We all work. But someone may lose the opportunity to earn a living through honest labor. To facilitate the fate of such people, state social insurance was invented.
general information
Why was social insurance created at all? This is necessary in order to provide financial assistance to persons who agreed to this mechanism in the event of the foreseeable risks. Policyholders are required to timely assess contributions for this case. When an insured event occurs, a person needs to contact the Social Insurance Fund and document that he has the right to receive funds from the state. This is another way to socially provide people who are in a labor relationship with employers. And who offers state social insurance? Three organizations can help in this matter:
- Social Insurance Fund. This option will be optimal if there is a threat of injury in the workplace.
- Pension Fund. This option is suitable if there are plans and confidence that it will be possible to retire successfully and without incident.
- Compulsory Health Insurance Fund. It looks like the first institution, but is especially suitable for those who, after treatment, plan to recover and continue to work.
Of course, it should be noted that the division described in the article is very conditional and not mandatory. It’s just that with the specifics of work it will be a little easier to get the money due when a specific insured event occurs. And so the institution that is closest to the house can be chosen. Although if you are interested in social insurance for temporary disability, the first option is best.
How it works?
What are the principles of the social insurance system? The most important, according to the announced goals, is the establishment of partnerships. Then comes the formation and use of various trust funds. An important role in the system is given to the prevention of social risks. What is important for the functioning of the entire mechanism of social security? When social insurance is implemented, this implies the existence of certain funds, from which the financing of needs comes. Moreover, the specifics here are such that the funds must cover the available costs, which arise in connection with the fulfillment of obligations. In addition, the above organizations are interested in increasing the standard of living for different categories of Russian citizens.
Take, for example, social insurance against occupational diseases. This is the real scourge of our time. Practically any person after decades or maybe even years of work has an occupational disease. In most cases, it is not diagnosed before old age, but it happens, it manifests itself even before retirement. Therefore, state organizations are directly interested in ensuring that a person maintains his health as long as possible - because then they will not have to pay him money. For this, a variety of means can be used, ranging from certain restrictions and requirements, ending with preventive measures to monitor compliance with rest standards.
Methods and Goals
So, now you have an idea of what social insurance is. It's good. Now let's look at what its types exist. At the moment, in the Russian Federation you can meet the following types:
- By temporary disability.
- Health insurance.
- From occupational diseases and industrial accidents.
- Social pension insurance for citizens currently working.
These are not all possible means. Standing apart is voluntary insurance. It can be attended by persons who independently provide themselves with work. It should also be noted that non-state companies can act as insurers. This has a number of advantages and disadvantages. Relative to the first, a rather significant level of success in actions can be noted (which is confirmed by the US example). But on the other hand, the state is not responsible for settlements. Therefore, if you run into scammers, it will be very difficult to return your hard-earned money.
Subjects and Contributions
The main asset that social insurance has is people. Who is of most interest? The answer is the subjects of which are the insured persons. They include Russian citizens who are in labor relations with their employer (which may include commercial companies, individual entrepreneurs and government organizations). That is, all those who provide people with jobs are referred to policyholders. But what about contributions? We know about the fact that they go to certain organizations (even which ones). But how much money is paid? The single social contribution provides for the collection of 26.2% and up to 34.5% of wages. Why is there such a significant difference? What is included in these percentages? Initially, the Pension Fund should be mentioned - it accounts for 20%. Another 3.2% goes to social insurance. This money will subsequently be spent directly on the person himself. In addition, 2.8% of the salary goes to health insurance. This is the case for sick leave, visits to doctors (such as a dentist) and so on. In addition, there is also insurance against accidental accidents that were at work. Thanks to this point, there is such a significant difference that could be seen earlier. So, the contribution in this case can range from 0.2% to 8.5%.
Payout money
Consider mandatory social insurance at work. Suppose a certain incident arose. In this case, the insured person can count on a certain amount of payments. The final value is calculated as a percentage of the salary. What model of collateral is valid in the Russian Federation? So, if a person transferred funds for 30 years, then he can count on receiving 40% of his salary in the form of pension benefits. Those people who have officially worked for more than 40 years, claim to be 60%. If temporary disability occurs, then a person is entitled from 80% to 90% of the amount of wages. When people become unemployed, they can expect to receive funds in the amount of 50-60%. There are certain bonuses when receiving medical care and purchasing medicines. Here the amount of payments depends on where the person is. If he is in the hospital - 100% of all expenses will be paid. For those who are on outpatient care, only 75% of the cost of drugs and medical care is provided for. In addition, you can count on more financial support in connection with a number of incidents: loss of work, funeral, registration of pregnant women, payments at birth, and so on. It should be noted that, according to the current labor legislation, every citizen of the Russian Federation who is formalized must have a concept of what state social insurance is and actively use it. At the factory, in the office or laboratory - it does not matter where he will work. According to the law, every person must be protected.
When and how much is the allowance issued?
Compulsory social accident insurance provides for various periods. So, if a person has temporarily lost his ability to work, then money will be provided to him from the first day. The end is considered the restoration of work functions or the establishment of disability by the medical labor commission. Everything is a little different with domestic injuries. It is envisaged that in the case of them, benefits are paid only on the sixth day. True, there are some nuances here. So, if an injury was received as a result of a certain natural disaster (such as an earthquake, hurricane, flood or fire) or due to an anatomical defect, then financial assistance is issued for the whole time and is regulated by general rules. Social accidents insurance for seasonal and temporary workers provides benefits in the event of an occupational disease or work injury. Moreover, this is carried out on a common basis. If we are dealing with temporary disability, then the deadline in this case is 75 calendar days. Here you can meet with an interesting aspect. So, it is common that temporary disability can occur when the worker is on annual leave. In this case, a person needs to stock up on a sick leave, and he will be given benefits for the entire time of exemption from activity. True, if leave is without pay, then you can’t count on anything. Also, one should not rely on payments if temporary disability is a direct result of injuries and diseases that arose as a result of intoxication.
Features
And what if the close relative of the employee falls ill? For many, this will be a novelty, but the law provides that the need to care for a sick family member can also serve as a basis for receiving temporary disability benefits. In this case, the situation should meet the following criteria:
- It must be established that lack of care has a significant risk to the health or even life of a sick person.
- There is no way to place a family member in the hospital due to specific indications.
- There is no other person except the employee himself who could take care of the patient. An exception may be made here for mothers who have a child under 2 years old.
Compulsory social insurance against accidents with such a loss of capacity provides a standard period of 3 calendar days. It can be extended, but only in exceptional cases, when a family member has a serious illness. But in general, the period should not exceed seven calendar days. The exception is in the case of children. So, if a child has not reached the age of 14 and is ill and still has a need for care, then the period may be 14 calendar days. But this is not the maximum. So, if there is a child under 3 years old (or a disabled person under 16), then the allowance can be issued for the entire period when he needs care. It should be noted that there is a strong differentiation in the size of payments. The final amount of money depends on the cause of temporary disability, the number of minor children, the length of uninterrupted work experience, and so on. Also, if a person received a labor injury or an occupational disease, then his allowance will be in the amount of 100% of the salary.
Maternity Payments
Some rules in this case are the same as general ones. But there are also features. So, when a woman is granted maternity leave, then payments are made for all days. But this must be confirmed by a sick leave certificate. How many women are allowed to rest? Before the date of the approximate birth, 70 calendar days are given. But if the pregnancy is multiple, then 84 days are provided. Also, after giving birth in standard situations, women have 70 calendar days. If there was a complicated situation, then this period increases to 86 days. In cases where two or more children were born, 110 calendar days are provided. It should be noted that paid leave is provided in total. In other words, it doesn’t matter how many days were used before delivery. All unspent can be walked off later, if this word generally applies to mothers. It should be noted that our state cares that people receive about 100% of their wages. But if a woman at the time of pregnancy and childbirth was removed from office, then the benefit is not paid.
As you can see, there are a significant many different aspects. Also, if a miscarriage occurs after the 196th day of pregnancy, the woman will still receive benefits. In addition, one should not lose sight of a number of types of other material assistance. So, you can receive a lump sum at the birth of a child, as well as caring for him until he reaches the age of 1.5 years. These payments are not provided if the fetus was stillborn. The priority is given to the mother of the child. But if she died, then it is issued to the father or other person who is engaged in the actual education of the baby. True, for this it is necessary to write a written statement.
Appointment and payment
As you can see, many people are grateful to compulsory social insurance in case of temporary disability, since with such a responsible and serious matter any ruble is in the account. Therefore, if a person can claim payments, you need to know who appoints them and where they receive them. As a rule, this is done at the place of work. The social insurance commission of the trade union committee of the enterprise is engaged in this. But it may be that it is not. In this case, benefits will be assigned directly by the trade union committee. And what to do when working in small enterprises where there is no such organization? In this case, the trade union organizer and the insurance delegate will be able to help. When the benefit has been assigned, its payment is made by the administration of the enterprise at the expense of social insurance contributions. So simple. It should be noted that this appointment scheme also works when a person's incapacity for work occurred during his stay outside the enterprise.
As an example, you can cite the previously considered vacation or business trip. Despite the fact that individual days are considered, direct payment is carried out together with wages. Although there are nuances regarding childbirth and preceding pregnancy. In such cases, the allowance is paid once (all at once). To receive a lump sum payment for the child at his birth, the parent must have a certificate issued by the registry office. The same applies to burial payments. All that has been accrued, but not paid, must be transferred to the employee within the deadlines that are set for the payment of unearned wages. It should be borne in mind that if the amount of the benefit was excessively increased due to an arithmetic error or abuse, then it will be withheld in the future.
Conclusion
State social insurance is an extremely useful tool for stabilizing society and supporting its individual members. This mechanism allows people to look more confidently at their future. And this, in turn, entails the fact that a person works better and there is less tension in society. Although the existing system is not without its drawbacks. But the issue of improvement is still being resolved over time. At the same time, you do not need to stand aside when you have an established fact of abuse of your capabilities. It doesn’t matter who and what violates - a state organization or a private entrepreneur. It is always necessary to strive to ensure that human rights and the existing social contract are not violated. And already the tracking of this lies with us - ordinary citizens.