Changes in benefit calculations in 2021

A new billing period has arrived. In the article we will tell you what you need to pay attention to when calculating benefits from 01/01/2017, what indicators for calculating benefits for temporary disability, pregnancy and childbirth, and child care have changed and what are the maximum benefits in 2021.

Let us remind you that the calculation of benefits for temporary disability, pregnancy and childbirth, and child care is carried out on the basis of the following regulatory documents:

Federal Law No. 255-FZ of December 29, 2006 “On compulsory social insurance in case of temporary disability and in connection with maternity” (hereinafter referred to as Federal Law No. 255-FZ);
Federal Law No. 81-FZ of May 19, 1995 “On state benefits for citizens with children” (hereinafter referred to as Federal Law No. 81-FZ);
Provisions on the specifics of the procedure for calculating benefits for temporary disability, pregnancy and childbirth, monthly child care benefits for citizens subject to compulsory social insurance in case of temporary disability and in connection with maternity, approved by Decree of the Government of the Russian Federation of June 15, 2007 No. 375 (hereinafter - Regulation No. 375).

The procedure for calculating benefits in 2021 remains the same, but the indicators that need to be applied have undergone changes. So, from 01/01/2017 the following indicators have changed:

billing period;
maximum payment amount;
number of calendar days in the billing period;
maximum average daily earnings;
maximum benefit amount.

Let's look at each of them in more detail.

General provisions

The current regulatory framework regulates the following grounds for issuing sick leave:

illness or injury that led to temporary disability;

quarantine
installation of a prosthesis
treatment in a sanatorium
pregnancy

Registration of sick leave in 2021 is carried out within the established procedure:

Mandatory examination by a doctor, which confirms the basis for issuing the sheet.
Based on the results of the examination, the doctor can issue a sick leave certificate, which is opened from the date of application to the medical institution.

The period for which sick leave is issued depends on several parameters. The deadline, which is issued at the medical institution, is 30 days. After the first visit, sick leave is issued for a period that cannot exceed 10 days. After which the validity period can be extended as a result of a repeat visit. In addition, a special commission can extend sick leave up to 12 months if the illness or injury has serious consequences.

Depending on the reason for filing sick leave in 2021, the current standards determine the following maximum periods:

care for a child in case of illness - from 30 to 60 days depending on age
disability – 5 months
pregnancy – 140 days

Sick leave payments in 2021: essential features

Payment for sick leave in 2021 is made from two sources: employer funds (first 3 days) and Social Insurance Fund (starting from the 4th day). If the reason for registration is child care, then financing comes exclusively from the Social Insurance Fund.

In the following cases, the employee will not be able to obtain sick leave:

the established hospital regime is violated
activities are carried out within the framework of a contract
if the injury was sustained as a result of an unlawful act
if an employee is suspended from performing duties or carries out actions without appropriate permissions
if sick leave is issued after the end of the illness

Determination of the amount of sick leave benefits in 2021.

Sick leave in 2021 It will be correct to calculate using the following formula, which is provided for in Article No. 14, paragraph 1 and Article No. 1, paragraph 2 of Federal Law No. 255:

The amount of benefits due to temporary disability in 2021. = Salary (average daily) for calculating sick leave benefits in 2021. X Percentage, which depends on the employee’s length of insurance (60-100%) X Number of calendar days of illness.

Read on the topic: Examples of calculating sick leave in 2021

Nuances of calculations and payments

Calculation of sick leave in 2021 is carried out according to the following algorithm:

Fixation of the total salary that the employee received over the last two years
Calculation of average daily income. To do this, the total income is divided into 730 days (for a leap year - 731 days)
The result obtained is multiplied by the number of working days during which the employee was on sick leave
The length of service coefficient is applied, which is determined based on the following principles:

if the length of service is up to 6 months, then for each month of sick leave the employee will receive more than 1 minimum wage
for 3-5 years of experience K 0.6 is applied
for 6-8 years of experience K 0.8 is applied
if the experience exceeds 8 years, K 1.0 is applied

The maximum amount of payment to an employee during the year cannot exceed RUB 270,450.

Calculation example

The total amount of the employee’s salary for the last two years is 860 thousand rubles. In this case, the work experience reaches 9 years and sick leave is issued for 10 days. In this case, the payment amount will be:

860,000 / 730 x 10 x 1 = 11,780.82 rubles.

The amount calculated for sick leave is paid after the employee returns to the workplace at the next salary payment. Personal income tax will be withheld from this amount.

In addition, it is worth considering the following nuances when calculating sick leave in 2021:

If the injury was sustained at work or the employee suffered an occupational disease, then the sick leave payment will be 270 thousand rubles
If an employee falls ill during vacation, he must contact a medical facility. In this case, sick leave will be open from the first day of going to work or transferred to another day in agreement with the employer
Sick leave for pregnancy or child care is paid exclusively from the Social Insurance Fund. In this case, the duration of sick leave is regulated at the legislative level.
If an employee is a part-time worker and works in several companies at once, then he will be able to apply for sick leave in each organization
If the time interval between the termination of the employment contract and the employee’s illness is less than 30 days, then sick leave is issued with K 0.6 of the average salary at the corresponding place of work.

Payment of sick leave next year is carried out at the expense of the employer and funds from the Social Insurance Fund. To register, you will need to contact a medical institution and obtain the appropriate certificate. When calculating the payment, the following parameters are taken into account:

total income for the last two years
number of days on sick leave
work experience

Who pays for sick leave?

Initially, the employer pays the benefit to the sick person, then, after all the documents are completed and submitted to the Social Insurance Fund, he is compensated for part of the amount - payments for the fourth and subsequent days of incapacity for work.

This situation, which is costly for the entrepreneur, applies in cases where a subordinate was absent from the workplace due to his own illness or injury.

For other cases (for example, caring for a sick relative), the Social Insurance Fund reimburses sick leave starting from the first day.

Already now, in certain regions of the country (for example, in the Samara region), there is an experimental system in place where sick leave payments are credited directly to the employee’s individual account by the Social Insurance Fund.

At the all-Russian level, it is planned to introduce a similar system from January 2021. That is, the Social Insurance Fund will not compensate the payment to the employer, but will independently accrue it to the insured person.

Calculation of sick leave: fundamental principles and changes in 2021

The calculation of sick leave is based on a number of key rules that every accountant should follow. These include the following:

Payment for sick leave in 2021 in case of illness or injury is made from 2 sources: the first 3 days are paid from the employer’s funds, the remaining days from the social insurance fund. If sick leave is issued to care for a sick relative, due to quarantine, or the need to undergo rehabilitation in a sanatorium, then it is paid in full from the Social Insurance Fund.
Calculation of sick leave is carried out on calendar days falling on the full period of illness, with the exception of days when the employee was suspended from official duties and was not entitled to wages for these days. A list of such exceptions can be found in Article 9 of Law No. 255-FZ of December 29, 2006.
The amount of disability benefits payable is calculated based on the employee’s average salary. This indicator is determined for the previous 2 years. If a person has been working at a given place of work recently, then the data provided by his previous employers is taken into account. To calculate average earnings, the summed salary for 2 years is divided by 730.
The amount of the benefit is directly related to the length of the insurance period. If it does not exceed 5 years, sick leave is calculated based on 60% of average earnings. For more than 5 years of experience, but not more than 8, the ratio of 80% of the average salary is applied. And finally, with more than 8 years of experience, the amount of sick leave is equal to average earnings. Moreover, starting from the 11th day of sick leave, benefits are accrued in the amount of ½ of the average earnings, no matter how long the insurance period you have.
The calculation of sick leave in 2021 is based on all payments that were made in favor of the employee and from which the employer transferred insurance premiums for the previous 2 years.

As you can see, changes in the calculation of sick leave in 2021 are practically insignificant. To illustrate the application of these principles, we will try to show how to calculate sick leave in 2017 using a specific example.

Let’s assume that a certain Marina Nikolaevna Ivanova, having 7 years of insurance experience, fell ill between January 16 and January 25, 2021. Accordingly, guided by the above rules, to calculate average earnings we need the period 2015 and 2021. According to accounting data, her total salary for 2015 was 480,000 rubles, and for 2021 - 520,000 rubles. Thus, over the previous 2 years she earned a total of 1,000,000 rubles. Please note that this amount takes into account all payments in favor of M.N. Ivanova, for which the company where she works transferred insurance contributions to extra-budgetary funds.

So, the average earnings of Ivanova M.N. is 1,369.86 rubles (1,000,000/730). Considering that her insurance experience is more than 5 but less than 8 years, we use a coefficient of 0.8 (80%). Thus, to calculate benefits for 10 calendar days of sick leave, average earnings are used at the rate of 1,095.89 rubles. (RUB 1,369.86 x 80%). Accordingly, payment of sick leave to Ivanova M.N. will be 10,958.90 rubles. (RUB 1,095.89 x 10 calendar days).

It is very convenient to use a free online calculator for calculating patients, which is offered by various services on the Internet. By entering the information necessary for the calculation, within a few seconds you will receive a calculation of the benefit amount in accordance with all current rules and restrictions, as well as links to legislative acts.

Who pays the benefit

Before we understand how long sick leave is paid, let’s look at who makes the payment and how. According to Federal Law No. 255-FZ of December 29, 2006 on compulsory social insurance in case of temporary disability and in connection with maternity, this responsibility lies with:

on employers: they pay the minimum period of sick leave - the first 3 days at their own expense, and the rest of the benefit is reimbursed to them from the Social Insurance Fund. If we are talking about an industrial injury, the enterprise pays for the entire period of treatment of the employee from its own funds and has the right to offset the paid benefits against contributions for injuries (clause 1, paragraph 1, article 8 of the law of July 24, 1998 No. 125-FZ). If the injury is considered not as an industrial injury, but as a domestic injury, benefits for it are paid according to the general procedure;
on the Social Insurance Fund, if at least one of the conditions appears: the employer has already paid for 3 days, and the period of temporary disability lasts longer;
the enterprise is registered in the region where the pilot project is being carried out in accordance with Decree of the Government of Russia dated April 21, 2011 No. 294;
the organization has already been liquidated at the time of registration of illness papers;
the employer is at the stage of bankruptcy;
the amount of accrued insurance premiums is not enough to compensate for the period of temporary disability;
sick leave was issued for child care or in connection with quarantine;
Payment is made in connection with sick leave for pregnancy and childbirth.

Please note: in regions where the pilot project does not operate, part of the benefit is paid by the employer, and the second by the Social Insurance Fund, and the money is received by the employee in two different payments and sometimes at different times. This point should be explained to the person so that he does not run to complain to the Labor Inspectorate about late receipt of benefits.

How is sick leave paid in 2021 if earnings are less than the minimum wage?

It happens that an employee who finds himself on sick leave has no earnings during the billing period, or it is extremely small, not even reaching the minimum wage. In this case, the calculation of sick leave is based precisely on the minimum wage. Let us give a corresponding example of calculating sick leave in 2017.

So, let’s assume that M.N. Ivanova, who participated in our previous calculation, did not work in the calculation period of 2015 and 2021. It is also not possible to replace these years with some others, since she was not on maternity leave, but simply did not work during these years. An employee fell ill in July 2021 for a period of 10 calendar days.

In this case, you will have to rely on the minimum wage, which will be 7,800 rubles from the second half of 2021. We calculate the average earnings by multiplying the minimum wage by 24 months and dividing by 730. Its amount will be 256.44 rubles. Now we multiply this amount by 80% based on the existing insurance experience and get the amount of daily earnings for calculating sick leave of 205.15 rubles. Accordingly, sick leave payment for 10 calendar days will be 2,051.50 rubles.

Maternity leave

The duration of the vacation is (Article 255 of the Labor Code of the Russian Federation):

for normal childbirth – 70 calendar days before birth and 70 calendar days after birth;
for complicated births – 70 calendar days before birth and 86 calendar days after birth;
for the birth of two or more children – 84 calendar days before birth and 110 calendar days after birth.

EXAMPLE.
DETERMINING THE DURATION OF MATERNITY LEAVE An employee of Passiv LLC Panina will go on maternity leave from April 14. Panina’s birth was complicated. The total duration of Panina’s maternity leave will be 156 calendar days (70 + 86). Thus, Panina must go back to work on September 17th. Let's assume that this day falls on Sunday. This means that Panina’s first working day will be September 18th.

Leave is also provided if the employee has adopted a child under three months of age. The duration of leave in this case is the period from the date of adoption until the expiration of 70 calendar days from the date of birth of the child. When adopting two newborn children - before the expiration of 110 calendar days from the date of their birth.

note

A woman who is on maternity leave cannot be fired.

Read also: “Calculation of maternity leave”

What are the limits on disability benefits?

Current legislation limits the maximum amount of average earnings, based on which benefits are determined. It is stipulated that the amount that serves as the basis for calculating benefits for each year should not exceed the limit of the base for calculating insurance premiums in the same year. Considering that in 2015 this limit was 670,000.00 rubles, in 2016 - 718,000 rubles, dividing the amount for 2 years by 730, we get the average earnings limit for 2017 at the level of 1901.37 rubles. The FSS simply will not accept payments for a larger amount.

How to correctly calculate the insurance period for calculating sick leave

There are certain subtleties about which periods can be included in the calculation of length of service for sick leave, and which cannot. The list of periods to be included in 2021 is enshrined in Article 16 of Federal Law No. 255-FZ, as well as the Rules of the Ministry of Health and Social Development of the Russian Federation dated 02/06/2007 No. 91. Such periods include state or military service. While the period of work under GPC contracts is not taken into account when calculating the insurance period. If a situation arises where the periods seem to overlap one another, then one of them is used. To confirm insurance experience, in addition to entries in the work book, employment contracts can be used, if suddenly there is no entry in the book, a military ID confirming the time of service, as well as individual entrepreneur documents confirming the transfer of insurance premiums for the period of business.

Based on materials: 2017god.com, bbcont.ru

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