Program for direct payments of benefits from the Social Insurance Fund to the regions. Calculation of insurance premiums: difficulties of filling out

The law, in accordance with which it is proposed to postpone for two years (from January 1, 2019 to January 1, 2021) the start of direct payments by the territorial bodies of the Federal Social Insurance Fund of Russia of benefits to insured persons upon the occurrence of an insured event. Payments in this case occur without the participation of the employer. As noted in the explanatory note to the bill, such a decision will delay the need to repay part of the accounts payable of the Federal Social Insurance Fund of Russia to policyholders (employers) and reduce the required amount of funds from the federal budget.

Let us remind you that currently part of the benefit amount is paid by the employer, and then offsets the paid benefits against insurance premiums (Part 2 of Article 15 of the Federal Law of July 24, 2009 No. 212-FZ ""; hereinafter referred to as Law No. 212- Federal Law). The tariff for OSS in case of temporary disability and in connection with maternity within the limits for calculating insurance premiums is 2.9%, premiums are not paid above the base ().

We are talking about the following types of payments:

  • for temporary disability (including due to an accident at work and (or) occupational disease);
  • for pregnancy and childbirth;
  • a one-time benefit for women registered in medical institutions in the early stages of pregnancy;
  • lump sum benefit for the birth of a child;
  • monthly child care allowance;
  • payment of leave (in addition to annual paid leave) to the insured person injured at work.

In what cases will an employee not be paid temporary disability benefits? Find out from the material "Periods for which temporary disability benefits are not awarded" in "Encyclopedia of solutions. Taxes and fees" Internet version of the GARANT system. Get full access for 3 days for free!

Initially, only the Karachay-Cherkess Republic and the Nizhny Novgorod region participated in it. In 2015, the project was implemented in 14 regions of Russia, including the Republics of Crimea, Karachay-Cherkessia and Tatarstan, Khabarovsk Territory, Astrakhan, Belgorod, Kurgan, Nizhny Novgorod, Novgorod, Novosibirsk, Rostov, Samara and Tambov regions, Sevastopol. In 2016, six more regions joined the project - the Republic of Mordovia, Bryansk, Kaliningrad, Kaluga, Lipetsk and Ulyanovsk regions ().

The procedure for receiving benefits directly from the Federal Social Insurance Fund of Russia is as follows: upon the occurrence of an insured event, the insured person contacts the employer with an application for payment of the appropriate type of benefit and the documents necessary for its assignment and payment. The employer, no later than five calendar days from the date of receipt of the application and documents, sends them to the regional branch of the FSS of Russia. Moreover, the insured person can independently submit documents only if the policyholder ceases his activities, including if it is impossible to establish his actual location on the day of applying for benefits. The decision on the appointment and payment of benefits must be made by the territorial body of the FSS of Russia within 10 calendar days from the date of receipt of documents from the employer. The money will be sent either by bank transfer to the bank account of the insured person, or by mail to the address of his residence (clauses 2-3, 8-9 of the Regulations on the specifics of the appointment and payment in 2012 - 2016 to insured persons of insurance coverage for compulsory social insurance in case of temporary disability and in connection with maternity and other payments in the constituent entities of the Russian Federation participating in the implementation of the pilot project).

Arranging financial assistance for people is one of the main sources of funds along with wages, especially if a person is disabled. They are accrued in the organization where the citizen is officially employed, when the employer makes the calculation and sends the information to the insurance organization.

In some regions of the Russian Federation, innovations are being introduced related to the provision of activities involving social assistance and support through direct payments from the Social Insurance Fund, without the participation of the employer with whom the person is employed.

What is meant by direct payments to the Social Insurance Fund?

The state is committed to facilitating the mechanism for receiving benefits, so in some areas it is practiced to charge direct payments within the limits of compulsory insurance. Previously, the provision was implemented according to a complex scheme, when the employer had to give the amount required by accounting calculations to a person from his payroll fund, and then reimburse this money to the insurance institution.

Today, this method of assigning benefits is simplified. It is enough for a citizen to independently contact the Social Insurance Fund, where the calculation is made in accordance with the law. Funds are paid not as from the employer on the day the salary is transferred, but within ten days from the date of registration of a written request for the transfer of money and provision of information.

The project has been in effect since 07/01/2011, has already been distributed in 33 territories, and 6 districts have been added to them since 07/01/2018. Payment of benefits is regulated PP number 294, valid from 21.04. 2011.

Benefits of direct payments

In the future, government agencies plan to transfer all regions to this mechanism, when the Social Insurance Fund calculates and issues benefits to temporarily disabled citizens independently.

This system has the following advantages:

  • funds are transferred in full;
  • the amount of payments is guaranteed to the applicant without taking into account the financial condition of the organization where he was officially employed and carried out professional activities;
  • convenient ways to receive;
  • absence of difficulties in communicating with the manager regarding the accuracy of amounts and accounting calculations;
  • When applying to the Social Insurance Fund, a person is guaranteed a transfer of the due benefit in 100% of cases, provided that the package of necessary papers is collected in full, and the data contained in it confirms the fact of incapacity for work.

IMPORTANT! The applicant is entitled to funds only if he made contributions to the Social Insurance Fund, that is, he officially worked in the organization, and the employer sent monthly amounts for each employee.

Explanations from the Social Insurance Fund regarding direct payments

As a supplement to the Government Resolution defining the basis for the provision of maintenance, the government agency issued information explaining to potential recipients the specifics of the implementation of the FSS “direct payments” pilot project.

It says: the purpose of the adoption of the Resolution is to improve the financial situation of people who need to calculate benefits in a simplified mode and employers who take on this responsibility, paying money from their budget, and then reimbursing them through the insurance body. The information indicates the types of benefits, the mechanism for their calculation and issuance.

Types of benefits

Payment of insurance coverage when sending application information is carried out by fund branches in the constituent entities. They have the right to issue money after the applicant submits data on the following types of benefits:

  • upon the onset of temporary disability (for expectant mothers, people exposed to injuries in the event of emergency situations);
  • maintenance due during pregnancy and after childbirth (in case of visiting a gynecologist up to 12 weeks, a one-time benefit after childbirth, for care up to 1.5 years).

ATTENTION! These types of benefits at the expense of the Social Insurance Fund for a one-time transfer are paid no later than ten calendar days from the date of execution of the application document. And in the case of a monthly transfer, they are transferred to the recipients’ accounts from the first to the fifteenth of each month.

The procedure for calculating benefits for mothers with children and pregnant women

The system for registering support measures due to disability due to pregnancy and childbirth is beneficial in provision and involves the work of only 2 entities - the applicant and the Social Insurance Fund. Specialists from the competent institution calculate maternity benefits taking into account the woman’s average monthly earnings for the last 2 years of work.

For all regions, the calculation method is the same; it should be equal to 100 percent of the mother’s average monthly earnings. It is calculated this way:

  • in order to obtain the average salary, it is necessary to divide the amount received for the previous 2 years of work by the number of days actually worked during the same period;
  • the amount of payments is calculated by multiplying the average earnings per day during the last 2 years of work by the number of days the woman is on maternity leave.

Thus, the specialist receives the amount required to be transferred to the applicant monthly. The sizes of other species (for early registration, after 30 weeks of pregnancy, up to 1.5 years) are established Federal Law No. 81, in force since May 19, 1995, they do not need to be calculated.

Registration procedure

The employer is also interested in a simplified mechanism for providing payments, so the legislation one way or another attracts him to this scheme. But not by making their own expenses, but by transferring data about expectant mothers preparing to go on maternity leave, for whom benefits are required to be transferred.

The registration method is the same for all subjects and consists of the following actions:

  • the organization keeps personnel records of workers who pay monthly insurance premiums, makes a selection of citizens who are entitled to receive maintenance in the next month;
  • these citizens fill out applications requesting the accrual of benefits;
  • the institution sends complete packages of documents for each person;
  • Applications are reviewed at the competent institution, and money is transferred to personal accounts.

ADVICE! Not all companies are responsible in providing data to the insurance institution. If the company refuses, the woman can apply on her own. If the package of documents is incomplete, the insurer may make inquiries to the departments.

List of required documents

If you want to apply for support measures, you should know what documents for payment of benefits need to be sent for their calculation and execution:

  • citizen's statement;
  • register of expenses taking into account paid insurance benefits (from the employer);
  • calculation of accrual of amounts according to the established form 4-FSS (from the employer);
  • documents confirming expenses (certificate of incapacity for work, if employed less than 6 months ago - order of enrollment, copy of work record book, contract).

If the organization employs more than twenty-five people, the employer submits information in the form of an electronic declaration.

Regions of direct payments

  • Nizhny Novgorod Region.
  • Karachay-Cherkess Republic.

A year later, in 2012, 5 regions and 1 region joined them:

  • Tambovskaya.
  • Novosibirsk.
  • Novgorodskaya.
  • Astrakhan.
  • Kurganskaya.
  • Khabarovsk region.

In 2015, 3 regions and 2 Republics underwent innovations:

  • Crimea.
  • Tatarstan.
  • Samara.
  • Belgorodskaya.
  • Rostovskaya.

In 2016, the system included 1 Republic and 5 regions:

  • Mordovia.
  • Kaliningradskaya.
  • Bryansk.
  • Ulyanovskaya.
  • Lipetskaya.
  • Kaluzhskaya.

In 2017, the new order was adopted by 4 Republics, 2 territories, 7 regions:

  • Adygea.
  • Kalmykia.
  • Buryatia.
  • Altai.
  • Altaic.
  • Seaside.
  • Magadan.
  • Tomskaya.
  • Jewish.
  • Orlovskaya.
  • Omsk.
  • Amurskaya.
  • Vologda.

Since 2018, work has been carried out taking into account innovations in 2 regions and 4 Republics:

  • Kostroma.
  • Kurskaya.
  • Kabardino-Balkarian.
  • Karelia.
  • Tyva.
  • North Ossetia.

This list is updated annually, and the result of a complete transition to a system of direct payments through the Social Insurance Fund is gradually being achieved.

In case of illness or maternity, the employee is paid allowance.


Essentially, a benefit is an insurance payment. In this case, the employer is the policyholder the insured person.

When an insured event occurs - illness or maternity, the employee receives social benefit or, in other words, insurance. The benefit amount is partially or fully paid from the social insurance fund (SIF).


There are currently two insurance payment mechanisms:

  1. credit system;
  2. direct payments.

The employer first independently calculates the amount of social benefits, and then pays it to the employee from his own funds.

Due to the fact that the employer is obliged to pay monthly insurance premiums in case of VNII, he has the right to compensation for the costs of paying benefits.


To compensate for expenses when test system The policyholder has the following options.

  • Test
  • Refund

For reimbursement of expenses The following documents must be submitted to the social insurance fund.

  1. Supporting documents

In our opinion, the main flaw The offset system is an independent calculation by the employer of the amount of social benefits, and then payment of them from his own funds. At the same time, the process of reimbursement of expenses incurred is quite lengthy.


If social insurance employees discover errors in calculating the amount of benefits, the employer may assess additional insurance premiums, penalties and fines.

Legislators have developed a mechanism for direct payments to pay benefits to employees directly pilot project FSS.


The pilot project does not operate everywhere, but only in some regions of the Russian Federation. Those registered in such a subject automatically participate in the pilot project:

  • organizations;

An employer participating in the FSS pilot project should take into account the following: peculiarities.

  1. No need to count and pay
  2. in full
  3. Need to get from employee statement And documentation for payment of benefits and transmit information in the FSS.
  4. cannot be counted reimburse from the fund's budget.

The money is transferred by the fund to the employee’s bank account specified in the application, or by postal order.


Thus, the employer participating in the pilot project only needs to submit a package of documents to the fund.


The employer, no later than 5 days from the date of receipt of the application and documents from the employee, must transfer them to his social insurance department along with the inventory. The list of documents depends on the type of payment.


Type of benefit

List of required documents

For temporary disability

  • Certificate of incapacity for work

For pregnancy and childbirth

For women registered in the early stages of pregnancy

At the birth of a child

  • Certificate from the other parent’s place of work stating that he does not receive benefits
  • If the parents are divorced, a divorce certificate and a certificate confirming cohabitation with the child

Caring for a child until he reaches the age of 1.5 years




A package of documents for payment of benefits can be submitted in two ways:

  1. inventory;

A pilot project participant can choose any method of submitting documents if the average number of employees does not exceed 25 people. If the number of employees more than 25 people electronic form.


Please note that the FSS pilot project is provided for five types of benefits:

  • for pregnancy and childbirth;
  • women who registered in the early stages of pregnancy;
  • at the birth of a child;
  • for child care until he reaches the age of 1.5 years.

For other payments, for example, when paying for additional days off to care for a disabled child, the policyholder pays, as before, from his own funds. But these expenses cannot be counted against the payment of insurance premiums; they can only be reimbursed from the Social Insurance Fund budget.

  • Electronic sick leave

In case of illness or maternity, the employee is paid allowance.


Essentially, a benefit is an insurance payment. In this case, the employer is the policyholder, since by paying contributions to the Social Insurance Fund for cases of temporary disability and maternity, he insures the employee. The employee is accordingly the insured person.

When an insured event occurs - illness or maternity, the employee receives social benefit or, in other words, insurance. The benefit amount is partially or fully paid from the social insurance fund (SIF).


There are currently two insurance payment mechanisms:

  1. credit system;
  2. direct payments.

Credit system for payment of benefits

The employer first independently calculates the amount of social benefits, and then pays it to the employee from his own funds.

Due to the fact that the employer is obliged to pay monthly insurance premiums in case of VNII, he has the right to compensation for the costs of paying benefits.


To compensate for expenses when test system The policyholder has the following options.

  • Test expenses incurred for social benefits to repay the insurance premiums accrued in the corresponding period for VNiM.
  • Refund from social insurance of expenses incurred, if the cost of paying for sick leave and other benefits exceeds the amount of accrued contributions.

For reimbursement of expenses The following documents must be submitted to the social insurance fund.

  1. Statement
  2. Help-calculation
  3. Breakdown of expenses
  4. Supporting documents

In our opinion, the main flaw The offset system is an independent calculation by the employer of the amount of social benefits, and then payment of them from his own funds. At the same time, the process of reimbursement of expenses incurred is quite lengthy.


If social insurance employees discover errors in calculating the amount of benefits, the employer may assess additional insurance premiums, penalties and fines.

Direct payments or pilot project

Legislators have developed a mechanism for direct payments to pay benefits to employees directly, and not through the employer. This mechanism is called pilot project FSS.


The pilot project does not operate everywhere, but only in some regions of the Russian Federation. Those registered in such a subject automatically participate in the pilot project:

  • organizations;
  • separate divisions that independently pay salaries to employees.

An employer participating in the FSS pilot project should take into account the following: peculiarities.

  1. No need to count and pay workers some social benefits. They are paid directly by the FSS to insured persons.
  2. It is necessary to pay insurance premiums for VNiM in in full, without reducing the amount of benefits costs.
  3. Need to get from employee statement And documentation for payment of benefits and transmit information in the FSS.
  4. You must still pay at your own expense for the first three days of sick leave.
  5. You must pay at your own expense for additional days off to care for a disabled child, funeral benefits and expenses to reduce injuries. These amounts cannot be counted to pay insurance premiums, you can only reimburse from the fund's budget.
  6. It has become easier to fill out form 4-FSS and calculate insurance premiums. The reports do not need to include data on social benefits.


What should the employee and employer do with direct payments?

Step 1.

The employee must submit to the employer a completed application accompanied by supporting documents.

Step 2.

The employer must submit this application and the documents necessary to receive social benefits to the Social Insurance Fund within 5 calendar days.

Step 3.

As a general rule, the social insurance fund has 10 calendar days to make a decision and pay benefits.

The money is transferred by the fund to the employee’s bank account specified in the application, or by postal order.


Thus, the employer participating in the pilot project only needs to submit a package of documents to the fund.



Please note that the FSS pilot project is provided for five types of benefits:

  • for temporary disability;
  • for pregnancy and childbirth;
  • women who registered in the early stages of pregnancy;
  • at the birth of a child;
  • for child care until he reaches the age of 1.5 years.

For other payments, for example, when paying for additional days off to care for a disabled child, the policyholder pays, as before, from his own funds. But these expenses cannot be counted against the payment of insurance premiums; they can only be reimbursed from the Social Insurance Fund budget.

  • Electronic sick leave
  • What reports must policyholders submit?
  • How to pay insurance premiums for VNIM cases
  • Electronic submission of the register of information to the FSS
  • List of subjects participating in the FSS pilot project

A single calculation must be submitted after the 1st quarter, 6, 9 and 12 months. The deadline is no later than the 30th day of the month following such reporting period. The combination of numbers informing tax authorities about the reporting period is defined in Appendix No. 3 of the procedure for filling out a single calculation:

As you can see, the billing period is a year. It corresponds to code 34.

To determine which payment attribute to put - 1 or 2 in Appendix 2 of the calculation of contributions, you must first understand what a “payment attribute” is and what it is connected with.

What is the calculation of insurance premiums in 2018

In October 2016, by order of the Federal Tax Service of Russia (No. ММВ-7-11/551), a new report was approved, which essentially replaced the previously submitted reports in the field of insurance. Since that time, the administration of insurance premiums, with the exception of contributions for injuries, which continue to be transferred to the Social Insurance Fund, is carried out by tax control authorities.

As for all other aspects of the calculation and payment of insurance premiums, starting from 2017, they are concentrated in the hands of the Federal Tax Service.

The calculation of insurance contributions to the Federal Tax Service 2018 is a document that combines information on compulsory, pension and social insurance.

The structure of this document can be presented in the form of three sections, each of which reflects certain information.

Thus, Section 1 is used to disclose information about the calculated amount of insurance premiums for various reasons. Many applications allow you to structure the presented data.

Section 2 can only be used by companies or entrepreneurs whose main activities are related to agriculture, that is, it is used only by agricultural producers. Accordingly, this section does not fall into the category of mandatory tax report elements.

If the employer discovers in the calculation submitted to the tax office the fact that information is not reflected or is incompletely reflected, as well as errors leading to an underestimation of the amount of insurance premiums payable, the payer is obliged to make the necessary changes to the calculation and submit an updated calculation to the tax authority. The procedure for submitting updated calculations is prescribed in Art. 81 Tax Code of the Russian Federation.

note

When recalculating the amounts of insurance premiums during the period of an error (distortion), the updated calculations are submitted to the tax authority in the form that was in force in the settlement (reporting) period for which the recalculation of the amounts of insurance premiums is made.

If the detected errors did not lead to an underestimation of the amount of insurance premiums payable, submitting an updated calculation is the right and not the obligation of the payer.

The following should be included in the adjusted calculation:

  • sections of the calculation and appendices to them, which were previously submitted by the payer to the tax authority (with the exception of Section 3 “Personalized information about insured persons”), taking into account the amendments made to them;
  • other sections of the calculation and appendices to them in case of amendments (additions) to them;
  • Section 3 “Personalized information about insured persons” for those individuals in respect of whom changes (additions) are made.

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So, in 2017, organizations and individual entrepreneurs who make payments to individuals will submit calculations of insurance premiums to the tax office. This calculation replaces the usual forms RSV-1 and 4-FSS.

A single deadline for submitting calculations has been established - no later than the 30th day of the month following the billing (reporting) period. The calculation contains sections and appendices that are mandatory for all (title page, section.

1, subsection 1.

1 and 1. 2 appendices 1 to section.

1, appendix 2 to section. 1, sec.

3), as well as sections, subsections and appendices, which are filled out only if the employer made appropriate payments or calculated insurance premiums at reduced rates.

Code of the tax authority to which the report was submitted

If there are no actions related to reorganization or liquidation, a dash is placed in the appropriate field.

The universal 24-page document consists of:

  • title;
  • 1st section, combining information about the obligation to pay contributions;
  • 2nd section, including information on the obligations of heads of peasant farms;
  • Section 3, containing personal data for each insured person.

Depending on the status of the policyholder and the type of activity of the company, a certain set of pages is filled out, which are then numbered consecutively. For example, all legal entities and individual entrepreneurs (except heads of peasant farms) are required to prepare the following pages in the calculation:

  • title page;
  • section 1 with subsections 1.1 and 1.2, appendices No. 1, No. 2, No. 3;
  • section 3.

If the payer uses preferential/additional tariffs, then the list of DAM pages is supplemented by the design of subsections 1.3.1, 1.3.2, 1.4, appendices No. 5-10 to section 1, paying benefits to the liquidators of the Chernobyl nuclear power plant - appendix No. 4, paying sick leave and maternity benefits and childbirth - Appendix No. 3.

Who submits the calculation of insurance premiums 2018

The body responsible for receiving the tax document on insurance contributions is the Federal Tax Service. Organizations must submit the calculation to the territorial Federal Tax Service at the place of their registration. As for individual entrepreneurs, they should report to the tax authorities at their place of residence.

The calculation of insurance premiums for compulsory health insurance, compulsory medical insurance and VniM must be distinguished from the Calculation of 4-FSS. The latter is filled out only for contributions for injuries and submitted to the territorial body of the Social Insurance Fund. We talked more about Calculation for “accident” insurance in our consultation.

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Location code

Let's assume that Guru LLC is located in Russia - in Tomsk. Then in the field in question they put the number 214, and the Federal Tax Service code is 7017:

Activity code

On the title page, after the name of the organization, you must indicate the code of economic activity - according to OKVED2. It contains information about the name of the company’s field of activity and a description of the grouping of its specific activities. You can view its value:

  • in the all-Russian classifier;
  • certificate of registration of an economic entity.

Calculation of insurance premiums 2018: due date

The report “Calculation of insurance premiums” 2018 belongs to the category of quarterly reports. This means that at the end of each quarter, policyholders must generate, verify and submit a single calculation of insurance premiums in 2018.

Calculation of insurance premiums 2018 - deadlines for submission to the inspection are established within the 30th day of the month following the reporting quarter.

Accordingly, the calculation of insurance premiums for the 1st quarter of 2018 must be submitted to the tax authorities by April 30, 2018. The report for the half-year is submitted to the Federal Tax Service by July 30, 2018, for nine months - no later than October 30, and the report for 2018 must be submitted by January 30, 2019.

The report (calculation) of insurance premiums in 2018 must be submitted no later than the 30th day of the month following the corresponding reporting (calculation) period (clause 7 of Article 431 of the Tax Code of the Russian Federation). Of course, if the deadline for submitting the Calculation coincides with a weekend or non-working holiday, the deadline for submission is postponed to the first working day following such a day (clause 7 of Article 6.1 of the Tax Code of the Russian Federation).

What codes to indicate for methods of submitting calculations for insurance premiums?

On the second page of the reporting in question, it is necessary to indicate the code of the country of citizenship. A list of all values ​​is presented in the All-Russian Classifier of Countries of the World (Resolution of the State Standard of the Russian Federation No. 529-st).

In the section about the address of residence, indicate the code of the region of Russia in which the person is registered. When writing, follow Appendix No. 7 for the procedure for filling out a single calculation.

The Direct Payments project has been extended until December 31, 2020. It started in 2011 in 2 regions; by mid-2015, 14 constituent entities of the Russian Federation already participated in it, and from July 1, 2016, 6 more were added: the Republic of Mordovia, Bryansk, Kaliningrad, Kaluga, Lipetsk and Ulyanovsk regions (Resolution of the Government of the Russian Federation ).

From July 1, 2017, new regions will join the FSS “Direct Payments” pilot project for the fifth time: the republics of Adygea, Altai, Buryatia, Kalmykia, Altai and Primorsky Territories, Amur, Vologda, Magadan, Omsk, Oryol, Tomsk regions and the Jewish Autonomous Region region.

In the pilot regions, benefits are paid to employees not by the employer, but directly by the Social Insurance Fund (see Decree of the Government of the Russian Federation dated April 21, 2011).

Lenar Shakirov,

Head of the Naberezhnye Chelny branch No. 9 of the State Institution - regional branch of the Federal Social Insurance Fund of the Russian Federation in the Republic of Tatarstan

Under the traditional scheme, the FSS works with organizations on an offset principle: benefits are paid to the employee by the employer, and the Fund transfers to the policyholder the difference between the amount of insurance premiums and the amount of benefits paid to them. In the pilot regions, the employer is practically excluded from the benefit payment scheme; his responsibilities only include submitting the relevant documents to the Fund’s branch. At the same time, the size and formula for calculating benefits remain the same. Only the scheme of interaction between the Fund and the employer and the insured is changing.

Insurance contributions for compulsory social insurance are no longer reduced by the amount of expenses incurred, but are paid to the Social Insurance Fund in full. Payment for the first three days of temporary disability, as before, is made by the employer at his own expense.

New data reporting scheme for benefit payments

Direct payments: step-by-step algorithm for an accountant

1. Reception of documents from the insured

The employee must submit to the employer a certificate of incapacity for work and an application to receive benefits no later than 6 months after the occurrence of the insured event.

Advantages and disadvantages of the new benefit payment scheme

Elena Krivosheeva,

Deputy Head of the Insurance Department in Case of Temporary Disability and in Connection with Maternity of the State Institution - Samara Regional Branch of the Federal Social Insurance Fund of the Russian Federation

The transition to a new benefit payment system is intended to reduce the likelihood of insurance fraud and eliminate non-payment of benefits when the company's accounts are frozen or it is in the process of bankruptcy or liquidation. Because, firstly, the financial condition of a number of organizations does not allow payments for temporary disability to be made on time. And secondly, there are common cases when enterprises are liquidated during the period of maternity leave of employees. In addition, we expect that as a result of the implementation of this project, the document flow between the Fund, policyholders and medical institutions will be simplified.

Table 1. Advantages and disadvantages of the netting benefit payment scheme and the “direct payment” scheme for all participants in the process*

Contents of operation Advantages and disadvantages
Offsetting Direct payments

For policyholders

It is necessary to divert the company's working capital to pay benefits until the Fund reimburses the costs to the policyholder Yes No
You need to calculate the part of the benefit that is paid from the Social Insurance Fund and spend working time on it Yes No
It is necessary to reflect the amounts of expenses for the payment of benefits in reporting on Form 4-FSS Yes No
Documents for payment of benefits can be submitted electronically No Yes

For the insured

The benefit is paid immediately after the insured event; there is no need to wait until payday to receive it. No Yes
Payment of benefits depends on the integrity of the employer and on whether the company currently has the necessary funds Yes No
Guarantee of competent calculation of the amount of benefits by FSS specialists No Yes
Each time you need to write an additional application; to receive benefits, it is not enough to simply submit supporting documents No Yes
Timely receipt of benefits regardless of the financial and any other circumstances of the employer No Yes
Possible conflict situations with the employer due to delay, non-payment or incorrect calculation of benefits Yes No
It is necessary to apply for information about the calculation of benefits, as well as for a 2-NDFL certificate at a branch of the Fund No Yes
Selecting the method of receiving benefits (to a bank account or through the post office) No Yes

For the Social Insurance Fund

It is impossible to control the process of calculation, payment and validity of benefits at each stage. All checks are carried out after the payment has been made. The process of recalculation and refund if an error is detected is complex and time-consuming Yes No
Control of the assignment, calculation and payment of all benefits at each stage and, as a result, reducing cases of insurance fraud No Yes
Convenience and efficiency of working with electronic information submitted by policyholders No Yes
Possibility in the future to introduce a mechanism for electronic exchange of information with all participants in the pilot project No Yes
In the future, the transition to electronic certificates of incapacity for work No Yes

* The editors of the magazine would like to thank the regional offices and branches of the FSS of the Russian Federation in the cities of Nizhny Novgorod, Naberezhnye Chelny, Elabuga and Samara for the information provided.

Are there any difficulties?

FSS specialists note that one of the problems in assigning benefits under the new scheme is the lack of information about the actions of policyholders and insured persons.

— At the beginning of the year, our regional office received many letters from insurance companies from large city-forming enterprises, in which concerns were expressed about the increase in payment terms. There were also requests to exclude this or that urban district from the participants in the pilot project in the Samara region,” says Elena Krivosheeva. — Gradually, in the process of studying regulatory documents and explanations from our specialists, an understanding came of the thoughtfulness and effectiveness of the new benefit payment scheme. A weighty argument was the fact that all financial risks of policyholders in terms of fulfilling social obligations to employees are assumed by the Social Insurance Fund, and in a crisis economy this is especially relevant.

— The deadline for submitting documents to us is only five calendar days. This worries policyholders, says Ksenia Somova. — I think that at the first stage there may indeed be problems with timing, even though the Fund’s employees conducted training seminars for all policyholders. Such problems are especially likely for large enterprises with a large number of insured persons and for enterprises with branches outside the Republic of Tatarstan. Policyholders are also concerned about the methodology for filling out electronic registers and application forms by employees.

In addition, FSS specialists note that untimely change of documents by insured women when changing their last name entails the return of payment documents from credit institutions and a delay in receiving benefits. Below, FSS employees answer in detail common questions from policyholders.

How are benefits paid to employees who are on maternity leave?

Lenar Shakirov: Persons who, at the time of the start of the “Direct Payments” pilot project, are on parental leave until the child reaches the age of 1.5 years and will use this leave after 07/01/2016, need to contact their employer with an application for transfer of benefits in the prescribed form . After the initial application of the policyholder with a package of documents, the subsequent payment of the monthly child care benefit to the insured person is carried out by the FSS from the 1st to the 15th day of the month following the month for which such benefits are paid. If circumstances arise that entail the termination of benefit payment, the employee is obliged to immediately notify the employer or the branch of the Fund making the payment.

Irina Sheveleva: When the project was launched in the Nizhny Novgorod region, many women who were assigned child care benefits before 07/01/2011 (before the start of the pilot project “Direct Payments” in the region. - Note ed.), did not know about the need to fill out applications for benefits. It was difficult to find them in the summer, and with the onset of autumn, upon returning to the city, numerous questions arose, because for two or three months they had not received benefits. To avoid similar situations in regions where the project starts in July 2016, we recommend that employers inform their employees in advance.

Where will the benefits assigned to the insured be transferred?

Lenar Shakirov: Benefits will be transferred to the personal accounts of insured persons opened in credit institutions, including banks, or by postal order to the address specified by the recipient. The details to which benefits will be transferred must be indicated in the insured person's application. Those who wish to receive funds using bank cards will need to specify the 20-digit number of the personal account to which the bank card is linked. The number can also belong only to the recipient.

Where should the insured receive 2-NDFL certificates?

Ksenia Somova: This is one of the most significant changes. Before the implementation of the pilot project, individuals received 2-NDFL certificates at their place of work. However, when calculating benefits, we will also transfer taxes, and now the employer will not have complete information about the amount of taxes paid. Therefore, the insured must apply for these documents to the branch of the territorial bodies of the Federal Social Insurance Fund of the Russian Federation at the place of registration of the employer.

Irina Sheveleva: The 2-NDFL certificate is of a declarative nature. An application for a certificate of the amount of benefits paid must be completed in any form. It must indicate the full name, SNILS, passport details, full name of the employer, and residential address of the insured. If it is impossible to obtain this certificate in person, it can be sent to the insured person by registered mail with notification.

There are several ways to get 2-NDFL:

  1. The insured person can personally contact the branch at the place of registration of his employer.
  2. Send an application for the required certificate by mail to the branch at the place of registration of the employer.
  3. A representative of the insured person with a power of attorney drawn up in simple written form can apply to the place of registration of the employer.
  4. You can also send your application to the branch's email address.

Table 2. Difficulties in submitting electronic documents under the new scheme and their solution using special services

Problem How the service solves the problem
Errors when filling out documents and, as a result, multiple corrections and sending to the Social Insurance Fund, delays in deadlines The service implements more than 400 checks of the FSS gateway. Errors are highlighted in red right when filled out, and hints appear on how to correct them. The system will not allow you to send a document with an error.
Re-filling data for one employee to receive each new benefit The employee's details only need to be entered once. From now on, you can select the employee’s name from the list, the information will be loaded automatically. In addition, this data will be available when reporting to the Pension Fund via Extern
There are data that are difficult to enter manually: names of medical institutions, bank details, 20-digit personal account number for transferring benefits The system implements directories of hospitals, banks and addresses (KLADR) with an auto-substitution function:
  • It is enough to enter the OGRN of the medical institution, and its name will be loaded.
  • The address can be selected from the list.
  • The directory of banks is regularly updated from the website of the Central Bank of the Russian Federation. After entering the bank's BIC, the name is entered automatically.
  • The account number is entered once and then entered automatically.
  • If the account number and the bank's BIC do not match, the system will not allow you to send the document
Filling out the employer details block multiple times In the service, you only need to enter this data once. They are associated with the details of the Extern payer and will be available when filling out other reports
Abundance of fields in the electronic form: it is not clear what needs to be filled out to receive a specific benefit The service displays only those fields that need to be filled in for the specified type of benefit
Questions and mistakes made by employees when filling out an application for benefits Just fill out the document to send to the Social Insurance Fund and click “Print the application”, which can be given to an employee for verification and signature
It is labor-intensive to transfer data from sick leave into electronic form The order of fields on the “Incapacity Sheet” tab fully corresponds to the paper form
On the FSS gateway, it is impossible to view the entire history of sending a document in one place; each fact of sending, including corrected versions, is a new line The entire history of document flow for a specific benefit is stored in one place. The document, receipts and error logs can be viewed, downloaded and printed
The usual accounting program does not implement a complete check of data before sending it to the Social Insurance Fund and/or it is inconvenient to send documents and track their status You can download documents for payment of benefits from any programs for verification and submission. And after checking, correct errors directly in the service