Payments of benefits under bir in the social insurance fund. Social payments of the social insurance fund of the Russian Federation Payments to the social insurance fund

E.A. Sharonova, economist

Payment of benefits directly from the Social Insurance Fund

What employers need to know

A pilot project for the payment of social insurance benefits directly to employees by territorial branches of the Social Insurance Fund started back in 2012. At first, the experiment was carried out only in two regions - the Karachay-Cherkess Republic and the Nizhny Novgorod region.

Then it was gradually extended to another 12 subjects - Astrakhan, Belgorod, Kurgan, Novgorod, Novosibirsk, Rostov, Samara and Tambov regions, Khabarovsk Territory, the Republic of Crimea and Tatarstan, as well as the city of Sevastopol clause 2 of Government Decree No. 294 of April 21, 2011 (hereinafter referred to as Decree No. 294).

And from July 1, 2016, six more regions will join the pilot project - the Republic of Mordovia, Bryansk, Kaliningrad, Kaluga, Lipetsk and Ulyanovsk regions and Government Decree No. 1389 dated December 19, 2015.

In all these regions, the pilot project will operate until the end of 2016. So, organizations in new regions are interested in: what will change in their work and what will they have to do?

What benefits will the Social Insurance Fund pay to employees?

The territorial offices will pay the following types of benefits directly to employees: pp. 1, 6 Regulations... in case of temporary disability and in connection with maternity, approved. Resolution No. 294 (hereinafter referred to as the Regulations... in case of temporary disability and in connection with maternity); clause 1 of the Regulations... in connection with an industrial accident, approved. Resolution No. 294 (hereinafter referred to as the Regulations... in connection with an industrial accident):

  • temporary disability benefits due to illness starting from the 4th day;
  • maternity benefits;
  • a one-time benefit for women registered with medical institutions in the early stages of pregnancy;
  • lump sum benefit for the birth of a child;
  • monthly child care allowance;
  • temporary disability benefit due to an industrial injury (in connection with an industrial accident or occupational disease) starting from the 1st day;
  • payment of leave to an employee injured at work (in addition to the annual paid leave established by the legislation of the Russian Federation), for the entire period of treatment and travel to and from the place of treatment.

The employer does not accrue or pay these types of benefits to its employees. Their calculation and payment is handled directly by the territorial body of the Social Insurance Fund. And in order for this to become possible, you are obliged to submit the necessary documents to your FSS branch.

What will employers themselves pay to employees?

You, as the employer, will still be pp. 1 , , ,:

  • accrue and pay sickness benefits to employees at their own expense for the first 3 days;
  • pay 4 additional days off for an employee-parent (guardian, trustee) to care for disabled children;
  • pay funeral benefits to a family member of a deceased employee.

Moreover, the FSS will reimburse you for the costs of paying the last two social guarantees by transferring money to your current account pp. 10, 11 Provisions... in case of temporary disability and in connection with maternity.

How everything will work

In a pilot project for direct payments of social insurance benefits, the employer essentially acts as an intermediary between the employee and the Social Insurance Fund office. In order for the FSS department to be able to pay benefits, you are obliged to hand over the necessary documents according to the inventory, in particular - applications on behalf of employees for the payment of a particular benefit according to the form approved by the FSS appendices No. 1, 2 to the FSS Order No. 335 of September 17, 2012 (hereinafter referred to as the FSS Order No. 335), sick leaves indicating information about the employee’s length of service and average earnings, certificates from previous places of work about earnings for the pay period Appendix No. 1 to Order of the Ministry of Labor dated April 30, 2013 No. 182n, an industrial accident report, if there was a work injury, a copy of the child’s birth certificate and others pp. 2, , 6 Regulations... in case of temporary disability and in connection with maternity; pp. 2, 3, 11 Regulations... in connection with an accident at work.

What documents must be submitted to the FSS for payment of a particular benefit are indicated in the application form for payment of benefits approved by the FSS, which you submit to the FSS on behalf of the employee. In this application, the employee must indicate how he wants to receive benefits. clause 9 of the Regulations... in case of temporary disability and in connection with maternity; clause 9 of the Regulations... in connection with an accident at work; Appendix No. 1 to FSS Order No. 335:

  • <или>to a bank account. Then you need to indicate the account number and details of the recipient bank. If desired, you can also receive benefits on a salary card from website of the Astrakhan RO FSS; website of Rostov RO FSS;
  • <или>in cash at the post office at your place of residence.

Attention

You cannot receive benefits in cash at the Social Insurance Fund branch.

By the way, you can fill out an application for an employee yourself. The regional branches of the FSS do not object to this. But you cannot sign the application instead of the employee; he must do this personally. Before signing his autograph, the employee must check all his data and details for transferring benefits. website of the Astrakhan RO FSS; website of the Belgorod RO FSS.

The interaction between the three parties looks like this.

1clause 3 of the Regulations... in case of temporary disability and in connection with maternity; clause 3 of the Regulations... in connection with an accident at work; 2Appendix No. 2 to FSS Order No. 335; 3Appendix No. 1 to FSS Order No. 223 dated June 15, 2012 (hereinafter referred to as FSS Order No. 223); 4pp. 8, 9 Provisions... in case of temporary disability and in connection with maternity; pp. 7, 9 Regulations... in connection with an accident at work

This is what an ideal scheme looks like. But if something goes wrong, the terms for payment of benefits from the Social Insurance Fund may increase.

For example, if, after receiving a paper set of documents and information necessary for the assignment and payment of a particular type of benefit, the FSS department discovers that you have not submitted them in full, then within 5 working days the department will send you a notice in the form established by the FSS indicating the missing documents. And you must also submit these documents within 5 working days from the date of receipt of the notification ; ; pp. 6, 13 Regulations... in connection with an accident at work. By the way, notice sent by mail is considered received after 6 business days from the date of sending.

In addition, you will receive a notification if it turns out that the certificate of incapacity for work was filled out incorrectly. And it doesn’t matter who made the mistake - you or the medical institution. Along with the notice, the sheet itself will be returned to you so that corrections can be made to it. clause 8 of the Regulations... in case of temporary disability and in connection with maternity; clause 7 of the Regulations... in connection with an accident at work. After you eliminate all the mistakes and re-submit the certificate of incapacity for work to the FSS department, it will assign benefits to the employee within 3 working days.

If you have not fully submitted the register of information in electronic form, then there are some nuances here. First, you will receive an electronic notification from the FSS about the provision of the missing information. You must then acknowledge receipt of this notice within 1 business day. If you do not do this, the FSS branch, within 3 business days from the date of expiration of the period established for confirmation of receipt of the notice, sends you such a notice by registered mail. You must send the missing information to the FSS office within 5 working days from the date of receipt of the notice. Appendix No. 4 to FSS Order No. 335; clause 7 of the Regulations... in case of temporary disability and in connection with maternity.

In what form should documents be submitted to the FSS?

Attention

If an employee missed the 6-month deadline for applying for benefits and there are no documents confirming the validity of the reason for the absence, the employer should not submit documents to the Social Insurance Fund for payment of benefits. clause 14 of the Regulations... in case of temporary disability and in connection with maternity.

The procedure for submitting documents to the Social Insurance Fund depends on the average number of employees of the organization and the type of benefit for which the employee applied pp. 4, 4(1) Provisions... in case of temporary disability and in connection with maternity:

  • <если>The average number of employees for 2015 is 25 people or less; a set of documents is submitted on paper to the Social Insurance Fund department (for the list, see the diagram on). It is better to bring these documents to the department in person, since you need to submit the originals of all documents (sick leave certificates, certificates from previous employers, etc.). By the way, if you wish, instead of a paper set of documents, you can submit electronic registers;
  • <если>The average number of employees for 2015 is more than 25 people; registers of information must be submitted in electronic form to the FSS department. There is no additional need to submit original documents. Moreover, registers of only five types of benefits can be submitted electronically:
  • for temporary disability;
  • for pregnancy and childbirth Appendix No. 1 to FSS Order No. 223;
  • women who registered in the early stages of pregnancy and Appendix No. 1 to FSS Order No. 223;
  • at the birth of a child Appendix No. 3 to FSS Order No. 223;
  • to care for a child until he reaches the age of one and a half years.

But for benefits in connection with an accident at work, with paid leave for the victim of an industrial injury, electronic registers are not provided. So for these types of benefits, regardless of the number of employees, only paper sets of documents must be submitted.

Where are the original documents stored?

After the FSS department makes a decision on the assignment and payment of benefits to employees, it will return the originals of all documents submitted on paper (applications, certificates of incapacity, certificates, etc.) to you. And it is you who will have to keep them with you clause 13 of the Regulations... in case of temporary disability and in connection with maternity.

But there are exceptions to this rule. Certificates of incapacity for work issued in connection with an industrial injury or occupational disease are retained by the Fund's department. There is no provision for their return to employers.

The nuances of filling out sick leave by an employer

When you become a participant in the pilot project, you will still be required to complete your disability certificate section, but with one caveat. Since the FSS department will be in charge of calculating and paying its part of the benefit, then on sick leave you no need fill in the lines “Amount of benefit from the Social Insurance Fund of the Russian Federation” and “Total accrued”.

Moreover, in the sheet issued in connection with illness, in the line “Amount of benefit at the expense of the employer” you need to indicate the accrued amount of benefit for the first 3 days, taking into account personal income tax Letter of the FSS dated October 28, 2011 No. 14-03-18/15-12956 (clause 11). Accordingly, you must calculate and withhold personal income tax only from your part of the benefit.

Please note that now you have no reason to withhold personal income tax from the entire benefit amount (as you did before). After all, with a pilot project regarding Social Security benefits, you are no longer the source of payment of income, but pp. 1-3 tbsp. 226 Tax Code of the Russian Federation. And if you withhold personal income tax from the entire amount of the benefit, it turns out that you have withheld tax from the employee excessively and you will have to return it clause 1 art. 231 Tax Code of the Russian Federation.

The FSS itself will withhold personal income tax and issue 2-NDFL certificates

Since the FSS branch, within the framework of the pilot project, itself accrues and pays temporary disability benefits to individuals (due to illness or work injury), it becomes a tax agent for personal income tax. This means that the FSS branch will withhold personal income tax from the amount of benefits when they are paid to individuals and transfer it to the budget. Art. 226 Tax Code of the Russian Federation; website of the Astrakhan RO FSS; website of the Belgorod RO FSS; website of Rostov RO FSS.

At the same time, when performing agency duties, FSS branches will not provide tax deductions to individuals (standard for children, property, social). Such explanations are posted on the websites of regional branches of the Social Insurance Fund - participants in the pilot project. website of the Belgorod RO FSS; website of the Astrakhan RO FSS; Lipetsk RO FSS website.

But the 2-NDFL certificates of the FSS department will be compiled and issued to company employees if they apply to them website of the Astrakhan RO FSS; website of the Belgorod RO FSS; Lipetsk RO FSS website. Your employee will have to receive such a certificate from the Social Insurance Fund office at the end of the year if he plans to submit a 3-NDFL declaration to his Federal Tax Service Inspectorate in order to receive a property deduction for the purchase of housing, social deductions in connection with treatment or education, or to collect the standard deduction for children (if the annual amount of income, taking into account the benefits accrued by the FSS department, is 350,000 rubles or less e) clause 2 art. 219, para. 7, 8 tbsp. 220, sub. 4 clause 1, pp. 3, 4 tbsp. 218 Tax Code of the Russian Federation.

Who should withhold alimony when paying sick leave?

As you know, alimony must also be withheld from temporary disability benefits. clause 9, part 1, art. 101 of the Law of October 2, 2007 No. 229-FZ; subp. “c” clause 2 of the List, approved. Government Decree No. 841 dated July 18, 1996.

The fact that the employer will withhold alimony from his part of the accrued benefit (for 3 days) is understandable. But the organizations of the acceding regions - participants in the pilot project - have a question: will they be required to transfer the original document of execution (writ of execution, court order, notarized agreement on the payment of alimony to Part 1 Art. 12, part 3 art. 98 of the Law of October 2, 2007 No. 229-FZ) to your FSS department so that it withholds alimony from its part of the benefit?

As explained by the regional branches of the Social Insurance Fund - participants in the pilot project, such an obligation is not provided for employers. Contact the Fund branch website of Tambov RO FSS:

  • <или>the recipient of alimony must submit any of the executive documents - a writ of execution, a court order or an agreement on the payment of alimony or their duplicates;
  • <или>maybe the bailiff service. When the claimant (recipient) presents the enforcement documents to her, she will send a resolution to initiate enforcement proceedings to the territorial body of the Fund.
You can find out about the position of the Lipetsk Regional Social Insurance Fund on the issue of withholding alimony from paid sick leave: Lipetsk RO FSS website→ Manual for accountants → slide 13

Then the FSS department will withhold alimony from the amounts of assigned temporary disability benefits.

Another option is also possible - at the insistence of the alimony claimant, the bailiff service has the right to send a request to the territorial body of the Federal Social Insurance Fund of the Russian Federation about the amount of the benefit paid. After the FSS reports this amount, the resulting arrears in payment of alimony will be collected by order of the bailiff. Moreover, this resolution can be presented by the recipient of alimony at the debtor’s place of work.

What will change in the procedure for paying contributions to the Social Insurance Fund?

Newbie organizations that join the project from 07/01/2016 need to take this into account. Contributions accrued for July 2016 in connection with illness and maternity, as well as contributions “for injuries” must be transferred to the Social Insurance Fund in full. clause 3 of the Regulations on the specifics of payment of insurance premiums, approved. Resolution No. 294(with the exception of offset of the benefit amount against the payment of contributions - see). After all, since the FSS department will pay benefits itself, you will simply have nothing to reduce the assessed contributions. The same procedure for paying contributions will be in effect until December 2016 inclusive.

Features of filling out FSS reporting

Form 4-FSS Appendix No. 1 to the Order of the Social Insurance Fund dated February 26, 2015 No. 59 for the first half of 2016 you fill out as usual. Moreover, in this 4-FSS calculation you must include benefits that you accrued up to 06/30/2016 inclusive, but have not yet paid. You can pay these benefits to employees in July.

But starting with reporting for 9 months of 2016, you no longer need to record data on benefits paid from the Social Insurance Fund. But if from the beginning of the year to June inclusive you paid employees some benefits reimbursed from the Social Insurance Fund, then the features of filling out the 4-FSS calculation for 9 months of 2016 will be the same section III of the appendix to the FSS Order dated June 23, 2015 No. 267:

  • in line 15 “Expenses for the purposes of compulsory social insurance” of Table 1 of Section I and in line 15 “Expenses for compulsory social insurance” of Table 7 of Section II, you do not need to fill out the columns “1 month”, “2 month”, “3 month”. After all, you simply don’t have such data for July, August and September. And even if you paid benefits to an employee by mistake, the Fund branch will not accept these expenses.

In line 15 of tables 1 and 7, you need to show only the amount of benefits paid from the Social Insurance Fund as of July 1, 2016, as well as benefits accrued in the last days of June, but not yet paid as of July 1, 2016. That is, you only need to fill in the line “at the beginning of the reporting period.” It is not subject to change until the end of the year 2016.

In this case, the total amount of expenses in column 3 of tables 1 and 7 will be the same as in the calculation for the first half of the year;

For information on what to do if you, and not the Social Insurance Fund department, paid benefits to an employee by mistake, read:
  • in tables 2, 5 and 8, where information about benefits paid at the expense of the Social Insurance Fund is deciphered, you must indicate data only for the first 6 months of 2016.

You will fill out the 4-FSS calculation for 2016 in the same order.

Transitional nuances

In addition, when moving from an offset mechanism for paying social insurance benefits to a direct one (from the Social Insurance Fund), you need to take into account the following:

  • <если>before 07/01/2016 you did not have time to accrue (this is given 10 calendar days from the day the employee brought all the necessary documents Part 1 Art. 15 of the Law of December 29, 2006 No. 255-FZ) and, accordingly, did not reflect any benefit in the calculation of 4-FSS for the six months, then the Fund’s department will accrue and pay it. For example, if an employee brought sick leave on June 30, 2016, then you can transfer it to the Social Insurance Fund for payment of benefits;
  • <если>you accrued and paid maternity benefits to an employee in June 2016 and as a result, in the calculation of 4-FSS for the six months, you incurred a debt for the FSS (as of 07/01/2016), then you can, upon application Part 2 Art. 4.6 of the Law of December 29, 2006 No. 255-FZ; Part 2.1 Art. 15 of the Law of July 24, 2009 No. 212-FZ:
  • <или>offset it against the payment of contributions before the end of the calendar year;
  • <или>reimburse it from the Social Insurance Fund. It is advisable to apply for real money if you are sure that the base for calculating contributions will not increase by the end of the year.

In conclusion, we note that in order to prevent the payment of an inflated monthly child care benefit, you are required to notify the FSS department within 3 days clause 4(2) of the Regulations... in case of temporary disability and in connection with maternity:

  • about the dismissal of an employee caring for a child;
  • about his next annual leave if he works part-time;
  • about this employee returning to work full time;
  • about the death of a child.

If you submit to the FSS department an electronic register of information necessary for the assignment and payment of a monthly child care allowance Appendix No. 5 to FSS Order No. 223, then you reflect the above information in column 28 of this register clause 2.15 of Appendix No. 6 to FSS Order No. 223.

If you submit sets of documents to the FSS department on paper, then you can report the above events in any form with attached documents (dismissal order, vacation, etc.).

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Women while expecting a child and after childbirth can calculate benefits that are paid by the employer with subsequent reimbursement to the Social Insurance Fund. This is regulated by the Federal Law of December 29, 2006 No. 255-FZ “On compulsory social insurance in case of temporary disability and in connection with maternity.” The size of payments depends on the category to which they belong, for example:, etc.

Recently, in some regions of the country it became possible to receive benefits directly from the Social Insurance Fund bypassing the employer. This will be discussed further in the article.

Who is entitled to payments to the Social Insurance Fund?

General grounds for payment of benefits:

  1. Maternity benefits are assigned upon registration with a gynecologist at the due date, namely up to 12 weeks. Mandatory recipients are: those left without work due to the liquidation of the enterprise, and military personnel.
  2. One-time payments are due to all employees after registration for a reason. Women are also entitled to benefits in the event of liquidation of an enterprise, but if they contacted the employment service no later than a year from the date of these events.
  3. due to one of the parents at the birth of a child. This payment can be used by all categories of citizens without restrictions.
  4. accrued to employed persons and unemployed persons. Payments are made monthly.

Individual cases:

  1. Wives of contract military personnel are paid a monthly allowance while they are expecting a child. from 180 days.
  2. monthly amounts are calculated for each child until they reach 3 years of age. This period lasts until the pope is dismissed from the armed forces.

As a rule, benefits are paid

About the types of possible payments at the regional level

Support for pregnancy and motherhood is also provided from regional budgets, everything depends on the capabilities of local authorities.

These include payments:

  • additional assistance to young parents;
  • payment of benefits for single-parent families;
  • benefits for young families under the age of 30 years;
  • compensation for food for pregnant women after 12 -week period;
  • monetary compensation for nursing mothers;
  • preferential payments for children under the age of 3 years under difficult life circumstances.

About benefits for pregnancy and the postpartum period

Payments of maternity benefits are provided for by state regulations. From time to time, these issues are raised at State Duma meetings, and changes and additions are made to regulations. One of the clarifications is increasing the powers of the Social Insurance Fund.

In general, registration and receipt of benefits is provided in the following places:

  • at the employer- for those officially employed by an enterprise or organization;
  • at the place of duty- women performing military service, including under contract;
  • in an educational institution- female students studying at this educational institution.

Reasons for applying to the FSS

Now you can apply for payments directly to the Social Insurance Fund, but only in the following cases:

  1. If the official employer did not fulfill its legal requirements, trying to save on payments of required benefits or did not pay them at all due to various circumstances.
  2. If a special FSS project has started operating in the region "Direct payments". Beginning with 2011 year, appeared in a number of regions a unique opportunity to receive the required funds from the Social Insurance Fund. These regions are called “pilot”, that is, all the nuances of improving the payment system are gradually being worked out and implemented in practice.

The project is designed to help women pay benefits and calculate them. This innovation significantly simplifies the mechanism for processing and calculating required payments.

Payment of benefits under the Direct Payments project

Direct payments provided for by the “pilot” project are already in effect today in many regions. This is convenient for applying for benefits and benefits. On deadline 30 weeks of pregnancy after receiving sick leave or 28 weeks during a multiple pregnancy, a woman submits an application for the need to go on maternity leave, after which the following actions are performed:

  1. The employer sends information with the submitted documents, as well as data on women who made this request to the social insurance fund within a period of no more than 5 working days after receiving the information.
  2. Upon receipt of data, the FSS processes it. To carry out this work, no more than 10 days.
  3. After a decision is made in favor of the pregnant woman, a benefit payment is assigned, which is made until 26 date of the calendar month following the request.
  4. Insurance premiums are withheld from the employer in favor of the Social Insurance Fund.

Operating principle of “Direct Payments”

On the merits of the “pilot” project

  1. Work on accrual and payment of funds carried out by fund employees, and this function is removed from the employer.
  2. Risk occurrence of erroneous accruals and refusals to pay benefits is decreasing.
  3. Benefit payments are guaranteed. Starting from the first half of 2016, benefit amounts range from 34 520 - 248 164 rubles This depends on the number of days indicated on the sick leave certificate. These funds are required to be paid, and the financial situation of the employer is not taken into account at the moment.

If a woman works for several employers at the same time, then she can apply for maternity leave to one of them. Next, the appeal will be submitted to the FSS.

For what period are payments due?

Sick leave for pregnancy and childbirth is paid for the period 140 calendar days, and individually this time is divided into:

  • 70 days before birth;
  • 70 days after birth.

But there are some clarifications, for example, if the pregnancy is multiple, then the number of days is 84 and 110. If the birth was complicated, then the paid postpartum period is 86 days.

The employer pays in full for the entire period of the woman’s incapacity for work. There are no separate divisions for payments for sick leave for the prenatal and postpartum periods.

Required documents

In order for maternity leave to be fully paid, the following documents must be prepared:

  1. . Issued in the hands of a woman from the clinic at her place of registration.
  2. A certificate confirming the amount of earnings, which is taken as the basis for calculating benefits, or a copy thereof. Issued at the request of a woman if she was employed elsewhere before pregnancy.

How is sick leave paid?

After receiving the sick leave certificate in hand, the woman goes to the employer. Payments are made within 10 calendar days, but not later than the specified period. Starting from the first day, expenses are borne by the Social Insurance Fund of the Russian Federation, while the direct employer does not spend funds for this type of payment, but the deadline for applying will be 6 months, starting from the date of completion of maternity leave.

In case of failure to register leave, payments will not be made. The paid benefit is calculated at 100%, and the length of service is not taken into account.

How benefits are calculated

The rules and procedure for calculating funds and paying out funds to the Social Insurance Fund are carried out in the same way as at the enterprise. In Russia, this payment is regulated by regulatory documents. The benefit amount is 100% of average monthly earnings for the last 2 years. An FSS specialist checks the calculations made at the enterprise, so the risk of errors will be significantly reduced.

The benefit is calculated as follows:

  1. The average earnings per day of work over the last 2 years are determined. The total earnings are divided by the total number of working days.
  2. To determine the amount of benefit calculation, the resulting number is multiplied by the summed number of days on maternity leave.

The data necessary to determine the amount of payments is transferred by the organization’s accounting department directly to the Social Insurance Fund, or a separate request is made to the Pension Fund.

Mandatory information will be:

  1. Information about monthly salary.
  2. Working days spent on sick leave and other needs, since deductions from this amount are not made to the Social Insurance Fund.

Calculation example

An example of cash calculation is as follows:

  • A woman goes on maternity leave with 08.2016 . She worked at the same company for two years. Information was sent to the Social Insurance Fund that the total amount of earnings for the last 2 year, namely for 2014 And 2015 amounts to 584,684.84 rubles.

Eg, It took 30 days for treatment, that is, the woman was on sick leave, while The total duration of maternity leave is 140 days.

  • If the years of work were not leap years, then the number of days worked is 730.
  • Next, the number of days is determined based on this number, and the benefit is calculated. For this case it is 730 - 30 = 700 days.
  • Average daily earnings are calculated as follows: 584 684,84 / 700 = 835,26 rubles per day of work.
  • A comparative analysis is carried out with the established minimum wage. For a period of 2016 year this amounted to 7 500 rubles The minimum benefit amount is 7500 x 24 months / 730 = 246,57 rubles But the amount 835,26 is greater than the minimum value, and therefore it is accepted for further calculations.
  • The maximum payout is 1 828 770 rubles, while the amount obtained by calculation is less than this value, that is, it is accepted for calculation.
  • In general, the benefit amount for a specific case will be 140 x 835.26 = 116,936.4 rubles

Online payment on the FSS website

A programmed calculation calculator is posted on the official website of the Social Insurance Fund. It is easy to calculate the amount of cash accruals for sick leave.

The algorithm of actions is as follows:

  1. Fill in the fields with the dates from the certificate of incapacity for work.
  2. Replace the accounting years if 2015-2016 years, the woman was on another maternity leave.
  3. Click on the tab that says "Calculation conditions" and enter the data into the windows there.
  4. Click the button "Calculate"- the calculation result will appear on the screen.

The results will be as close to the truth as possible, since FSS employees, when calculating the amount of benefits, use exactly the same data that you will enter into this calculator.

How to make an application

To apply to the fund for benefits, you need to write an application. There is a unified document form established by FSS Order No. 335 of September 17, 2002.

The document should reflect the following information:

  1. Full surname and initials, passport details, date of birth.
  2. Bank account where the cash benefit will be transferred.
  3. Data on citizenship, temporary registration and others.

Sample (blank form) application for benefits to the Social Insurance Fund:

You can send the document by mail or online, in person or with the help of your representative.

Attached to the application:

  • copy of the passport;
  • certificate of incapacity for work;
  • court decision on the need for payment;
  • certificate of salary for the last 2 years of work.

If an employer refuses to pay cash benefits

There are cases in practice when an employer, for some reason, cannot pay the required benefits to a woman. The reasons for this may be bankruptcy, lack of funds or liquidation of the organization. But, nevertheless, the expectant mother is not deprived of this right. This is why the Social Insurance Fund exists.

If a “pilot” project is not accepted in the region, the following must be done:

  1. A woman appeals to a judicial authority with a fact confirming the impossibility of paying benefits by her employer. An application must be attached to the main document. There is plenty of time to apply up to 6 months after the end of maternity leave.
  2. Wait for the result of a court decision in your favor.
  3. Prepare a package of documents, including a court decision, and contact the local fund authority.

Benefits are calculated based on salary over the past 2 years. Wage payments are confirmed by certificates from the former employer. If these documents are not provided from the place of work, then FSS employees independently contact the Pension Fund.

If there are no documents about the bankruptcy of the enterprise, you can still go to court. Requests for missing documents are made by bailiffs.

In accordance with the Federal Law of December 29, 2006 N 255-FZ "On compulsory social insurance in case of temporary disability and in connection with maternity" and the Federal Law of May 19, 1995 N 81-FZ "On state benefits for citizens with Children" The Social Insurance Fund of the Russian Federation (FSS RF) pays child benefits to persons subject to compulsory social insurance in case of temporary disability and in connection with maternity, at their place of work.

In 2018, unified rules for the indexation of social payments, benefits and compensations established by Federal Law dated December 19, 2016 N 444-FZ “On amendments to certain legislative acts of the Russian Federation regarding changes in the procedure for indexing payments, benefits and compensations established by the legislation of the Russian Federation” came into force. Federation, and suspension of Part 2 of Article 6 of the Federal Law “On additional measures of state support for families with children.”

In accordance with adopted legislative norms, the amount of child benefits assigned and paid in accordance with Federal Law of May 19, 1995 N 81-FZ “On State Benefits for Citizens with Children” is subject to indexation once a year from February 1 of the current year based on consumer price growth index for the previous year. The indexation coefficient is determined by the Government of the Russian Federation.

From February 1, 2019 child benefits are indexed based on the actual consumer price growth index for 2018. The indexation coefficient is established by Decree of the Government of the Russian Federation of January 24, 2019 N 32 “On approval of the indexation coefficient of payments, benefits and compensation in 2019” in the amount of 1.043. The amounts of child benefits from February 1, 2019 are given below:

List of child benefits paid by the Federal Social Insurance Fund of the Russian Federation

  • One-time benefit for women registered in medical institutions in the early stages of pregnancy

    Persons subject to compulsory social insurance are paid a monthly child benefit in the amount of 40% of average earnings, on which insurance contributions to the Federal Social Insurance Fund of the Russian Federation are calculated, but not less than:

    • 3277 rub. 45 kopecks for caring for the first child.
    • 6554 rub. 89 kopecks for caring for the second child and subsequent children.
  • Benefit for the adoption of a child under three months of age

    In the amount of average earnings on which insurance contributions are calculated to the Federal Social Insurance Fund of the Russian Federation, according to the same rules as for the payment of maternity benefits.

  • Payment of four additional days off per month to one of the working parents to care for disabled children

    In the amount of average earnings for each additional day off.

  • Temporary disability benefit for caring for a sick child

    When treating a child on an outpatient basis- for the first 10 calendar days in the amount determined depending on the length of the insurance period of the insured person, and for subsequent days in the amount of 50% of average earnings;

    When treating a child in an inpatient setting- in the amount determined depending on the duration of the insurance period of the insured person:

    • With 8 or more years of experience - 100% of average earnings.
    • With 5 to 8 years of experience - 80% of average earnings.
    • With up to 5 years of experience, 60% of average earnings.

The employer pays these benefits to the employee on the basis of a personal application with copies of the necessary documents attached in the manner established for the payment of wages (other payments and remunerations), and reimbursement of the amount of benefits to the employer from the Federal Social Insurance Fund of the Russian Federation is made in the prescribed manner after his written application to the territorial body for place of registration.

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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 pilot project “Direct Payments” 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 on 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, we began to understand 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 surname 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 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 they had not received benefits for two or three months. 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 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

The benefit assigned in connection with pregnancy and upcoming childbirth is included in the group of payments made through the employer by the Social Insurance Fund. In regions where the pilot project has been implemented, the Social Insurance Fund directly transfers funds to women on maternity leave. And in the constituent entities of the Russian Federation, where there is a scheme for paying social benefits by employers, reimbursement of the Social Insurance Fund for pregnancy and childbirth and for sick leave is practiced. Let's look at how this happens.

Refund Mechanism

According to the law, the return of maternity benefits from the Social Insurance Fund is based on the principle of offset. So, if the benefit is paid from the employer’s funds, then the amount of money spent is counted towards the repayment of insurance premiums accrued in the corresponding reporting period.

If there is a significant gap between the amount of the benefit and current contributions, an application for reimbursement is submitted for the difference between these indicators.

This application must be accompanied by a set of supporting documentation. The list of documents for reimbursement of maternity benefits from the Social Insurance Fund is approved by law.

The amount of the benefit in question is regulated by Art. 11 of Law No. 255-FZ. As a general rule, this should be 100% of the average earnings of a pregnant woman.

Benefit payment

The system of social guarantees for the population is enshrined in current Russian legislation. It is implemented through benefits and targeted financial assistance. Payment of funds from the FSS resources occurs:

1. Upon the occurrence of a certain insured event.

2. If there are documents confirming this fact (one of them is pregnancy and childbirth).

Law of July 16, 1999 No. 165-FZ<Об основах обязательного соцстраха˃ устанавливает обязательства работодателя по обеспечению своих наемных работников социальными выплатами. Он допускает проведение таких перечислений не только за счет средств Фонда социального страхования, но и из имеющихся у предприятия собственных ресурсов. Право работодателей на зачет выплаченных персоналу пособий в счет страховых взносов закреплено ст. 4.6 Закона от 29 декабря 2006 г. № 255-ФЗ <Об обязательном соцстрахе на случай временной нетрудоспособности и материнства˃ (далее – Закон № 255-ФЗ).

An excess of the benefit amount over the amount of calculated contributions is the basis for generating a request for compensation from the Social Insurance Fund.

Here's how to get reimbursement from the Social Insurance Fund for maternity benefits: you need to contact the branch of the Social Insurance Fund, which serves the employer at the place of its registration. The fund's specialists check the package of documentation presented to them and make a decision on whether there is a basis for reimbursement of maternity benefits (or other payments) to the Social Insurance Fund. If compensation is denied, the fund draws up a written response providing reasons in favor of its negative decision.

Documents to justify the amount of compensation

Employers who submit a written application to the Social Insurance Fund serving them can apply for compensation. A unified template for such an application form is presented in the FSS letter dated December 7, 2016 No. 02-09-11/04-03-27029:

It must contain the following information:

  • legal entities must indicate their name and address information; Individual entrepreneurs indicate passport details with full name. and registration address;
  • registration number that was assigned to the company or entrepreneur when registering with the Social Insurance Fund as an insurer;
  • the amount requested for reimbursement to the current account of a business entity.

Documents submitted to the Social Insurance Fund for reimbursement of maternity benefits are attached to this application. In 2018, this supporting documentation is included in the list, which was approved by order of the Ministry of Health and Social Development dated December 4, 2009 No. 951n.

Required applications include:

  • a calculation certificate that provides information on insurance premiums, including for a period equal to the last 3 months;
  • breakdown of costs for compulsory social insurance;
  • copies of documents justifying the expenses incurred and indicating the occurrence of an insured event.

Word formats of these forms can be found on the FSS website at the link below:

Deadlines

By law, the FSS has 10 calendar days to transfer the amount of compensation.

Within 3 working days, the fund’s specialists must send the employer who contacted them a notification form about a positive decision on his request for compensation. The countdown begins from the date of entry into force of the FSS verdict.

If compensation for benefits is denied, then no more than 3 working days should pass from the moment the negative decision is made to the day the notification is sent.

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