Download Sickness insurance system

Sickness insurance system
Employee sickness insurance system provides 4 benefits in cash:
 sickness benefit
 financial support for care of family members
 pregnancy and maternity compensation benefit
 maternity benefit
Sickness insurance of self-employed persons provides 2 benefits in cash:
 sickness benefit
 maternity benefit
Applying for benefits
Applying for sickness benefit is done by submitting the prescribed form issued by the
supervisory doctor.
A woman who accepts a child for substitute parental care applies for maternity benefit in
cash by submitting a written application.
Employees apply for a benefit via their employer, self-employed individuals by the
relevant district social security management.
Also, an employee whose employment relationship has terminated however who is still in the
so-called protection period has a right to receive benefits. The protection period is 7 days
from the day when employment terminated otherwise, if the employee was employed for a
shorter period the last time s/he was employed, the protection period is only for as many days
as the employee was employed. For women whose employment ended when they were
pregnant the protection period is always six months. The same applies for self-employed
individuals.
Conditions for awarding benefits
Sickness benefit – Employees
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recognition of temporary incapacity to work or quarantine
participation in sickness insurance or the duration of the protection period during
which the temporary incapacity to work occurred
no work performed in the job for which the sickness benefit was awarded
support time not utilized
Self-employed persons (besides the conditions as stipulated for employees)
 are not allowed to perform individual earning activity in person during the time of
temporary incapacity to work or quarantine
 must have paid the premiums for sickness insurance
 must have been participating in self-employed persons' sickness insurance for the
minimum period of 3 months prior to the temporary incapacity to work occurred
Financial support for care of family members
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participation in sickness insurance or the duration of protection period in the time
when the need for care of a family member occurred
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the employee is unable to work due to the necessity of taking care of a family member
or child under 10 years of age for the reasons specified
living in the same household with the person who is being taken care of, this condition
does not apply if a parent is taking care of a child under 10 years of age
no work performed in the job from which the sickness benefit was awarded
Pregnancy and maternity compensation benefit
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woman's participation in sickness insurance
transfer of the pregnant employee or the mother until the ninth month after giving
birth to a different job for reasons specified
 a reduction in the woman's earnings because of the role transfer, not because of her
own performance
The compensation benefit is calculated as the difference between the daily assessment base
that the employee was entitled to prior to being transferred to a different job, and the average
daily recognizable income after the transfer to the different job.
Maternity benefit – Employees
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the woman's participation in sickness insurance or the duration of the protection period
achieving at least 270 calendar days of participation in sickness insurance in the last
two years preceding the birth
giving birth
no work performed in the job from which the sickness benefit was awarded
Self-employed persons (besides the conditions as stipulated for employees)
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must have paid the premiums for sickness insurance
are not allowed to perform individual earning activity in person during the benefit
period
also achieve at least 180 days of participation in sickness insurance of self-employed
persons during the year preceding the birth
Calculation of sickness insurance benefits
Daily assessment base – Employees
Eligible income registered for the employee in the decisive period which is usually 12
calendar months preceding immediately upon the occurrence of incapacity to work,
quarantine, the need to care of a family member or commencement of maternity leave, is
divided by the number of calendar days of the relevant decisive period. However, some
days are not to be included in the number of days in order to prevent unreasonable dilution of
the assessment base (for example the days of sickness benefit).
Self-employed persons
For self-employed persons the method of calculation of the daily assessment base is
analogical with the stipulation that the decisive period is usually the calendar year
preceding the year in which the sick leave occurred or in which the woman commences
maternity leave, and the eligible income is understood to be the sum of the monthly
assessment bases for the calculation of social security premiums deposits.
Reduction limits
Two limits are set for reduction: CZK 825, 1,237 and CZK 2,474. The calculated daily
assessment base is to be reduced if its sum exceeds the set limit as follows:
 for sickness benefit and financial support for care of family members, to the amount of
CZK 825, 90 per cent being calculated,
 the amount between 825 and 1,237 limits, 60 per cent being calculated,
 the amount between 1,237 and 2,474 limits, 30 per cent being calculated,
 the sum exceeding the third reduction limit is not taken into account.
Percentage rate
The sickness benefits are calculated from the daily assessment base by means of the relevant
percentage rate:
 for maternity benefit 70 per cent,
 for support for care of a family members 60 per cent,
 for sickness benefit 60% from the 22nd day of illness to the termination of the
illness.
Support period
Sickness benefits are awarded per calendar day. The sickness benefit is awarded for a
maximum of 380 days from the beginning of the incapacity to work, however, not for longer
than until the end of the incapacity to work or until full or partial disability is confirmed.
Financial support for care of family members is awarded for a maximum of the first 9
calendar days, or a maximum of 16 calendar days, to an employee who is living alone and
looks after a child who has not yet completed the mandatory school attendance and would
otherwise be alone.
Maternity benefit is awarded for a maximum of 28 weeks, or 37 weeks in the case of women
who have given birth to two or more children at the same time and look after at least two of
them, or if they are single, widowed, divorced or alone for any other significant reason, or
who do not live with a partner.
Pregnancy and maternity compensation benefit is awarded, maximally, until the woman
commences maternity leave and after the maternity leave, maximally, until the end of the
ninth month after the birth.