As of 1 June 2021, Serbia will get amendments to the Law on Health Insurance (“Official Gazette of RS” no. 25/2019) (the “Law”). Among other things, the most significant changes refer to defining rare diseases, but also to the new benefits for pregnant women and parents who are absent from work for the purpose of childcare. Perhaps the best news for most citizens is that they no longer have to bring sick leave certificates to their employer.
- Definition of Rare Diseases
The first novelty that awaits us is the definition of rare diseases. The legislator prescribes that rare diseases are those that affect less than five people per 10,000 citizens. As stated in the explanation in the Draft Law, this definition will be the basis for the formation of a register of persons suffering from rare diseases, which will enable insight into frequency, prevalence, duration, outcomes, demographic, clinical and other characteristics of persons suffering from rare diseases.
- Simpler and Quicker Calculation of Compensation
In addition, the changes of the Law refer to the fact that the employer no longer calculates the compensation for the employee. Instead, this calculation is performed by the Republic Health Insurance Fund (which has so far only supervised it), based on the data on paid taxes and contributions for the insured, received through official channels from the Tax Administration. This calculation, as well as the compensation itself, as proposed, is submitted i.e. paid by the Republic Health Insurance Fund, to the employer within a shorter period (15 days), as opposed to the current solution (30 days). Thereby, double calculation of compensation has been avoided and the entire procedure is simplified.
This change represents an improvement in the regulation, considering that now the Republic Health Insurance Fund has a half shorter deadline (15 days) for the payment of compensation to the employer’s account.
- Right to Compensation Due to Childcare
An additional change, i.e. extension of rights, refers to the right to compensation due to childcare. Namely, in the previous version of the Law, it remained unclear whether a parent whose spouse has military insurance or is insured abroad is entitled to this compensation, because the other parent is prevented from caring for a sick child. The Draft Law introduces the right of parents to compensation for childcare even when the other parent is obligatorily insured with another competent health insurance provider (e.g. military or foreign insurance).
- Full Rights from Obligatory Health Insurance for Pregnant Women
Another change for the better in the regulations is that pregnant women will exercise all their rights from obligatory health insurance, regardless of whether the employer has paid their contributions.
It is proposed that in case of temporary incapacity for work due to illness or complications related to the maintenance of pregnancy, insured women exercise the rights from the compulsory health insurance regardless of whether the due contribution has been paid, i.e. they exercise the right to compensation due to temporary incapacity for work, which is not the case according to the current regulations. Namely, the regulations in this respect currently prescribe that, when the due contributions for health insurance have not been paid, the insured, in accordance with a special law, can exercise the right to healthcare and the right to reimbursement of transportation costs related to the use of healthcare.
- Sick Leave Certificates Submitted to the Employer Electronically by the Doctor
Another change that substantially benefits employees, but the employers as well, is the proposal that the insured, or a member of his family, does not personally submit a certificate of temporary incapacity for work to the employer (the so-called “sick leave certificate”), as prescribed by the current law, but that this information be submitted electronically by the selected doctor to the employer.
This really makes it easier for the employee, considering that a lot of cases have been recorded in which the employee is seriously ill and thus unable to submit a sick leave certificate to the employer, with no family members who could do it for him. In such situations, it sometimes happened that the employer terminated the employment contract of the employee due to his absence from work, because the employer had no knowledge that the employee was ill. The electronic delivery of certificates to the employer by the doctor significantly reduces the possibility of such situations occurring in the future.
On the other hand, this will also prevent the employees from submitting subsequently fabricated certificates of alleged illnesses and inability to work, with the dates matching the period when they were absent from work, although they were not incapacitated at all. Now that the doctors are sending the certificates to the employers directly, it will be almost impossible to cover up for the period during which the employees were absent, justifying their absence by the alleged sick leave.
Summary
The Draft Law on Health Insurance brings several significant innovations. They are undoubtedly beneficial, serving as improvements in relation to the currently valid Law.
The legislator noted the need for certain procedural changes (such as the manner of submitting sick leave remittances to the employer) which considerably facilitate both employers and employees. On the other hand, a very important change is the exercise of all rights based on compulsory health insurance for pregnant women, which is a significant improvement over the previous solution. This shows that the state cares for insured pregnant women, wishing to provide them with maximum protection during pregnancy.
Moreover, the need to define rare diseases was detected, including the monitoring of the population that suffers from them, so as to learn as much as possible about rare diseases, and enable these persons to be treated. Keeping a register of people suffering from rare diseases is very important, because it simplifies and accelerates the diagnostics process.
Additionally, by introducing the announced amendments the legislator facilitates communication between the employer and employee in case the employee is prevented from coming to work, and there is no one to inform the employer about it.
Having in mind the above, as well as the importance of health insurance in general, the legislator introduced these changes with the aim of improvements, given that this field requires constant work on finding better and more innovative solutions.
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