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Maternity leave and Sick pay policies
Notice : the following information regards only the nationals from the European Union or the European Economic Space.
--> General comments
--> Particulars cases
1. You are a cross-border worker
2. You are an expatriated worker
3. You are a migrant workert
4. You are an unemployed worker
5. You work in various States at the same time
6. You stay abroard temporarily (non professional stay
7. You are retired
--> Useful Addresses
--> General comments
1. Principles
~ Exercising the activity in a single country
• You are expatriated : you are a wage-earner sent in a temporary mission by your employer to another member State for an estimated period of 12 months. You will still be affiliated to the Social Security regime of your origin country if you have an E 101 form, given by your employer.
• You are a non expatriated worker : you are affiliated in your Activity State.
~ Exercising remunerated activities in different countries : affiliation for the set of your activities in a single specified country as follows :
• If you carry out part of your activity in your residence State: you will be affiliated in your residence State.
• Should you not carry out any activity in your Residence State: the competent State for affiliation will be the State where the registered office of the employer is or, if you have more than one employer in different States, it will be the Residence State.
~ Exercising non remunerated activities in different countries : affiliation for the set of your activities in a single specified country as follows :
• Should you carry out part of your activity in your Residence State: you will be affiliated in your Residence State.
• Should you not carry out any activity in your Residence State, you will be affiliated in the State where you carry out the main activity.
~ Simultaneous non remunerated and remunerated activities carried out in different countries :
• Affiliation in both activity States for the following cases :
- non remunerated in Belgium and remunerated in France, Germany or Luxembourg ;
- non remunerated in France and remunerated in Germany or Belgium; ;
- non remunerated in agriculture in France and remunerated in Luxembourg, Germany or Belgium.
• Affiliation in the remunerated Activity State for the other cases.
2. Conditions for the opening of rights
In Belgium and in France, the right to these benefits is subject to working time or registration conditions. This will not be the case for Luxembourg and Germany.
Formalities: for these working or insurance periods carried out in the country of the last affiliation to be taken into account by the competent institution of your new employment country, you will have to present (in order to open your rights in Belgium or in France) an E 104 form (“Attestation related to the adding up of the employment periods, of insurance or residence”).
This form, mentioning the insurance periods accomplished under the last competent legislation, will be handed out by the Insurance Fund or the Insurance Company of the country you were last affiliated in.
3. Benefits/ Allowances
1- In kind benefits : they are care benefits as the ones foreseen by the legislation applied by the institution giving them (dental care, medical care, hospitalization, medicines, etc). The in kind benefits are, generally, given by the institution of the Residence State according to the applicable legislation in this last country, but payable by the Affiliation State.
2- Cash benefits : these are pecuniary allowances paid in case of working incapacity. These cash allowances will be given by the institution of the Affiliation State.
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--> Particular cases
1. You are a cross-border worker
~ Definition
As far as Social Security is concerned (community regulation), the cross-border worker will be the person (wage-earning or not) working in a member State of the European Union or of the EES (European Economic Space) residing in another member State to which, in principle, he/she returns each day or at least once a week.
N.B. The cross-border worker sent by its company or affecting a service in the territory of its residence State or of another State will preserve the quality of cross-border worker for 4 months even if during this period he/she will not return at least once a week to his/her residence.
~ Previous Formalities
• Mandatory affiliation to the social security of the country where the remunerated activity is carried out.
- in Germany : your employer will generally affiliate you at the Local Illness Fund (Ortskrankenkasse – AOK) of your working place or the company’s (Betriebskrankenkasse) or even in a professional illness fund (Innungskrankenkasse),.
- in Belgium : you will have to register yourself at a Belgian Mutuality that you choose,
- in France : your employer will affiliate you at the Caisse Primaire d’Assurance Maladie (Local Illness Fund),
- in Luxembourg : your employer will have to affiliate you at the Common Centre of the Social Security which at its turn will register you at the competent Illness Fund.
Affiliation at the Social Security at the residence country competent fund or mutuality) in order to profit from in kind benefits (health care), you and your family, in your residence country.
Formalities : You will have to fill in an E106 form for you and the members of your family residing with you.
Particularity : the Luxembourg Belgian workers will have to present a BL 1 form (instead of form E 106) issued by the State Work Institution in order to register themselves at the social security of their residence country.
~ Right to in-kind allowances
• You are the insured person
You can choose to receive the care at your residence country or at your employment country (to the difference of the regular migrant worker). In this case, you will obtain the allowances according to the country’s legislation where the care has been given. The drugs, bandages, glasses, small accessories, analysis and laboratory tests can not be, in principle, given out our carried out in the country where they have been prescribed.
• For the members of your family, with rights
They will benefit from health care in the residence country or in the employment country under certain conditions.
Notes :
- Cross-border workers residing in Alsace-Moselle will benefit from a local regime
- Following a belgain-luxembourgeoise convention, the cross-border worker and his/her family members in his/her charge being healed in their residence country will benefit from a complement issued by the employment country.
~ Right to in-cash benefits
The in-kind benefits given in case of unemployment due to illness or non professional accident will be issued by the competent institution of the employment country (Mutual Insurance Company or illness mutual company).
Formalities:
1- The employer has to have the unemployment certificate the third day of unemployment.
2- You will also have to send, as soon as possible, to the competent mutual company the unemployment certificate.
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2. You are an expatriated worker
~ Definition
You are a wage earner sent by his/her employer in temporary mission in another Member State for an estimated period of 12 months. You will remain affiliated to the social security regime of your origin country on the condition that you have an E 101 form, given by your employer.
~ Previous Formalities
You remain affiliated to the competent institution of the Origin State: you will not need to register in the employment country.
To prove your affiliation, your employer will have to demand to the competent institution of the origin country, a detachment certificate (E 101 form “Attestation concernant la legislation applicable” (Attestation concerning the applicable legislation).
The competent institution is :
- in Germany : the institution which is assuring you.Should you not be assured, the Bundesversicherungsanstalt für Angestellte (Federal Bureau for employees assurance) in Berlin
-in Belgium : the ONSS (Office National de la Sécurité Sociale; National Bureau of the Social Security)
- in France : the CPAM (Caisse Primaire d’Assurance Maladie; Primary Health Care Fund)
- in Luxembourg : the IGSS (Inspection Générale de la Sécurité Sociale ; General Inspection of the Social Security).
~ Right to in-kind benefits
You and the members of your family accompanying you can also receive care at the Departure State and at the Employment State. You will have to present an E 128 form, issued by the mutual company from the origin country.
Should they not accompany you, the members of your family will only be able to receive treatment in their Residence State.
~ Right to in-cash benefits
The everyday benefits of the illness-maternity leave in case of unemployment are paid by the affiliation mutual company of the origin country.
Procedure : in order to obtain these benefits, you will have to, in the period of three days, present to the institution of the residing place, a notice of unemployment or a certificate of working incapacity issued by the doctor treating you. The institution of the residence country establishes an E 115 form and it will transmit this document to the competent institution.
N.B. Do not forget to send the certificate of unemployment to the employer the third day of unemployment.
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3. You are a migrant worker
~ Definition
You are neither a cross-border worker nor an expatriated worker, you reside in a country different to the country where you live.
~ Previous formalities
• Mandatory affiliation to the social security of the country where you exercise the remunerated activity
- in Germany : votre employeur vous affilie en règle générale auprès de la caisse locale de maladie (Ortskrankenkasse - AOK) de votre lieu de travail ou de la caisse d’entreprise (Betriebskrankenkasse) ou encore d’une caisse de maladie professionnelle (Innungskrankenkasse).
- in Belgium : you have to register personally at a Belgian Mutuality Fund that you may choose.
- in France : your employer affiliates you at the Primary Illness Insurance Mutuality Fund :
- from your working place if you do not reside in France,
- from your usual residence if you reside in France
- in Luxembourg : your employer has to affiliate you at the Common Centre of the Social Security which will register you in the competent illness Mutuality Fund.
~ Right to in-kind benefits
These are care benefits (dental care, medical care, hospitalisation, drugs…).
• You are the insured person : You will benefit form health care in your affiliation country as if you were residing.
• For your family members, with rights : The family members, as defined by the legislation of the residence country, will benefit from health care in the employment country unless the latter open rights in the residence country.
~ Right to in-cash benefits
The daily benefits of the illness-maternity leave in case of unemployment are paid by your affiliation mutuality.
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4. You are an unemployed worker
~ You are an unemployed worker seeking for a job in another State
Previous formalities
In order to benefit from the in-cash benefits, you will have to provide yourself with an E 119 form (Attestation concerning the right of the unemployed workers and the members of their families to the benefits of the illness-maternity insurance).
These documents are issued before your departure, by the competent illness fund (Germany, France, and Luxembourg) or the mutuality (Belgium) from the residence country.
In-kind benefits
You and your family can benefit from these during the concerning period (3 months maximum) in the State where you seek for work (the repayment of care will be done according to the legislation of this State).
In-cash benefits
These benefits are given by the competent institution of the departure country and according to the legislation applied. In order to benefit from them, you will have to provide with a certificate of incapacity of work issued by the doctor treating, within 3 days to the illness insurance institution of the place you are, indicating the date until you can benefit from the unemployment allowances as well as your address.
~ You are a cross-border worker out of work
Should you be a cross-border worker totally out of work, you will benefit form in-kind and in-cash benefits according to the legislation of your Residence State as if you had been subdued to this legislation during your last employment.
5. You work in various States at the same time
~ Carrying out a paid activity in various member States
You can receive the medical care in your Residence State, if you present an E 106 form if you have no activity in your Residence State.
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6. You stay abroad temporarily (non professional stay)
~ Conditions
You and the members of your family can benefit from the allowances abroad, out of the competent State in the 2 following cases :
- in case of emergency
- authorisation by the competent institution to go to the territory of another member State to receive appropriate treatment
~ Formalities to benefit from the in-kind allowances
- you have to present to the institution of the locality you are staying at, an E 111 form, issued by the competent institution before your departure.
- you have to present to the institution of the locality you are staying at an E 112 form, issued by the competent institution in case of changing to another member State to receive appropriate care.
~ Service of benefits
The in-kind benefits are served by the institution of the locality you are staying at according to their own legislation, on behalf of the institution of the locality of departure.
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7. You are retired
Should you have exerted part of your activity in your residence State, you and your family have right to the benefits only from your residence State.
If, during your retirement, you live in a country where you have never carried out any activity, you and the members of your family can receive treatment in the activity State after presenting at the mutuality of this State, an E 121 form, issued by the fund of the competent State, that is, the State were you have been affiliated the longer.
Note : The previous belgian-luxembourgeois wage-earners having either carried out a complete carrier in Luxembourg, or having finished their carrier in Luxembourg, and the people under their responsibility will benefit from a complement (see point 1 of the cross-border workers).
Annabelle Daniau, Juriste, CRD EURES Lorraine
Joël de Marneffe, Juriste, Coordonateur EURES Transfrontalier PED
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Useful Addresses
~ Germany
AOK für das Saarland
Halberstrasse, 1
D-66 121 SAARBRÜCKEN
tel : 00 49 / 681 60 01 0
fax : 00 49 / 681 60 01 550
http://www.aok.de/saarland/
AOK für Rheinland Pfalz
Paulinstrasse, 21
D-54 292 TRIER
tel : 00 49 / 651 20 95 0
fax : 00 49 / 651 20 95 302
http://www.aok.de/rlpf/
~ Belgium
INAMI
(Institut National d’Assurance Maladie Invalidité)
Avenue de Tervuren, 211
B-1150 BRUXELLES
tel : 00 32 / 2 739 71 11
fax : 00 32 / 2 739 72 91
http://inami.fgov.be/
~ France
CPAM Nancy
5 à 9, boulevard Joffre
F-54047 NANCY Cedex
tel : 00 33 / 3 83 85 50 00
fax: 00 33 / 3 83 44 42 56
http://www.cnamts.fr/
CPAM Longwy
3, avenue Poincaré
F-54 401 LONGWY Cedex
tel : 00 33 / 3 82 25 21 21
fax : 00 33 / 3 82 23 81 40
CPAM Metz
18 – 22, rue Haute Seille
F-57 751 METZ Cedex 9
tel : ++ 33 / 3 87 39 36 36
fax: ++ 33 / 3 87 76 15 71
CPAM Sarreguemines
2, rue de l’Ecole - BP 31169
F-57 217 SARREGUEMINES Cedex
tel : 00 33 3 87 95 80 00
fax : 00 33 / 3 87 98 28 06
CPAM Thionville
2, allée Bel Air
F-57 128 THIONVILLE Cedex
tel : 00 33 / 3 82 55 94 00
fax : 00 33 / 3 82 55 94 99
For the cross-border workers :
CPAM / Service EEE
15, rue Voltaire
F-57300 HAGONDANGE
tel : 00 33 / 3 87 70 87 17
fax : 00 33 / 3 87 71 38 12
~ Luxembourg
Caisse de Maladie des Ouvriers
125, route d’Esch
L-2973 LUXEMBOURG
tel : 00 352 / 40 112 1
fax : 00 352 / 40 06 11
http://www.cmo.lu/
Caisse de Maladie des Employés Privés
125, route d’Esch
L-2972 LUXEMBOURG
tel : 00 352 / 40 113 1
fax : 00 32 / 40 97 20
http://www.cmep.lu/
Caisse Maladie de l’ARBED (ouvriers et employés)
Portail Neudorf
L-4006 ESCH-SUR-ALZETTE
tel : 00 352 53 13 37 02
fax :00 352 53 13 37 99
For more information, please contact the two resources centres in the Grande Région.
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