be fully covered even if their employer has not fulfilled his insurance obligations. Pensioners and those receiving periodical social security benefits other than family allowances for dependent children.

Access to health insurance is also provided to family members of insured persons, including, under certain conditions: the spouse of the person insured or the person co-habiting with the insured for at least one year, and that persons children, lineal descendants of the insured or his/her spouse, whatever their legal filiation, brothers and sisters of the insured person, and fostered children, regardless of age, adopted children and minors being fostered while the adoption process is in progress, lineal ascendants of the person insured and his/her spouse,

Those who are separated or divorced or whose marriage has been annulled and are not otherwise covered can still have health insurance access, as long as the primary beneficiary is entitled to health-care benefits. Spanish emigrants, while temporarily resident in Spain or upon their return, may join the healthcare scheme, as long as they possess no other entitlement to healthcare. Healthcare is also provided to residents who lack sufficient means of subsistence. Detailed conditions are prescribed which relatemainly to residence, insufficient means, lack of social 54

insurance coverage, and sometimes the age of the beneficiary. If these conditions are not met, one may be entitled only to emergency care in the event of serious illness or accident. Insurance is not possible on the grounds of salaried work which is considered marginal and does not present basic income for living. What is covered? Healthcare The national health insurance system covers medical treatment at home (ayuda domiciliaria, for instance for retired and disabled persons), in a health centre and in (a public or private) hospital, contracted by Comunidades Autnomas or INGESA. The national health insurance system also covers hospitalisation and emergency care (with or without hospitalisation) in an emergency medical centre. If an ambulance is needed, the cost will be covered by the national health insurance system. The national health insurance system provides medicines, surgical prostheses, orthopaedic equipment and ordinary wheelchairs. It does not cover dental prostheses or eyeglasses. Rehabilitation is provided free of charge, if the treating physician believes it is medically necessary. Under certain conditions treatment with thermal cures is also possible. Ships at sea can get medical advice by radio from the Social Institute for Sea workers (ISM) twenty-four hours a day. Special schemes Specific rules The Special Social Security Scheme for Sea workers makes specific provisions for accident or illness on board a ship or in foreign ports. Special programmes for the disabled The national health insurance system provides healthcare and pharmaceuticals for the handicapped, including special functional and psychotherapeutic rehabilitation programmes, psychological treatment and counselling, general and special education programmes, occupational rehabilitation, vocational integration programmes, etc. Disabled persons over the age of three years with a degree of invalidity of at least 33 percent who cannot use public transport are eligible for a mobility allowance or compensation for transport costs. How is healthcare accessed? To obtain healthcare, you have to present your national health system users card (tarjeta de usuario del Sistema National de Salud). Medical care is generally free of charge, although dental care is not fully covered. For outpatient treatment, medicines are free for certain beneficiaries, particularly pensioners and those receiving benefits for accidents at work or occupational diseases. Others must pay part of the cost (generally 40 percent of the price). No charge is made for medicines administered as part of hospital treatment. Senior Ferrol 2011-2012-

If you are entitled to health insurance as the beneficiary of the insured person (normally as a spouse) and you are no longer living together, you can apply to your provincial National Social Security Institute (INSS) directorate for a health insurance card for yourself and your cohabiting children. Healthcare is provided exclusively through the network of Health Centres in the Autonomous Communities (except for Ceuta and Melilla, where it is provided through the National Institute for Health Management - INGESA) or approved medical centres (Centros mdicos concertados). As a rule, medical care obtained from another medical centre is not covered by the national healthcare system. If you need to see a general practitioner (GP), a paediatrician or a dentist, you can do so directly. To consult another specialist, you have to be referred by your GP. Within your own health-care district you can select a GP and a paediatrician, as long as their patient lists do not exceed the quota set for the district. Except in emergencies, in order to be admitted to hospital you need to be referred by a specialist. Generally, there is no possibility to choose a hospital. Patients have a hospital assigned to them according to their address (with the exception of emergencies, when access to any hospital is provided). Old-age pensions and benefits When are you entitled to old-age benefits? Contributory retirement pensions Persons 65 years of age or older who are registered with a social security scheme or are in an equivalent situation (e.g. involuntarily unemployed), who have paid social security contributions for at least 15 years - two of them in the 15 years immediately preceding their retirement - and who retire from employment, are entitled to a contributory retirement pension (pensin de jubilacin). The same contribution period is required for persons who at the date of their retirement are not affiliated with a social security scheme or in an equivalent situation. A special retirement scheme exists for self-employed persons and a special regime for civil servants. Early, partial and flexible pensions Persons in occupations classified as arduous, toxic, unhealthy or hazardous (coal miners, railway workers, flight crews and sea workers), and persons with a degree of incapacity of 45 percent (or in certain cases 65 percent or more) may retire on full pension before the age of 65. The number of bonus days earned in certain categories or specialisations is determined by applying the specific coefficient. Persons who paid into a private pension plan before 1967 may retire at the age of 60 with a proportionally reduced pension. Workers who have paid 30 years of contributions, who are registered with an employment agency and who are involuntarily unemployed, may apply for a reduced pension at the age of 61. 56

Workers are entitled to a partial pension (pensin de jubilacin parcial) at the age of 61 and until they reach the generally recognised retirement age if: they have concluded a part-time employment contract with their employer, reducing their working hours and salary by between 25 and 75 percent; the employer simultaneously concludes a bridging contract with a job-seeker, whose working time must be compulsorily insured until the retirement date of the worker he is replacing (this is not necessary when the partial retiree has reached the age of 65).

Spain also has a flexible pension scheme, under which persons receiving retirement pensions can work part-time (between 25 and 75 percent of a working day), in which case their pension will be reduced proportionally. Non-contributory old age pension Elderly persons living on low incomes who have never paid social security contributions, or have not done so for long enough to be eligible for a contributory pension, may be entitled to a non-contributory old age pension. What is covered? Contributory retirement pensions For fifteen years of insurance contributions, the pension amounts to 50 percent of the calculation base. The percentage increases by three percent for each additional year up to twenty five years, and by two percent from the 26th year onwards, reaching 100 percent after 35 years of contributions. The calculation base is determined by dividing the persons contribution bases for the 180 months preceding the one previous to his retirement by 210. The contribution bases for the 24 months immediately before retirement are counted at face value, and the rest are adjusted on the basis of the consumer price index. Employees over 65 years of age with more than 15 contribution years who continue working are entitled to a two percent increase in their pension for each additional year. The increase is three percent per additional year, if they have collected more than 40 contribution years. A minimum pension (pensin mnima) and maximum pension are set (e.g. 2,466.20 per month in 2010). Pension is paid 14 times a year. Pre-retirement benefits This is an area that is still largely unregulated. Pre-retirement schemes are private plans and have nothing to do with the ordinary social security retirement pensions. Although careless use of the term has led to confusion, people on pre-retirement schemes are not in fact retired. A pre-retirement scheme may be defined as an agreement between the company and an employee who has not yet reached retirement age, by which the latter stops working in return for an assured income similar to that which he previously enjoyed, until he or she does. The fact that he or she has stopped working does not entitle him or her to a retirement pension. Their financial situation is guaranteed either by means of compensation paid by the company or by means of benefits and unemployment allowances paid by INEM, or by a combination of the two. During this period, the worker signs a special agreement with the General Social Senior Ferrol 2011-2012-

Security Revenue Office to pay his or her social security contributions until he or she reaches the retirement age. How are old-age benefits accessed? Old-age benefit should be applied for at the competent social security administration. The National Social Security Institute (Instituto Nacional de la Seguridad Social - INSS) is responsible for granting and calculating contributory retirement pensions and the Institute for Elderly and Social Services (Instituto de Mayores y Servicios Sociales - IMSERSO) administers, with the Autonomous Communities, pensions paid under the non-contributory scheme.

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Healthcare

All the countries mentioned in this study have social protection systems that provide health coverage to the entire population and all of them include: Universal coverage for the whole population with a compulsory public insurance system. Public financing according to the income level. Wide coverage of benefits Cost control mechanisms built, are: The basic elements, of which health systems are

Conclusions

Financing sources. Providers: health personnel, pharmacies, hospitals, etc. Assignment mechanisms of resources to providers.

And taking into account the different ways of combining these elements, there are a wide variety of organizational schemes of healthcare. Healthcare systems can be classified in two blocks according to their financing sources: Bismarck model: countries with Social Security systems financed by compulsory social security contributions. Beveridge model (National Health Service): countries financed by taxes. Health systems can be also classified according to the way in which financial resources go to providers (doctors, pharmacies, hospitals, etc.).There are two basic ways: Contract Integration In systems based on contracts, the insurer buys, through contracts to private or public providers, the health services needed for their population. This is the typical model of classical Social Security systems that neither have hospitals nor employ doctors. On the contrary in systems based on integration, Public Administration produces its medical health services, integrating the providers in its organization, setting up its own
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network of health services. It is the integrated model in which the health personnel are public employees and it is also the typical model of systems financed by taxes. We have seen that we can classify health systems according to two criteria: financing sources and assignment mechanisms of resources to providers. Due to the overlaps in each of these two criteria and the great variations within each category we cannot accurately generalize but we observe that countries with predominantly financing systems by taxes, have integrated systems and, on the contrary countries no-integrated in Social Security systems operate through contracThe following table let us see in a global way, the general characteristics of these two models with their advantages and disadvantages.

Models of Healthcare Systems Social Security System (contributions) Germany, Belgium, Czech R., Poland Contract between Social Security and public or private providers. Health personnel belong to different entities. Does not favor the organizational planning or the coordination among the different levels of care. Primary Care does not exist in a formal way. Patients have freedom of choice (medical specialty, times, etc.). There are not almost waiting lists. Satisfaction degree: high with little significant variation. National Healthcare System (taxes) Italy, Spain Generally Health Services belong to Government (Integrated System). Health personnel are public employees with some exceptions. The organization is based on territorial planning of health services with coordination among levels of care. Healthcare is based on Primary Care medicine (family doctors with list of population). Patients have to go first to the family doctor and if necessary they will be sent to a specialist. There are important waiting lists.

Satisfaction degree: low in Italy and intermediate in Spain. Lower health spending (greater Government control).

Higher health spending (more demand)

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Retirement Pensions Due to the heterogeneity of pensions systems in each of these countries and the lack of a statistical framework it becomes very difficult to make a comparison among retirement pensions. In fact, we have not found a comparative study covering all the variables: age, sex, marital status, years of contribution, percentage of gross annual salary, complementary plans, cost of living etc. These conclusions are accompanied with a statistical table that reflects the spending for healthcare and retirement pensions in each country in PPS. The PPS is an artificial common reference unit used in the European Union.

Graphic about Healthcare Expenditure and Pension Expenditure in the partner countries

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European workshop More Than Neighbours

Arantza Ajuria Antonio Domnguez Beln Ruano Carlos Pieiro Chicha Varela Fernanda Faraldo Jos M. Fernndez Luz Caldern Luis Vzquez
Senior University Ferrol (A Corua) 2011-2012 Teacher: Pilar Millor

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Bibliography

Social Security. Publications and Reports. Ministry of Employment and Social Security. Spain. Sozialkompass Europa. Bundesministerium fr Arbeit und Soziales. Germany. Social Security: history and sources. Ricardo Nugent. Health in a century of the History of Spain (1898-1998). A hundred years later. S. Cervera Soto. Theories about Welfare State. Josep Pico Lpez. Contradictions in the Welfare State. Claus Offe. Welfare State. Freedom and alienation in technologically advanced societies. Oposipedia. Present and future of Welfare State: the European debate. Ulrich Beck. Fotography. Internet. http://www.bmas.de/DE/Service/Publikationen/a802-sozial-kompass-englisch.html
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http://epp.eurostat.ec.europa.eu/portal/page/portal/statistics/search_database www.elpais.com www.lavozdegalicia.es www.cincodias.com

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