The procedure and sample for filling out a sick leave according to a pilot project of the FSS. FSS pilot project: direct payments from the fund In which regions does the FSS pay benefits directly

Which regions are participating in the pilot project in 2017? Who is not involved in the pilot? What types of insurance coverage are available under the pilot project? How do the employee, organization and territorial body of the FSS interact? What are the features of filling out the calculation in the 4-FSS form within the framework of the pilot project?

Despite the fact that the functions of administering insurance contributions, including those for compulsory social insurance in case of temporary disability and in connection with maternity, have been transferred to the tax authorities, the territorial bodies of the FSS are responsible for reimbursing the costs of compulsory social insurance. In the article, we recall which regions are participating in the pilot project in 2017, and also talk about the interaction of organizations with the territorial bodies of the FSS in the event of an insured event. In addition, we will outline the features of filling out the calculation in the 4-FSS form within the framework of the pilot project.

At the beginning, we recall that at present, by the Decree of the Government of the Russian Federation of April 21, 2011 No. 294 (hereinafter - Resolution No. 294), it is established:

Regulation on the specifics of the appointment and payment in 2012 - 2019 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;

Regulations on the specifics of the appointment and payment of temporary disability benefits to insured persons in 2012 - 2019 in connection with an industrial accident or occupational disease, as well as payment for the insured person's vacation (in excess of the annual paid vacation established by the legislation of the Russian Federation) for the entire period of treatment and travel to the place of treatment and back in the constituent entities of the Russian Federation participating in the implementation of the pilot project;

Regulations on the specifics of reimbursing the insured's expenses in 2012 - 2019 for preventive measures to reduce occupational injuries and occupational diseases of employees in the constituent entities of the Russian Federation participating in the pilot project;

Regulations on the specifics of paying insurance premiums in 2012 - 2019 in the FSS in the constituent entities of the Russian Federation participating in the implementation of the pilot project.

Which regions are participating in the pilot project in 2017?

In accordance with clause 2 of Resolution No. 294, the following are involved in the implementation of the pilot project:

Who is not involved in the pilot?

So, the participants of the pilot project are not recognized:

separate subdivisions located in the region participating in the implementation of the pilot project, which do not carry out independent settlements with the FSS, subordinate to the head institution registered in the region where traditional payments of benefits are applied. Insurance premiums for them are paid by the head office at the place of registration in the region of traditional settlements for the payment of benefits;

head offices located in regions of traditional settlements for the payment of benefits, whose separate divisions independently pay in the regions participating in the implementation of the pilot project;

persons who voluntarily entered into a legal relationship on compulsory social insurance in case of temporary disability and in connection with motherhood.

Types of insurance coverage under the pilot project.

Note that the peculiarity of participation in the implementation of the pilot project is that the territorial bodies of the Social Insurance Fund calculate and pay benefits for compulsory social insurance in case of temporary disability and in connection with maternity directly to working citizens (at a bank or by mail). These benefits include:

temporary disability benefit, including in connection with an industrial accident and occupational disease;

maternity allowance;

one-time allowance for women registered with medical institutions in the early stages of pregnancy;

a lump sum for the birth of a child;

vacation payment (in excess of the annual paid vacation established by the legislation of the Russian Federation) for the entire period of vacation and travel to the place of treatment and back to persons who have suffered as a result of an industrial accident or occupational disease.

The territorial body of the FSS within the framework of the pilot project reimburses the employer-insured only the expenses made by him:

to pay for four additional days off to care for children with disabilities;

to pay social benefits for burial;

to take preventive measures to reduce occupational injuries and occupational diseases of workers.

Interaction between the employee, the organization and the territorial body of the FSS.

Employee. The insured person must contact his employer in the event of an insured event. It represents:

Note:

The list of documents required for the appointment and payment of benefits is determined in accordance with federal laws No. 255-FZ and 81-FZ.

Here is a list of documents that the employee must submit to the employer.

Note:

An employee - an insured person directly applies to the territorial body of the FSS in case of termination by the insured (employer) of activities, including if it is impossible to establish his actual location on the day the insured applies for benefits. At the same time, he must also submit an application and documents necessary for the appointment and payment of the appropriate allowance.

Employer. The insured is obliged, within five calendar days from the date of the employee's submission of the application and documents, to transfer to the territorial body of the FSS at the place of registration the application and documents received by him, necessary for the appointment and payment of the relevant types of benefits, as well as the list of the submitted applications and documents in the form approved by the Order FSS RF No. 335.

Note:

Similar terms are established in case of submission by the insured person of an application for recalculation and a certificate (certificates) on the amount of earnings.

In addition, the insured must, within three days, send a notice to the territorial body of the FSS about the termination of the right of the insured person to receive a monthly childcare allowance in the event of:

termination of labor relations with him;

starting (resuming) its work on a full-time basis;

the death of his child;

termination of the circumstances, the presence of which became the basis for the appointment and payment of the corresponding benefit.

Also, the employer needs to remember the following. Policyholders whose average number of individuals, in whose favor payments and other remunerations are made, for the previous settlement period exceeds 25 people, as well as newly created (including during reorganization) organizations, in which this number exceeds the named limit, submit information, required for the appointment and payment of the appropriate allowance, in electronic form in the formats established by the FSS. Forms of information registers and the procedure for filling them out are also approved by the FSS. In the same form, information can be transmitted by organizations whose average number of individuals is less than 25 people.

Territorial body of the FSS. After receiving the application and the documents necessary for the appointment and payment of the appropriate allowance, or the register of information, the territorial body of the FSS within 10 calendar days from the date of their receipt decides on the appointment and payment of the allowance. The payment of benefits to the insured person is carried out by the territorial body of the FSS by transferring the benefits to the bank account of the insured person specified in the application or the register of information, or through the federal postal service, another organization at the request of the insured person (his authorized representative) within 10 calendar days from the date of receipt statements and documents or information that are necessary for the appointment and payment of the appropriate allowance.

Note:

The initial payment of the monthly childcare allowance is made in a similar manner. Subsequent payment of benefits to the insured person is made by the territorial body of the FSS from the 1st to the 15th day of the month following the month for which the benefit is paid.

In addition, if the insured did not submit all the documents to the territorial body of the FSS, the fund employees within five working days from the date of their receipt send (hand) him a notice of the need to send the missing documents or information. The form of such a notification is also established by Order of the FSS of the Russian Federation No. 335. Further, the insured (employer) must submit the missing documents or information to the fund within five working days from the date of receipt of the notification, if it is sent by registered mail. In this case, the notification is considered received after six working days from the date of sending the registered letter. The policyholder shall electronically confirm receipt of the notification within one working day from the date of receipt. In the absence of confirmation of receipt of the notification, the territorial body of the FSS, three working days from the date of expiry of the period established for confirmation of receipt, sends such a notification to the policyholder by registered mail.

Features of filling out the calculation in the form 4-FSS in the framework of the pilot project.

It is known that starting from the 1st quarter of 2017, a new form of calculation has been applied for the calculated and paid insurance premiums for compulsory social insurance against industrial accidents and occupational diseases, as well as for the costs of paying insurance coverage (Form 4-FSS). This form was approved by Order of the FSS of the Russian Federation of September 26, 2016 No. 381. This is due to the fact that the administration of insurance contributions for compulsory social insurance in case of temporary disability and in connection with maternity has been transferred to the tax authority.

On April 28, 2017, Order of the FSS of the Russian Federation No. 114 came into force, which approved the Features of filling out the calculation in the 4-FSS form by insurers registered with the territorial bodies of the FSS located on the territory of the subjects of the Russian Federation participating in the implementation of the pilot project (hereinafter - Features No. 114).

According to clause 2 of Feature No. 114, policyholders who are already participating in the implementation of the pilot project:

do not fill in line 15 "Expenses for compulsory social insurance" in table 2 "Calculations for compulsory social insurance against industrial accidents and occupational diseases";

do not fill in and do not submit table 3 “Expenditures on compulsory social insurance against industrial accidents and occupational diseases”.

Note:

Clause 2 of Features No. 114 must be applied when filling out the calculation in the 4-FSS form starting from the 1st quarter of 2017.

According to clause 3 of Features No. 114, the policyholders who will join the implementation of the pilot project from 01.07.2017:

do not fill in line 15 "Expenses for compulsory social insurance" in column 1 "For the last three months of the reporting period", in the lines "1 month", "2 months", "3 months" in table 2;

in table 3 "Expenditures on compulsory social insurance against industrial accidents and occupational diseases" reflect data on expenses incurred by the policyholders at the expense of compulsory social insurance against industrial accidents and occupational diseases, as of July 1 of the year of accession of the RF subject to pilot project. Starting from the first quarter of the year following the year of the accession of the constituent entity of the Russian Federation to the pilot project, in the submitted calculation of insurance premiums, this table is not filled in and is not presented;

show the amount of expenses for the purposes of compulsory social insurance against industrial accidents and occupational diseases incurred by the insured in the current billing period, not accepted for offset by the territorial body of the fund as of July 1 of the year of the accession of the constituent entity of the Russian Federation to the pilot project, by reducing the indicators of expenses previously reflected by them on line 15 "Expenses for compulsory social insurance" in column 1 "At the beginning of the reporting period" and column 3 "Amount" of table 2 "Calculations for compulsory social insurance against industrial accidents and occupational diseases", as well as on the corresponding lines in the table 3 “Expenditures on compulsory social insurance against industrial accidents and occupational diseases”.

Note:

The provisions of clause 3 of Features No. 114 must be applied when filling out the calculation in the 4-FSS form, starting from the calculation for nine months of the year of joining the subject of the Russian Federation to the pilot project.

In conclusion, we note once again that the peculiarity of the implementation of the pilot project is that the insured person receives benefits directly from the territorial body of the FSS, but the application and documents necessary for the appointment and payment of benefits are submitted to the employer at the place of work (service). The organization, in turn, needs to remember about the peculiarities of filling out the calculation in the 4-FSS form as part of the pilot project.

Order of the FSS of the Russian Federation of 17.09.2012 No. 335 "On approval of the forms of documents used for the payment of insurance coverage and other payments in 2012 and 2013 in the constituent entities of the Russian Federation participating in the implementation of a pilot project providing for the appointment and payment of insurance coverage to insured persons for compulsory social insurance in case of temporary disability and in connection with maternity and compulsory social insurance against accidents at work and occupational diseases, other payments and expenses by territorial bodies of the Social Insurance Fund of the Russian Federation.

Federal Law of December 29, 2006 No. 255-FZ "On compulsory social insurance in case of temporary disability and in connection with motherhood."

Federal Law No. 81-FZ of 19.05.1995 “On State Benefits to Citizens with Children”.

Order of the FSS RF of 28.03.2017 No. 114 "On approval of the specifics of filling in by insurers registered with the territorial bodies of the Social Insurance Fund of the Russian Federation located on the territory of the constituent entities of the Russian Federation participating in the implementation of the pilot project, the calculation of the accrued and paid insurance premiums from industrial accidents and occupational diseases, as well as expenses for the payment of insurance coverage (Form 4-FSS), the form of which was approved by Order of the Social Insurance Fund of the Russian Federation No. 381 dated September 26, 2016 ".

The introduction of any innovation is associated with significant risk. In case of failure, not only will you not be able to make money, but you will also have to say goodbye to all investments. The situation is even worse if the funds were borrowed. A pilot project is a way to assess risks and prospects before the immediate start of change. If this preliminary study proves that it is worthwhile to waste money and time, then large-scale change begins.

Method usage

A pilot project is a good start to any large-scale study with a large sample. Its implementation is necessary to save time and money. If the pilot project of the program turned out to be unsuccessful, then there is no point in starting large-scale changes at the enterprise, in the industry or the whole country. Pre-testing like this is a real way to avoid wasting money that is better off elsewhere. In order for the situation to be reflected objectively, the participants in the pilot project must be representatives of the relevant social groups and recruit other people for further research, since their involvement can influence their behavior in the second case.

A pilot experiment is often used to test analytical methods in a larger study. It can also be directly a way to find out the reaction of a potential consumer to a product or service. The results of this mini-study are used to refine the data processing system or the product itself.

Application in production

A pilot project is a preliminary study that originally had purely engineering applications. After development, part of it was sold in order to prove that its release was a worthwhile investment of funds. In some cases, a larger experiment was carried out further, but often the success of the preliminary design was enough to start production. Why spend extra money if the results of this method of assessment are completely objective? Pilot projects are increasingly being used to test the convenience and rationality of the provision of certain social services.

"School card"

In 2014, in educational institutions in one of the districts of Tatarstan, a project was launched to use electronic passes. The card is given to every student. It contains all the information about the student, as well as money for the dining room. As soon as the child enters or leaves the building, a message is sent to the parents' phone. Some students are outraged by such excessive control over their pastime, but teachers are convinced that this will not only help improve academic performance, but also have a general positive effect on Parents are also notified when children eat in the cafeteria. The authorities have allocated 15 million rubles for the implementation of the system; similar electronic access systems will soon be introduced in circles

FSS pilot project

From July 1, 2015 in Tatarstan it is also planned to start implementing a project for the payment of benefits through the regional branches of the Social Insurance Fund. According to the manager R. Gayzatullin, from this date the money will go not through employers, but directly from the state to the personal accounts of individuals in banks. Those working citizens who do not have them will receive the funds due to them by postal order. The benefit payment scheme itself will also change. Before that, the credit principle was in effect, now the money for insurance must be transferred in full. Such a system should be beneficial to the employer, as it saves money. In addition, it significantly reduces the possibility of fraudulent insurance payments. Today the project is already being implemented in ten regions of the Russian Federation.

Experimental drugs

In May 2015, Johnson & Johnson, through its representatives, announced that it had decided to create a committee to prescribe drugs that have not yet ended testing for terminally ill people. We are talking about those drugs that have not yet been approved and have not been launched into mass production. It should be noted that in the eighties, it was experimental drugs that saved the lives of millions of patients during a large-scale AIDS epidemic. In the United States, for example, ZMapp, which has not yet been tested, was approved, but the manufacturer soon announced that it was out. This case illustrates two main problems: fears of unsafe new drugs and their shortages after approval of trials. Jonson & Jonson representatives will independently choose who to provide the experimental drug. The committee will include not only doctors, but also lawyers and bioethics experts.

Meanwhile, a pilot project on hypertension has been suspended in Ukraine due to insufficient funding. Previously, it was assumed that the state will provide people with high blood pressure with the simplest medicines. In many cities, pharmacies have not appeared where they can be purchased.

Application in other fields

In social sciences, particularly in sociology, a pilot project is a small study that is needed to adjust some technical parameters. After it, a complete study is usually carried out.

Despite the fact that pilot experiments have been used for quite some time, their usefulness as part of a strategy remains in question. The prospects for the development of this research method are associated with the use of resources of average quality and rejection of the most favorable conditions for their implementation. In this case, we can talk about the objectivity of its results, which will help to correctly distribute free monetary resources.

If you keep records of organizations that are registered in the regions participating in the pilot project, then to enable the mode of its support, you must specify the date of joining the project. Documents on the appointment of benefits, which will be registered after this date, will be supplemented with a tab for filling out the data necessary for the formation of printed forms in accordance with the orders of the FSS. In order to indicate the date of joining the project, you must open the form for setting accounting parameters and in the section "State benefits" indicate the date in the field "Payment of benefits transferred to the FSS from".

Let us consider in more detail what exactly will change in the documents on the appointment of benefits.

Document "Accrual for sick leave".

1. Formation of an application, benefits for temporary disability.

Now the allowance that is accrued at the expense of the Social Insurance Fund will not be calculated in the document, instead, lines with the calculation type "sick leave payment" will appear, where the amount of accruals will be zero. These lines should be left in the document and cannot be deleted. You should also not indicate the result of the calculation in this line, otherwise the program will generate an error "The policyholders participating in the pilot FSS project do not receive benefits!" and will not post the document.

An additional tab "Application and information for the Registry" will appear in the document, in which you will have to fill in all the necessary data, this is necessary to form an application, inventory and register. from the same form you can print the application.

Let's take a closer look at filling out the "Application and information for the Registry" tab. This tab contains, in turn, 3 more sub-tabs "Application", "Data of the certificate of incapacity for work", "Data of the certificate of incapacity for work (continued)".

In the first tab "Application" you must specify the data for the application for payment of benefits in the form of Appendix No. 1 to the Order FSS dated September 17, 2012 No. 335.

• Fill in the name of the employee
• Enter the passport details of the employee. If the employee is a foreign citizen, then it is necessary to indicate the type of document confirming his permanent or temporary residence. and also fill in the details of this document.
• Indicate the registration address (registration address) and the telephone number of the individual.
• Next, you need to choose the method of transferring the benefits, at the request of the employee, this is either a transfer to a bank account, in this case, you must indicate the bank and the account number to which you want to transfer funds; or the allowance is paid by postal order, in this case it is necessary to indicate the exact address and the KLADR code (filled in automatically). If the program already has documents entered for this employee as part of a pilot project, then the details of the current document can be filled in automatically based on the previous data; if there were no such documents, then the information for automatic filling is taken from the data entered into the program.
• The official salary is filled in, it should also be filled in automatically based on the data of your base.
• If necessary, for the period of downtime, the average daily earnings are filled in manually;
• The authorized person and his position, these details are filled in automatically if you have completed the information register of the responsible persons of the organization.

If any data in the program has changed, then in order to see these changes in the document, click on the "Update" button.

After all the fields are filled in, the document is written down and posted, you can print the application by clicking on the "Application - Filled Form" button. It is also possible to print an empty form by clicking on the button "Application - Blank form"

After checking and completing all these fields, as well as posting the document, you can print the completed application using the "Application - Filled Form" button (2011 or 2012). If you need to fill out an application manually using a pen, you can print an empty form by clicking the "Application - Blank Form" button.

2. Formation of an application, maternity allowance.

Let's consider some differences in the option of filling out the document when calculating maternity benefits. Unlike temporary disability benefits, here you can calculate the average earnings according to the 2010 rules. To do this, in the document "Accrual for sick leave", you must tick the "Calculate earnings according to the rules of 2010".

In the case of registration of maternity benefits, additional fields appear on the "Application" tab: "Maternity benefit is calculated from the salary (tariff rate)" - is set if the calculation is made according to the 2010 rules, indicating the official salary; and "Registered in the early stages of pregnancy, date of the certificate" - established if there is a certificate of such a statement.

After filling in all the data, you can also print the application.

Formation of the list of applications and the register.

In the document "Accrual for sick leave" there are two more tabs for filling out information for the Registry, these are "Data of the sick leave" and "Data of the sick leave (continued)";

In these sections, data from the certificate of incapacity for work is entered, they will also fall into the printed form of the register and the generated register file for sending to the FSS. You can leave these fields blank, but when forming the register itself, you will need to fill them in. The program also provides the ability to enter data on the certificate of incapacity for work using a barcode scanner. You can read more about this procedure in the article.

Further, in order to form a register for transfer to the FSS in 1C, you need to go to the "Payroll" tab and select the "Registers (FSS pilot project)" item, a document journal will open, create a new document in it and fill it out. You can read more about filling out the register on the page

Since 2011, a phased reform of the social insurance system has been carried out in Russia. As part of this large-scale project, the credit system is being replaced by a system of direct payments of benefits from the Social Insurance Fund. The introduction of a new payment order is taking place in a test mode, called the "FSS pilot project". What changes the project brings to its participants, and in which regions it operates today - this is our article.

FSS - pilot project: direct payments instead of offsets

The system of credits, when an employer pays benefits to his employees in payment of social insurance contributions, no longer meets modern realities. With this approach, in case of bankruptcy of the employer or his refusal to pay the benefits prescribed by law, the employee is forced to seek justice through the courts. Also, there are frequent cases of inappropriate use of funds by policyholders. An alternative to the outdated system is the assignment and payment of benefits to the insured person directly from the FSS.

A pilot project with direct payments makes it possible to correctly calculate benefits to insured persons, makes it possible to monitor sick leave certificates and reduce the number of cases of fraud with them. In the course of the FSS reforms, from July 1, 2017, along with paper sick leave certificates, electronic sick leave certificates will start to operate everywhere, which should completely eliminate the problem of counterfeit sick leave certificates.

Where there is a pilot project, the employer, as usual, pays at his own expense for the first 3 days of the employee's illness, and the rest of the benefit to the employee is calculated and directly transferred by the Fund. In this case, monthly social insurance contributions are paid in full, since the employer has nothing to reimburse from the Social Insurance Fund.

What benefits the FSS pays directly to insured persons:

• for temporary disability, except for the first 3 days of illness,
• for temporary disability due to injury at work,
• one-time allowance for those registered in the early stages of pregnancy,
• for child care,
• payment of leave for the period of treatment and travel to the place of treatment for the victim of an industrial injury.

FSS 2017 pilot project: actions of the employee and employer

Employees, as before, draw up a sick leave, provide it to the employer, and other documents confirming the right to benefits are submitted to him (birth certificate of a child, certificates from the place of work of the other parent, etc.). At the same time, in addition, the employee writes an application indicating his details for transferring money (this can be a bank account, or details for a postal order), and the employer indicates all the information necessary for calculating the benefit: about average earnings, billing period, etc.

The employer's obligation is to submit the application and supporting documents to the FSS within 5 days. The law gives another 10 days for the Fund to make a decision and transfer payments to the employee. Thus, the employee will receive his allowance in 2 stages: for the first 3 days of illness - from the employer along with the salary, for the remaining days - from the FSS to his bank account or by postal transfer.

FSS pilot project in 2017

Today, in the pilot project of the FSS, according to the decree of the Government of the Russian Federation of 21.04.2011 No. 294, 20 regions of Russia participate. The first to enter the project were the Nizhny Novgorod region and Karachay-Cherkessia, they have been working with the FSS in a new way since January 2012, and six months later, the Khabarovsk Territory and the Astrakhan, Kurgan, Novgorod, Novosibirsk, Tambov regions joined them.

In 2015, the regions of Crimea and Sevastopol, Tatarstan, Samara, Belgorod and Rostov regions were added to the pilot project of the FSS, and in 2016 - the Bryansk, Kaluga, Kaliningrad, Lipetsk, Ulyanovsk regions and the Republic of Mordovia.

From July 1, 2017, the republics of Adygea, Altai, Buryatia, Kalmykia, Altai and Primorsky Territories, as well as a number of regions - Amur, Vologda, Omsk, Oryol, Magadan, Tomsk and Jewish Autonomous Region will join the experiment. Thus, the number of regions of the pilot FSS project in 2017 will increase by another 13 and the total number of entities that have switched to direct payments will be 33.

Employers located in the regions joined to the pilot project will not need to accrue and pay benefits to employees from that date, except for the payment of the first 3 days of illness.

It is planned that all regions will finally switch to direct payments from the FSS until January 1, 2021 (clause 3, article 5 of the law of 03.07.2016 No. 243-FZ). During 2018-2020. all other subjects will join the project, the last of which will be the cities of Moscow and St. Petersburg, Moscow, Leningrad, Tyumen and Sverdlovsk regions.

The FSS pilot project for filling out sick leave is aimed at changing the system of benefits that are paid in connection with the onset of temporary disability. The main idea of \u200b\u200bthe pilot "Direct payments" is that benefits are assigned and paid to insured persons directly by the Social Insurance Fund, as a result, the employer is relieved of this function.

The reform of the social insurance system began in mid-2011. The FSS took the initiative to change the credit system to a system of direct payment of benefits. It was supported by the relevant ministry and the Russian Government. In 2012, the new system began to be tested in the Nizhny Novgorod Region and the Karachay-Cherkess Republic. Until the end of 2020, the list of pilot regions was gradually expanding.

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The transition to a new system is a large-scale project associated with the need to develop new methods for receiving and processing information, training personnel, and creating a stock of finance, which will be enough to ensure uninterrupted payments. Carrying out a pilot on the territory of test regions guarantees minimization of risks and negative consequences.

What is it and what regions are involved in it

Until July 2011, insured workers received benefits from their employers, which subsequently reduced the amount of insurance premiums paid to the Social Insurance Fund by the amount paid.

The new approach was approved by government decree No. 294 of April 21, 2011. It consisted in the following: if an insured event occurs, the employee submits an application and a package of documents to the employer, who must submit them to the Social Insurance Fund within 5 days.

After consideration of the application by the representative of the Fund, a decision is made, as a result of which the funds are paid to the employee. They are transferred to his personal bank account or an appropriate postal order is sent to his name, within 10 calendar days. It should be noted that the employer still has to pay for the first three days of illness, while the next days are paid by the Fund from its own budget.

Foundation pilot testing was carried out until the end of 2020 in the following territories:

All insurers from these regions were required to participate in a pilot project initiated by the Social Insurance Fund, the right to choose each of them was not legally provided.

Why is it needed

Due to the fact that the social insurance system began to work in the conditions of a mobilization economy, the currently used crediting principle does not correspond to economic peculiarities and realities.

In the event that the company is declared bankrupt, there may be a violation of the principles of insurance in general and the rights of the insured person in particular. In such a situation, the payment of benefits, which are guaranteed by the state, will have to be sought in court.

An insured employee finds himself in a similar situation if the employer refuses to pay benefits for temporary disability, maternity or childcare.

The modernized system will help to strengthen the FSS control over the examination of temporary disability. Annually, within the framework of the insurance system, the Fund pays for over 30 million disability certificates, which amounts to about 400 million per day. The average amount of payments per one sheet is about 5.5 thousand rubles.

The size of the benefit, which is increasing, is the reason for the direction of finance not for their intended purpose, that is, for the emergence of fraudulent schemes in the insurance industry. Such inappropriate payments leave an imprint on the budget of the Social Insurance Fund and upset its balance.

Thus, the modification of the social insurance system will block the path for insurance fraud and reduce the risk of non-payment of benefits to insured persons to zero if the company is at the stage of bankruptcy or liquidation and its accounts are arrested.

Features of payment of benefits

Innovations in the field of payments of benefits, to which a person is entitled in connection with temporary disability, enable the representatives of the FSS to check the legality of calculating the payment and the correctness of its calculation even before it was made. This is an effective tool aimed at combating fraudsters who are engaged in forging certificates of incapacity for work. The Direct Payments project will enable the FSS to optimize costs by eliminating all payments that are inappropriate.

The Foundation does not undertake the function of preserving documents. It is assumed that after a decision has been made about the appointment and payment of benefits, the papers provided for checking the case of the insured person are returned to the employer or the insured person herself if she personally applies to the FSS.

In order to reduce the time for inspecting insured events, as well as save time for medical workers and employers who fill out certificates of incapacity for work, a complete transition to the electronic sick leave system is planned. It will also help to avoid delays associated with incorrect form design and significantly reduce the incidence of insurance fraud.

The project, which is being implemented by the FSS, has a number of bonuses for policyholders. For example, the calculation of the sums insured is carried out by employees of the Fund's territorial offices. The policyholder, whose staff is up to 25 employees, can provide data on the average earnings, seniority of the person, etc. enter into the sick leave form or provide information by entering them into the electronic register of the pilot project.

If there are more than 25 employees in the staff, the employer has no choice, and he must enter the data into the electronic register. You can find an example of filling out such a register in the Order of Social Insurance No. 223 dated June 15, 2012.

It is planned that this obligation will be removed from the insured, and the Fund will receive the information necessary for the calculations from the personalized accounting system of the Pension Fund of Russia.

The introduction of the new system allows insured citizens to get rid of dependence, which may appear when it is necessary to interact with the employer. In case of any problems, the employee has the right to independently apply to the FSS department at the place of registration of the insured with a certain package of documents and an application for payment of his sick leave.

What documents are used by the participants

In the event of an insured event, the employee must apply to the employer with an application for the payment of the benefits due to him.

Together with the application, he must submit a certain package of documents, depending on what is the basis for payment:

• when it comes to temporary disability benefits or maternity benefits, a certificate of incapacity for work should be provided;
• to receive a one-time payment to a woman who registered with a medical institution at an early stage of pregnancy - a corresponding certificate issued by a medical structure;
• the monthly childcare allowance can be obtained by providing a certificate of the birth of a baby and its copy or an extract from the decision to take custody of the child, as well as providing a certificate that the mother and father of the baby do not receive such allowance at their place of work, study or at the place of residence in the bodies of social protection of the population;
• to receive payment for the funeral, you will need a certificate of death, an invoice for funeral services, and a receipt for payment of such services.

FSS Order No. 195 approved the following forms of documents:

• application for the payment of benefits;
• application for compensation for expenses incurred for payment of temporary disability;
• a list of papers that are needed to calculate benefits;
• notification about the provision of documents or data that are missing;
• decision to refuse benefits;
• application for reimbursement of expenses for payment of 4 additional days off, to which one of the parents / guardians caring for a disabled child is entitled;
• application for reimbursement of expenses incurred for the funeral;
• a statement about compensation for the cost of certain services, which are guaranteed by the state, in connection with the burial;
• refusal to consider the submitted papers;
• calculation of the amount to pay for vacation for the period of treatment.

When the register is submitted to the FSS in electronic form, the forms approved by Order of the Fund No. 223 are used, among them:

• the form and procedure for filling out the Register of data that are necessary for the appointment and payment of temporary disability benefits to a woman in connection with pregnancy and childbirth or when registering with a medical institution at an early stage of pregnancy;
• the form and procedure for filling out the Data Register when assigning a birth allowance, which is paid only once;
• the form and procedure for filling out the Data Register, if it comes to the appointment of a monthly payment for caring for a baby.

Rules and sample for filling out a sick leave for a pilot FSS project

For those regions that take part in the FSS pilot, the sick leave pattern is somewhat different from the usual one. In the course of filling, you need to be guided by the order of the Ministry of Health and Social Development No. 624n, which was adopted in June 2011. It is this normative act that approved the Filling Procedure.

The basic rules to take note of are as follows:

• A ballpoint pen cannot be used when filling out the form.
• If an inaccuracy is made, you can make a correction by crossing out the incorrectly entered information, the correct one is recorded on the back of the form.
• If, when filling out the hospital, the employer made a mistake that affects the amount of the benefit, he must make the necessary corrections to the form and notify the FSS about this fact. In case of overpayment for sick leave, the difference must be compensated to the Fund by the policyholder.

Pilot participants should not enter data in the following fields of the form:

• “At the expense of the Social Insurance Fund”;
• "Accrued in total."

These columns must be filled in by a representative of the Fund, since, according to the legislation, it is this structure that is responsible for calculating the amount of the benefit.

Formation of the register

In 2020, the Specification, which was approved on July 13, 2020, is valid for the exchange of data on sick leave certificates with the FSS in electronic format.

It contains:

• two algorithms by which a register of certificates of incapacity for work can be created;
• link to the program, which is posted on the Foundation's website;
• the address to which the register should be sent.

Sick leave is added to the Foundation's program according to an obvious algorithm, so there are no difficulties in using it. However, social insurance does not exclude the possibility of using other software tools when forming the register, the only condition is that they meet the requirements of the Specification.

The register must be completed and sent to the Fund within 5 days, starting from the moment when the employer received a sick leave from the employee. In order to avoid disagreements with the Fund, it is necessary to meet this deadline even if an error crept into the certificate of incapacity for work, which was made by medical workers when filling out, and the employee does not have the opportunity to quickly obtain a duplicate.

According to the legislation, in case of disruption of the terms for sending data to the FSS, as well as for hiding information or their inaccuracy, the organization should be held liable. Its manager or other official responsible for maintaining sick leave will be fined of an administrative nature in the amount of 300-500 rubles.

Also, if, through the fault of the company, the Fund paid an allowance in a larger amount than it should be, social insurance has the right to collect the amount of the allowed overpayment from the organization. Arbitration practice confirms this fact (determination of the Supreme Arbitration Court No. 303-ES16-3905 dated October 26, 2020).

If the Social Security Fund refuses payments

When preparing documents for calculating benefits to an employee by the Social Insurance Fund, it should be borne in mind that an inaccuracy or mistake made in the papers may lead to the fact that the payment will be considered overpaid. If the documents do not go to the Fund at all, the employee should not hope that the benefit will be credited to him at all.

In the event that the amount of the payment exceeds the amount that should have been paid in reality, the employer must be ready to compensate the Fund for losses incurred in connection with the overpayment from its own budget.

How to display in 1C

The FSS pilot project for filling out sick leave in certain regions of Russia suggests some features that will be noted by its participants during the course of 1C:

• The document no longer presupposes the calculation of benefits accrued by the Social Insurance Fund. Instead, the lines "sick leave payment" were introduced, in which the amount of charges will be equal to zero. You cannot delete these dates. If you specify the result of the calculation, the program will show that an error has been made and the document will not be posted.
• Additionally, a tab "Applications and data for the Registry" appears in the document. Here you need to enter all the information for the formation of an application, preparation of an inventory and register. From here it will be possible to print the application.
• This tab contains 3 attachments: Application, Sick leave data, Sick leave data (continued).

In the first attachment of the Application, you must specify the information for the application for the payment of benefits:

• The full name of the employee.
• His passport details. If we are talking about a citizen of a foreign state, you need to indicate a document that confirms temporary or permanent residence on the territory of Russia, and its details.
• The address at which the person is registered, and contact phone number.
• Preferred payment method: bank or postal order. It is also important to indicate the details for the transfer. If the program contains documents that were previously entered for this employee, the details of the flow document can be filled in automatically, based on the previous information.
• Information is entered about the size of the official salary, which is filled in automatically based on information from the employer's database.
• If the capacity of the enterprise has been idle for some time, the average daily earnings can be filled manually.
• Information about the authorized person and the position he occupies is filled in automatically in case of preliminary filling of the corresponding register of information.