NewsWhore
09-07-2009, 04:10 PM
Today the Superintendence of Health and Labor Risks (Sisalril) will begin to receive requests for the Sickness Compensation package that is being offered for common illnesses. The actual program began last Tuesday, according to the Director of Subsidies. Fausto Perez Espinosa said that the measure would benefit thousands of employees who work in shopping centers, small and large businesses and contribute to social security and when they used to get sick their work contracts were suspended in accordance with the Labor Code. Among the common illnesses that are not work-related and are covered under the new protection are surgeries such as appendectomies or pneumonia.
The resources to cover these expenses will come out of the contributions that the employees and the employers make to the system, which were increased beginning 1 September to 0.43% that is specialized for Maternity and Breast Feeding subsidies as well.
The benefits include coverage for both government and private employees under the Family Health Insurance scheme (SFS) that have had deductions taken out for the past twelve consecutive months before the request for the subsidy. Perez said that the illnesses would begin to be covered starting on the fourth day and protection will run for 26 weeks.
The subsidy can be extended and a request made through the Social Security Treasury webpage - www.tss.gov.do (http://www.tss.gov.do).
The coverage is 60% of the average salary when the illness is ambulatory and 40% if there is hospitalization, as established in Article 131 of Law 87-01. The director of Subsidy Control said that the percentage for hospitalization is lower because the system covers hospitalization, doctor's bills, lab work and medicine.
In order to prevent employees from faking common illnesses, the authorities created a form to request the subsidy that workers can access through the Internet, which needs to be taken to the doctor who is treating the employee so that they can fill it out with their personal data, for patients to hand in to their employers.
In turn, the employer should send this form to Sisalril, by fax or other electronic means.
There is also an international coding system for medical procedures that will have to be filled in and that in principle, Sisalril will do this, as the administrator of the subsidy funds, and designate medical inspectors to review the process. Sisalril will also receive the medical claims and cross-reference the information with the health insurance providers (ARS).
The employer will pay the amount of the subsidy to workers and Sisalril, and later this will be returned in the form of a certificate of payment as a credit when the procedure is proven to be valid.
People with several jobs are also covered under this scheme, according to Perez Espinosa. If someone works in two places and in one of them has a salary of RD$20,000 and in the other job pays RD$10,000, he or she will contribute 60% according to the larger salary, and 40% for the lesser salary. This has a ceiling of RD$56,350 in earnings according to the law.
Social Security treasurer Henry Sadhala reported that the contributions that social security receives both from employees and employers should increase over the next 12 months to between RD$700 and RD$800 million, and the rate goes from 0.33% to 0.43%.
According to director of Information and Defense of Affiliates (DIDA), Nelsida Marmolejos, the subsidy for common illnesses will stop many workers from going to work sick for fear of losing their jobs.
More... (http://www.dr1.com/index.html#8)
The resources to cover these expenses will come out of the contributions that the employees and the employers make to the system, which were increased beginning 1 September to 0.43% that is specialized for Maternity and Breast Feeding subsidies as well.
The benefits include coverage for both government and private employees under the Family Health Insurance scheme (SFS) that have had deductions taken out for the past twelve consecutive months before the request for the subsidy. Perez said that the illnesses would begin to be covered starting on the fourth day and protection will run for 26 weeks.
The subsidy can be extended and a request made through the Social Security Treasury webpage - www.tss.gov.do (http://www.tss.gov.do).
The coverage is 60% of the average salary when the illness is ambulatory and 40% if there is hospitalization, as established in Article 131 of Law 87-01. The director of Subsidy Control said that the percentage for hospitalization is lower because the system covers hospitalization, doctor's bills, lab work and medicine.
In order to prevent employees from faking common illnesses, the authorities created a form to request the subsidy that workers can access through the Internet, which needs to be taken to the doctor who is treating the employee so that they can fill it out with their personal data, for patients to hand in to their employers.
In turn, the employer should send this form to Sisalril, by fax or other electronic means.
There is also an international coding system for medical procedures that will have to be filled in and that in principle, Sisalril will do this, as the administrator of the subsidy funds, and designate medical inspectors to review the process. Sisalril will also receive the medical claims and cross-reference the information with the health insurance providers (ARS).
The employer will pay the amount of the subsidy to workers and Sisalril, and later this will be returned in the form of a certificate of payment as a credit when the procedure is proven to be valid.
People with several jobs are also covered under this scheme, according to Perez Espinosa. If someone works in two places and in one of them has a salary of RD$20,000 and in the other job pays RD$10,000, he or she will contribute 60% according to the larger salary, and 40% for the lesser salary. This has a ceiling of RD$56,350 in earnings according to the law.
Social Security treasurer Henry Sadhala reported that the contributions that social security receives both from employees and employers should increase over the next 12 months to between RD$700 and RD$800 million, and the rate goes from 0.33% to 0.43%.
According to director of Information and Defense of Affiliates (DIDA), Nelsida Marmolejos, the subsidy for common illnesses will stop many workers from going to work sick for fear of losing their jobs.
More... (http://www.dr1.com/index.html#8)