Interaction diagrams between the Employee (Insured Person), the Employer (Policy Holder) and the Fund before and after January 01, 2021 are presented in Figures 1 and 2.
The social benefits eligibility and payment procedure is as follows:
- When applying for a job or in the course of work, the Employee provides the Employer with the information required to receive benefits. The information form will be approved by the Social Insurance Fund. Information can be provided both in electronic form and on paper.
- When an insured event (illness, birth of a child) occurs, the Employee, whether personally or through their authorized representative, provides the documents (information) required to receive benefits to the Employer.
The list of documents required for eligibility and payment of benefits is determined by the federal laws "On Compulsory Social Insurance in case of Temporary Disability and Maternity" and "On State Benefits for Citizens with Children".
- The employer submits documents (information) to the regional branch of the Fund. Generally, the period for transferring documents (information) to the Fund is 5 calendar days after receipt of documents (information) from the Employee.
- The Fund verifies the documents (information) and makes a decision on eligibility and payment of benefits. Usually, the Fund considers documents and makes a decision on eligibility and payment of benefits within 10 calendar days after receipt of documents (information) from the Employer (Policy Holder).
- Benefits are paid either to the Employer (Policy Holder) or to the Employee (Insured Person), depending on the type of benefit, as shown in Figures 3 and 4.
- Benefits are paid to the Employee (Insured Person) in the manner specified in the Information (by postal order or cash transfer to the Employee’s bank account).
- Temporary disability benefits (sick pay) for the first 3 days of the temporary disability period are granted and paid by the policy holder at its own expense.
- The first payment of the childcare benefit is granted and paid at the same term and in the same manner as the temporary disability benefit; the subsequent payments are paid from the 1st to the 15th day of the month following the month for which the benefit is paid.
- Please note that the new rules shall also apply to the insured events for which the policy holder has not granted and paid benefits before January 1, 2021.
Eligibility and payment of specific types of insurance benefits in 2021 is governed by Decree N 2375 of the Government of the Russian Federation dated December 30, 2020.