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Social insurance

2.1 Introduction
 
Just like in a case of health insurance in Poland an individual can be subject to mandatory social insurance or purchase such insurance individually and voluntarily. Mandatory social insurance is granted for those who are legally employed in Poland and are working on the territory of Poland – in that also working foreigners. That means that an employer is obliged to send monthly a part of an employee's salary (as a contribution for social insurance) the the Social Insurance Institution (ZUS). An employer is also obliged to register a new employee in the social insurance system within 7 days from the day of beginning work.
 
Persons who perform economic activities (for example their own companies) are obliged to calculate their contributions and pay them by themselves.
 
The social insurance system in Poland consists of the following elements:
 
-        retirement pension insurance – insurance granted in virtue of inability to work because of reaching certain age,
-        disability pension insurance – insurance granted in virtue of loosing ability to work or death of a family provider,
-        insurance for sick and maternity leave – insurance granted in case of illness or maternity,
-        workman's compensation insurance – insurance granted in case of accidents at work and occupational diseases.
 
When any of the above circumstances occur (disease, maternity, reaching retirement age, disability to work, accidents at work) a person who is insured will have a possibility to obtain retirement pension, disability pension or other benefits. But if an employee is employed illegally (which means he/she does not have any work permit or did not sign any contract) and an employer does not pay contributions for social insurance to the ZUS, he/she will not be eligible for such benefits. If an employee is employed legally but an employer does not pay proper contributions he/she has a right to request to a labour and social insurance court as well as seek for help at the National or Regional Labour Inspectorate (PIP) or at the ZUS.  
 
Employers are obliged to inform their employees monthly about an amount of contributions paid on behalf of them. A RMUA form can be used to do that.
 
2.2       Legal acts
 
The social insurance system in Poland is regulated by the following legal acts:
 
- Act of 13 October 1998 on social insurance system (Journal of Law of the Republic of Poland 2007 No 11, item 74) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20070110074,
 
- Act of 17 December 1998 on retirement and disability pensions paid from the Social Insurance Fund (J.L 1998 No 162, item 1118) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU19981621118,
 
 
-Act of 25 June 1999 on social insurance benefits in case of illness or maternity (J.L. 2005 No 31, item 267 with changes) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20050310267 .
 
 
2.3 When are foreigners eligible for retirement and disability insurance?
 
Mandatory insured
 
All foreigners who are employed on the territory of Poland are subject to mandatory retirement and disability insurance.
Pupils and students under 26 years of age who are employed on the basis on any kind of a contract for performing some kinds of service are not mandatory insured. It means that there are no contributions paid by an employer.
Ø An exception is made for those foreigners who are not living in Poland permanently and who are employed in foreign diplomacy agencies, consular offices, missions, special missions or international organizations (unless international contracts regulate it in a different way). In fact they are insured on the basis of contracts with their employers or international contracts.
 
Besides the above mandatory social insurance (retirement and disability pension) is granted for those foreigners who stay on the territory of Poland and:
·         have sports scholarships,
·         are working on the basis of a referral to perform paid work during the period of serving imprisonment or temporary detention,
·         are unemployed and registered in a labour office,
·         are paid scholarship for a period of participating in a training, internship or vocational preparation training that they were sent to by a different institution than a poviat labour office,
·         are paid scholarships based on regulations on promoting employment and labour market institutions during a period of post-graduate studies and being unemployed,
·         are clerics,
·         are on maternity leaves or are granted maternity allowance (or an allowance of the same amount as maternity allowance),
·         are granted social benefits while being on a leave or are granted social allowance paid at the time of changing their vocational skills and searching for new employment,
·         are paid salaries granted for the time of using miner benefits or at the time of being granted a scholarship to change skills (such benefits are defined by separate regulations or collective labour systems),
·         are granted training benefits paid after the termination of employment.
 
 
 
Voluntarily insured
 
Voluntary retirement and disability insurance is available for foreigners who:
·         are students or students of doctoral studies (if they are not eligible for insurance because of any other circumstances),
·         are alumni of clerical seminars, novitiates, postulants and juniors until reaching 25 years of age,
·         are not able to work because of an obligation to take care of a family member – due to that they are not mandatory insured but can be insured voluntarily,
·         are participating in adaptation internships on the basis of rules of recognition of vocational skills in the EU,
·         are insured businessmen who temporarily suspended their economic activities.
 
2.4 Who is eligible for health insurance?
 
Mandatory health insurance is granted for those foreigners who are workers (which means that are employed on the basis of a contract, a vocation, a choice or an appointment).
 
Attention! In reference to the above mandatory health insurance is not granted for those who are working for cottage industries or on the basis of civil contracts (umowa zlecenie/umowa o dzieło) or who perform economic activities. These persons have a right to insure themselves voluntarily.
 
2.5 Who is eligible for a workman's compensation?
 
Individuals liable to retirement and disability pension insurance are also eligible for mandatory workman's compensation. Also individuals who perform economic activities – as long as they are due to that eligible for mandatory social insurance – are liable for mandatory workman's compensation.
 
Ø Until October 1, 2010 there is an exception made for those who are unemployed and granted unemployment benefit as well as those who are paid training allowance after termination of employment. In the above mentioned cases a workman's compensation is not mandatory.
 
2.6 Contributions for social insurance
 
Individuals who perform economic activities are obliged to calculate and to pay their contributions for retirement, disability, health and workman's insurance by themselves. The same applies to those who are insured voluntarily. Those who are employed are not obliged to do that as their employers do that for them. A RMUA form can be a confirmation that employers fulfill this obligation.
 
The basis to calculate an amount of contributions for social insurance is an individual's income (income gross/a scholarship/unemployment benefit/minimal salary for clerics).
 
Ø a contribution for retirement pension is equal 19,52% of the basis,
Ø for disability pension – 6%,
Ø for health insurance – 2,45%,
Ø for workman's insurance – from 0,40% to 8,12% (depending on a profession and a risk of accident or occupational disease connected with it).
 
A part of contribution for retirement pension insurance is paid by the ZUS to an Open Retirement Fund (OFE) chosen by an individual (so called second pillar of insurance).
 
Besides that employers are obliged to pay contributions for the Labour Fund and Guaranteed Labour Benefits Fund (0,10%). The Labour Fund guarantees benefits in case of loosing a job as the Guaranteed Labour Benefits Fund guarantees salary to an employee in a case of an employer being not able to pay it. The same rules apply to foreigners employed in Poland.
 
2.7 Retirement pension
 
The general rule that refers to retirement pension says that every individual born after December 31, 1948 who has been paying contributions in Poland is able to, after reaching retirement age (see below), request for Polish retirement pension. It should be known however that paying retirement pension to citizens of particular countries is regulated by international agreements.
 
·         Citizens of the EU countries – regulations that apply to them are those on coordination of social security systems. Period of insurance from all the EU countries are added and each country pays separably. Detailed information can be found at the website of the Ministry of Labour and Social Policy – http://www.mpips.gov.pl/index.php?gid=64 . This matter is a competence of the Department of Coordination of Social Security Systems. Information can also be found in relevant ministries competent in a matter of social insurance in a country of origin of a given foreigner.
·         The US citizens – regulations that apply to them are those defined in an agreement on social security signed by Poland and the US in Warsaw on April 2, 2008 (J.L. 2009 No 46, item 374) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20090460374 and an administrative agreement to apply the above agreement (J.L. 2009 No 46, item 376) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20090460376  .
According to the above mentioned legal acts what is usually done to calculate an amount of retirement pension is adding periods of employment in Poland and in the US (but only those in which an individual was actually insured). A Polish institution that is competent to provide with more information is the ZUS – www.zus.pl.
·         Canadian citizens – regulations that apply to them are defined by an agreement on social security signed by Poland and Canada in Warsaw on April 2, 2008 (J.L. 2009 No 133, item 1097) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20091331095. and an administrative agreement to apply the above agreement (J.L. 2009 No 133, item 1097) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20091331097. If a particular person is not eligible for retirement pension because he/she has not completed enough number of periods (see below for contribution and non-contribution periods) accepted by Poland or by Canada, an amount of retirement pension is calculated by adding periods of insurance in Poland and in Canada (unless those periods lay on each other). More information can be provided by the ZUS www.zus.pl .
·         Macedonian citizens – regulations that apply to them are those defined in an agreement between Poland and Macedonia on social security (J.L. 2007 No 229, item 1686) – http://isap.sejm.gov.pl/DetailsServlet?id=WDU20072291686 .
This agreement says that Macedonian citizens who are employed in Poland have the same rights and obligations as Polish citizens. Retirement pension is calculated in the same way as for Polish Citizens (see below). To calculate an amount of retirement pension periods of insurance in Poland and Macedonia are added (unless they lay on each other). A Polish institution that can provide with more information is the ZUS – www.zus.pl .
 
If there is no agreement between Poland and a country of origin of a particular foreigner who was employed in Poland and is staying on the territory of Poland, he/she is eligible for retirement pension on the same rules as Polish citizens. That mans that:
a)      if it is an individual born before January 1, 1949 the rules of the “old retirement insurance system” apply to him/her. A condition to be granted retirement pension is reaching retirement age and working (being employed) for a certain period of time (contribution and non-contribution period).
 
Contribution periods – it is mainly a period of insurance but also, among others, a period of maternity allowance.
Non-contribution periods – these periods in which either a nursing allowance, a rehabilitation benefit, health pension, unemployment benefit, training allowances or scholarships were paid as well as periods of studies or doctoral studies.
 
What is important is the fact that retirement pension for each individual is calculated only for those periods when he/she was insured in Poland. That means that periods in which they worked for instance in their country of origin (unless it is a country Poland has an agreement with) are not included. If such persons did not work in Poland for a suitable period of time they will not be eligible for retirement pension.
 
Retirement age in Poland is:
-        for men – 65 years.
-        For women – 60 years.
 
Minimal contribution and non-contribution periods are:
-        25 years for men,
-        20 years for women.
 
 
b)      if it is an individual born after December 31, 1948 the “new” rules apply to him/her. In this case the only requirement is to reach the retirement age (see above). Nevertheless the right to raise an amount of retirement pension to a level of minimal retirement pension (see chapter Guaranteed minimal retirement and disability pensions) is eligible only for those who can prove a 20-year (for women) or 25-year (for men) contribution and non-contribution periods. If they worked for a shorter period their retirement pension will still be paid but will equal a very low amount.
It is worth knowing that in a case of an individual born after 1968 a part of a contribution is obligatory paid to OFE. Individuals born between 1949 and 1968 can chose an OFE but it is not obligatory. The OFE is chosen by a particular individual.
An amount of retirement pension of an individual born after 1968 will be calculated basing on:
- an amount of capital accumulated on both ZUS and OFE accounts,
- indicator of average life expectation.
 
In order to be granted retirement pension an individual should apply to a pension organ relevant for a place of living. An application should consist of the following documents that confirm:
-        periods of social insurance,
-        salaries – issued by an employer (ZUS Rp-7 form). It can also be an insurance document and a contract in which salary is indicated.
 
2.8 Disability pension
 
If there is no agreement between Poland and a country of origin of a particular individual the same rules as for Polish citizens are applied to them. They are presented below.
 
There are three types of disability pension: disability, training and family pensions.
 
Disability pension is granted for those workers who lost their ability to work. This loss can be either entire (if they cannot perform any work) or partial (if they cannot perform work that is in accordance with their skills). Inability to work is usually certificated for a period of time not longer than 5 years. It is issued by a medical doctor who is entitled to do so by the ZUS. An individual can refer this certificate to a medical commission within 14 days.
 
Training pension is granted for individuals who are not capable of performing their profession and have to change their vocational qualifications. In order to do that such individuals participate in trainings organized by labour offices. Training pension is granted for a 6-month period that can be extended to maximum 30 months or shortened if a person granted a pension does not participate in trainings (decisions in that matter are made a poviat governor).
Training pension is equal 75% of the amount of disability pension.
 
Pension is granted for those individuals who lost their ability to work in a period in which contributions were paid for them. A right to be granted such pension depends on the length of this period:
-        for those who lost their ability before reaching 20 years of age – 1-year period is required,
-        for individuals between 20 and 22 years of age – 2 years,
-        for individuals between 22 and 25 years of age – 3 years,
-        for individuals between 25 and 30 years of age – 4 years,
-        for individuals over 30 years of age – 5 years.
 
In a case when a given person lost his/her ability to work before reaching 18 years of age or within 6 months after graduating form secondary school this period can be shorter than required. Such individuals are however required to confirm their contribution and non-contribution periods from before the loss of ability to work (which means that they had to be previously employed or paid maternity allowance).
 
An amount of pension depends on income that was the basis for paying contributions for pension insurance.
 
Applying for disability or training pension
 
In order to obtain the right for pension an individual should submit a request to the ZUS in his/her area. The following documents should be enclosed to that request:
-        a certificate of health condition issued by a doctor in charge,
-        a ZUS N-10 form filled in by an employer,
-        a certificate confirming an amount of salary issued by an employer (Rp-7 form)
 
 
Family pension is granted for family members of an individual who at the time of death was eligible for retirement or disability pension. Family members in this case are:
·         own children, children of a spouse or adopted children.
Children are eligible for family pension until reaching 16 or 25 years of age if they receive education (until 26 years of age if they are at the final year of studies) or without any limitations if they are entirely incapable of working and taking care of themselves,
·         minor grandchildren, siblings, other children (in that from foster families) raised and maintained by a deceased person.
The same rules apply to them as to own children. But there are two conditions: such children were taken care of at least a year before the time of death of an insured person (unless death was a result of an accident) and they are not eligible for pension after their own parents nor are they supported by them and a deceased person was their legal guardian appointed by a court.
·         a spouse.
A widowed spouse is eligible for pension after a deceased spouse if he/she has reached certain age (50 years) or is not capable of working at the time of death. This right is also granted for such a spouse who is raising at least one child eligible for pension after a deceased person (a child, a grandchild, a sibling who is under 16 years of age or 18 years of age if receiving education or is entirely incapable of working). Besides that a right for a pension is also granted for a spouse who fulfills a condition of age or incapability to work within 5 years from the time of a spouse's death or from the moment from which he/she is no longer raising the above mentioned child. A divorced or separated spouse is eligible for a pension if he/she was granted a right for alimony.
·         parents (in that also step-parents).
They are eligible for pension if were supported by a deceased person and fulfill the same conditions as a spouse – age, inability to work or raising minors (see above).
 
An amount of family pension depends on an amount of retirement or disability pension that a deceased person would be getting.
 
For one eligible person it is equal 85% of the amount of retirement/disability pension.
 
For two eligible persons – 90%.
 
For three and more persons – 95%.
 
If there is more than one person – an amount is divided into equal parts.
 
2.9 Guaranteed minimal retirement and disability pensions
 
From March 1, 2009 there are following amounts of minimal retirement and disability pensions settled:
·         retirement pension/disability pension in virtue of entire incapability to work/family pension – 675,10 zlotys,
·         disability pension in virtue of partial incapability to work – 519,30 zlotys,
·         disability pension in virtue of entire incapability to work due to an accident or occupational disease/family accident pension – 810,12 zlotys,
·         disability pension in virtue of partial incapability to work due to an accident or occupational disease – 623,16 zlotys.
 
2.10          Nursing amendment
 
Foreigners who are granted retirement or disability pension are also eligible for a nursing amendment. It is granted for individuals who are entirely incapable of working or taking care of themselves or if they reached 75 years of age. It is equal 173,10 zlotys and is paid monthly.
 
 
2.11          Health insurance benefits
 
a)      illness allowance – is granted for an insured person who fell ill and due to that became incapable of working. For the first33 days a sick person gets salary for a time of illness (paid by an employer). Illness allowance is granted from the 34th day of illness and can be paid for the period of illness but not longer than for 182 days (in a case of tuberculosis – for 270 days). This period covers getting salary for the time of illness and days free of work.
It is important to define when a certain person was health insured:
·         If it is obligatory – a sick person can be granted this allowance only if he/she was insured continuously for 30 days,
·         If it is voluntary – a sick person can be granted this allowance only if he/she was insured for at least 180 days.
            Exceptions are made for:
-        graduates of schools and universities if after completing their education they were health insured within a period of 90 days,
-        individuals whose incapability to work is a result of an accident occurred on the way to/from work,
-        mandatory insured individuals who were insured for 10 years.
            Such individuals can be granted illness allowance at the first day if they were granted health        insurance.
            A monthly amount of illness allowance is equal 80% of the basis of an allowance (usually salary). If a sick person is in a hospital – it is 70%. If incapability to work occurred during  or was caused by an accident on the way to/from work or was a result of being subject to        medical examination (for cell, tissue or organ donors).
 
b)      rehabilitation allowance – is granted for an insured person who did not recover from incapability to work after illness allowance has been used up. This allowance can be granted for a period not longer than 12 months. The right to be granted this allowance is decided upon by a medical doctor appointed by the ZUS (this decision can be referred to a medical commission within 14 days).
            Rehabilitation allowance is not granted for those who are granted retirement or disability pension in virtue of inability to work/unemployment benefit/pre-retirement         benefit/compensation benefit for teachers or who are on leave to repair their health.
            An amount of rehabilitation allowance is equal 90% of illness allowance for the first 3       months and then 75%. If inability to work covers a period of pregnancy – 100%.
 
c)      compensation allowance – is granted only for insured persons who are workers (mainly employed on the basis of work contracts). It is meant for those workers whose salary went down due to:
-        rehabilitation in a rehabilitation centre,
-        health condition that caused shifting them to another position that is adjusted to needs of adaptation and vocational training.
Compensation allowance is granted for a period of rehabilitation but for no longer than 24 months (if it turns out that rehabilitation is pointless – for a shorter period). A need for such rehabilitation is decided upon by a voivodship centre of labour medicine or by a medical doctor appointed by the ZUS.
An amount of compensation allowance is a difference between average monthly salary and salary at time of rehabilitation.
Compensation allowance is not granted for those workers who are already eligible for retirement or disability pension or compensation benefit for teachers.
 
d)     maternity allowance – is granted for a person who is working and insured and who at the time of being health insured or on maternity leave:
- gave birth to a child,
- accepted a child under 7 years of age to take care of (or under 10 years of age if an education obligation was postponed) and requested to a court for adopting this child,
- accepted a child to take care of as a foster family (except for vocational foster families not related to a child); a child must be under 7 years of age (or under 10 years of age if an education obligation was postponed).
            This allowance is paid at the time of maternity leave. Depending on a number of children that were born in one delivery a benefit is paid for the following periods:
-        20 weeks if one child was born,
-        31 weeks if two children were born,
-        33 weeks if three children were born,
-        35 weeks if four children were born,
-        37 weeks if five or more children were born.
            Also an insured father of a child is eligible for this allowance. He is granted this allowance            if, because of the death of a mother or her abandonment of a child, he has to leave his work    to take care of a child. A father can also be granted this allowance if a mother uses at least 14          days of her leave and resigns of the rest of her maternity allowance in favour of the father  who is on maternity leave or leaves his work to take care of a child.
            A monthly amount of maternity allowance is equal 100% of salary.
 
e)      nursing allowance – is granted for insured persons who have to leave their work to take care of:
- a child under 8 years of age in a case of:
·         sudden close of a groove/pre-school/school a child attends,
·         childbirth or illness of a spouse who was taking care of a child,
·         a spouse taking care of a child having to be placed in a hospital or other institution of such kind,
-        a sick child under 14 years of age,
-        another sick family member (a spouse/a parent/a parent-in-law/a grandparent/a grandchild/a sibling/a child over 14 years of age) if he/she is living together with an insured person at the time of being taken care of.
 
Allowance is granted for a period not longer than 60 days per year (in a case of taking care of a child under 8 years of age or a sick child under 14 years of age) or 14 days per year (in a case of taking care of other family members).
 
Monthly nursing benefit is equal 80% of salary.