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Sickness Insurance Organisation and Implementation

The Act modifies the organisational arrangement of sickness insurance. The sickness insurance authorities include the District Social Security Administrations  (OSSZ), the Czech Social Security Administration  (ČSSZ), service authorities, and the Ministry of Labour and Social Affairs. The service authorities include the Ministry of Defence, the Ministry of the Interior, the Prison Service of the Czech Republic, the General Customs Directorate, the Security Information Service, and the Office for Foreign Relations and Information.

Sickness insurance for all insured people (with the exception of officers, those in custody and convicts) will only be conducted by District Social Security Administrations , and no longer by employers. Sickness insurance information systems are being established, i.e. the Register of Insured and the Register of Employers. The administrator of the registers, for employees, self-employed persons and employers of employees, is the Czech Social Security Administration . The administrator of registers for officers and convicts is the relevant service authority.

The District Social Security Administration  will pay the appropriate benefit within 1 month after the day on which the application (i.e. the proof of the right to the benefit payment) was delivered to this Administration . Employees may choose how the benefits will be paid – to a bank account or in cash (by money order); if paid in cash (by money order), the cash delivery costs will be borne by the employee. The payment of benefits to foreign countries, on the basis of insured person’s application, can only be made to an insured person’s bank account, with the insured paying the money transfer costs.

The institute of special beneficiary has been introduced; this addresses the issue where an insured person or his/her legal representative cannot receive the appropriate benefits. This special beneficiary may be a natural or legal entity if the entity agrees with this status.

The responsibilities of employers and health facilities have changed. If natural entities (insured people or beneficiaries not included among the insured, employees, self-employed persons, a natural entity who is an employer, etc.) breach or fail to comply with the responsibilities enumerated by law, this will be regarded as an offence, which may be subject to a fine. Legal entities (i.e. including legal entities who are employers) and health facilities are considered to have committed administrative offences, which are subject to fines, if they breach or fail to comply with the responsibilities laid down by law.

In enumerated cases, the District Social Security Administration  may decide an issue under shortened proceedings, which will not be subject to Administrative Rules and no decision will be issued. The insured person will receive a written notification.