Health insurance for employee

In Estonia an employee working under an employment contract, recipient of employment or the service fees on the basis of a contract under the law of obligations, a member of the directing body and the controlling body of a legal person, a self-employed person and their spouses participating in their business activities, and business income tax payers are entitled to health insurance cover. You can read more about them here.

All natural and legal persons providing employment must register the employment data of their employees (commencement, suspension and termination of employment) in the employment register of the Tax and Customs Board.

 

Employees working under an employment contract

Persons who work on the basis of an employment contract concluded for a term exceeding one month or for an unspecified term and for whom the employer pays social tax are entitled to health insurance cover.  

The insurance cover will commence upon expiry of a waiting period of fourteen days from the date of commencement of work entered in the employment register. If the date of commencement of work entered in the employment register remains within the term of validity of the valid insurance cover, the insurance cover will continue on the new ground without interruption.

The employment register will forward the data received from employers for insuring employees and for suspending or terminating insurance are forwarded to EHIF.

The insurance cover will be suspended two months after the date of commencement of the suspension of work entered in the employment register (for example, an employee enters active service, goes on parental leave, etc.).

The insurance cover won’t be suspended in the case of unpaid leave granted by agreement of the parties, provided that social tax has been paid for the person.

The insurance cover will continue as of the date following the date of termination of the suspension of work entered in the employment register.

The suspension of employment must be registered in the employment register within ten days as of the date of the suspension of employment. More information available at the Tax and Customs Board.

The insurance cover of persons insured as employees will terminate two months after the date of termination of work entered in the employment register.

Termination of employment must be registered in the employment register within ten days from the date of termination of employment. More information available at the Tax and Customs Board.

Persons receiving remuneration or service fees on the basis of a contract under the law of obligations

A person working based on a contract under the law of obligations must be registered in the employment register. The insurance cover will commence on the day following the term for submitting the income and social tax, mandatory funded pension payment and unemployment insurance contribution declaration (TSD), provided that the declaration has payments declared with codes 17, 18, 19, 123 or 125. In order to qualify for health insurance cover, social tax must be declared either in the TSD of one employer or in the TSDs of several employers in the monthly total amount at least to the extent of the minimum social tax obligation (in 2023, the monthly rate is 654 euros and thus the minimum amount of social tax is 215.82 euros per month).

The suspended insurance cover resumes on the day following the receipt of data certifying the declaration of the minimum social tax obligation.

The insurance cover of an insured person is suspended after a month has passed from the due date where according to the information received from the Tax and Customs Board social tax has not been declared to the extent of the minimum social tax obligation.

Members of the management or controlling bodies of legal persons

A member of the management or controlling body who receives remuneration for his or her work must be registered in the employment register. The insurance cover will commence on the day following the term for submitting the income and social tax, mandatory funded pension payment and unemployment insurance contribution declaration (TSD), provided that the declaration has payments declared with codes 21, 22, 29, 30, 156 or 158. In order to qualify for health insurance cover, social tax must be declared either in the TSD of one employer or in the TSDs of several employers in the monthly total amount at least to the extent of the minimum social tax obligation (in 2023, the monthly rate is 654 euros and thus the minimum amount of social tax is 215.82 euros per month).

The suspended insurance cover resumes on the day following the receipt of data certifying the declaration of the minimum social tax obligation.

The insurance cover of an insured person is suspended after a month has passed from the due date where according to the information received from the Tax and Customs Board social tax has not been declared to the extent of the minimum social tax obligation. You can check the validity of health insurance cover in the state portal eesti.ee under the service " Health insurance and family physician information" or by calling the EHIF’s customer service +372 669 6630.

Please note! Data on persons for whom the minimum amount of social tax has been received shall be submitted by the Tax and Customs Board to the Health Insurance Fund on the day following the deadline for submission of the TSD.

The deadline for submitting a TSD is the 10th of each month.  If the 10th day falls on a day off or a public holiday, EHIF will receive the data on the following working day.

If the TSD is submitted before the deadline, the Tax and Customs Board will forward the data to EHIF on the day following the deadline for submission of the TSD (for example, the 10th date).

If the TSD of previous calendar month is corrected, the corrected data will be submitted to EHIF on the next day. Corrections made to declarations from previous periods will not be submitted to EHIF.

Data provider’s liability

Please submit declarations in a timely manner to avoid interruption of insurance cover!

If a person applying for insurance cover would have had the right to receive health insurance benefits, but a person obligated to submit documents necessary for insurance cover to commence failed to perform such obligation as required, the person who violated the obligation must compensate the person applying for insurance cover for the loss incurred due to the failure to receive the health insurance benefits. 

Examples

  • Example 1. The employment contract is signed on 1 January. The person receives a payment on 31 January, TSD is submitted on 10 February and the health insurance cover will be valid from 11 February to 10 March. Please note! The insurance cover commences every month after the submission of TSD.
  • Example 2. The employment contract is signed on 1 January. The person receives a payment on 1 February, TSD is submitted on 10 March and the health insurance cover will be valid from 11 March to 10 April. Please note! The insurance cover commences every month after the submission of TSD.
  • Example 3. The board member contract has been entered into for a term of five years as of 1 January. Every month, social tax is paid on the remuneration of a board at least to the extent of minimum rate. Please note! The insurance cover commences every month after the submission of TSD.
  • Example 4. A person works under an authorisation agreement at several different employers. Social tax is paid on all the agreements in total of at least to the extent of minimum rate. Please note! The insurance cover commences every month after the submission of TSD.

Регистрация работника с местом жительства в другом государстве

ПОСТАНОВКА НА УЧЁТ РАБОТНИКА, ЕСЛИ МЕСТО ЕГО ПРОЖИВАНИЯ НАХОДИТСЯ В ДРУГОМ ГОСУДАРСТВЕ ЕВРОПЕЙСКОГО СОЮЗА

  • Если Вы хотите поставить на учёт в Кассе Здоровья работника, просим обратить внимание на то, в какое именно государство должен будет  поступать социальный налог работника, и выбрать при регистрации работы в  Регистре Работы соответствующий вид или вид выплат, соответствующий TSD. Если выплата социального налога будет проводиться в Эстонию, то медицинская страховка будет оформлена для Эстонии и поэтому у работника может возникнуть дублированная медицинская страховка в нескольких странах-участницах Европейского Экономической зоны или Швейцарии (далее страна-участница  ЕС), а это не разрешено законодательством1.
  • Человек, который работает в нескольких стран-участница ЕС, должен ходатайствовать в организации страховой защитой страны своего проживания о получении  формы А1 или Е101. Если отмеченная страна страхования на форме - не Эстония, то по отношению к работнику применяются правовые акты другой страны-участницы ЕС и у него нет права на медицинскую страховку в Эстонии2.
  • По отношению к человеку, который заключил трудовой договор с работодателем Эстонии, но при этом сам работает в другой стране-участнице ЕС, в общем случае применяются законные акты о социальном страховании. В таком случае  социальный налог  выплачивают другой стране ЕС и медицинскую страховку оформляют также в другой стране3.
  • Работник, работающий в приграничной зоне, который работает на территории Эстонии, но при этом сам проживает в другой стране ЕС, в которую он приезжает на регулярной основе каждый день или по крайней мере раз в неделю, может ходатайствовать в Кассе Здоровья о форме Е106/S1, на основе которой у него появится право оформить медицинскую страховку в стране проживания4.

1 Постановление Европейского Совета и Парламента №883/2004, от 29 апреля 2004 года, раздел 1 статьи 11 о координировании системы социального страхования;

2 Постановление Европейского Совета и Парламента №883/2004, от 29 апреля 2004 года, статья 13 о координировании системы социального страхования;

3 Постановление Европейского Совета и Парламента №883/2004, от 29 апреля 2004 года, раздел 3 статьи 11 о координировании системы социального страхования;

4 Постановление Европейского Совета и Парламента №883/2004, от 29 апреля 2004 года,   статья 17 о координировании системы социального страхования;

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