1 Article 14 of Law 255 Federal Law. Law on benefits for temporary disability, pregnancy and childbirth - Rossiyskaya Gazeta

home / Feelings

The main law that regulates the procedure for payments for sick leave is Law No. 255-FZ.

Dear readers! The article talks about typical ways to resolve legal issues, but each case is individual. If you want to know how solve exactly your problem- contact a consultant:

APPLICATIONS AND CALLS ARE ACCEPTED 24/7 and 7 days a week.

It's fast and FOR FREE!

In order to correctly make all calculations and make the necessary payments, you need to carefully monitor changes that may be adopted.

What the law says

This was specifically developed to ensure that there was regulatory regulation and a legal framework for making payments on sick leave.

The latter is issued in the event of illness of the employee himself, his relatives who require care, and in connection with upcoming motherhood.

The main points of this Law are as follows:

The procedure for issuing a certificate of incapacity for work.
How to correctly calculate benefits for the period of temporary disability of an employee.
For what reasons should compensation be made?
What is the basis for issuing the document?
Some benefits provided to employees.
Provisions relating to the provision of maternity leave and payment for this period.

It is precisely the period of pregnancy and childbirth, as well as the subsequent period, that many provisions of this Law are devoted to.

This Law states that a woman has the right to:

In addition, a woman has the right to issue a sick leave certificate if her child falls ill.

The period of absence from work will also be paid, but when calculating, slightly different rules will be applied than when calculating maternity benefits.

When came into effect

This law was developed and finalized throughout 2006. The main reasons for constant discussions are women's rights related to motherhood and their protection.

But, on December 20, 2006, Federal Law No. 255 was adopted by the State Duma, and a week later it was approved by the Federation Council.

The new Federal Law No. 255-FZ came into force on December 29, 2006.

Changes made to the Federal Law

Since then, many changes have been made to the document. So in 2019, some nuances and improvements came into force. In just 12 years of the law, about 25 changes were made to it.

The document has never changed fundamentally; only some adjustments have been made to it regarding the introduction of modern technologies.

The last changes were made on 03/07/2019. They touched upon the new rules for issuing sick leave and making payments to women during pregnancy and childbirth, and for child care.

The procedure for providing a certificate of temporary incapacity for work

Now you can receive a certificate of incapacity for work not only on paper, but also in electronic form.

This innovation has greatly simplified the lives of workers and employers.

The employee no longer has to worry that the document may become wrinkled, lost, or destroyed due to insurmountable circumstances, since it is quite difficult to obtain a duplicate.

The scheme of operation of electronic certificates of incapacity for work is as follows:

An insured event occurs	All grounds for registration of sick leave are specified in Art. 5 of Law No. 255-FZ
The employee notifies his employer about the occurrence of an insured event	If the employer has the opportunity to accept sick leave electronically, he must inform his employee about this. The employee gives / does not give permission to receive the document in electronic format
If he gave a positive answer	The doctor who will deal with the registration must inform about this. The doctor draws up an electronic sick leave and signs it with his electronic signature
The document enters a single database	Where the employer can find him
After the management makes sure that the employee was really sick and sick leave is issued in his name	It must fill in the appropriate lines and indicate the relevant information in them
In a single database of electronic sick leave certificates	They are available for inspection by the FSS inspector

This unified database linked together the employee - employer - FSS inspector. Now the interaction between these parties has become much more transparent and understandable.

Calculation criteria

Temporary disability benefits are calculated using the following formula:

Benefit = average earnings for 1 day of work * duration of the period.

To calculate the average earnings for 1 day of work for a specific employee, it is necessary to take into account all of his labor income for the last 2 years.

If the period of incapacity for work fell in 2019, then for the calculation you need to use data for 2017 and 2016, respectively.

All periods during which the employee officially received labor income and the employer made contributions to the Social Insurance Fund for him are taken into account.

This value must be divided by 730 (this is the number of days in 2 years) or 731 (if one of the previous years was a leap year).

The resulting quotient will be the average daily earnings of a particular employee.

To know how much the employee will receive, it is necessary to multiply the average daily earnings by the number of days of temporary absence from work.

Benefit payment procedure

The amount of benefits an employee will receive depends on the reason for absence from work and the employee’s length of service.

If the situation is standard, that is, the employee himself gets sick, then he will receive:

In some cases, sick leave is paid based on the minimum wage. These are cases such as:

From 01.01.2019, the federal minimum wage was set at 9,489 rubles, but from 01.05.2019 there was another increase to the subsistence level. Now the minimum wage is 11,163 rubles.

Regardless of length of service, sick leave is paid:

Payment period

The faster an employee submits a sick leave certificate to the employer’s accounting department, the faster he will receive his temporary disability benefit. But, he has six months from the moment the sick leave ends to provide it.

As soon as the certificate of incapacity for work is submitted to the accounting department, employees of this service begin calculating benefits.

It must be assigned within 10 days from the moment the document was received by the employee. The same period is required for the Social Insurance Fund to consider the situation regarding payments.

If an electronic sick leave certificate has been issued, then even fewer disputes arise. It immediately appears in a single database, and calculations can be made.

The employee must receive the entire amount in the coming days of salary payment at the enterprise.

List of reasons for reducing the amount of compensation

In Art. 8 of Law No. 255-FZ provides the grounds on which the amount of temporary disability benefits may be reduced.

Such circumstances include:

If these circumstances exist, payment for the period of incapacity for work occurs based on the minimum wage, which is established at the federal level at the time of the occurrence of these circumstances.

The document is an amendment to

Changes and amendments

Chapter 1. GENERAL PROVISIONS

Article 1. Subject of regulation of this Federal Law

1. This Federal Law regulates legal relations in the system of compulsory social insurance in case of temporary disability and in connection with maternity, determines the circle of persons subject to compulsory social insurance in case of temporary disability and in connection with maternity, and the types of compulsory insurance coverage provided to them, establishes the rights and responsibilities of subjects of compulsory social insurance in case of temporary disability and in connection with maternity, and also determines the conditions, amounts and procedure for providing benefits for temporary disability, pregnancy and childbirth, monthly child care benefits for citizens subject to compulsory social insurance in case of temporary disability and in connection with maternity.

2. This Federal Law does not apply to relations related to the provision of citizens with temporary disability benefits in connection with an industrial accident or occupational disease, with the exception of the provisions of Articles 12, 13, 14 and 15 of this Federal Law applicable to these relations in terms of , which does not contradict the Federal Law of July 24, 1998 N 125-FZ “On compulsory social insurance against industrial accidents and occupational diseases.”

Article 1.1. Legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity

1. The legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity is based on the Constitution of the Russian Federation and consists of this Federal Law, Federal Law of July 16, 1999 N 165-FZ "On the Basics of Compulsory Social Insurance", Federal the law “On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds”, other federal laws. Relations related to compulsory social insurance in case of temporary disability and in connection with maternity are also regulated by other regulatory legal acts of the Russian Federation.

2. In cases where an international treaty of the Russian Federation establishes rules other than those provided for by this Federal Law, the rules of the international treaty of the Russian Federation apply.

3. For the purpose of uniform application of this Federal Law, if necessary, appropriate clarifications may be issued in the manner determined by the Government of the Russian Federation.

Article 1.2. Basic concepts used in this Federal Law

1. For the purposes of this Federal Law, the following basic concepts are used:

1) compulsory social insurance in case of temporary disability and in connection with maternity - a system of legal, economic and organizational measures created by the state aimed at compensating citizens for lost earnings (payments, rewards) or additional expenses in connection with the occurrence of an insured event under compulsory social insurance for case of temporary disability and in connection with maternity;

2) an insured event under compulsory social insurance in case of temporary disability and in connection with maternity - an accomplished event, upon the occurrence of which the insurer becomes obligated, and in some cases established by this Federal Law, the insured to provide insurance coverage;

3) compulsory insurance coverage for compulsory social insurance in case of temporary disability and in connection with maternity (hereinafter also referred to as insurance coverage) - fulfillment by the insurer, and in some cases established by this Federal Law, by the insured of its obligations to the insured person upon the occurrence of an insured event through payment of benefits established by this Federal Law;

4) funds of compulsory social insurance in case of temporary disability and in connection with maternity - funds generated by the payment of insurance premiums by policyholders for compulsory social insurance in case of temporary disability and in connection with maternity, as well as property under the operational management of the insurer;

5) insurance contributions for compulsory social insurance in case of temporary disability and in connection with maternity (hereinafter referred to as insurance premiums) - mandatory payments made by insurers to the Social Insurance Fund of the Russian Federation in order to ensure compulsory social insurance of insured persons in case of temporary disability and in connection with motherhood;

6) average earnings - the average amount of wages, other payments and remunerations paid by the policyholder to the insured person in the billing period, on the basis of which, in accordance with this Federal Law, temporary disability benefits, maternity benefits, and monthly child care benefits are calculated , and for persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity - the minimum wage established by federal law on the day the insured event occurred.

2. Other concepts and terms used in this Federal Law are used in the meaning in which they are used in other legislative acts of the Russian Federation.

Article 1.3. Insurance risks and insured events

1. Insurance risks for compulsory social insurance in case of temporary disability and in connection with maternity are recognized as temporary loss of earnings or other payments, remuneration by the insured person in connection with the occurrence of an insured event or additional expenses of the insured person or members of his family in connection with the occurrence of an insured event.

2. The following are recognized as insured events for compulsory social insurance in case of temporary disability and in connection with maternity:

1) temporary disability of the insured person due to illness or injury (with the exception of temporary disability due to industrial accidents and occupational diseases) and in other cases provided for in Article 5 of this Federal Law;

2) pregnancy and childbirth;

3) birth of a child (children);

4) caring for a child until he reaches the age of one and a half years;

5) death of the insured person or a minor member of his family.

Article 1.4. Types of insurance coverage

1. Types of insurance coverage for compulsory social insurance in case of temporary disability and in connection with maternity are the following payments:

1) temporary disability benefit;

2) maternity benefits;

3) a one-time benefit for women who registered with medical institutions in the early stages of pregnancy;

4) one-time benefit for the birth of a child;

5) monthly child care allowance;

6) social benefit for funeral.

2. The conditions, amounts and procedure for payment of insurance coverage for compulsory social insurance in case of temporary disability and in connection with maternity are determined by this Federal Law, Federal Law of May 19, 1995 N 81-FZ “On State Benefits for Citizens with Children” (hereinafter - Federal Law “On State Benefits for Citizens with Children”), Federal Law of January 12, 1996 N 8-FZ “On Burial and Funeral Business” (hereinafter referred to as the Federal Law “On Burial and Funeral Business”).

Article 2. Persons subject to compulsory social insurance in case of temporary disability and in connection with maternity

1. Citizens of the Russian Federation, as well as foreign citizens and stateless persons permanently or temporarily residing on the territory of the Russian Federation are subject to compulsory social insurance in case of temporary disability and in connection with maternity:

1) persons working under employment contracts;

2) state civil servants, municipal employees;

3) persons holding government positions in the Russian Federation, government positions in a constituent entity of the Russian Federation, as well as municipal positions filled on a permanent basis;

4) members of a production cooperative who take personal labor participation in its activities;

5) clergy;

6) persons sentenced to imprisonment and involved in paid work.

2. Persons subject to compulsory social insurance in case of temporary disability and in connection with maternity in accordance with this Federal Law are insured persons.

3. Lawyers, individual entrepreneurs, members of peasant (farm) households, individuals not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in accordance with the legislation of the Russian Federation), members of family (tribal) communities of indigenous minorities peoples of the North are subject to compulsory social insurance in case of temporary disability and in connection with maternity if they voluntarily entered into a relationship under compulsory social insurance in case of temporary disability and in connection with maternity and pay insurance premiums for themselves in accordance with Article 4.5 of this Federal law.

4. Insured persons have the right to receive insurance coverage subject to the conditions provided for by this Federal Law, as well as the Federal Law “On State Benefits for Citizens with Children” and the Federal Law “On Burial and Funeral Business”. Persons who voluntarily entered into a relationship under compulsory social insurance in case of temporary disability and in connection with maternity acquire the right to receive insurance coverage subject to payment of insurance premiums during the period determined by Article 4.5 of this Federal Law.

5. For the purposes of this Federal Law, persons working under employment contracts are persons who have concluded an employment contract in the prescribed manner from the day on which they were supposed to start work, as well as persons actually admitted to work in accordance with labor legislation.

6. Legislative and regulatory legal acts of the Russian Federation and constituent entities of the Russian Federation may establish other payments to provide for federal state civil servants, state civil servants of constituent entities of the Russian Federation in case of temporary disability and in connection with maternity, financed accordingly from the federal budget, budgets subjects of the Russian Federation.

Article 2.1. Policyholders

1. Insurers for compulsory social insurance in case of temporary disability and in connection with maternity are persons who make payments to individuals subject to compulsory social insurance in case of temporary disability and in connection with maternity in accordance with this Federal Law, including:

1) organizations - legal entities formed in accordance with the legislation of the Russian Federation, as well as foreign legal entities, companies and other corporate entities with civil legal capacity, created in accordance with the legislation of foreign states, international organizations, branches and representative offices of these foreign entities and international organizations created on the territory of the Russian Federation;

2) individual entrepreneurs, including heads of peasant (farm) farms;

3) individuals who are not recognized as individual entrepreneurs.

2. For the purposes of this Federal Law, lawyers, individual entrepreneurs, members of peasant (farm) households, individuals who are not recognized as individual entrepreneurs (notaries engaged in private practice, other persons engaged in private practice in accordance with the procedure established by the legislation of the Russian Federation), are treated as insured persons. members of family (tribal) communities of indigenous peoples of the North who voluntarily entered into relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Article 4.5 of this Federal Law. These persons exercise the rights and bear the obligations of policyholders provided for by this Federal Law, with the exception of the rights and obligations associated with the payment of insurance coverage to the insured persons.

3. If the policyholder simultaneously belongs to several categories of policyholders specified in parts 1 and 2 of this article, the calculation and payment of insurance premiums are made by him on each basis.

Article 2.2. Insurer

1. Compulsory social insurance in case of temporary disability and in connection with maternity is carried out by the insurer, which is the Social Insurance Fund of the Russian Federation.

2. The Social Insurance Fund of the Russian Federation and its territorial bodies constitute a single centralized system of bodies for managing compulsory social insurance funds in the event of temporary disability and in connection with maternity.

3. The legal status and procedure for organizing the activities of the Social Insurance Fund of the Russian Federation are determined by federal law.

Article 2.3. Registration and deregistration of policyholders

1. Registration of policyholders is carried out in the territorial bodies of the insurer:

1) insurers - legal entities, within five days from the date of submission to the territorial body of the insurer by the federal executive body carrying out state registration of legal entities, information contained in the unified state register of legal entities and submitted in the manner determined by the federal executive body authorized by the Government of the Russian Federation ;

2) insurers - legal entities at the location of separate divisions, having a separate balance sheet, current account and accruing payments and other rewards in favor of individuals, on the basis of an application for registration as an insurer, submitted no later than 30 days from the date of creation of such a separate divisions;

3) insurers - individuals who have entered into an employment contract with an employee, at the place of residence of these individuals on the basis of an application for registration as an insurer, submitted no later than 10 days from the date of conclusion of the employment contract with the first of the hired employees.

2. Deregistration of policyholders is carried out at the place of registration in the territorial bodies of the insurer:

1) policyholders - legal entities, within five days from the date of submission to the territorial bodies of the insurer by the federal executive body carrying out state registration of legal entities, information contained in the unified state register of legal entities, in the manner determined by the federal executive body authorized by the Government of the Russian Federation;

2) insurers - legal entities at the location of separate divisions that have a separate balance sheet, current account and accrue payments and other remunerations in favor of individuals (in case of closure of a separate division or termination of authority to maintain a separate balance sheet, current account or accrual of payments and other remunerations in favor of individuals), within fourteen days from the date the policyholder submits an application for deregistration at the location of such unit;

3) policyholders - individuals who have entered into an employment contract with an employee (in the event of termination of the employment contract with the last hired employee), within fourteen days from the date the policyholder submits an application for deregistration.

3. The procedure for registration and deregistration of policyholders specified in paragraphs 2 and 3 of part 1 of this article, and persons equated to policyholders for the purposes of this Federal Law, is established by the federal executive body exercising the functions of developing state policy and legal norms. regulation in the field of social insurance.

Article 3. Financial support for expenses for payment of insurance coverage

1. Financial support for the costs of paying insurance coverage to insured persons is carried out from the budget of the Social Insurance Fund of the Russian Federation, as well as from the funds of the policyholder in the cases provided for in paragraph 1 of part 2 of this article.

2. Temporary disability benefits in the cases specified in paragraph 1 of part 1 of Article 5 of this Federal Law are paid:

1) to insured persons (with the exception of insured persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Article 4.5 of this Federal Law) for the first two days of temporary disability at the expense of the insurer, and for the rest the period starting from the 3rd day of temporary disability at the expense of the budget of the Social Insurance Fund of the Russian Federation;

2) insured persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Article 4.5 of this Federal Law, at the expense of the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.

3. Temporary disability benefits in the cases provided for in paragraphs 2 - 5 of part 1 of Article 5 of this Federal Law are paid to insured persons from the budget of the Social Insurance Fund of the Russian Federation from the 1st day of temporary disability.

4. Financial support for additional expenses for the payment of benefits for temporary disability, pregnancy and childbirth associated with the inclusion in the insurance period of the insured person of the periods of service specified in Part 1.1 of Article 16 of this Federal Law, during which the citizen was not subject to compulsory social insurance in case of temporary disability and in connection with maternity, is carried out at the expense of interbudgetary transfers from the federal budget provided for these purposes to the budget of the Social Insurance Fund of the Russian Federation. Determination of the volume of interbudgetary transfers from the federal budget provided to the budget of the Social Insurance Fund of the Russian Federation to finance additional expenses, regarding periods of said service that took place before January 1, 2007, is not made if these periods are taken into account when determining the duration of the insurance period in accordance with Article 17 of this Federal Law.

5. In cases established by the laws of the Russian Federation, federal laws, financial support for the costs of paying insurance coverage in amounts in excess of those established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity is carried out at the expense of interbudgetary transfers from the federal budget provided for these purposes to the budget of the Social Insurance Fund of the Russian Federation.

Article 4. Provision of insurance coverage to persons sentenced to imprisonment and involved in paid work

The provision of insurance coverage to persons sentenced to imprisonment and involved in paid work is carried out in the manner determined by the Government of the Russian Federation.

Chapter 1.1. RIGHTS AND OBLIGATIONS

SUBJECTS OF COMPULSORY SOCIAL INSURANCE IN CASE

TEMPORARY DISABILITY AND IN CONNECTION WITH MATERNITY

Article 4.1. Rights and obligations of policyholders

1. Policyholders have the right:

1) contact the insurer to receive the funds necessary to pay insurance coverage to the insured persons, in addition to the accrued insurance premiums;

2) receive free information from the insurer about regulatory legal acts on compulsory social insurance in case of temporary disability and in connection with maternity;

3) go to court to protect your rights.

2. Policyholders are obliged to:

1) register with the territorial body of the insurer in the cases and in the manner established by Article 2.3 of this Federal Law;

2) pay insurance contributions to the Social Insurance Fund of the Russian Federation in a timely manner and in full;

3) in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, pay insurance coverage to insured persons upon the occurrence of insured events provided for by this Federal Law;

4) keep records and reports on accrued and paid insurance contributions to the Social Insurance Fund of the Russian Federation and expenses for the payment of insurance coverage to insured persons;

5) comply with the requirements of the territorial bodies of the insurer to eliminate identified violations of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity;

6) submit for verification to the territorial bodies of the insurer documents related to the accrual and payment of insurance contributions to the Social Insurance Fund of the Russian Federation and the costs of paying insurance coverage to insured persons;

7) inform the territorial bodies of the insurer about the creation, transformation or closure of separate divisions specified in paragraph 2 of part 1 of Article 2.3 of this Federal Law, as well as about changes in their location and name;

8) fulfill other duties provided for by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity.

3. The rights and obligations of policyholders as payers of insurance premiums are established by the Federal Law “On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Territorial Compulsory Medical Insurance Funds.”

Article 4.2. Rights and obligations of the insurer

1. The insurer has the right:

1) conduct checks on the correctness of the calculation and payment of insurance premiums by policyholders to the Social Insurance Fund of the Russian Federation, as well as the payment of insurance coverage to insured persons, demand and receive from policyholders the necessary documents and explanations on issues arising during the checks;

2) request from policyholders documents related to the calculation and payment of insurance contributions to the Social Insurance Fund of the Russian Federation, expenses for the payment of insurance coverage to insured persons, including when allocating funds to the policyholder for these expenses in excess of accrued insurance contributions;

3) receive from the Federal Treasury authorities information about the amounts of insurance contributions, penalties, and fines received by the Social Insurance Fund of the Russian Federation;

4) not to take into account against the payment of insurance premiums expenses for the payment of insurance coverage to insured persons, made by the policyholder in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, not supported by documents, made on the basis of incorrectly executed or documents issued in violation of the established procedure;

5) contact the federal executive body exercising the functions of supervision and control in the field of healthcare with requests to conduct inspections in medical organizations of the organization of examination of temporary disability, the validity of issuing and extending certificates of incapacity for work;

6) bring claims against medical organizations for reimbursement of the amount of expenses for insurance coverage for unreasonably issued or incorrectly executed certificates of incapacity for work;

7) represent the interests of the insured persons before the policyholders;

8) exercise other powers established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity.

2. The insurer is obliged:

1) manage the funds of compulsory social insurance in case of temporary disability and in connection with maternity in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity and the budget legislation of the Russian Federation;

2) draw up a draft budget for the Social Insurance Fund of the Russian Federation and ensure execution of the budget of the Social Insurance Fund of the Russian Federation in accordance with the budget legislation of the Russian Federation;

3) keep records of compulsory social insurance funds in the event of temporary disability and in connection with maternity in accordance with the established procedure;

4) draw up a draft report on the execution of the budget of the Social Insurance Fund of the Russian Federation, as well as established budget reporting;

5) exercise control over the correctness of calculation, completeness and timeliness of payment (transfer) of insurance contributions to the Social Insurance Fund of the Russian Federation (hereinafter referred to as control over the payment of insurance contributions), as well as control over compliance by policyholders with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity when paying insurance coverage to insured persons;

6) carry out, in cases established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, payment of insurance coverage to the insured persons;

7) allocate to policyholders in the prescribed manner the necessary funds for the payment of insurance coverage in excess of the insurance premiums accrued by them;

8) register policyholders, maintain a register of policyholders;

9) keep records of individuals who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity, as well as the insurance premiums they paid and the amounts of insurance coverage paid to them;

10) provide free consultation to policyholders and insured persons on the application of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity;

11) not to disclose, without the consent of the insured person, information about the results of his medical examinations (diagnosis), the income he receives, except for cases provided for by the legislation of the Russian Federation;

12) fulfill other requirements established by the legislation of the Russian Federation.

3. The rights and obligations of the insurer related to monitoring the payment of insurance premiums are established by the Federal Law “On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Territorial Compulsory Medical Insurance Funds.”

Article 4.3. Rights and obligations of insured persons

1. Insured persons have the right:

1) receive insurance coverage in a timely manner and in full in accordance with the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity;

2) freely receive information from the policyholder about the calculation of insurance premiums and exercise control over their transfer to the Social Insurance Fund of the Russian Federation;

3) contact the policyholder and the insurer for advice on the application of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity;

4) contact the insurer with a request to verify the correctness of the payment of insurance coverage by the policyholder;

5) protect your rights personally or through a representative, including in court.

2. Insured persons are obliged:

1) present to the policyholder, and in cases established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, to the insurer, reliable documents on the basis of which insurance coverage is paid;

2) notify the policyholder (insurer) about circumstances affecting the terms of provision and the amount of insurance coverage within 10 days from the date of their occurrence;

3) comply with the treatment regimen determined for the period of temporary incapacity and the rules of behavior of the patient in medical organizations;

4) fulfill other requirements established by the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity.

3. If the insured persons fail to fulfill the obligations established by part 2 of this article, the insurer has the right to recover from them the damage caused in accordance with the legislation of the Russian Federation.

Chapter 1.2. FEATURES OF PAYMENT OF INSURANCE PREMIUMS

Article 4.4. Legal regulation of relations related to the payment of insurance premiums

Legal regulation of relations related to the payment of insurance premiums by policyholders specified in Part 1 of Article 2.1 of this Federal Law, including the determination of the object of taxation of insurance premiums, the base for calculating insurance premiums, amounts not subject to insurance premiums, establishing the calculation procedure, procedure and the timing of payment of insurance premiums is carried out by the Federal Law “On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Territorial Compulsory Medical Insurance Funds”.

Article 4.5. The procedure for voluntary entry into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity

1. The persons specified in Part 3 of Article 2 of this Federal Law enter into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity by submitting an application to the territorial body of the insurer at the place of residence.

2. Persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity, pay insurance contributions to the Social Insurance Fund of the Russian Federation, based on the cost of the insurance year, determined in accordance with Part 3 of this article.

3. The cost of an insurance year is determined as the product of the minimum wage established by federal law at the beginning of the financial year for which insurance premiums are paid, and the tariff of insurance premiums established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation , Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds" in terms of insurance contributions to the Social Insurance Fund of the Russian Federation, increased 12 times.

4. Payment of insurance premiums by persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity is made no later than December 31 of the current year, starting from the year of filing the application for voluntary entry into legal relations under compulsory social insurance in case of temporary disability and in connection with motherhood.

5. Persons who have voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity, transfer insurance premiums to the accounts of the territorial bodies of the insurer by non-cash payments, or by depositing cash in a credit institution, or by postal transfer.

6. Persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity acquire the right to receive insurance coverage, subject to their payment of insurance contributions in accordance with Part 4 of this article in the amount determined in accordance with Part 3 of this article, for the calendar year preceding the calendar year in which the insured event occurred.

7. If a person who voluntarily entered into a legal relationship under compulsory social insurance in case of temporary disability and in connection with maternity, did not pay insurance premiums for the corresponding calendar year by December 31 of the current year, the legal relationship between him and the insurer under compulsory social insurance in case of temporary disability and in connection with maternity are considered terminated.

8. The procedure for paying insurance premiums by persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity, including the procedure for terminating legal relations with them under compulsory social insurance in case of temporary disability and in connection with maternity, is determined by the Government Russian Federation.

Article 4.6. The procedure for financial support for the costs of policyholders for the payment of insurance coverage from the budget of the Social Insurance Fund of the Russian Federation

1. The insurers specified in Part 1 of Article 2.1 of this Federal Law pay insurance coverage to the insured persons against the payment of insurance contributions to the Social Insurance Fund of the Russian Federation, with the exception of the cases specified in paragraph 1 of Part 2 of Article 3 of this Federal Law, when the payment of insurance provision is carried out at the expense of policyholders.

2. The amount of insurance contributions to be transferred by the policyholders specified in Part 1 of Article 2.1 of this Federal Law to the Social Insurance Fund of the Russian Federation is reduced by the amount of expenses incurred by them to pay insurance coverage to the insured persons. If the insurance premiums accrued by the policyholder are not enough to pay the insurance coverage to the insured persons in full, the policyholder applies for the necessary funds to the territorial body of the insurer at the place of his registration.

In 2010, funds for the payment of compulsory insurance coverage for compulsory social insurance in case of temporary disability and in connection with maternity (with the exception of payment of benefits for temporary disability in case of loss of ability to work due to illness or injury for the first two days of temporary disability) to citizens working under employment contracts , concluded with organizations or individual entrepreneurs who have switched to a simplified taxation system or who are payers of a single tax on imputed income for certain types of activities or a single agricultural tax, are allocated to these organizations and individual entrepreneurs by the territorial bodies of the Social Insurance Fund of the Russian Federation in the manner established by parts 3 - 6 Article 4.6 of this document, at the place of their registration as policyholders.

3. The territorial body of the insurer allocates the necessary funds to the policyholder for payment of insurance coverage within 10 calendar days from the date the policyholder submits all necessary documents, except for the cases specified in part 4 of this article. The list of documents that must be submitted by the policyholder is determined by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

4. When considering the insured’s request for the allocation of the necessary funds for the payment of insurance coverage, the territorial body of the insurer has the right to verify the correctness and validity of the insured’s expenses for the payment of insurance coverage, including an on-site inspection, in the manner established by Article 4.7 of this Federal Law, and also request that the policyholder additional information and documents. In this case, the decision to allocate these funds to the policyholder is made based on the results of the audit.

5. In case of refusal to allocate the necessary funds to the insured for the payment of insurance coverage, the territorial body of the insurer makes a reasoned decision, which is sent to the insured within three days from the date of the decision.

6. The decision to refuse to allocate the necessary funds to the policyholder for the payment of insurance coverage may be appealed by him to a higher body of the insurer or to court.

7. Funds for the payment of insurance coverage (with the exception of payment of benefits for temporary disability in case of loss of ability to work due to illness or injury for the first two days of temporary disability) to citizens who work under employment contracts concluded with organizations that have received the status of participants in a research and development project and commercialization of their results in accordance with the Federal Law "On the Skolkovo Innovation Center", and in respect of which the tax authority has established compliance with the criteria specified in Article 145.1 of the Tax Code of the Russian Federation, are allocated to these organizations by the territorial bodies of the insurer in the manner established by parts 3 - 6 of this article, at the place of their registration as policyholders.

Article 4.7. Carrying out checks by the insurer regarding the correctness of expenses for payment of insurance coverage

1. The territorial body of the insurer at the place of registration of the insured conducts desk and on-site inspections of the correctness of the insured’s expenses for the payment of insurance coverage.

2. On-site inspections of the policyholder are carried out no more than once every three years, except for the cases specified in Part 4 of Article 4.6 of this Federal Law and in Part 3 of this Article.

3. If the insured person receives a complaint about the policyholder’s refusal to pay insurance coverage or about the policyholder’s incorrect determination of the amount of insurance coverage, the territorial body of the insurer has the right to conduct an unscheduled on-site inspection of the correctness of the policyholder’s expenses for payment of insurance coverage.

4. If expenses for the payment of insurance coverage are identified, made by the policyholder in violation of the legislation of the Russian Federation on compulsory social insurance in case of temporary disability and in connection with maternity, not supported by documents, made on the basis of incorrectly executed or issued documents in violation of the established procedure, the territorial the insurer's body that conducted the inspection makes a decision not to accept such expenses as offset against the payment of insurance contributions to the Social Insurance Fund of the Russian Federation.

5. The decision not to offset the costs of payment of insurance coverage, together with the request for their compensation, is sent to the insured within three days from the date of the decision. The forms of the decision on non-acceptance of expenses for the payment of insurance coverage and claims for their reimbursement are approved by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

6. If, within the period established in the specified requirement, the policyholder has not made compensation for expenses that were not accepted for offset, the decision not to accept for offset the costs of payment of insurance coverage is the basis for collecting from the insured the arrears in insurance premiums resulting from the implementation of such expenses. Collection of arrears of insurance premiums is carried out by the insurer in the manner established by the Federal Law “On Insurance Contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Territorial Compulsory Medical Insurance Funds.”

7. On-site inspections of the correctness of the insured's expenses for the payment of insurance coverage are carried out by the insurer simultaneously with on-site inspections of the insured on the correctness of calculation, completeness and timeliness of payment (transfer) of insurance contributions to the Social Insurance Fund of the Russian Federation, except for the cases specified in part 4 of article 4.6 of this Federal Law and Part 3 of this article.

Article 4.8. Accounting and reporting of policyholders

1. Insurers specified in Part 1 of Article 2.1 of this Federal Law are obliged, in the manner established by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance, to keep records of:

1) the amounts of accrued and paid (transferred) insurance premiums, penalties and fines;

2) the amount of expenses incurred for the payment of insurance coverage;

3) settlements for compulsory social insurance in case of temporary disability and in connection with maternity with the territorial body of the insurer at the place of registration of the policyholder.

2. Quarterly, no later than the 15th day of the month following the end of the quarter, policyholders specified in Part 1 of Article 2.1 of this Federal Law are required to submit reports (calculations) to the territorial bodies of the insurer in the form approved by the federal executive body exercising the functions of development of state policy and legal regulation in the field of social insurance, on the amounts:

1) accrued insurance contributions to the Social Insurance Fund of the Russian Federation;

2) the funds they used to pay insurance coverage;

3) expenses for the payment of insurance coverage, subject to offset against the payment of insurance contributions to the Social Insurance Fund of the Russian Federation;

4) insurance contributions, penalties, fines paid to the Social Insurance Fund of the Russian Federation.

3. Forms of reports (calculations) submitted by persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Article 4.5 of this Federal Law, as well as the timing and procedure for their submission are approved by the federal executive body, carrying out the functions of developing state policy and legal regulation in the field of social insurance.

Chapter 2. PROVIDING BENEFITS

FOR TEMPORARY DISABILITY

Article 5. Cases of provision of temporary disability benefits

1. Providing insured persons with temporary disability benefits is carried out in the following cases:

1) loss of ability to work due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization (hereinafter referred to as illness or injury);

2) the need to care for a sick family member;

3) quarantine of the insured person, as well as quarantine of a child under 7 years of age attending a preschool educational institution, or another family member recognized as legally incompetent in accordance with the established procedure;

4) implementation of prosthetics for medical reasons in a hospital specialized institution;

5) follow-up treatment in the prescribed manner in sanatorium-resort institutions located on the territory of the Russian Federation, immediately after inpatient treatment.

2. Temporary disability benefits are paid to insured persons upon the occurrence of the cases specified in part 1 of this article, during the period of work under an employment contract, performance of official or other activities, during which they are subject to compulsory social insurance, as well as in cases where illness or the injury occurred within 30 calendar days from the date of termination of the specified work or activity or during the period from the date of conclusion of the employment contract until the day of its cancellation.

Article 6. Conditions and duration of payment of temporary disability benefits

1. A temporary disability benefit in case of loss of ability to work due to illness or injury is paid to the insured person for the entire period of temporary disability until the day of restoration of working capacity (establishment of disability), except for the cases specified in parts 3 and 4 of this article.

2. When an insured person undergoes further treatment in a sanatorium-resort institution located on the territory of the Russian Federation, immediately after inpatient treatment, temporary disability benefits are paid for the period of stay in the sanatorium-resort institution, but not more than 24 calendar days (except for tuberculosis) .

3. An insured person recognized as a disabled person in accordance with the established procedure is paid a temporary disability benefit (except for tuberculosis) for no more than four months in a row or five months in a calendar year. If these persons fall ill with tuberculosis, temporary disability benefits are paid until the day of restoration of working capacity or until the day the disability group is revised due to tuberculosis.

4. An insured person who has entered into a fixed-term employment contract (fixed-term service contract) for a period of up to six months, as well as an insured person whose illness or injury occurred during the period from the date of conclusion of the employment contract until the day of its cancellation, temporary disability benefits (with the exception of tuberculosis) is paid for no more than 75 calendar days under this agreement. In case of tuberculosis, temporary disability benefits are paid until the day the ability to work is restored (disability is established). In this case, an insured person whose illness or injury occurred during the period from the date of conclusion of the employment contract until the day of its cancellation is paid temporary disability benefits from the day on which the employee was supposed to start work.

5. Temporary disability benefits, if it is necessary to care for a sick family member, are paid to the insured person:

1) in the case of caring for a sick child under 7 years of age - for the entire period of outpatient treatment or joint stay with the child in an inpatient treatment facility, but not more than 60 calendar days in a calendar year for all cases of caring for this child, and in the case of a child’s illness included in the list of diseases determined by the federal executive body exercising the functions of developing state policy and legal regulation in the field of healthcare and social development, no more than 90 calendar days in a calendar year for all cases of child care this child in connection with the specified disease;

2) in the case of caring for a sick child aged 7 to 15 years - for a period of up to 15 calendar days for each case of outpatient treatment or joint stay with a child in an inpatient medical institution, but not more than 45 calendar days in a calendar year for all cases of caring for this child;

3) in the case of caring for a sick disabled child under the age of 15 years - for the entire period of outpatient treatment or joint stay with the child in an inpatient medical institution, but not more than 120 calendar days in a calendar year for all cases of caring for this child;

4) in the case of caring for a sick child under 15 years of age who is HIV-infected - for the entire period of joint stay with the child in an inpatient treatment and prevention institution;

5) in the case of caring for a sick child under the age of 15 years with his illness associated with a post-vaccination complication, with malignant neoplasms, including malignant neoplasms of lymphoid, hematopoietic and related tissues - for the entire period of outpatient treatment or joint stay with the child in an inpatient hospital medical and preventive institution;

6) in other cases of caring for a sick family member during outpatient treatment - no more than 7 calendar days for each case of illness, but no more than 30 calendar days in a calendar year for all cases of caring for this family member.

6. Temporary disability benefits in case of quarantine are paid to the insured person who was in contact with an infectious patient or who was found to be a carrier of the bacteria, for the entire period of his suspension from work due to quarantine. If children under 7 years of age attending preschool educational institutions, or other family members recognized as legally incompetent in the established manner, are subject to quarantine, temporary disability benefits are paid to the insured person (one of the parents, another legal representative or other family member) for the entire quarantine period .

7. Temporary disability benefits in the case of prosthetics for medical reasons in a stationary specialized institution are paid to the insured person for the entire period of release from work for this reason, including travel time to the place of prosthetics and back.

8. Temporary disability benefits are paid to the insured person in all cases specified in parts 1 - 7 of this article, for calendar days falling on the corresponding period, with the exception of calendar days falling on the periods specified in part 1 of article 9 of this Federal Law.

Article 7. Amount of benefit for temporary disability

1. Temporary disability benefits for loss of ability to work due to illness or injury, except for the cases specified in part 2 of this article, during quarantine, prosthetics for medical reasons and after-care in sanatorium-resort institutions immediately after inpatient treatment, are paid in the following amount:

1) to an insured person with 8 or more years of insurance experience - 100 percent of average earnings;

2) to an insured person with an insurance period of 5 to 8 years - 80 percent of average earnings;

3) to an insured person with up to 5 years of insurance experience - 60 percent of average earnings.

2. Temporary disability benefits for loss of ability to work due to illness or injury are paid to insured persons in the amount of 60 percent of average earnings in the event of illness or injury occurring within 30 calendar days after termination of work under an employment contract, official or other activity during which they are subject to compulsory social insurance.

3. Temporary disability benefits when it is necessary to care for a sick child are paid:

1) for outpatient treatment of a child - for the first 10 calendar days in the amount determined depending on the length of the insurance period of the insured person in accordance with Part 1 of this article, for subsequent days in the amount of 50 percent of average earnings;

2) in case of inpatient treatment of a child - in the amount determined depending on the length of the insurance period of the insured person in accordance with Part 1 of this article.

4. Temporary disability benefits if it is necessary to care for a sick family member during his outpatient treatment, with the exception of cases of caring for a sick child under 15 years of age, is paid in an amount determined depending on the length of the insurance period of the insured person in accordance with Part 1 of this article.

5. Lost force on January 1, 2010. - Federal Law of July 24, 2009 N 213-FZ.

6. An insured person with an insurance period of less than six months is paid a temporary disability benefit in an amount not exceeding for a full calendar month the minimum wage established by federal law, and in regions and localities in which regional coefficients are applied to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.

7. Temporary disability benefits for the period of inactivity are paid in the same amount as wages are maintained during this time, but not higher than the amount of benefits that the insured person would receive according to the general rules.

Article 8. Grounds for reducing the amount of temporary disability benefits

1. The grounds for reducing the amount of temporary disability benefits are:

1) violation by the insured person without good reason during the period of temporary disability of the regime prescribed by the attending physician;

2) failure of the insured person to appear without good reason at the appointed time for a medical examination or for a medical and social examination;

3) illness or injury resulting from alcohol, drug, toxic intoxication or actions related to such intoxication.

2. If there are one or more grounds for reducing the temporary disability benefit specified in Part 1 of this article, the temporary disability benefit is paid to the insured person in an amount not exceeding for a full calendar month the minimum wage established by federal law, and in the regions and areas in which regional coefficients are applied to wages in accordance with the established procedure - in an amount not exceeding the minimum wage taking into account these coefficients:

1) if there are grounds specified in paragraphs 1 and 2 of part 1 of this article - from the day the violation was committed;

2) if there are grounds specified in paragraph 3 of part 1 of this article - for the entire period of incapacity.

Article 9. Periods for which temporary disability benefits are not awarded. Grounds for refusal to grant temporary disability benefits

1. Temporary disability benefits are not assigned to the insured person for the following periods:

1) for the period of release of the employee from work with full or partial retention of wages or without payment in accordance with the legislation of the Russian Federation, with the exception of cases of loss of ability by the employee due to illness or injury during the period of annual paid leave;

2) for the period of suspension from work in accordance with the legislation of the Russian Federation, if wages are not accrued for this period;

3) during the period of detention or administrative arrest;

4) during the period of the forensic medical examination.

2. The grounds for refusing to grant temporary disability benefits to an insured person are:

1) the onset of temporary disability as a result of a court-established intentional infliction of harm to one’s health by the insured person or an attempted suicide;

2) the onset of temporary disability as a result of the commission of an intentional crime by the insured person.

Chapter 3. PROVIDING MATERNITY AND MATERNITY BENEFITS

Article 10. Duration of payment of maternity benefits

1. Maternity benefits are paid to the insured woman in total for the entire period of maternity leave lasting 70 (in the case of a multiple pregnancy - 84) calendar days before childbirth and 70 (in the case of complicated childbirth - 86, for the birth of two or more children - 110) calendar days after childbirth.

2. When adopting a child (children) under the age of three months, maternity benefits are paid from the date of his adoption until the expiration of 70 (in the case of simultaneous adoption of two or more children - 110) calendar days from the date of birth of the child (children).

3. If, while the mother is on maternity leave until the child reaches the age of one and a half years, she begins maternity leave, she has the right to choose one of two types of benefits paid during the periods of the corresponding leaves.

Article 11. Amount of maternity benefit

1. Maternity benefits are paid to the insured woman in the amount of 100 percent of average earnings.

2. Lost force on January 1, 2010. - Federal Law of July 24, 2009 N 213-FZ.

3. An insured woman with an insurance period of less than six months is paid maternity benefits in an amount not exceeding for a full calendar month the minimum wage established by federal law, and in districts and localities in which district coefficients are duly applied to wages, in an amount not exceeding the minimum wage, taking into account these coefficients.

Chapter 3.1. PROVIDING MONTHLY ALLOWANCE

FOR CHILD CARE

Article 11.1. Conditions and duration of payment of monthly child care benefits

1. Monthly child care benefits are paid to insured persons (mother, father, other relatives, guardians) who actually care for the child and are on parental leave, from the date of granting child care leave until the child reaches the age of one and a half years .

2. The right to a monthly child care allowance is retained if the person on parental leave works part-time or at home and continues to care for the child.

3. Mothers entitled to maternity benefits, during the period after childbirth, have the right from the day of birth of the child to receive either a maternity benefit or a monthly child care benefit with credit for previously paid maternity benefits if The monthly child care benefit is higher than the maternity benefit.

4. If child care is provided simultaneously by several persons, the right to receive a monthly child care allowance is granted to one of these persons.

Article 11.2. Amount of monthly child care benefit

1. A monthly child care benefit is paid in the amount of 40 percent of the average earnings of the insured person, but not less than the minimum amount of this benefit established by the Federal Law “On State Benefits for Citizens with Children.”

2. In the case of caring for two or more children before they reach the age of one and a half years, the amount of the monthly child care benefit, calculated in accordance with Part 1 of this article, is summed up. In this case, the total amount of the benefit cannot exceed 100 percent of the average earnings of the insured person, determined in the manner established by Article 14 of this Federal Law, but cannot be less than the total minimum amount of this benefit.

3. When determining the amount of the monthly allowance for caring for the second child and subsequent children, previous children born (adopted) by the mother of the child are taken into account.

4. In the case of caring for a child (children) born to a mother who was deprived of parental rights in relation to previous children, a monthly child care allowance is paid in the amounts established by this article, excluding children in respect of whom she was deprived of parental rights right

Chapter 4. ASSIGNMENT, CALCULATION AND PAYMENT OF BENEFITS

FOR TEMPORARY DISABILITY, PREGNANCY AND CHILDREN,

MONTHLY CHILD CARE ALLOWANCE

Article 12. Deadlines for applying for benefits for temporary disability, pregnancy and childbirth, monthly child care benefits

1. Temporary disability benefits are assigned if the application for it follows no later than six months from the date of restoration of working capacity (establishment of disability), as well as the end of the period of release from work in cases of caring for a sick family member, quarantine, prosthetics and after-care.

2. Maternity benefits are assigned if the application for it follows no later than six months from the date of termination of maternity leave.

2.1. A monthly child care allowance is assigned if the application is made no later than six months from the date the child reaches the age of one and a half years.

3. When applying for temporary disability benefits, maternity benefits, monthly child care benefits after a six-month period, the decision to assign benefits is made by the territorial body of the insurer if there are good reasons for missing the deadline for applying for benefits. The list of valid reasons for missing the deadline for applying for benefits is determined by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

Article 13. Procedure for assigning and paying benefits for temporary disability, pregnancy and childbirth, monthly child care benefits

1. The assignment and payment of temporary disability benefits, maternity benefits, and monthly child care benefits are carried out by the insurer at the place of work (service, other activity) of the insured person (except for the cases specified in parts 3 and 4 of this article).

2. If the insured person is employed by several insurers, benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by the insured for all places of work (service, other activities), and a monthly child care benefit - by the insured for one place work (service, other activities) at the choice of the insured person.

3. An insured person who has lost his ability to work due to illness or injury within 30 calendar days from the date of termination of work under an employment contract, official or other activity, during which he was subject to compulsory social insurance in case of temporary disability and in connection with maternity, temporary benefits disability is assigned and paid by the policyholder at his last place of work (service, other activity) or by the territorial body of the insurer in the cases specified in part 4 of this article.

4. The insured persons specified in Part 3 of Article 2 of this Federal Law, as well as other categories of insured persons in the event of termination of activities by the insured on the day the insured person applies for benefits for temporary disability, pregnancy and childbirth, monthly child care benefits or If it is impossible for the policyholder to pay them due to insufficient funds in his account with a credit institution and the use of the order of debiting funds from the account provided for by the Civil Code of the Russian Federation, the assignment and payment of these benefits are carried out by the territorial body of the insurer.

5. To assign and pay benefits for temporary disability, pregnancy and childbirth, the insured person submits a certificate of incapacity for work issued by a medical organization in the form and in the manner established by the federal executive body exercising the functions of developing state policy and legal regulation in the field social insurance, and for the appointment and payment of these benefits by the territorial body of the insurer, also information on the average earnings from which the benefit should be calculated, and documents determined by the specified federal executive body confirming the insurance period.

7. An insured person employed by several insurers, when applying to one of these insurers of his choice for the appointment and payment of a monthly child care benefit, along with the documents provided for in Part 6 of this article, submits a certificate (certificates) from his place of work (service) , other activities) from another policyholder (from other policyholders) that the assignment and payment of monthly child care benefits is not carried out by this policyholder.

8. The policyholder pays temporary disability benefits, maternity benefits, and monthly child care benefits to the insured person in the manner established for paying wages (other payments, remunerations) to insured persons.

9. In case of assignment and payment of benefits for temporary disability, maternity, monthly child care benefits by the territorial body of the insurer, provided for in Part 4 of this article, payment of temporary disability benefits, maternity benefits, monthly child care benefits carried out in the established amounts by the territorial body of the insurer that assigned the specified benefits, through the federal postal service organization, credit or other organization at the request of the recipient.

Article 14. Procedure for calculating benefits for temporary disability, pregnancy and childbirth, monthly child care benefits

1. Benefits for temporary disability, pregnancy and childbirth, monthly child care benefits are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months of work (service, other activities) for this insurer, preceding the month of the onset of temporary disability, vacation maternity leave, parental leave. If the insured person did not have a period of work (service, other activity) immediately before the occurrence of these insured events in connection with temporary disability, maternity leave or child care leave, the corresponding benefits are calculated based on the average earnings of the insured person, calculated for the last 12 calendar months of work (service, other activities) for this policyholder, preceding the month of the occurrence of the previous insured event.

2. The average earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits are calculated, include all types of payments and other remunerations in favor of the employee, which are included in the base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation in accordance with the Federal Law "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds."

2.1. For the insured persons specified in Part 3 of Article 2 of this Federal Law, the average earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits are calculated, are taken equal to the minimum wage established by federal law on the day of insured event. At the same time, the calculated monthly child care benefit cannot be less than the minimum amount of the monthly child care benefit established by the Federal Law “On State Benefits for Citizens with Children.”

3. The average daily earnings for calculating temporary disability benefits, maternity benefits, and monthly child care benefits are determined by dividing the amount of accrued earnings for the period specified in part 1 of this article by the number of calendar days falling on the period for which wages are taken into account.

3.1. The average daily earnings from which benefits for temporary disability, pregnancy and childbirth are calculated cannot exceed the average daily earnings determined by dividing the maximum base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation, established by the Federal Law "On Insurance Contributions to the Pension Fund". Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds" on the day of the occurrence of the insured event, at 365. In the event that the assignment and payment of the specified benefits to the insured person is carried out by several policyholders in accordance with Part 2 Article 13 of this Federal Law, the average daily earnings from which the specified benefits are calculated cannot exceed the average daily earnings determined on the basis of the specified limit value when calculating these benefits by each of these insurers.

4. The amount of the daily benefit for temporary disability, pregnancy and childbirth is calculated by multiplying the average daily earnings of the insured person by the amount of the benefit established as a percentage of the average earnings in accordance with Articles 7 and 11 of this Federal Law.

5. The amount of benefits for temporary disability and maternity leave is determined by multiplying the amount of the daily benefit by the number of calendar days falling during the period of temporary disability and maternity leave.

5.1. The monthly child care benefit is calculated from the average earnings of the insured person, which is determined by multiplying the average daily earnings, determined in accordance with Part 3 of this article, by 30.4. The average earnings from which the monthly child care allowance is calculated cannot exceed the average earnings determined by dividing the maximum base for calculating insurance contributions to the Social Insurance Fund of the Russian Federation, established by the Federal Law "On Insurance Contributions to the Pension Fund of the Russian Federation, the Fund social insurance of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds" on the day of the occurrence of the insured event, on 12.

5.2. The amount of the monthly child care benefit is determined by multiplying the average earnings of the insured person by the amount of the benefit established as a percentage of the average earnings in accordance with Article 11.2 of this Federal Law. When caring for a child for an incomplete calendar month, the monthly child care allowance is paid in proportion to the number of calendar days (including non-working holidays) in the month during the period of care.

6. Lost force on January 1, 2010. - Federal Law of July 24, 2009 N 213-FZ.

7. The specifics of the procedure for calculating benefits for temporary disability, pregnancy and childbirth, monthly child care benefits, including for certain categories of insured persons, are determined by the Government of the Russian Federation.

Article 15. Terms of appointment and payment of benefits for temporary disability, pregnancy and childbirth, monthly child care benefits

1. The insurer assigns benefits for temporary disability, maternity benefits, and monthly child care benefits within 10 calendar days from the date the insured person applies for it with the necessary documents. Payment of benefits is carried out by the policyholder on the day closest to the date of payment of wages after the appointment of benefits.

2. The territorial body of the insurer, in the cases provided for in parts 2 and 3 of Article 13 of this Federal Law, assigns and pays benefits for temporary disability, pregnancy and childbirth, monthly child care benefits within 10 calendar days from the date the insured person submits the corresponding application and necessary documents.

3. Temporary disability benefits, maternity benefits, and monthly child care benefits assigned but not received by the insured person in a timely manner are paid for the entire past period, but not more than for three years preceding the application for it. A benefit not received by the insured person in whole or in part due to the fault of the policyholder or the territorial body of the insurer is paid for the entire past time without any limitation.

4. Amounts of benefits for temporary disability, pregnancy and childbirth, monthly child care benefits, excessively paid to the insured person cannot be recovered from him, except in cases of accounting error and dishonesty on the part of the recipient (submission of documents with deliberately incorrect information, concealment of data affecting the receipt of benefits and its amount, other cases). Withholding is made in the amount of no more than 20 percent of the amount due to the insured person for each subsequent payment of benefits or his wages. If the payment of benefits or wages is terminated, the remaining debt is collected in court.

5. Accrued amounts of benefits for temporary disability, pregnancy and childbirth, monthly child care benefits not received due to the death of the insured person are paid in the manner established by the civil legislation of the Russian Federation.

Article 16. The procedure for calculating the insurance period to determine the amount of benefits for temporary disability, pregnancy and childbirth

1. The insurance period for determining the amount of benefits for temporary disability, pregnancy and childbirth (insurance period) includes periods of work of the insured person under an employment contract, state civil or municipal service, as well as periods of other activities during which the citizen was subject to compulsory social insurance in case of temporary disability and in connection with maternity.

1.1. The insurance period, along with the periods of work and (or) other activities that are provided for in Part 1 of this article, includes periods of military service, as well as other service provided for by the Law of the Russian Federation of February 12, 1993 N 4468-1 "On pension provision for persons who served in the military, served in the internal affairs bodies, the State Fire Service, agencies for control over the circulation of narcotic drugs and psychotropic substances, institutions and bodies of the penal system, and their families."

2. The insurance period is calculated in calendar order. If several periods counted in the insurance period coincide in time, one of such periods is taken into account at the choice of the insured person.

3. The rules for calculating and confirming the insurance period are established by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

Chapter 5. PROCEDURE FOR ENTRY INTO FORCE

OF THIS FEDERAL LAW

Article 17. Retention of previously acquired rights when determining the amount of temporary disability benefits and the duration of the insurance period

1. Establish that citizens who started work under an employment contract, official or other activity, during which they are subject to compulsory social insurance, before January 1, 2007 and who before January 1, 2007 had the right to receive temporary disability benefits in in an amount (as a percentage of average earnings) that exceeds the amount of benefits (as a percentage of average earnings) due in accordance with this Federal Law, temporary disability benefits are assigned and paid in the same higher amount (as a percentage of average earnings) , but not higher than the maximum amount of temporary disability benefits established in accordance with this Federal Law.

2. If the duration of the insurance period of the insured person, calculated in accordance with this Federal Law for the period before January 1, 2007, turns out to be less than the duration of his continuous work experience used when assigning temporary disability benefits in accordance with previously valid regulatory legal acts , for the same period, the duration of the insurance period is taken to be the duration of the continuous work experience of the insured person.

Article 18. Application of this Federal Law to insured events occurring before and after the day it comes into force

1. This Federal Law applies to insured events that occur after the day this Federal Law comes into force.

2. For insured events that occurred before the day of entry into force of this Federal Law, benefits for temporary disability, pregnancy and childbirth are calculated according to the norms of this Federal Law for the period after the day of its entry into force, if the amount of the benefit calculated in accordance with this Federal Law by law, exceeds the amount of benefits due under the norms of previously applicable legislation.

E. L. Dzhabazyan, Chief Editor

Amendments made Federal Law dated December 8, 2010 No. 343-FZ, changed the rules for calculating benefits for temporary disability, pregnancy and childbirth, as well as monthly child care benefits. In the material presented, we answered the main questions related to the payment of benefits.

How are benefits calculated in 2011?

Changes made Federal Law No. 343-FZ, affected the procedure for calculating benefits for temporary disability, maternity benefits, and monthly child care benefits. At the same time, the following changed:

– the billing period for which the insured person’s earnings are taken into account when calculating benefits;

– the procedure for determining average earnings for calculating benefits;

– procedures for calculating benefits.

Determination of the billing period. Yes, according to Part 1 Art. 14 Federal Law of December 29, 2006 No. 255-FZ benefits will be calculated based on the average earnings of the insured person, calculated for two calendar years preceding the year of the insured event, including during work (service, other activities) with another policyholder (other policyholders).

For persons who, in the two calendar years immediately preceding the year of temporary disability, maternity leave, child care leave, or in one of these years were on maternity leave and (or) parental leave child Federal Law No. 255-FZ it is possible to replace the corresponding calendar years (calendar year) with previous calendar years (calendar year) at the request of the insured person, provided that this leads to an increase in the amount of the benefit.

Calculation of average earnings. According to Part 2 Art. 14 in the new edition, starting from 2011, the average earnings on the basis of which benefits are calculated will include all types of payments and other remunerations in favor of the insured person, which are accrued in the Social Insurance Fund (in the current year, the average earnings include all types of payments and other remunerations in favor of employee, which are included in the base for calculating insurance contributions to the Social Insurance Fund). In this case, the indicated average earnings must be taken into account for each calendar year in an amount not exceeding that established in accordance with Federal Law No. 212-FZ for the corresponding calendar year, the maximum value of the base for calculating insurance contributions to the fund. For the period before January 1, 2010, and for persons working under employment contracts for insurers applying special tax regimes - for the period before January 1, 2011, the maximum base value is RUB 415,000. for each calendar year ( Art. 2 of Federal Law No. 343-FZ).

It should be noted that since 2011, the rule limiting the average daily earnings of the insured person when calculating benefits for temporary disability, pregnancy and childbirth to the average daily earnings, determined by dividing the maximum base for calculating insurance premiums by 365 (for monthly child care benefits) has been abolished – a rule limiting the average earnings of the insured person to the average earnings, determined by dividing the maximum value of the base for calculating insurance premiums by 12).

The average daily earnings of the insured person is determined by dividing the amount of accrued earnings for the billing period by 730 (Part 3 of Article 14 of Federal Law No. 255-FZ). That is, the number of calendar days falling within the period for which it is taken into account will not matter when calculating benefits from 2011.

Benefit calculation procedure. For clarity, we present the algorithm for calculating benefits before and after the amendments made came into force Federal Law No. 343-FZ.

Procedure for calculating benefits in 2010	Procedure for calculating benefits in 2011
*1. Determination of average earnings*
Average earnings are calculated per *last 12 calendar months* work (service, other activities) *with this policyholder* preceding the month of temporary disability, maternity leave, parental leave	Average earnings are calculated *for two calendar years preceding the year* onset of temporary disability, maternity leave, parental leave, *including during work (service, other activities) with another policyholder (other policyholders)*
*2. Determination of average daily earnings*
Average daily earnings are determined by dividing the amount of total earnings by the number of calendar days falling within the period for which wages are taken into account	Average daily earnings are determined by dividing the amount of accrued earnings by 730
We determine the average earnings based on the maximum base for calculating insurance premiums (RUB 415,000 / 365)
We compare the average earnings calculated based on the actual salary and the maximum base value. The indicator with the lower value is used to determine the amount of daily allowance
*3. Determination of the amount of daily allowance*
The amount of the daily benefit for temporary disability, maternity benefit is calculated by multiplying the average daily earnings of the insured person by the amount of the benefit established as a percentage of the average earnings in accordance with Art. 7 And 11 Federal Law No.255-FZ
*4. Determination of benefit amount*
The amount of benefits for temporary disability, pregnancy and childbirth is determined by multiplying the amount of daily benefits by the number of calendar days falling during the period of temporary disability, maternity leave

Who should I contact for temporary disability benefits, maternity benefits, and monthly child care benefits?
Federal Law No. 343-FZ The approach to determining the insurer who assigns and pays insurance coverage to the insured person has been changed in the following cases.

1. If the insured person is employed by several policyholders at the time of the insured event and was employed by the same policyholders in the two previous calendar years:

– benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by insurers for all places of work (service, other activities) and are calculated based on the average earnings during work (service, other activities) with the insurer assigning and paying benefits (excluding earnings from another policyholder);

– monthly is assigned and paid by the policyholder for one place of work (service, other activity) at the choice of the insured person.

2. If the insured person at the time of the insured event is employed by several policyholders, and in the two previous calendar years was employed by other policyholders (another policyholder), the above benefits are assigned and paid to him by the policyholder at one of his last places of work (service, other activity) at the choice of the insured person.

3. If the insured person at the time of the insured event is employed by several policyholders, and in the two previous calendar years was employed by both these and other policyholders (another policyholder), benefits for temporary disability, pregnancy and childbirth are assigned and paid to him :

– or for all places of work (service, other activity) based on the average earnings during work (service, other activity) with the insurer assigning and paying the benefit;

– or by the policyholder at one of the last places of work (service, other activity) at the choice of the insured person.
For convenience, we present all options for assigning and paying benefits to insured persons in the table.

Option
Base	Part 2 Art. 13 Federal Law No. 255-FZ	Part 2.1 art. 13 Federal Law No. 255-FZ	Part 2.2 art. 13 Federal Law No. 255-FZ
What benefits?		Temporary disability benefit, maternity benefit, monthly child care allowance	Temporary disability benefit, maternity benefit
Where is the payment made?	For each place of work (service, other activity)	For one place of work (service, other activity)	Either for each place of work (service, other activity), or for one place of work
What conditions does the choice of option depend on?	At the time of the insured event, the insured person is employed by several employers who were also employed in the two previous calendar years	At the time of the insured event, the insured person was employed by several employers, and in the two previous calendar years was employed by other employers (another employer)	At the time of the insured event, the insured person was employed by several employers, and in the two previous calendar years was employed by both the same and other employers (another employer)

Potapov D.M. works at LLC “Organization A” and part-time at LLC “Organization B”. On February 7, 2011, he submitted to Organization A LLC a certificate of incapacity for work from January 27, 2011 to February 4, 2011. Potapov D. M.’s insurance experience is 3 years 8 months, and he is entitled to a benefit of 60%. The following income information is available for the two years preceding the onset of disability.

In accordance with the norm of Part 2 of Art. 13 of Federal Law No. 255-FZ Potapov D.M. applied for benefits for each place of work.

Calculation of benefits in organization A:

– average daily earnings – 684.93 rubles. ((210,000 + 290,000) rub. / 730);

– daily allowance – 410.96 rubles. (RUB 684.93 x 60%);

– benefit amount – 7,388.64 rubles. (RUB 410.96 x 9 days).

Calculation of benefits in organization B:

– average daily earnings – 321.92 rubles. ((95,000 + 140,000) rub. / 730);

– daily allowance – 193.15 rubles. (RUB 321.92 x 60%);

– benefit amount – 1,738.35 rubles.

Average earnings during work (service, other activities) for another policyholder (other policyholders) should not be taken into account in cases where benefits for temporary disability, pregnancy and childbirth are due Part 2 Art. 13 Federal Law No. 255-FZ are assigned and paid to the insured person at all places of work (service, other activities). In this case, the average earnings are taken into account for each calendar year in an amount not exceeding the maximum base for calculating insurance contributions to the Social Insurance Fund for the corresponding calendar year by each policyholder (for 2009 and 2010 - 415,000 rubles for each specified calendar year) ( Part 3.1 Art. 14 Federal Law No. 255-FZ).

Let's change and supplement the conditions of example 1. At the employee's choice, the benefit is assigned and paid by Organization A LLC. Let’s assume that in 2009 Potapov D.M. also worked at Organization V LLC, and the information about his income is as follows.

The average salary must include:

– for 2009 – 305,000 rubles. (210,000 + 95,000);

– for 2010 – 415,000 rubles. (RUB 415,000< 430 000 руб. (290 000 + 140 000)).

First, let's determine the average daily earnings. It will be 986.30 rubles. ((305,000 + 415,000) rub. / 730).

In what cases are benefits calculated based on the minimum wage?

Article 14 of Federal Law No. 255-FZ was supplemented by Part 1.1 (clause “b”, clause 9 of Article 1 of Federal Law No. 343-FZ). This part provides for the rule for calculating benefits based on the minimum wage established by federal law on the day the insured event occurs in the following situations:

– if the insured person had no income during the above periods;

– if the average earnings calculated for the above periods, calculated for a full calendar month, are lower than the minimum wage established by federal law on the day the insured event occurred.

If at the time of the insured event the insured person is working part-time, the average earnings, on the basis of which benefits are calculated in these cases, are determined in proportion to the working hours of the insured person.

It should be noted that in all cases, the calculated monthly child care benefit cannot be less than the minimum monthly child care benefit established Federal Law of May 19, 1995 No. 81-FZ“On state benefits for citizens with children.”

According from Part 1.1 Art. 14 Federal Law No. 255-FZ Minimum Wage applies without taking into account the regional coefficient.

How many days of disability are paid at the expense of the employer?

In 2010, the policyholder paid at his own expense only for the first two days of temporary disability. Now the burden on policyholders has increased - they will have to pay for the first three days of sick leave. Item 2 tbsp. 1 of Federal Law No. 343-FZ changes have been made to clause 1 part 2 art. 3 of Federal Law No. 255-FZ. According to the new version of this paragraph, temporary disability benefits are paid to insured persons (with the exception of insured persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Article 4.5 of this Federal Law) for the first three days of temporary disability at the expense of the policyholder, and for the remaining period starting from the 4th day of temporary disability at the expense of the budget of the Social Insurance Fund of the Russian Federation.

Let us remind you that insured persons who voluntarily entered into legal relations under compulsory social insurance in case of temporary disability and in connection with maternity in accordance with Art. 4.5 Federal Law No. 255-FZ, benefits are paid from the Social Insurance Fund budget from the 1st day of temporary disability.

Payment of temporary disability benefits at the expense of the policyholder is carried out in the cases specified in clause 1 part 1 art. 5 of Federal Law No. 255-FZ, namely in case of loss of ability to work due to illness or injury, including in connection with an operation for artificial termination of pregnancy or in vitro fertilization.

What rules of law should be followed during the transition period?

Federal Law No. 343-FZ it is possible to recalculate benefits to insured persons for the period from January 1, 2011 according to the norms Federal Law No. 255-FZ in the new edition for insured events that occurred in 2010 and continued or ended in 2011. Such recalculation is possible provided that the amount of benefit calculated in accordance with Federal Law No. 255-FZ in the new edition, will exceed the amount of benefits due according to the norms Federal Law No. 255-FZ as amended in force until January 1, 2011 ( Art. 3 of Federal Law No. 343-FZ).

What should you pay attention to when paying temporary disability benefits for a period of downtime?

Clause 6 of Art. 1 of Federal Law No. 343-FZ changes have been made to Art. 7“Amount of temporary disability benefit” Federal Law No. 255-FZ. In particular, the new edition set out Part 7 of this article. According to the new rules, in the case of temporary disability that occurred before the downtime period and continues during the downtime period, temporary disability benefits for the downtime period are paid in the same amount as wages are maintained during this time, but not higher than the amount of temporary disability benefits, which the insured person would receive according to the general rules.

Besides, Part 1 Art. 9“Periods for which temporary disability benefits are not awarded. Grounds for refusal to grant temporary disability benefits" Federal Law No. 255-FZ has been supplemented with clause 5 (clause 7 of Article 1 of Federal Law No. 343-FZ). In accordance with the newly introduced norm, temporary disability benefits are not assigned to the insured person for the period of downtime, except in cases provided for Part 7 of Article 7 of this Federal Law.

What is included in the list of documents required for calculating and paying benefits?

In accordance with Part 5 Art. 13 Federal Law No. 255-FZ(before changes are made Federal Law No. 343-FZ) in order to assign and pay benefits for temporary disability, pregnancy and childbirth, the insured person had to submit to the employer a certificate of incapacity for work issued by a medical organization.

Sub-clause "c" clause 8 of Art. 1 of Federal Law No. 343-FZ named part Federal Law No. 255-FZ presented in a new edition. Now, if the insured person is employed by several employers, it is additionally necessary to submit a certificate (certificates) about the amount of earnings from which the benefit should be calculated, from the place (places) of work (service, other activity) with another policyholder (other policyholders) .

Moreover, in the cases specified in Parts 2.1 and 2.2 Art. 13 Federal Law No. 255-FZ, the insured person, when applying for benefits for temporary disability, pregnancy and childbirth to the policyholder at one of the last places of work (service, other activity) at the choice of the insured person, also presents a certificate (certificates) from the place of work (service, other activity) from another the insured (from other insureds) that the assignment and payment of benefits is not carried out by this insured ( Part 5.1 Art. 13 Federal Law No. 255-FZ).

To assign and pay a monthly child care benefit in accordance with the insured person, submit an application for the appointment of the specified benefit, a birth (adoption) certificate of the child being cared for, and its copy or an extract from the decision to establish guardianship over the child, a certificate of birth (adoption, death) of the previous child (children) and its copy, a certificate from the place of work (study, service) of the mother (father, both parents) of the child stating that she (he, they) does not use parental leave and does not receive a monthly child care allowance, and if the mother (father, both parents) of the child does not work (does not study, does not serve), a certificate from the social protection authorities at the place of residence of the mother (father) of the child about non-receipt of the monthly allowance child care benefits. In the case of the appointment and payment of a monthly child care benefit by the territorial body of the insurer, the insured person also provides information on average earnings, based on which the specified benefit should be calculated.

Subparagraph “e” of paragraph 8 of Art. 1 of Federal Law No. 343-FZ second sentence part 6 art. 13 Federal Law No. 255-FZ is stated in the following wording: in order to assign and pay a monthly child care benefit, the insured person also submits, if necessary, a certificate (certificates) about the amount of earnings from which the benefit should be calculated.

The insured person, instead of the original certificate of the amount of earnings, on the basis of which benefits for temporary disability, maternity, and monthly child care benefits should be calculated, may submit a copy of the certificate of the amount of earnings, certified in the prescribed manner ( Part 7.1 Art. 13 of Federal Law No. 255-FZ).

According to Part 7.2 Art. 13 Federal Law No. 255-FZ in the event that the insured person is not able to submit a certificate (certificates) about the amount of earnings, on the basis of which the benefit should be calculated, from the place (places) of work (service, other activity) with another policyholder (other policyholders) in connection with the termination activities by this insured (these insureds) or for other reasons, the insured who assigns and pays the benefit, at the request of the insured person, sends a request to the territorial body of the Pension Fund of the Russian Federation to provide information on wages, other payments and remunerations of the insured person from the corresponding insured (relevant insureds) based on information from individual (personalized) registration in the compulsory pension insurance system.

The form of the said application of the insured person, the form and procedure for sending a request, the form, procedure and deadlines for submitting the requested information by the territorial body of the Pension Fund of the Russian Federation are established by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

Policyholders and insured persons: what additional rights, obligations and responsibilities are established for them by Federal Law No. 255-FZ?

From 2011, policyholders will be required to issue the insured person, on the day of termination of work or upon his written request, a certificate of the amount of earnings for two calendar years preceding the year of termination of work or the year of application for the certificate, and the current calendar year for which insurance premiums were calculated (clause 3, part 2, article 4.1 of Federal Law No. 255-FZ). The form and procedure for issuing this certificate must be approved by the Ministry of Health and Social Development.
For the accuracy of the information contained in the documents issued to the insured person and necessary for the assignment, calculation and payment of benefits, the policyholders will be responsible ( Art. 15.1 of Federal Law No. 255-FZ).

The policyholder who assigns and pays benefits to the insured person also has the right to send requests to the territorial bodies of the Social Insurance Fund in order to verify information about the policyholder (policyholders) who issued (issued) to the insured person a certificate (certificates) on the amount of earnings necessary for calculating benefits ( clause 4, part 1, art. 4.1 Federal Law No. 255-FZ). The form and procedure for sending such requests will be approved by the Ministry of Health and Social Development.

In turn, the insured person has the right to receive from the policyholder a certificate of the amount of earnings necessary for calculating benefits (clause 2, part 1, article 4.3 of Federal Law No. 255-FZ). Insured persons are subject to liability for submitting documents with deliberately incorrect information, including certificate(s) of the amount of earnings on the basis of which the specified benefits are calculated ( Part 4 Art. 15 of Federal Law No. 255-FZ).

In conclusion, we note that according to clause 5 of the Order of the Federal Social Insurance Fund of the Russian Federation dated December 14, 2010 No. 269“On organizing work to implement the Federal Law “On Amendments to the Federal Law “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Maternity,” managers of regional branches of the FSS must carry out organizational activities with employees of regional branches of the fund and their branches, as well as with insurers on the application of new norms established by federal legislation governing the procedure for calculating and paying benefits for temporary disability and maternity benefits from January 1, 2011, to ensure that explanatory work is carried out in connection with the implementation Federal Law No. 343-FZ. In particular, the FSS issued Letter dated December 14, 2010 No. 02 03 17/05-13765, in which department officials listed the main changes coming into force in the new year. Unfortunately, additional explanations and comments on the law were not provided in the said letter.

2. If the insured person at the time of the insured event is employed by several policyholders and in the two previous calendar years was employed by the same policyholders, benefits for temporary disability, pregnancy and childbirth are assigned and paid to him by the policyholders for all places of work (services). , other activities), and the monthly child care benefit - the insured at one place of work (service, other activity) at the choice of the insured person and is calculated on the basis of average earnings determined in accordance with Article 14 of this Federal Law for the duration of work (service , other activities) from the insurer assigning and paying benefits.

2.1. If the insured person at the time of the insured event is employed by several policyholders, and in the two previous calendar years was employed by other policyholders (another policyholder), temporary disability benefits, maternity benefits, and monthly child care benefits are assigned and paid to him by the policyholder at one of the last places of work (service, other activity) at the choice of the insured person.

2.2. If the insured person at the time of the insured event is employed by several policyholders, and in the two previous calendar years was employed by both these and other policyholders (another policyholder), benefits for temporary disability, pregnancy and childbirth are assigned and paid to him or her in accordance with Part 2 of this article by the insured for all places of work (service, other activity) based on the average earnings during work (service, other activity) with the insurer assigning and paying the benefit, or in accordance with Part 2.1 of this article by the insured for one of last place of work (service, other activity) at the choice of the insured person.

4. Insured persons specified in “Part 3 of Article 2” of this Federal Law, as well as other categories of insured persons in the event of termination of activities by the policyholder on the day the insured person applies for temporary disability benefits, maternity benefits, monthly child care benefits , or in the absence of the possibility of their payment by the policyholder due to insufficient funds in his accounts in credit institutions and the use of the order of debiting funds from the account provided for by the Civil “Code” of the Russian Federation, or in the absence of the possibility of establishing the location of the policyholder and his property, which may be levied upon, if there is a court decision that has entered into legal force establishing the fact of non-payment of benefits by such policyholder to the insured person, or if on the day the insured person applies for these benefits, the procedures applied in the bankruptcy case of the policyholder are being carried out against the policyholder , the appointment and payment of these benefits, with the exception of temporary disability benefits paid at the expense of the policyholder in accordance with “clause 1 of part 2 of article 3” of this Federal Law, are carried out by the territorial body of the insurer.

5. The assignment and payment of benefits for temporary disability, pregnancy and childbirth are carried out on the basis of a certificate of incapacity for work issued by a medical organization in the form of a paper document or (with the written consent of the insured person) generated and posted in the insurer’s information system in the form of an electronic document signed using an enhanced qualified electronic signature by a medical worker and a medical organization, if the medical organization and the policyholder are participants in the information exchange system for the purpose of generating a certificate of incapacity for work in the form of an electronic document. To assign and pay these benefits, the insured person submits a certificate (certificates) about the amount of earnings from which the benefit should be calculated from the place (places) of work (service, other activity) with another policyholder (other policyholders), and for the appointment and payment of the specified benefits by the territorial body of the insurer - a certificate (certificates) on the amount of earnings from which the benefit should be calculated, and documents determined by the federal executive body exercising the functions of developing and implementing state policy and legal regulation in the field of labor and social protection of the population , confirming insurance experience. The form, procedure for issuing and procedure for issuing certificates of incapacity for work, as well as the procedure for generating certificates of incapacity for work in the form of an electronic document are established by the federal executive body exercising the functions of developing and implementing state policy and legal regulation in the field of healthcare, in agreement with the federal executive body , which carries out the functions of developing and implementing state policy and legal regulation in the field of labor and social protection of the population, and the Social Insurance Fund of the Russian Federation. The procedure for information interaction between the insurer, policyholders, medical organizations and federal state institutions of medical and social expertise for the exchange of information for the purpose of generating a certificate of incapacity for work in the form of an electronic document is approved by the Government of the Russian Federation.

5.1. In the cases specified in parts 2.1 and 2.2 of this article, the insured person, when applying for benefits for temporary disability, pregnancy and childbirth to the policyholder at one of the last places of work (service, other activity) at the choice of the insured person, also submits a certificate (certificates ) from the place of work (service, other activity) with another policyholder (other policyholders) that the assignment and payment of benefits is not carried out by this policyholder.

6. To assign and pay a monthly child care benefit, the insured person submits an application for the appointment of the specified benefit, a birth (adoption) certificate of the child being cared for, and a copy of it or an extract from the decision to establish guardianship over the child, a birth certificate (adoption, death) of the previous child (children) and its copy, a certificate from the place of work (service) of the mother (father, both parents) of the child stating that she (he, they) does not use parental leave and does not receive monthly child care benefits, and if the mother (father, both parents) of the child does not work (does not serve) or is studying full-time in basic educational programs in organizations engaged in educational activities, a certificate from the social protection authorities at the place of residence (place of stay, actual residence) of the child’s mother (father) about non-receipt of monthly child care benefits. To assign and pay a monthly child care benefit, the insured person also submits, if necessary, a certificate(s) about the amount of earnings from which the benefit should be calculated. To assign and pay a monthly child care allowance in accordance with Part 4 of this article, a certificate (information) from the social protection authorities at the place of residence (place of stay, actual residence) of the father, mother (both parents) of the child about non-receipt of a monthly child care allowance for the child is requested by the insurer from the authorized executive body of the constituent entity of the Russian Federation, which has such information at its disposal. The insured person has the right, on his own initiative, to submit the specified certificate for the assignment and payment of benefits. The insurer's interdepartmental request for documents (information) is sent within three calendar days from the date of receipt of the application for payment of monthly child care benefits in accordance with Part 4 of this article. The period for preparation and sending by the authorized executive body of a constituent entity of the Russian Federation a response to the specified interdepartmental request cannot exceed five calendar days from the date of receipt of the interdepartmental request by the specified bodies.

7.1. The insured person, instead of the original certificate of the amount of earnings, from which benefits for temporary disability, pregnancy and childbirth, and monthly child care benefits should be calculated, may submit a copy of the certificate of the amount of earnings, certified in the prescribed manner.

7.2. If the insured person is unable to submit a certificate(s) of the amount of earnings from which the benefit should be calculated from the place(s) of work (service, other activity) with another policyholder(s) due to termination of activity by this policyholder (these policyholders) or for other reasons, the policyholder assigning and paying benefits, or the territorial body of the insurer assigning and paying benefits in the cases specified in parts 3 and 4 of this article of this Federal Law, at the request of the insured person sends a request to the territorial body of the Pension Fund of the Russian Federation on the provision of information on wages, other payments and remunerations of the insured person from the corresponding policyholder (corresponding policyholders) based on information from individual (personalized) registration in the compulsory pension insurance system. The form of the said application of the insured person, the form and procedure for sending the request, the form, procedure and deadlines for submitting the requested information by the territorial body of the Pension Fund of the Russian Federation are established by the federal executive body exercising the functions of developing state policy and legal regulation in the field of social insurance.

9. Payment of benefits for temporary disability, pregnancy and childbirth, monthly child care benefits in the cases provided for in part 4 of this article is carried out in the established amounts by the territorial body of the insurer that assigned these benefits, through the federal postal service, credit or other organization at the request of the recipient.

10. Information on the assignment and payment to insured persons in the cases provided for in part 4 of this article, temporary disability benefits, maternity benefits, and monthly child care benefits is posted in the Unified State Social Security Information System. The placement and receipt of this information in the Unified State Social Security Information System is carried out in accordance with Federal Law of July 17, 1999 N 178-FZ “On State Social Assistance”.