These benefits include:
- Nursing
- Long-term care allowance
- Maternity cash assistance
- Paternal
- Pregnancy and maternity allowance
The aim of this change is to speed up and streamline processes, reduce the administrative burden on employers, employees and doctors and speed up the payment of benefits.
Obligations of employers in the electronicisation of benefits
On the employer's side, it is essential to set up company processes from the outset to effectively communicate information about these benefits to employees. Employers can take internal applications or sample applications provided by the Czech Social Security Administration and modify them to suit the company's needs. There is no mandatory format for the transmission of this information, but employers are required not only to prepare and electronically submit a new Employer Notification of Employee's Claim for Benefits form to the CSSA, but also to retain the supporting documentation for the employee's claim for benefits for 10 calendar years after the year to which the documentation relates.
Changes to the benefit application process
Advancement to the end of 2024
For example, until the end of 2024, an employee would receive a printed form from his or her doctor confirming the date of treatment. The employee, on the other hand, filled in the necessary information and handed it over to the employer. The employer then completed the attachment with the required information and sent the form to the CSSA.
New process from 1 January 2025
From January 2025, the procedure will be completely different:- the attending physician enters the need for treatment electronically into the system and simply sends the event identifier to the employee's mobile phone via SMS or email.
- the message to the employee contains only the identifier (i.e. decision/certificate number), the type of claim (e.g. nursing care) and the first name and year of birth of the person to whom the claim relates (e.g. the name of the child being treated). From the 18-digit identifier, it is possible to determine at a glance the type of the insured event, according to the last character of the identifier (M - maternity allowance, L - long-term nursing allowance, T - paternity allowance, N - nursing allowance, Z - nursing allowance due to the closure of a school facility). The report also contains a link to the ČSSZ ePortal, where the insured person can view the complete decision with all the necessary data after logging in.
- The employee shall give the identifier, together with other details of the sickness insurance benefit, to his employer in writing.
If the employee deletes the SMS or email with the identifier and has no possibility to log in to the CSSA portal (via electronic ID card, NIA, data box or bank identity), he/she can contact his/her doctor to have the identifier communicated to him/her again. The procedure is therefore similar to that followed in previous years in the event of loss of the paper decision on the need for treatment form.
Data retention
After logging in to the ePortal of the ČSSZ, the employee can see the insurance claims of the current year and the next 5 years back. However, the system works in such a way that the insurance claim is only displayed to the person to whom it is linked. So in case of treatment, it is not seen by the person providing the treatment, but by the person being treated. The employer can find out information about the insurance claim via the CSSA ePortal. The input data are the decision number of the case (identifier) and the identification of the person indicated on the submission (ID number/EIN or surname + date of birth). Unlike sickness benefits, information on other insurance benefits is not provided to the employer automatically via the DZNP service. It is always necessary to enter the input data first and only then can the box requesting automatic sending of information on the given submission be ticked. However, this only works within a specific insurance claim.
Obligations of employers
The employer is obliged to send a new form Employer's Notification of Employee's Claim for Benefit (NEMPRI_2025) to the CSSA after the expiry of the sub-assistance period of the insurance event in electronic form only. After selecting a specific benefit, the information to be filled in will be displayed. Some of the information is available to the employer, others must be communicated to the employer in a verifiable form by the employee (not verbally!). For sickness benefits, you can still use the original form Annex to the claim for benefits (NEMPRI_2020). For all other types of benefits, the new form must be used from 1 January 2025.
An employee who has an attending physician abroad will not receive any identifier at the time of the insured event. The documents available from the doctor are then forwarded in paper form to the employer. The latter shall convert them into electronic form and attach them as an annex to the Employer's Notification. On this form, he will tick the box 'foreign (without decision number)', in which case he will be allowed to submit the claim without the completed identifier.
It is therefore recommended to inform employees about the new way of operating sickness insurance benefits and to set up internal systems and information circulation so that the new claim for benefits can be processed automatically and the information provided by the employee can be proven in the event of an inspection.
Autor: Jana Heranová