Form for achieving the annual Report to the European Code of Social Security

Report for the period 1 July 2016 – 30 June 2017 conducted by the Romanian Government in accordance with Article 74 of the European Code of Social Security

I.    Please provide a list of legislation and administrative regulations, etc., applying the Code, under Article 2. Please specify in each case that these texts are part of the related code. Please send copies of that legislation.

Part II –Medical Care

·         Law no. 95/2006 regarding the health reform, republished (the initial version published in the Official Gazette no. 372 from April 28, 2006, republished version in the Official Gazette 652 from August 28, 2015), including subsequent amendments and additions- Title VIII “Social Health Insurance”;

·         Government Resolution no. 161/2016 for the approval of service packages and Framework Agreements which regulate the conditions of granting social assistance, medicinal products and devices, within the  social health system for 2016 – 2017, including subsequent amendments and additions, with effect form 1 July 2016;

·         Decision of the Minister of Health and of the President of The National Health Insurance House no. 763/377/2016 regarding the approval of Detailed rules for the application during 2016 of the Government Resolution no. 161/2016 for the approval of service packages and Framework Agreements which regulate the conditions of granting social assistance, medicinal products and devices, within the  social health system for 2016 – 2017, including subsequent amendments and additions, with effect in the period July 1, 2016 – March 31, 2017.

·         Decision of the Minister of Health and of the President of the National Health Insurance Fund no. 196/139.2017 regarding the approval of Detailed rules for the application during 2017 of the Government Resolution no. 161/2016 for the approval of service packages and Framework Agreements which regulate the conditions of granting social assistance, medicinal products and devices, within the social health system for 2016 – 2017, including subsequent amendments and additions, with effect form 1 April 2017;

·         Decision of the President of the National Health Insurance Fund no. 581/2014 regarding the approval of Detailed rules for the establishment of the supporting documents regarding the acquisition of the insured status (published in the Official Gazette no. 658 from September 19, 2014) with effect from September 19, 2014,

·         Government Resolution no. 720/2008 for the approval of the List comprising Nonproprietary Names from the Classification of medicinal products for human use granted to the insured persons, with or without personal contribution, on the basis of medical prescriptions, within the social health insurance system, including subsequent amendments and additions,

·         Decision of the President of the National Health Insurance Fund no. 188/2013 for the approval of  the methodology for establishing the reference price and the corresponding rental amounts for the types and categories of medical devices designed for the recovery of organic or functional deficiencies in outpatients, within the social health insurance system, including subsequent amendments and additions, with effect in the period April 1, 2013 – September 30, 2016,

·         Decision of the President of the National Health Insurance Fund no. 803/2016 for the approval of the methodology for establishing the reference price and the corresponding rental amounts for the types and categories of medical devices designed for the recovery of organic or functional deficiencies in outpatients, within the social health insurance system, including subsequent amendments and additions, with effect from October 1, 2016.

Part III – Sickness benefits

·      Government Emergency Ordinance No 158/2005 on the medical leaves and health insurance benefits, with the subsequent amendments and supplements(initial form published in the Official Gazette No 1074 of November 29^th, 2005), as further completed or amended;

·      Order of the Minister of Health and of the President of the National Health Insurance House no. 60/32, dated January 27^th, 2006 for the approval of the application norms of the Government Emergency Order no. 158/2005 on the leaves of absence and health insurance benefits, with the subsequent amendments and supplements (initial form published in the Official Gazette no. 147, dated February 16^th, 2006), as further completed or amended;

·      Order of the Minister of Health and of the President of the National Health Insurance House no. 233/125/2006 approving the single medical leave certificate model and the instructions for the use and filling-in of the medical leave certificate based on which benefits are granted to the insured people within the health insurance system;

·      Law No 227/2015 on the Fiscal Code, as further completed and amended;

·      Government Decision No 1/2016 approving the Methodological Norms for the implementation of Law No 227/2015 on the Fiscal Code, as further completed and amended.

Part V- Old-age benefits

Law No.263 of 16 December 2010 on the Unitary System of Public Pensions, Law No.287 of 28 December 2010, Emergency Ordinance No. 117 of 2 December 2010, LAW No.94 of 6 June 2011, Emergency Ordinance No. 98 of 16 November 2011, Law No.283 of 14 December 2011, Law No.294 of 21 December 2011, Emergency Ordinance No. 125 of 27 December 2011, Constitutional Court Decision No. 297 of 27 March 2012, Law No.76 of 24 May 2012, Emergency Ordinance No. 29 of 20 June 2012, Constitutional Court Decision No. 680 of 26 June 2012, Emergency Ordinance No. 44 of 23  August 2012, Emergency Ordinance No. 15 of 23 August 2012, LAW No.187 of 24 October 2012, Constitutional Court Decision No. 956 of 13 November 2012, Emergency Ordinance No. 1 of 22 January 2013, Ordinance No. 8 of 23 January 2012, Emergency Ordinance No. 4 of 30 January 2013, Law No.6 of 21 February 2013, Law No.37of 8 March 2013, Law No.168 of 29 May 2013, Law No.241 of 17 July 2013, Ordinance No.16 of 30 July 2013, Emergency Ordinance No.88 of 18 September 2013, Constitutional Court Decision No. 437 of 29 October 2013, LAW No.340 of 10 December 2013, Emergency Ordinance No.113 of 18 December 2013, LAW No.380 of 24 December 2013; Law No. 187 of 24 Octomber 2012; Decision No. 463 of 17 September 2014; Emergency Ordinance No. 68 of 21 Octomber 2014; Emergency Ordinance No.80 of 10 December 2014; , Law No.187 of 29 December 2014; Law No.155 of 18 June 2015; , Law No.192 of 7 July 2015; , Law No.218 of 23July 2015; , Law No.223 of 24 July 2015; Emergency Ordinance No 57 of 9 Decembre 2015; Law No. 325 of 16 Decembre 2015; Law No.340 of 18 Decembre 2015; Emergency Ordinance No. 65 of 30 December 2015; Law No.142 of 12 July 2016; Law No.155 of 15 July 2016; Law No.172 of 7 October 2016;  Law No.186 of 20 October 2016; Law No.222 of 17 november 2016; Emergency Ordinance No. 99 of 15 Decembre 2016; Law No. 1 of 6 January 2017; Emergency Ordinance No. 2 of 6 January 2017; Law No.7 of 16 February 2017; Law No.144 of 26 June 2017; Law No. 153 of 28 June 2017;  Law No.160 of 30 June 2017, Government Decision No.257 of 20 March 2011, G.D. No.291 of 5 May 2017.

·      Law No. 72 of 28 April 2016 regarding pensions and others insurance rights of lawyers; 

·      Law no. 223 of 4 July 2007 regarding the status of civil aeronautical professional civil aviation in Romania, as amended;

·      Law No. 94 of 8 September 1992, republished, on the organization and functioning of the Court of Auditors republished, with the subsequent amendments;

·      Law No. 216 of  21 July on pensions granted to the members of Romania's diplomatic and consular corps;

·      Law No. 7 of 11 January 2006, republished, regarding parliamentary civil servant’s status, republished, with the subsequent amendments;

·      Law No. 567 of 9 December 2004 on the status of specialized auxiliary personnel in courts and prosecutors' offices attached to them and the staff that works at the National Institute of Forensic Expertise, as amended;

·      Law No. 303 of 28 June 2004 on the status of judges and prosecutors, republished, with the subsequent amendments;

·      Law No. 223 of 24 July 2015 on the state military pensions, with the subsequent amendments;

Part VII - Family benefits

·      Law No. 292/2011 on social assistance, published in the Official Gazette of Romania, Part I, no.905 of December 20, 2011;

·      Law no. 61/1993 on child state allowance, republished in the Official Gazette of Romania, Part I, no. 767 of November 11, 2012;

·      Government Emergency Ordinance No. 148/2005 on family support for the child raising published in the Official Gazette of Romania, Part I, no.1008 of November 14, 2005, as amended and supplemented;

·      Law no. 448/2006 on the protection and promotion of the rights of the persons with disabilities, republished in the Official Gazette of Romania, Part I, no. 1 of January 3, 2008, as amended and supplemented;

·      Law no. 272/2004 on the protection and promotion of child rights, republished in the Official Gazette of Romania, Part I, no. 159 of March 5, 2014;

·      Law no 277/2010 concerning the allowance for family support, published in the Official Gazette of Romania, Part I, no.889 of December 30, 2010.

·      Emergency Ordinance no 124/2011 for modifying and completing the normative acts that regulate the granting of social assistance benefits, published in the Official Gazette of Romania, Part I, no.938 of December 30, 2011, as amended and supplemented;

·      Law 263/2007 regarding the establishment and organization of nurseries, published in the Official Gazette of Romania, Part I, no.507 of July 30, 2007, as amended and supplemented;

·      Law 193/2006 regarding the grant of crèches tickets, published in the Official Gazette of Romania, Part I, no.446 of May 23, 2006, as amended and supplemented;

·      Law 132/2011 approving the Emergency Ordinance no 111/2010 regarding the leave and the monthly indemnity for child raising, published in the Official Gazette of Romania, Part I, no.452 of June 28, 2011.

·      Law no. 416/2001 on minimum guaranteed income, published in the Official Gazette of Romania, Part I, no. 401 of July 20, 2001, as amended and supplemented.

·      Law 276/2010 for completing Law no. 416/2001 on minimum guaranteed income, published in the Official Gazette of Romania, Part I, no.888 of December 30, 2010;

·      Emergency Ordinance no. 70/2010 regarding the protection measures in cold season, published in the Official Gazette of Romania, Part I, no.629 of September 2, 2011, as amended and supplemented.

Part VIII – Maternity benefits

·         Emergency Ordinance no. 158 dated November 17th, 2005 on the leaves of absence and health insurance benefits, with the subsequent amendments and supplements (initial form published in the Official Gazette no. 1074, dated November 29th, 2005), as further amended and completed; 

·         Order of the Minister of Health and of the President of the National Health Insurance House no. 60/32, dated January 27th, 2006 for the approval of the application norms of the Government Emergency Order no. 158/2005 on the leaves of absence and health insurance benefits, with the subsequent amendments and supplements (initial form published in the Official Gazette no. 147, dated February 16th, 2006), as further amended and completed;

·         Order of the Minister of Health and of the President of the National Health Insurance House no. 233/125/2006 approving the single medical leave certificate model and the instructions for the use and filling-in of the medical leave certificate based on which benefits are granted to the insured people within the health insurance system;

·         Law No 227/2015 on the Fiscal Code, as further completed and amended;

·         Government Decision No 1/2016 approving the Methodological Norms for the implementation of Law No 227/2015 on the Fiscal Code, as further completed and amended.

Article 1

       1     In this Code:

               a  the term “the Committee of Ministers” means the Committee of Ministers of the Council of Europe;

               b  the term “the Committee” means the Committee of Experts on Social Security of the Council of Europe or such other committee as the Committee of Ministers may designate to carry out the duties laid down in Article 2, paragraph 3; Article 74, paragraph 4, and Article 78, paragraph 3;

               c  the term “Secretary General” means the Secretary General of the Council of Europe;

               d the term “prescribed” means determined by or in virtue of national laws or regulations;

               e  the term “residence” means ordinary residence in the territory of the Contracting Party concerned and the term “resident” means a person ordinarily resident in the territory of the Contracting Party concerned;

               f  the term “wife” means a wife who is maintained by her husband;

               g  the term “widow” means a woman who was maintained by her husband at the time of his death;

               h  the term “child” means a child under school‑leaving age or under 15 years of age, as may be prescribed;

               i   the term “qualifying period” means a period of contribution, or a period of employ­ment, or a period of residence, or any combination thereof, as may be prescribed.

       2     In Articles 10, 34 and 49 the term “benefit” means either direct benefit in the form of care or indirect benefit consisting of reimbursement of the expenses borne by the person concerned.

Article 2

       1     Each Contracting Party shall comply with:

               a  Part I;

               b  at least six of Parts II to X, provided that Part II shall count as two Parts and Part V as three Parts;

               c  the relevant provi­sions of Parts XI and XII; and

               d Part XIII.

       2     The terms of sub‑paragraph b of the foregoing paragraph can be regarded as fulfilled if:

               a  at least three of Parts II to X, including at least one of Parts IV, V, VI, IX and X are complied with; and

               b  in addition, proof is furnished that the social security legislation in force is equivalent to one of the combinations provided for in that sub‑paragraph, taking into account:

                  i   the fact that certain branches covered by sub‑paragraph a of this paragraph exceed the standards of the Code in respect of their scope of protection or their level of benefits, or both;

                  ii  the fact that certain branches covered by sub‑paragraph a of this paragraph exceed the standards of the Code by granting supplementary services of advantages listed in Addendum 2; and

                  iii branches which do not attain the standards of the Code.

3. A Signatory desiring to avail itself of the provisions of paragraph 2.b of this article shall make a request  to this effect in the report to the Secretary General submitted in accordance with the provisions of Article 78. The Committee, basing itself on the principle of equivalence of cost, shall lay down rules co‑ordinating and defining the conditions for taking into account the provisions of paragraph 2.b of this article. These provisions may only be taken into account in each case with the approval of the Committee, the decision to be taken by a two‑thirds majority.

Article 3

Each Contracting Party shall specify in its instrument of ratification those parts of Parts II to X in respect of which it accepts the obligations of this Code, and shall also state whether and to what extent it avails itself of the provisions of Article 2, paragraph 2.

Article 4

1.    Each Contracting Party may subsequently notify the Secretary General that it accepts the obligations of the Code in respect of one or more of Parts II to X not already specified in its ratification.

2.    The undertakings referred to in paragraph 1 of this article shall be deemed to be an integral part of the ratification and to have the force of ratification as from the date of notification.

Article 5

Where, for the purpose of compliance with any of the Parts II to X of this Code which are to be covered by its ratification, a Contracting Party is required to protect prescribed classes of persons constituting not less than a specified percentage of employees or residents, that Contracting Party shall satisfy itself, before undertaking to comply with such part, that the relevant percentage is attained.

Article 6

For the purpose of compliance with Parts II, III, IV, V, VIII (in so far as it relates to medical care),

IX or X of this Code, a Contracting Party may take account of protection effected by means of

insurance which, although not made compulsory by national laws or regulations for the persons to

be protected,

a.     is subsidised by the public authorities or, where such insurance is complementary only, is supervised by the public authorities or administered, in accordance with prescribed standards, by joint operation of employers and workers;

b.    covers a substantial part of the persons whose earnings do not exceed those of the skilled manual male employee, determined in accordance with Article 65; and

c.     complies, in conjunction with other forms of protection, where appropriate, with the relevant provisions of the Code.

Note: If this article applies, information requested further shall be provided on each Part, according to Article referring to people protected by the provisions of that respective Part (Articles 9, 15, 21, 27, 48, 55, 61)

Article 7

Each Contracting Party for which this part of this Code is in force shall secure to the persons protected the provision of benefit in respect of a condition requiring medical care of a preventive or curative nature in accordance with the following articles of this part.

Article 8

The contingencies covered shall include any morbid condition, whatever its cause, and pregnancy and confinement and their consequences.

Article 9

The persons protected shall comprise:

a      prescribed classes of employees, constituting not less than 50 per cent of all employees, and also their wives and children; or

b     prescribed classes of the economically active population, constituting not less than 20 per cent of all residents, and also their wives and children; or

c      prescribed classes of residents, constituting not less than 50 per cent of all residents.

A.     Please indicate which sub-paragraph of this article you refer to.

B.     Please indicate the classes of persons protected under the provisions of this Article.

C.     Please provide statistical information related to this article, as follows:

i.      if  subparagraph (a) applies as Title I of Article 74;

ii.    if subparagraph (b) applies as Title II of Article 74;

iii.  if subparagraph (c applies as Title III of Article 74.

D.     Please confirm that the dependent wife and children of protected persons are entitled to medical benefits under Article 10, as to the provisions of this Article. Please provide information, if possible, on the number of dependent wives and children protected.

E.     If Article 6 (voluntary insurance) applied for all or any system, please provide the information referred to in Article 6, as laid down in Article 6.

A.    Please state which of the letters of the current Article is your reference.

In the social health insurance system from Romania subparagraph c) of Article 9, applies.

B.     Please indicate the protected person classes in accordance with the provisions of the current Article.

In accordance with the provisions of Law 95/2016, republished within the Romanian social health insurance system the following are insured:

-   all Romanian citizens with domicile in the country and who provide proof of the payment of social insurance contribution to the fund;

-   foreign citizens and stateless persons who have requested and obtained the extension of the  temporarily right of residence or who have their domicile in Romania and provide proof of paying their social  health insurance contributions at the unique National Social Security Fund.

-   the citizens of the European Union Member States, the European Economic Area and of the Swiss Confederation, who do not possess any health insurance in the territory of another Member State which produces its effect on the territory of Romania, who have requested and obtained the right of residence in Romania for a period longer than 3 months, and who can provide proof of paying their social health insurance contributions to the fund;

-   persons of the European Union Member States, the European Economic Area and of the Swiss Confederation, fulfilling the conditions of a frontier worker, namely employed or self-employed in Romania and residing in another Member State where he usually returns daily or at least once a week and who can provide proof of paying their social health insurance contributions to the fund;

-   Pensioners in the public pension system who are no longer domiciled in Romania and who

-   establish the residence in the territory of a Member State of the European Union, of a State belonging to it The European Economic Area or of the Swiss Confederation, respectively the domicile in the territory of a state with which Romania applies a bilateral social security agreement with provisions regarding sickness-maternity insurance and who can provide proof of paying their social health insurance contributions to the fund.

In accordance with the provisions of Law no. 95/2006, republished, the following categories are covered by the insurance:

1.    The persons who have the status of health insured person without paying the insurance health contribution:

a)    all the children up to the age of 18 years old, young people aged 18 years up to the age of 26, if they are pupils, including high school graduates, until the beginning of the academic year, but not more than 3 months, apprentices or students and if they do not have any work income;

b)   young people aged up to 26 years who come from the child protection system and not have any work income or do not benefit from social assistance granted under Law no. 416/2001 regarding the minimum guaranteed income, including subsequent amendments and additions; husband, wife or parents without their own income being in the care of an insured person;

c)    persons whose rights are established by Decree-Law no. 118/1990 on granting certain rights to persons persecuted for political reasons by the dictatorship set up from 6 March 1945, as well as those deported abroad or considered as prisoners, republished, through Law no. 51/1993 on the granting of certain rights to magistrates who have been removed from justice for political considerations between 1945 and 1989, including subsequent amendments and additions, trough Government Ordinance no. 105/1999 regarding the granting of rights to persons persecuted for ethnic reasons by the regimes established in Romania from 6 September 1940 until 6 March 1945, approved with amendments and additions by Law no. 189/2000, with amendments and additions, through Law no. 44/1994 on war veterans, as well as on some rights of invalids and widows of war, republished with modifications and subsequent completions by Law no. 309/2002 on the recognition and granting of rights for the persons who performed the military service in the General Department of the Labor Service during 1950 -1961, with the subsequent amendments and completions, as well as the persons referred to in Art. 3 par. (1) (b) point 1 of the Law of Gratitude to the Heroes-Martyrs and the fighters who contributed to the victory of the Romanian Revolution of December 1989, as well as towards the persons who have sacrificed their lives or have suffered from the anti-communist workers' uprising in Brasov in November 1987 no.341/2004, as subsequently amended and supplemented, if they do not earn any income other that derived from the monetary rights granted by these laws.

d)   people with disabilities who do not earn any income from work, pension or other sources, except  for those obtained under Law no. 448/2006 on the protection and promotion of the rights of  Disabled Persons, republished, with the subsequent amendments and completions;

e)    patients with diseases included in the national health programs established by the Ministry of Health, until healing the condition, if he /she does not earn income from work, retirement or other resource;

f)    pregnant women and women who have recently given birth, if they do not have any income or have earnings below the gross national minimum wage.

2.      Persons who are insured for the period in which they are in one of the following situations, with  the payment of contributions from other sources:

a)     persons who are on  leave for temporary disability following an accident at work, granted following an accident at work or an occupational disease;

b)    persons on parental leave allowance up to the age of 2 years of the child, and in the case of a disabled child, until the child has reached the age of 3 years, or benefits on parental leave and allowance for children with disability aged  between 3 and 7 years old;

c)     serving a custodial sentence, is under house arrest or in provisional detention, as well as those who are serving the measures provided in Art. 109, 110, 124 and 125 of the Penal Code

with the subsequent amendments and completions, respectively those that are in the postponement period or interruption of the execution of the custodial sentence, if they do not have income;

d)    persons receiving unemployment benefits;

e)     foreigners in the accommodation centres for removal or deportation procedures, as well as those who are victims of trafficking in human beings and who are in the process of establishing their identity and are housed in specially arranged centres according to the law;

f)     persons who are part of a family entitled to social assistance, according to the Law no.416/2001, with the subsequent amendments;

g)    individuals with monthly income from pensions;

h)     Romanian citizens, who are victims of trafficking in human beings, for a period up too 12 months, if they do not have income;

i)      recognized monastic clergy staff registered with the State Secretariat for Religious Affairs, if they do not make any income from work, pensions or other sources.

Persons who do not fit in the above categories have the obligation to obtain health insurance and to pay social health security contributions.

Persons who are not insured, are entitled to a minimal service package that includes: health care services, medicinal products and sanitary equipment only in the case medical and surgical emergencies and endemoepidemic diseases, monitoring of pregnancy and childbirth evolution, family planning services, prevention services and community health services.

C.     Please provide statistical information according to the current Article, as follows:

i. when reference is made to point (a), the form set out in Title I, according to Article 74 below,         or

Answer: does not apply

ii. when reference is made to point (b), the form set out in Title Il according to Article 74 below;  or

Answer: does not apply

iii. when reference is made to point (e), the form set out in Title Ill according to Article 74 below

Answer:

A. The number of protected residents (all protected persons, including those protected by the carer’s legal rights)

B.  The total number of residents (all residents including children and older people)

C.  The number of protected residents (A) in percent of the total number of residents (B)

	31.12.2011	31.12.2012	31.12.2013	31.12.2014	31.12.2015	31.03.2016	31.12.2016
Total no. of insured  persons registered on the lists of family physicians (benefit from the basic package of services)	18.305.557	18.291.872	18.094.338	17.174.986	17.191.563	17.171.844	17.130.940
Total no. of uninsured  persons registered on the lists of family physicians (benefit from the minimal medical  service package)	21.138.001	2.238.620	2.419.346	3.430.298	3.349.056	3.464.657	3.459.449
Total no. of persons  Who benefit from the medical service packages, registered on the lists of family physicians	20.443.558	20.530.492	20.513.684	20.605.284	20.540.619	20.636.519	20.590.389
The population of Romania (data reported by the National Statistical Institute)	21.431.298	21.431.298	21.316.420	22.279.183	22.242.738	22.242.738	22.222.984
%	95,39%	95,80%	96,23%	92,49%	92,35%	92,78%	92,65%

D.  Please confirm that the dependent children and wives of the protected persons (classes of employees or of the economically active population) are also entitled to medical benefits under Article 16, in accordance with the provisions of the current Article. Please state, when possible, the number of protected dependent children and wives.

In accordance with the provisions of Law no. 95/2006, republished:

-    all children under 18 years old,

-    husband, wife and parents without their own income, dependant of an insured person, benefit of the insurance without paying the contribution.

	31.12.2011	31.12.2012	31.12.2013	31.12.2014	31.12.2015	31.03.2016	31.12.2016
No. children under 18 years old	4.039.668	4.002.523	3.953.892	3.884.142	3.823.398	3.739.640	3.652.640
No. of insured persons from the category husband, wife and parents without their own income, dependant of an insured person	867.496	905.550	870.094	846.083	813.360	802.081	735.107

E. When reference is made to Article 6 above (voluntary insurance), for all or any scheme in question, please provide information according to the current Article on the form established by Article 6, applied for the entire system, and please provide the information referred to in Article 6, in compliance with the provisions of Article 6.

In accordance with the provisions of Law no. 95/2006, republished, the social health insurance is the main funding system for health care of the population that provides access to a basic package of services for the insured persons.

Other forms of health insurance can also work in different special situations. These insurance is not mandatory and may be offered voluntarily by authorized insurers according to the law.

Voluntary health insurance does not exclude the obligation to pay the contribution for social health insurance.

Article 10

1     The benefit shall include at least:

a      in case of a morbid condition,

               i   general practitioner care, including domiciliary visiting;

               ii  specialist care at hospitals for in‑patients and out‑patients, and such specialist care as may be available outside hospitals;

               iii the essential pharmaceutical supplies as prescribed by medical or other qualified practitioners; and

               iv hospitalisation where necessary; and

b     in case of pregnancy and confinement and their consequences,

                  i   pre‑natal, confinement and post‑natal care either by medical practitioners or by qualified midwives; and

                  ii  hospitalisation where necessary.

2     The beneficiary or his breadwinner may be required to share in the cost of the medical care the beneficiary receives in respect of a morbid condition; the rules concerning such cost‑sharing shall be so designed as to avoid hardship.

3     The benefit provided in accordance with this article shall be afforded with a view to maintaining, restoring or improving the health of the person protected and his ability to work and to attend to his personal needs.

4     The institutions or government departments administering the benefit shall, by such means as may be deemed appropriate, encourage the persons protected to avail themselves of the general health services placed at their disposal by the public authorities or by other bodies recognised by the public authorities.

A. Please indicate in detail the benefits provided under each system, referring to paragraph 1 of this Article, specifying in particular pharmaceutical products supplied and services rendered in case of hospitalization.

B.  If   paragraph 2 applies, please indicate for each type of benefit listed in paragraph 1 (a) the extent to which the patient or his supporter should participate in the cost of medical benefits received. Please indicate measures taken to ensure that participation in bearing the cost is not too burdensome.

C. Please confirm that in accordance with paragraph 2, the participation in costs is not required in case of pregnancy and childbirth and its consequences. If the system provides reimbursement of costs the beneficiary or his sponsor was forced to bear to obtain the benefits provided for in paragraph 1 (b), please provide any available information to illustrate that the beneficiary or his sponsor does not participate in the cost of these benefits.

D. Please provide in detail all measures taken to implement the provisions of paragraphs 3 and 4 of this article.

A.  Please indicate in detail the benefits provided under each system, referring to paragraph 1 of this Article, specifying in particular pharmaceutical products supplied and services rendered in case of hospitalization.

1.a)   In Romania, insured persons benefit from the services provided by the basic package of services in the event of disease or accident, from the first day of disease or from the date accident until healing, granted by the service suppliers in a contractual relationship with the health insurance house. (The provisions of Title VIII of Law 95/2006, republished).

Insured persons are entitled to:

       - to benefit from the reimbursement of all expenses incurred during hospitalization with medical products, sanitary materials, and laboratory investigations to which they have been entitled without personal contribution, under the terms of the framework agreement;

       - to carry out prophylactic checks under the conditions set out in the framework agreement;

       - to receive preventive health care and health promotion services, including early detection of  diseases;

       - to receive outpatient and hospital services in contractual relations with health insurance houses;

       - to receive emergency medical services;

       - to receive some dental care services;

       - to receive physiotherapeutic and recovery treatment;

       - to benefit from medical devices;

       - to receive health care services at home;

       - to benefit from leave and allowance from the social health insurance, under the law.

The services packages that are granted on the various healthcare levels within the social health insurance system are laid down in the Order no.763 / 377/2016, Order no. 196/139/2017 and G.R. no. 161/2016 in force since 1 July 2016.

Insured persons have the obligation to pay monthly cash contribution for health insurance. In case of non-compliance, these persons benefit from healthcare services within a minimal package of services, in compliance with the provisions of Law no. 95/2006, republished, which include health care services, medicinal products and sanitary equipment only in the case medical and surgical emergencies and endemoepidemic diseases, monitoring of pregnancy and childbirth evolution, family planning services, prevention services and community health services, in the following assistance:

              I.     primary medical care

           II.     ambulatory care for clinical specialities,

        III.     ambulatory care for dental services

        IV.     hospital care.

I.                   Primary medical care is provided by the family physician as it follows:

o   For the persons who don’t provide the proof of paying their social  health insurance contributions at the unique National Social Security Fund- healthcare services within a minimal package of services.

o For the persons who are insured  (provide the proof of paying their social  health insurance contributions at the unique National Social Security Fund) - healthcare services within a basic package of services;

o  Emergency medical  services received by anyone who needs such services (regardless of the fact if he is registered or not on the list of the family physicians who provide emergency healthcare).

The basic package comprises of:

  1. Curative services for medical and surgical emergencies, acute and subacute conditions, acute exacerbation of some chronic conditions and for chronic conditions.

a. emergency consultation

b. consultations for acute /subacute diseases,  or acute exacerbation of some chronic conditions

c. consultations for chronic conditions, for:

     • monitoring the progress of the disease;

     • therapy continuity;

     • screening of the complications;

     • self-care education of the insured person ,

d. active monitoring through an integrated management plan is done for chronic diseases with major impact on the disease burden regarding: high cardiovascular risk - CVD dyslipidemia and type 2 diabetes, bronchial asthma, chronic obstructive respiratory disease (COPD), chronic kidney disease; it includes:

           - Initial assessment of the new case detected in the first trimester after the record,

             - Patient monitoring

2. Preventive and prophylactic healthcare services:

1. Preventive examination  is an active periodical consultation, for people aged between 0 up to 18 years, on growth and development, nutrition status and nutritional practices, detection and consequent intervention for age/gender specific risks, preventive services for children  grouped by age and gender,

2. Monitoring the evolution of pregnancy and recently given birth: (see Part VIII Art. 49)

3. Individual risk assessment in the asymptomatic adult – consultations at the cabinet of the family physician are actively granted to adults from the general population,

4. Surveillance and screening of  potential endemic-epidermal diseases,

5. Family planning services:

  a) counselling women regarding family planning;

  b) indicating a personal contraceptive method without risks.

3. Consultations at home – provided by the family physician for an insured person registered on his list.

4.Additional healthcare services represent optional services provided in the family physicians cabinets, exclusively to the insured persons on their own list. These services are:  general ultrasound- abdomen and pelvis and EKG performance and interpretation.

5.The support activities are represented by the issuance of the following documents: medical leave,

referrals, medical prescriptions, medical certificates for children in case of disease, medical records necessary for children in care under the social care system and child protection, medical certificates for enrolment in the community - released after performing the annual balance examinations of pre-schoolers and pupils and only when enrolling in each education cycle and the epidemiologic notice for (re) entry into the community, according to the legal provisions in force, as well as the issuance of the death certificate,  with the exception of suspicious situations requiring forensic expertise in compliance with the legal provisions, as a result of the examination for establishing  the death.

6. Drug administration services- intramuscular, subcutaneous, intradermal, intravenous or infusible, depending on the case, granted to the insured persons on their list of the family practitioner, during working hours in the office.

II)Specialised clinical outpatient care is provided by specialised doctors, along with other health-care specialised staff and other categories of staff, as well as with authorized or attested personnel, depending on the case, for the performance of health services related to the medical act, and for acupuncture by the doctors who have obtained the certificate/attestation of complementary acupuncture studies.

The basic package includes:

1. Services for medical and surgical emergencies

2. Consultations for acute /subacute diseases, or acute exacerbation of some chronic conditions

3. Consultations for chronic conditions

4. Consultation for detecting potential endemoepidemic diseases

5.  Family planning services (consultations)

6. Simple and complex diagnostic services and therapeutic/surgical and medical treatments

7. Health services related to the medical act may be subject to contracts concluded by Health insurance houses with specialised doctors; these are provided by psychologists, speech therapists and physiotherapists.

8. Monitoring services of pregnant and recently given birth women (see Part VIII Art. 49)

9. Acupuncture – consultations and treatments.

Medical assistance in specialized ambulatory for specialised clinical recovery, physical medicine and balneology is ensured by specialised doctors in recovery, physical medicine and balneology, together with other medico-sanitary specialists and other categories of personal.

Basic healthcare services package includes consultations and sets of procedures.

The consultation from the specialised doctor for outpatients and from the ambulatory care for the specialised clinical recovery, physical medicine and balneology, are ensured in the base of the referral note from the family physician, or other specialised doctor only if the insured person had the referral note originally issued by the family physician on whose list he is registered and only if the referral physician is in a contractual relationship with the health insurance house. The conditions under the legal provisions in force (see Annex 13 of Order no. 763/377/2016 and Annex 13 from Order no. 196/139/2017) are exempt from the obligation of presenting the referral note.

Dental care is provided by doctors of dental medicine and dentists, along with others health care professionals and other staff categories.  Basic healthcare services package includes dental treatments.

No referral note is required to provide medical dental services.

The basic healthcare package of services in the ambulatory care for paraclinical specialities includes:

1. Paraclinical examination-Laboratory investigations:

                     - Hematology

                     - Biochemistry – serum and urine

                     - Immunology

                     - Microbiology

                     - Testing sensitivity to antimicrobial and antifungal substances

                     - Histopathological and cytological examinations

2. Radiology laboratory investigations – medical imaging, nuclear medicine and functional exploration:

- Radiology – Medical imaging:   - Investigations with ionizing radiation

                                                      - Investigations without radiation exposure

                                                      - High performance investigations

- Functional exploration

- Nuclear medicine.

The paraclinical medical investigations are granted only on the basis of referral note, provided that the doctor who issued the referral note is in a contractual relationship with the same health insurance house with which the laboratory healthcare provider is in a contractual relationship.   

           

Medical devices designed to recover organic or functional deficiencies for outpatient are granted for a fixed or indefinite period, based on a medical prescription issued by the specialised doctor in a contractual relationship with the health insurance house. The basic package includes hearing aids in the ENT field, devices for ostomy stenting, urinary incontinence, prostheses for the inferior limb, for superior limb,

orthoses (for the spine, for the superior limb, for the inferior limb),orthopaedic footwear, devices for visual impairment, oxygen therapy equipment and noninvasive ventilation, walking devices, saline aerosol therapy devices, external breast prostheses.

III)Insured persons benefit from outpatient medicinal products with or without personal contribution, on medical prescription issued by physicians who are in contractual relationships with health insurance houses.

The method of prescribing and dispensing medicinal products is provided by the above mentioned Detailed implementation rules.

The list of Medicinal products (INN) to which insured persons are entitled, with or without contribution, is drawn up by the Ministry of Health and the National Health Insurance House, with the consultation of the College of Pharmacists in Romania and approved by Government resolution.

The list may include only the medicinal products listed in the Classification of Products (- the provisions of the Title VIII of Law 95/2006, republished).

Medicinal products with and without personal contribution in outpatient treatment and some specific sanitary materials provided for outpatient treatment of patients included in some national health programs for curative purposes are released through pharmacies belonging to the health units which run the respective programs or, as the case may be, through other pharmacies authorized by the Ministry of Health, evaluated in accordance with the legal regulations in force.

The list of International Nonproprietary Names from the Classification of medicinal products for human use granted to the insured persons for the outpatient treatment, with or without personal contribution, on medical prescription, is provided in Government Resolution no. 720/2008 for the approval of the List of International Nonproprietary Names  granted to the insured persons, with or with personal contribution, on a medical prescription, within the social health insurance system, as well as the international nonproprietary names granted within the national health programs, with subsequent amendments and additions

IV)  Hospital healthcare is provided in health units with beds, authorized and assessed under the terms of the law.

Hospital care services are preventive, curative, for recovery, palliative and they include: specialized medical consultations, investigations, medical diagnosis, medical and /or surgical treatments, recovery, care, medicinal products, sanitary materials, medical devices, accommodation and meals, as applicable, depending on the type of hospitalization.

Depending on the length of hospitalization, hospital care is granted in the following conditions:

a) continued hospitalization: includes acute and chronic care and is granted in compliance with the following admission  criteria:

    √ childbirth;

    √ medical and surgical emergencies and situations when the life of the patient is at risk, or which have such potential,  requiring continued medical surveillance;

    √ diseases with  endemoepidemic potential, which need treatment and isolation; 

    √ patients  referred to in Art. 109, 110, 124 and 125 from Law no. 286/2009 of the Penal Code, including subsequent amendments and additions, by order of the General prosecutor during trial or prosecution, who require compulsory isolation or admission, and the treatment of persons deprived of their liberty for which the court has ordered enforcement in a detention hospital, as well as the treatment of patients in prisons

 whose conditions require monitoring and re-evaluation within detention hospitals; patients who require

long-term hospital care-years;

    √ conditions for which diagnosis and /or treatment cannot be monitored in outpatient settings

or day hospitalization.

    • Patients presenting admission note for continued hospitalization will be scheduled for admission, depending on the condition and severity of the signs and symptoms they present and on the availability of hospital services requested.

    • Prevention of continuous hospitalizations considered as avoidable will be done through early diagnosis approach, treatment, and monitoring, respectively appropriate surveillance, in outpatient and day hospitalization, if appropriate.

Annex 22 to Order no. 763/377/2016 and Annex 22 to Order no. 196/139/2017 provide the list of main diagnoses considered as avoidable for continued hospitalizations and the specific criteria for their reduction / elimination from continued hospitalization.

b) day hospitalization:  includes acute and chronical care and is granted in compliance with the following admission  criteria:

     √ medical-surgical emergencies requiring medical supervision up to 12 hours, only in the health units with beds that also provide continued hospitalization;

    √ conditions for which diagnosis cannot be established and treatment cannot be performed and/or monitored in outpatient.

    • The services required to diagnose, treat or monitor the patient performed under day hospitalization may be multidisciplinary and/or involve multiple specializations, can be invasive, may be followed by side effects or an emergency risk during their performance or correlated with the patient's state of health, requiring medical supervision that cannot be performed in outpatient treatment.

  • Continued and day hospitalization services are granted on the admission note.

  • Specialised doctors that can issue admission notes are:

  - family physician;

  - The specialist physician in ambulatory health facilities, regardless of the form of organization;

  - specialised doctors in the social health care units;

  - specialised doctors from private dialysis centres in a contractual relationship with the health insurance houses/ National Health Insurance House, as applicable.

  - specialised doctors  working in TB dispensaries, in mental health care laboratories, respectively in mental health centres and inpatient day psychiatry, in dental practices, which are not in a contractual relation with the health insurance houses and which are situated in hospital structures as entities  without legal personality;

- occupational physicians.

   • The situations when the admission note is not required are regulated for (the entire reference period)

childbirth, medical and surgical emergencies diseases with endemoepidemic potential, which need treatment and isolation, patients  referred to in Art. 109, 110, 124 and 125 from Law no. 286/2009, including subsequent amendments and additions, by order of the General prosecutor during trial or prosecution, who require compulsory isolation or admission, and the treatment of persons deprived of their liberty for which the court has ordered enforcement in a detention hospital, as well as the treatment of patients in prisons

whose condition require monitoring and re-evaluation within detention hospitals; patients who require

long-term hospital care-years; occurrences with admission recommendation following a medical letter granted by specialised doctors from the integrated ambulatory care of the hospital, in a contractual relationship with the health insurance houses, in hospital transfers in the situation when the type of care needs to be changed, in hospital transfer, patients who have a medical discharge with the notice of return for admission, patients with haemophili who are in the national haemophilia program and in day hospitalization for medical and surgical emergency, chemotherapy, radiotherapy, proper drug administration according to INN marked with

marked with (**)I, (**)l ß and (**)l Ω referred to in Government  Resolution no. 720/2008, including subsequent amendments and additions, monitoring of HIV/AIDS patients, dynamic assessment of viro-immunological responses, monitoring and treatment of patients with thalassemia, monitoring a

oncological patients, treatment administration for rabies prophylaxis, monitoring primary  genital syphilis and secondary skin and mucosal syphilis, solving cases with admission recommendation to a hospital following a medical letter given by doctors in the integrated ambulatory of the respective hospital, in a contractual relationship with the health insurance houses, patients who have a medical letter on discharge with indication of a return to hospitalization, patients with haemophilia in the national haemophilia program.

     √ Hospital healthcare are provided to insured persons until healing.

Medical Assistance and Specialised clinical recovery, Physical Medicine and Balneology in Sanatoria, including Preventive and Balneal sanatoria is granted as hospitalization in sanatoria/ sanatoria sections for adults and children, including both the balneal as well as the prevention ones, based on a referral note for recovery treatments, physical medicine and balneology to a balneal sanatoria/other recovery treatment than the balneal and prevention ones,  issued in accordance with the specific pathology and associated condition of the insured and the peculiarities of the balneal treatment.

       1. (b) In the case of pregnancy, childbirth and their evolution – please see Part VIII, Article 49.

B.   If   paragraph 2 applies, please indicate for each type of benefit listed in paragraph 1 (a) the extent to which the patient or his supporter should participate in the cost of medical benefits received. Please indicate measures taken to ensure that participation in bearing the cost is not too burdensome.

           

The medical services where co-payment is applied are the medical services provided in health units with beds through continued hospitalization and medical services provided in the specialised recovery ambulatory, physical medicine and balneology; the minimum co-payment level is of 5 RON the maximum is of 10 RON.

The value of co-payment will be established by every healthcare unit based on its own criteria.

     

As provided for Title VIII of Lew no. 95/2006, the following insured categories are exempt form co-payment:

a) children up to the age of 18, young people between the age of 18 up to 26, if they are pupils,  high school graduates, until the beginning of the academic year, but not more than 3 months, apprentices or the students, if they do not earn income from work;

b) patients with diseases included in the national health programs established by the Ministry

Health, for medical services related to the underlying disease, if they do not earn any income from work, pensions, or other resources;

c) individuals with monthly income only from pensions whose amount is up to the value of a RON, complemented by a rounding up in addition, of the notional pension credits, for the current tax year.

d) all pregnant women and women who have recently given birth, for health services related to the evolution of the pregnancy, and for all healthcare services for those who do not have any income or have earnings below the gross national minimum wage.

Personal contribution is required for medical dental services, medicinal products, healthcare recovery, physical medicine and balneology in balneal sanatoria and medical recovery in other sanatoria and prevention centres, medical outpatient devices, as it follows:

Ø Dental care services- for healthcare dental treatment services granted:

       - For children between the ages of 0 and 18 years old, the National Health Insurance House reimburses 100% of the maximum healthcare service charge.

       -  for the insured people aged over 18 years old, the health insurance house reimburses percentages of maximum service charge.

       - for the insured people who benefit from the special laws (Law no.44/1994, Law no. 341/2004) the percentage of 100% is reimbursed if the services have been provided in private, public or military healthcare units, otherwise the percentage reimbursed by the health insurance house is of 60%.

       -  for other categories of insured people who benefit from the special laws the percentage reimbursed e by the health insurance house is of 100%.

Ø Medicinal products with and without personal contribution within the treatment in the ambulatory care

As provided for G.R no. 720/2008, with the subsequent amendments and completions:

The reimbursement percentage of the medicinal products of the common international nonproprietary names for those provided in sublist A is of 90% of the reference price, for those in sublist B is of 50% of the reference price, for those in sublist C for sections C1 and C3 is of 100% of the reference price, and for those in sublist D is of 20% of the reference price.

For pensioners with incomes only from pensions up to 700 RON/month, the amount of compensation for the medicinal products corresponding to the common international nonproprietary names provided in

Sublist B, is of 90% of the reference price, out of which 50% is covered by the unique National Social Security Fund and 40% by the transfers from the Health Ministry’s budget to the budget of the National Social Security Fund, for prescriptions whose value at the reference/prescription price is up to 330 RON per month.

The maximum amount sustainable by the health insurance houses of the Fund is the one corresponding to the compensation percentage of the medicinal products applied to the reference price.

Medical prescriptions for medicinal products without personal contribution are released in the following situations:

       a) for children aged between 0 up to 18 years, pregnant women and women who have recently given birth, young people from 18 to 26 years old, if they are pupils,  high school graduates, until the beginning of the academic year, but not more than 3 months, apprentices or the students;

       b) For chronic diseases related to certain groups of diseases according to the legal provisions in force;

       e) For the persons referred to in the special laws, in compliance with the provisions regarding the prescription of medicinal products.

Ø Health units with beds

            From the amounts contracted from the health insurance houses, the hospitals bear the corresponding amount for standard hotel services (standard accommodation and meal allowance) for the attender of the sick children aged up to 3 years, as well as for impaired persons or with severe disabilities.

Insured persons will bear the costs for high comfort standard hotel services (accommodation and/or meal) provided upon their request. The equivalent of the hotel service with a high degree of comfort is established by each hospital unit providing hospital services. For health units with beds, both public and private, the personal contribution of the insured for these services is maximum 300 RON/day.

Ø Medical Assistance and Specialised clinical recovery, Physical Medicine and Balneology in Sanatoria, including Preventive and Balneal sanatoria

In balneal sanatoria/sections from hospitals, the personal contribution of the insured represents 35% of the negotiated rate/hospitalization day.

For recovery services, physical medicine and balneology to a balneal sanatoria/other recovery treatment than the balneal and prevention ones, no contribution is required.

Ø Medical devices designed for the recovery of organic or functional deficiencies in outpatients

The maximum amount to be borne by the Health Insurance Fund for each medical device or a type of medical device designed for the recovery of organic or functional deficiencies in outpatients, within the social health insurance system is the reference price or, as applicable, the rental amount. The reference price and the rental amount will be established according to a methodology which will be approved by the President of the National Health Insurance House. If the retail or the rental price of the medical device is higher than the reference/rental amount established according to the methodology approved by the decision of the President of C.N.A.S (the National Health Insurance House) the insured will bear the difference trough personal contribution and will be paid directly to the supplier.

C.   Please confirm that in accordance with paragraph 2, the participation in costs is not required in case of pregnancy and childbirth and its consequences. If the system provides reimbursement of costs the beneficiary or his sponsor was forced to bear to obtain the benefits provided for in paragraph 1 (b), please provide any available information to illustrate that the beneficiary or his sponsor does not participate in the cost of these benefits.

In the case of pregnancy, childbirth and their evolution, the beneficiary of the healthcare services or her provider do not bear the cost of medical services, and according to the provisions of Law no.95/2006, republished, all pregnant and recently given birth women, are exempt from co-payment for services related to the evolution of pregnancy, and those who do not have any income or have earnings below the gross national minimum wage, from all healthcare services.

The value of the medicinal products for pregnant and recently given birth women is borne from the Fund at the reference price level.

D.   Please provide in detail all measures taken to implement the provisions of paragraphs 3 and 4 of this article.  

In compliance with the provisions of Law no. 95/2006, republished, for the purpose of prevention, early detection of disease and preservation of health, the insured persons will be permanently informed, directly or through the service providers, with which the insurance houses are in contractual relations, upon the means of preserving the health, of reducing and avoiding the causes of diseases and on the dangers to which they are exposed in case of drug use, alcohol and tobacco.

Article 11

The benefits mentioned in Art. 10 must be granted within the covered social risk at least for the protected persons who have personally or through their family provider completed the necessary contributions, in order to avoid abuse.

              

Please declare for every scheme in question the length of the period for the qualification considered to be necessary for the prevention of abuse. Please make a summary of the rules for calculating the qualification period.

Social insurance health legislation does not regulate a mandatory qualification period for the insured and co- insured person. The person is considered insured from the moment of payment of the contribution to the National Health Insurance Fund.

Article 12

The benefit specified in Article 10 shall be granted throughout the contingency covered, except that, in case of a morbid condition, its duration may be limited to 26 weeks in each case, but benefit shall not be suspended while a sickness benefit continues to be paid, and provision shall be made to enable the limit to be extended for prescribed diseases recognised as entailing prolonged care.

1.      Please specify for each system separately, if the duration of all medical benefits referred to in paragraph 1 (a) of Article 10 is limited; if the answer is yes, please, indicate:

a)   limit or limits set for each type of benefit;

b)   limit or limits of the diseases recognized as requiring extended care.

2.     Please indicate, on Article 68, if there are provisions for suspension of medical benefits referred to in Article 10, for each system.

1.    Please specify for each system separately, if the duration of all medical benefits referred to in paragraph 1 (a) of Article 10 is limited; if the answer is yes, please, indicate:

a)      limit or limits set for each type of benefit;

A.       Primary medical care

The basic package includes:

I. Curative services for medical and surgical emergencies, acute and subacute conditions, acute exacerbation of some chronic conditions and for chronic conditions

1. emergency situation

- each observed emergency situation is being granted a single consultation per person.

2. acute /subacute disease,  or acute exacerbation of some chronic conditions

- each disease occurrence is being granted maximum two consultations.

3. chronic condition

- each chronic condition/insured person is being granted a monthly consultation.

4. active monitoring through an integrated management plan

- Initial assessment of the new case detected in the first trimester after the record – occurrence that can include: 3 consultations with the family physician during a period of maximum 3 consecutive months.

- Patient monitoring – contains 2 scheduled consultations, which include disease control evaluation, screening of the complications, patient education, paraclinical investigations and treatment and a new monitoring is being done after 6 consecutive months, calculated over the month in which was made the second consultation of the management case previous monitoring.

II. Preventive and prophylactic healthcare services:

1. Preventive examinations are periodical, as it is:

a) on maternity discharge and after 1 month (at the child’s home);

            b) at 2, 4, 6, 9, 12, 15, 18, 24, 36 months;

            c) once per year from 4 to 18 years.

2. Monitoring the evolution of pregnancy and recently given birth: (see Part VIII Art. 49)

3. Preventive consultations for the insured persons which are over 18 years old:

- Individual risk assessment in the asymptomatic adult

-  Every person with the age between 18 and 39 years – once every 3 calendar years. A maximum of two consultations/insured person is being granted during the year of the individual risk assessment.

People with the age between 18 and 39 years with a high risk – granted maximum 2 annual consultations/insured person.

-   All people with the age above 40 – granted maximum 2 annual consultations/insured person.

4. Surveillance and screening of potential endemic-epidermal diseases

A single consultation per person for each suspected and confirmed disease with endemic-epidermal potential is being granted.

5. Family planning services: - maximum two consultations per calendar year, per insured person is being granted.

III. Consultations at home – are granted as follows:

-     maximum 2 consultations for each acute /subacute occurrence,  or acute exacerbation of some chronic conditions; maximum 4 consultations/year for chronical diseases and one consultation for each emergency situation.

IV.     Additional healthcare services

The maximum number of general ultrasound and EKG exams (performance and interpretation) that can be done and granted in one hour by the family physician cannot exceed 3.

V.       The support activities

Limitations imposed by the specifics of each document indicated in the basic package of services.

VI. Drug administration services – on medical recommendation.

B) Specialised clinical outpatient care

Payment of the specialised outpatient care services for clinical specialties and acupuncture is made based on rate for each quantified medical service in points or in RON.
National insurance houses reimburse medical practitioners of clinical specialties the value of medical services reimbursed by a rate expressed in points provided in the service package, if these services are performed in the medical offices where they perform their activity and interpreted by these doctors, taking into account the number of points for each medical service and the value set for one point.
The total number of points reported for consultations, medical services provided by specialized clinicians in clinical specialties, family planning cannot exceed the number of points resulting from the work schedule, according to the provisions of Annex 8

        - Order no. 763/377/2016 - for the period 1 July 2016- 31 March 2017,

        - Order no. 196/139/2017 - from 1 April 2017.

The basic package includes:

1.      Curative services for medical and surgical emergencies

-          A single consultation per person is granted for each detected emergency situation, which has received the first aid or has been solved at the medical office, except for children between 0 and 18 months for which a maximum of 2 consultations is being reimbursed.

2.      Acute and subacute conditions,  acute exacerbation of some chronic conditions

-          For the same occurrence of acute and subacute conditions, acute exacerbation of some chronic conditions a maximum of 3 consultations is being granted, during a period of 60 calendar days from provision of the first consultation, required for establishing the diagnosis, treatment and evolution of the case.

3.      Chronic conditions

-          In case of clinical and paraclinical evaluation, treatment prescription and monitoring the evolution of the insured people with chronic conditions, for one or more chronic diseases treated within the same specialty, 4 consultations/quarter/insured person are being reimbursed, but not more than 2 consultations per month.

4.      Screening of potential endemic-epidermal diseases

-          A single consultation per person for each suspected and confirmed disease with endemic-epidermal potential is being reimbursed.

5.      Family planning services:

-          four consultations per calendar year, per insured person is being granted.

6.      Simple and complex diagnostic services and therapeutic services / surgical and medical treatments - the total number of points reported for consultations, cannot exceed the number of points achieved as per the work schedule, according to the above-mentioned point ii).

7.      Medical services related to healthcare - The score related to health-related health services that can be reported to one or more insured persons regardless of type of related service or specialist doctor who has requested them may not exceed 90 points on average per day due to the person / s, except for the specialist paediatric psychiatrist for whom the score cannot exceed 180 points on average per day.

8.      Surveillance services for women who are pregnant or have recently given birth (see Part VIII Art. 49)

9.      Acupuncture – Insured persons have the right to maximum 2 consultations/treatments/calendar year for each insured person (one consultation for each treatment course). A course represents on average 10 days of treatment and around 4 procedures/day.

Medical assistance in specialized ambulatory for the clinical specialty of recovery, physical medicine and balneology

The basic package includes:

1.      Initial specialized medical consultation,

2.      Reassessment of the consultation,

3.      A series of specific recovery procedures, physical medicine and balneology established by the physician for recovery, physical medicine and balneology, provided for an insured, includes a maximum of 4 procedures / day of treatment.

The period for which specific recovery procedures, physical medicine and balneology are granted is maximum 21 days / year / provided for both children and adults, with the exception of children aged 0-18 with confirmed diagnosis of cerebral palsy, when specific recovery medical procedures, physical medicine and balneology are granted for a period of maximum 42 days per year / insured.

An initial specialized medical consultation and a reassessment consultation is being granted for each series of specific procedures.

For situations where an insured person is not recommended for a number of specific recovery medical procedures, physical medicine and balneology, 3 consultations/quarter are granted for the same condition.

Dental care

The basic dental care package:

-          a single consultation for a 12 months period for an insured person above 18 years old and a consultation each 6 months for children under 18 years old is granted.

-          the acrylic prosthesis mobilizable on the arcade is granted once every 4 years,

-          prosthetis repair, prosthesis rebasing - granted once a year,

-          sealing / tooth - a reimbursed procedure every 2 years.

Medicines with and without personal outpatient contribution

Periods for which medications can be prescribed are up to 7 days in acute affections, 8-10 days in underactive conditions and up to 30/31 days - 90/91/92 days for patients with chronic conditions. The period for which prescription drugs can be prescribed for cost-volume / cost-volume-result contracts is up to 30 to 31 days.

For chronic diseases, physicians may prescribe to an insured drug with and without personal contribution, subject to the following conditions:

a)      for sublists A, B and D - a prescription / multiple monthly prescriptions not to cumulatively exceed 7 different medications on all one-month prescriptions. The total value of the drugs in sublist B, calculated at the reference price level, is up to 330 RON per month;

b)      if a drug of sublist B indicated with # is prescribed during a month with a maximum treatment value of one month, calculated at the reference price, is higher than 330 lei, other drugs in sublist B cannot be prescribed during this month;

c)      for the pensioners with incomes only from pensions up to 700 lei / month, the provisions of Art. (a) and (b) are not applicable; they may benefit from a prescription / multiple monthly prescriptions that do not cumulatively exceed 7 drugs in sublists A, B and D; in this case, for a maximum of 3 drugs in sublist B, a single distinct prescription with 90% offset of the reference price is made, the equivalent reference price of which is up to 330 lei per month / prescription;

d)     for sublist C section C 1 - for each disease code, one prescription / maximum two monthly prescriptions, with a maximum of 3 drugs;

e)      for sublist C section C3 - a single monthly prescription with up to 4 drugs.

By way of exception, in the case of the medicinal products listed in table II of the Annex to the Law no. 339/2005 on the legal regime of plants, narcotic and psychotropic substances and preparations, with the subsequent modifications and completions, several prescriptions can be issued for the same insured according to the legal regulations in force.

Hospital care services are provided to insured persons until healing.

In the sanatoriums the lengths of hospitalization are:
Recovery, medicine and balneology - 14 - 21 days / year / insured given in a single episode involving at least 4 procedures / day.

2.    Please indicate, with reference to Article 68, the provision, if any, on the suspension of the medical benefits referred to in Article 10 under each scheme in question.

Insured persons have the obligation to pay a monthly contribution for health insurance. In case of non-compliance with the obligation, these persons benefit from medical services within a minimum package of medical services, according to the provisions of Law no.95 / 2006, republished.

According to the Law no. 95/2006, republished, as subsequently amended and supplemented, the documents certifying the quality of insured are:

·         National Health Insurance Card,

·         the 3-month insured certificate for persons who expressly refuse, for religious reasons or for conscience, the national card,

·         replacement certificate for those who will be issued a duplicate national card,

·         the documents provided under art. 223 par. (1) of Law no. 95/2006 republished with the subsequent modifications and completions (the insurance certificate issued by the insurer's house where the insured is inscribed or the document resulted from accessing by the suppliers in contract with the health insurance houses of the electronic instrument provided by CNAS).

Those who have not been issued with their national health insurance card can benefit from medical services without presenting them.

According to the provisions of Art. 342 and 343 of Law no. 95/2006, republished, with the subsequent modifications and completions, the insured persons over the age of 18 have the obligation to present the national health insurance card, or the documents mentioned above, as applicable.

Article 13

Each Contracting Party for which this part of the Code is in force shall secure to the persons protected the provision of sickness benefit in accordance with the following articles of this part.

According to E.G.O. no. 158/2005, with the subsequent amendments and supplements, as well as with the Order of the Minister of Health and President of the National Health Insurance House no. 60/32/2006, with the subsequent amendments and supplements, medical leaves for temporary labour incapacity, will be granted for a period of maximum 183 days per year, calculated from the first day of illness.   

Beginning with day 91, the medical leave can be extended to 183 days only with the approval of the expert physician of the social insurances.   

The leave and indemnity period for temporary labour incapacity is longer for special illnesses and is differentiated as follows:  

    a) one year during the past 2 years, for pulmonary tuberculosis and some cardiovascular diseases established by the National Health Insurance House with the approval of the Ministry of Health;  

    b) one year, with extension right, up to a year and six months, by the expert physician of social insurance, during the past 2 years, for meningeal, peritoneal and urogenital tuberculosis, included the adrenals tuberculosis, as well as AIDS and neoplasia, according to the illness stage;  

    c) one year and six months during the past 2 years, for operated and osteoarticular tuberculosis;

    d) 6 months with the possibility of extension up to maximum one year, during the past 2 years, for other types of extra-pulmonary tuberculosis, with the endorsement of the social insurance expert physician.     

To obtain the aforementioned endorsements, the attending physician will draft a medical report according to the template regulated by Order of the Ministry of Health and President of the National Health Insurance House no. 60/32/2006, with the subsequent amendments and supplements; the medical report will be sent to the medical expertise and recovery cabinet of the labour capacity within the territorial range of the insured individual.

The attending physician or, as applicable, the specialized physician in the mainly invalidating illness, can propose the invalidity retirement, if the ill person was not recovered at the expiration date of the indemnity granting periods for temporary labour incapacity.

In the cases justified by the possibility of recovery, the attending physician or, as applicable, the medical consultant can propose the extension of the medical leave past 183 days, for the purpose of avoiding the invalidity retirement and maintaining the insured individual's labour capacity.

The expert physician of the social securities office decides, as applicable, on the extension of the medical leave, to continue the recovering programme, to reduce the work schedule, to reinstate the activity related to the professional training and aptitudes or the invalidity retirement.

The extension of the medical leave past 183 days is carried out for at least 90 days, according to the procedures established by the National House of Pensions and Other Social Security Rights together with the National Health Insurance House, related to the case evolution and results of the recovery actions.

 

Article 14

The contingency covered shall include incapacity for work resulting from a morbid condition and involving suspension of earnings, as defined by national laws or regulations.

Article 15

The persons protected shall comprise:

       a      prescribed classes of employees, constituting not less than 50 per cent of all employees; or

       b     prescribed classes of the economically active population, constituting not less than 20 per cent of all residents; or

       c      all residents whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.

A.     Please indicate sub-paragraph of this applicable article.

B.     Please indicate the classes of persons protected under this Article, unless applied to sub-paragraph (c);

C.     Please provide statistical information related to this Article, as follows:

i.      if applicable sub-paragraph (a) in the form of Title I of Article 74;

ii.    if applicable sub-paragraph (b), as Title II of Article 74;

iii.  if applicable sub-paragraph (c) as Title III of Article 74.

D.     When applying Article 6 (voluntary insurance) for all or any system, please provide the information referred to in Article 6, as laid down in Article 6.

A.   Please indicate sub-paragraph of this applicable article.

Within the social insurance system, to the leave allowance and health security benefits is applicable the sub-paragraph b) of Article 15.

B.   Please indicate the classes of persons protected under this Article, unless applied to sub-paragraph (c).

The protected persons according to this article are insured persons, Romanian citizens, foreign citizens or stateless ones, which, according to the law, have a residence in Romania, especially:

-  persons with individual labour contracts or based on the service report, as well as any other dependant activities;

-   persons rendering activities in elective functions or appointed within the executive, legislative

or court authority, during the mandate;

-   members of handicraft cooperatives organizations;

-   the unemployed (receiving monthly financial benefits from the unemployment insurance budget).

The following persons also take advantage of the same rights, although they are not in same situations:

    a. shareholders, limited partners and stakeholders;

    b. members of family businesses;

    c. individuals authorized to carry out independent activities;

    d. persons concluding social insurance contracts for leaves of absence and maternity allowances and leaves of absence and allowances for the care of a sick child, provided they started to pay the contribution up to January 1st, 2006.

     f. wife / spouse of the owner of individual undertaking / authorized person (freelancers) who, without being registered / recorded with the Trade Register and authorized to operate himself / herself as the owner of the individual undertaking / authorized person, or, without being an employee, participates in the usual activities of the individual undertaking / authorized person, performing the same tasks or ancillary tasks.

C.   Please provide statistical information related to this Article, as follows:

            i. if applicable sub-paragraph (a) in the form provided for in Title I, according to Article 74; or

N/A

            ii. if applicable sub-paragraph (b) in the form provided for in Title I, according to Article 74;

A.    The average number of active persons, on national level, insured for leaves of absence and indemnities foreseen in the social health insurance system was as follows:

Period/Year	Average Number
June 1st 2011 – May 30th 2012	4 894 637
June 1st 2012 – May 30th 2013	4 957 523
June 1st 2013 – May 30th 2014	4 961 891
June 1st 2014 – May 30th 2015	5 102 849
June 1st 2015 – May 30th 2016	5.234.333

B. Overall number of residents^[1]

C. Average number of active individuals, on national level, protected (A iii.) as percentage of the overall number of residents (B).

     Please state the calculation method and provide reference data.

     iii. if applicable sub-paragraph (c) in the form provided for in Title I, according to Article 74.

N/A

D.      When applying Article 6 (voluntary insurance) for all or any system, please provide the information referred to in Article 6, as provided for in Article 6.

N/A

Article 16

1. Where classes of employees or classes of the economically active population are protected, the benefit shall be a periodical payment calculated in such a manner as to comply with the requirements of Article 65 or with the requirements of Article 66.

2. Where all residents whose means during the contingency do not exceed prescribed limits are protected, the benefit shall be a periodical payment calculated in such a manner as to comply with the requirements of Article 67; provided that a prescribed benefit shall be guaranteed, without means test, to the prescribed classes of persons determined in accordance with Article 15.a or b.

A.     If  sub-paragraph (a) or (b) of Article 15 applies to determine the persons protected, please indicate whether for the calculation of the benefit were applied the provisions of Article 65 or those of Article 66.

Please provide information under this Article as follows:

i.      if applicable Article 65, as set out in Titles I, II and V of Article 65;

ii.     whether Article 66 applies, as set out in Titles I, II and V of Article 66.

B. Whether, if case of Article 15 applies  sub-paragraph (c) to determine the persons protected, please provide information for this Article as set out in Title I, II and V of Article 67 or in Title I of Article 66;

If it applies to sub-paragraph (d) of Article 67, please provide information as set out in different titles of Article 67.

Please indicate what measures have been taken to ensure that, regardless of income, a benefit set for a class of people, determined under Article 15 (a) or (b).

A. If sub-paragraph (a) or (b) of Article 15 applies to determine the persons protected, please indicate whether for the calculation of the benefit were applied the provisions of Article 65 or those of Article 66.

Please provide information under this Article as follows:

i. if applicable Article 65, as set out in Titles I, II and V of Article 65;

The calculation basis of the indemnity is established as an average monthly income during the past six months of 12 which represents the qualifying period, up to the limit of 12 national minimum wages, used to calculate the contribution for leaves of absence and indemnities.

The gross amount of the monthly indemnity for temporary labour incapacity is established by a 75% application at the mentioned calculation base.

The gross amount of the monthly indemnity for temporary labour incapacity, caused by tuberculosis, AIDS, cancer, malignant illness or infectious diseases from group A and surgical emergency is 100% of the calculation basis.

The qualifying period in the health insurance system is obtained by summing the periods for which the contribution for medical leave allowance and indemnities is paid by the employer or insured individual, as the case may be, respectively, by the Fund in case of work accidents or occupational diseases, or from the unemployment insurance budget.

The minimum qualifying period entitling to rights is one month worked during the last 12 months previous to the month of medical leave.

The insured individuals shall be entitled to medical leave and indemnities for temporary work incapacity without meeting the mandatory qualifying period requirement in case of medical – surgical emergencies, tuberculosis, infectious-contagious diseases of group A, neoplasia and HIV. 

ii. whether Article 66 applies, as set out in Titles I, II and V of Article 66.

Reply: N/A

B. Whether, if case of Article 15 applies sub-paragraph (c) to determine the persons protected, please provide information for this Article as set out in Title I, II and V of Article 67 or in Title I of Article 66.

      If it applies to sub-paragraph (d) of Article 67, please provide information as set out in different titles of Article 67.

Reply: N/A

C.  Please indicate what measures have been taken to ensure, regardless of income, a benefit set for a class of people, as determined under Article 15 (a) or (b).

Article 17

The benefit specified in Article 16 shall, in a contingency covered, be secured at least to a person protected who has completed such qualifying period as may be considered necessary to preclude abuse.

Please specify for each system, duration of qualifying periods that are considered necessary to prevent abuse. Please provide briefly the rules to aggregate the qualification periods.

The qualifying period in the health insurance system is obtained by summing the periods for which the contribution for medical leave allowance and indemnities is paid by the employer or insured individual, as the case may be, respectively, by the Fund in case of work accidents or occupational diseases, or from the unemployment insurance budget.

The minimum qualifying period entitling to rights is one month worked during the last 12 months previous to the month of medical leave.

The insured individuals shall be entitled to medical leave and indemnities for temporary work incapacity without meeting the mandatory qualifying period requirement in case of medical – surgical emergencies, tuberculosis, infectious-contagious diseases of group A, neoplasia and HIV.  

Article 18

The benefit specified in Article 16 shall be granted throughout the contingency, except that the benefit may be limited to 26 weeks in each case of sickness, and need not be paid for the first three days of suspension of earnings.

1.      Please specify for each system, if the benefit duration of sickness is limited and if so, please indicate the limit or the limits and how they are determined. Please indicate if there is a qualification period and, if any, indicate the length of this period and the rules for its calculation.

2.     Please indicate, on Article 68, if there are provisions for suspension of benefits for sickness, for each system.

1. Please specify for each system, if the benefit duration of sickness is limited and if so, please indicate the limit or the limits and how they are determined. Please indicate if there is a qualification period and, if any, indicate the length of this period and the rules for its calculation.

The period of the temporary labour incapacity is 90 days from the first day of incapacity, which can be extended with the endorsement of the expert physician of the social securities, up to 183 days in one year, calculated from the first day of the illness. In justified cases, the possibility to recover the labour capacity, the medical leave can be extended beyond the 183 days up to 90 days.

For some cases (special illnesses foreseen by the law) the period of the leave of absence and indemnities is higher (cardiovascular diseases, malignant illness, tuberculosis, cancer, AIDS, etc. – Article 13, paragraph (3) of EGO no. 158/2005, with the subsequent amendments and supplements).

                 

2. Please indicate, on Article 68, if there are provisions for suspension of benefits for sickness, for each system.

Payment of indemnities shall cease on the day next to that on which:

    a) the beneficiary deceased;

    b) the beneficiary does no longer meet the legal requirements for being entitled to indemnities;

    c) the beneficiary established its residence on the territory of another State not having a social  security convention concluded with Romania;

    d) the beneficiary established its residence on the territory of another State having a social  security convention concluded with Romania, which provides for the payment of such indemnities by the other State in question.  

Article 25

Each Contracting Party for which this part of the Code is in force shall secure to the persons protected the provision of old‑age benefit in accordance with the following articles of this part.

Article 26

1.    The contingency covered shall be survival beyond a prescribed age.

2.    The prescribed age shall be not more than 65 years or than such higher age that the number of residents having attained that age is not less than 10 per cent of the number of residents under that age but over 15 years of age.

3.    National laws or regulations may provide that the benefit of a person otherwise entitled to it may be suspended if such person is engaged in any prescribed gainful activity or that the benefit, if contributory, may be reduced, where the earnings of the beneficiary exceed a prescribed amount and, if non‑contributory, may be reduced where the earnings of the beneficiary or his other means or the two taken together exceed a prescribed amount.

Please indicate for each system, which is the age for receiving the old age benefit.

 

According to Law no.263 of 16 December 2010 on the Unitary System of Public Pensions, old-age pensions shall be granted to the insured individuals who, on the date of their retirement, cumulatively meet the conditions with respect to the standard retirement age and the minimum contribution period achieved in the public system of pensions.

The standard retirement age is 63 years for women and 65 for men.

For women, that age is achieved by increasing the standard retirement age, until January of 2030, i.e. 63 years.  Thus, it is continued the gradual increase provided under the former pension law - Law no. 19/2000 on the public pension system and other social insurance rights – started in 1^st April.2001 (from 57 years for women and 62 years for men).

For the reference year 2016 and 2017, the standard retirement ages qualifying a person to draw an old-age pension, are the following:

Men:

Since January 2016 - 65 years

Women:

January 2016               – April 2016                60 years and 3 months

May 2016                    – August 2016            60 years and 4 months

Sepetember 2016        – December 2016        60 years and 5 months

January 2017               – April 2017                60 years and 6 months

May 2017                    – June 2017                 60 years and 7 months

Special conditions apply to some categories of people such as:

·      people who contributed under special or difficult working condi­tions;

·      people who had a handicap prior to obtaining the insured person status;

people persecuted for po­litical rea­sons by the regime in power af­ter 6 March 1945, deported abroad or taken prisoners of war.

In case of meeting specific conditions, the person is entitled to an old-age pension with reduced standard retirement age. For example, people who contributed under special or difficult working condi­tions must have compleated the full contribution period in order to qualify for the benefit of old-age pension with reduced standard retirement age.

If age is over 65, please indicate the number of residents who have reached that age as a percentage of total number of residents under that age, but more than 15 years.

 - Not applicable

Please specify if paragraph 3 of this article is applicable, and in this case, please summarize the rules for suspension or reduction of benefits if the beneficiary carries out an activity remunerated.

1.    Accumulation of pension rights with earnings from employment:

·      Irrespective of the level of earnings accumulation is permitted to:

   a) Orphan children having lost both parents, while attending school courses, but not exceeding the age of 26;

    b) Blind people;

    c) Old-age pensioners;          

    d) Category III invalidity pensioners.

·      Pensioner with Old-Age Pension and Old-Age Pension with Reduced Standard Retirement Age:

 -   Rule:Accumulation permitted.

 -  No exemptions.

·      Pensioner with Early Retirement Pension and Partial Early Retirement Pension:

-          Rule: Accumulation not permitted.

-          Exemptions: Accumulation permitted with earnings from work as a local or county counsellor.

2.    Accumulation of pension rights with earnings from self-employment:

·      Pensioner with Old-Age Pension and Old-Age Pension with Reduced Standard Retirement Age:

-          Rule: Accumulation permitted.

-          No exemptions.

·      Pensioner with Early Retirement Pension and Partial Early Retirement Pension: 

-          Rule: Accumulation not permitted.

-          No exemptions.

Article 27

The persons protected shall comprise:

a.     prescribed classes of employees, constituting not less than 50 per cent of all employees; or

b.    prescribed classes of the economically active population, constituting not less than 20 per cent of all residents; or

c.     all residents whose means during the contingency do not exceed limits prescribed in such a manner as to comply with the requirements of Article 67.

A.     Please indicate applicable sub-paragraph of this article.

B.     Please indicate the classes of persons protected under this Article provisions, unless they apply to sub-paragraph (c).

C.     Please provide statistical information related to this Article, as follows:

i.      if applicable sub-paragraph (a) in the form of Title I of Article 74;

ii.    if applicable sub-paragraph (b), as Title II of Article 74;

iii.  if applicable sub-paragraph (c) as Title III of Article 74.

D.     When applying Article 6 (voluntary insurance) for all or any system, please provide the information for this article, as laid down in Article 6.

A/.  The sub-paragraph of Article that applies in domestic legislation is (b) because certain categories of self-employed persons are also covered by the scheme.

B/. Persons protected under this Article are the insured that can be Romanian citizens, foreign citizens or stateless persons as long as they, by law, domicile or have their residence in Romania as follows: 

·      employees,

·      persons assimilated to employees (elected or appointed to executive, legislative or judicial authorities; co-operative members),

·      civil servants,

·      unemployed,

·      self-employed, if their monthly average net income exceeds the threshold of 35% of the Average Gross Earnings as projected for the Annual State Social Insurance Budget,  i.e. RON 1,096.

C/. Average annual at national level of the insured through the general system (public pension system) on December 2016 is 5.280.945 (employees and others insured persons).

 

In accordance with Title II under Article 76 of the Report Form, the scope of protection is determined as follows:

Number of economically active persons protected                   5.280.945

Total number of residents                                                       19.310.216

Percentage                                                                               27,34%

Article 28

The benefit shall be a periodical payment calculated as follows:

a.     where classes of employees or classes of the economically active population are protected, in such a manner as to comply either with the requirements of Article 65 or with the requirements of Article 66;

b.   where all residents whose means during the contingency do not exceed prescribed limits are protected, in such a manner as to comply with the requirements of Article 67

A.     If applicable sub-paragraph (a) or (b) of Article 27 to determine the protected persons, please indicate whether for the calculation of the benefit of old age have been applied the provisions of Article 65 or of Article 66.

Please provide information under this Article, as follows:

i.      whether Article 65 applies, as set out in Title I, III and V of Article 65;

ii.     whether Article 66 applies, as set out in Title I, III and V of Article 66.

B.     If applicable sub-paragraph (c) of Article 27, please provide the information for  this Article, as shown in the title I and III of Article 67 and Article 66.

If applicable the provisions of sub-paragraph (d) of Article 67 please provide information as different titles of Article 67

C.     In case of application of Article 65, Article 66 or Article 67, please provide information on the revision of old age benefit amount as set out in Title VI of Article 65.

A/.  For the calculation of old age retirement pension Article 65 applies.

In the public system, social security benefits are replacement income for total or partial loss of insured income as a result of old age, disability or death. Social insurance benefits are provided in the form of pensions, allowances or other benefits.

The old-age pension in the first pillar is calculated and paid on a monthly basis using a point system.

It is determined by the length of contribution period and the level of earnings (all being variables, characteristic to each person), as well as the pension point value (which is a constant for all pensioners).

The monthly score is equal to the person's monthly gross earnings divided by the average gross earnings. The score takes into consideration the gross income for which the social security contributions were paid. The monthly score for an insured person who also contributed to the second pillar shall be adjusted by the ratio between the contribution rate (employer and employee for normal working conditions) due to the public system of pensions and the contribution rate (employer and employee for normal working conditions) due to both the public system of pensions and the second pillar.

The annual score is equal to the sum of the monthly scores obtained during one year divided by twelve. The person is credited with annual scores for non-contributory periods.

The annual average score is equal to the sum of the annual scores divided by the full contribution period.

The amount of the old-age pension is calculated as the annual average score multiplied by the pension point value.

The old-age pension with reduced standard retirement age, the early retirement pension, and the partial early retirement pension are calculated in the same way as the old-age pension. Nevertheless, the non contributory periods are not taken into account for early retirement pension and partial early retirement pension calculation purposes. In case of partial early retirement pensions the amount is re­duced in relation to the number of months of anticipation.

The insured person who continues to contribute to the public system of pensions after becaming eligible for receiving an old-age pension is entitled to an increased score achieved in this period by 0.5% per month.

As of 1 January 2013 the pension point value is adjusted annually by 100% of the inflation rate plus 50% of the real growth in the average gross earnings of the previous year.

The pension point value since 1 January 2016 was RON 871,7 and since 1 January 2017 is 917,5.

B. If applicable sub-paragraph (c) of Article 27, please provide information for this article as set out in Title I and III of Article 67 and Title I of Article 66.

If applicable the provisions of sub-paragraph (d) of Article 67 please provide information as different titles of Article 67.

C. When applying Article 65, Article 66 or Article 67, please provide information on the revision of old age benefit amount as set out in Title VI of Article 65.

 

A/. For the calculation of old-age pension Article 65 applies.

The calculations of pension takes into account the the gross income for which the social security contributions were paid by the insured throughout the period of activity, establishing, for each month of contribution, a number of points calculated as the ratio between the monthly gross earnings of the insured/or insured monthly income and the monthly average gross earnings of the respective month. The monthly score for an insured person who also contributed to the second pillar shall be adjusted by the ratio between the contribution rate (employer and employee for normal working conditions) due to the public system of pensions and the contribution rate (employer and employee for normal working conditions) due to both the public system of pensions and the second pillar. The annual score is equal to the sum of the monthly scores obtained during one year divided by twelve. The annual average score is equal to the sum of the annual scores divided by the full contribution period.

The amount of the old-age pension is calculated as the annual average score multiplied by the pension point value.

Between 1^st  January and 30^th June 2017 the value of the pension point was 917.50 RON.

B/. In the national legislation sub-paragraph of paragraph 6 of Art. 65, which can be applied in national law is (a) and (b).

Old age pension calculation for the standard beneficiary

Standard beneficiary: man

Standard beneficiary was chosen as a person whose income equals 125% of average earnings of all persons protected.

According to art. 65 Section 6 of the European Code of Social Security, Part XI - Periodical payments calculation, for the purposes of this Article, a skilled male worker shall be:

a)    either an assistant or caster in machinery/mechanical industry other than electrical machinery,

b)   either a skilled worker, defined type  in accordance with paragraph 7 of this article,

c)    either a person whose income equals 125% of average earnings of all persons protected.

The qualified worker  referred to in point b) of the preceding paragraph of this article shall be a person chosen from the group with the highest number of male persons protected, in the cases under consideration those who look after their family in the division comprising the largest number of protected persons or those who look after their family, in this respect will be used  the International Classification by type of industry of all economic activities adopted by the Economic and Social Council of the United Nations in its Seventh Session of August 27, 1948 and reproduced in Annex 1 to this Code, taking into account any further changes.

Salary of a skilled male worker selected in accordance with paragraphs 6.a and b of this article shall be established on the basis of due wages for normal hours of work determined by collective agreements, or, if appropriate, under its national legislation or by custom, including compensation for price increases, if any, when wages so determined varies from region to region and in case the paragraph 8 of this Article is not applied, the average salary will be considered.

According to the article 17 of Law no. 340/ 2015 on the social insurance budget for 2016, since 1 January 2016 the pension point value was 871,7 RON and according to the article 12 of Government Emergency Ordinance no. 99/ 2016, since 1 January 2017 the pension point value is 917,5 RON.

The average gross wage used at the establishment of the state social security budget for the year 2016, according to art. 16 of Law no. 340/2015, was 2.681 RON and the average gross wage used at the establishment of the state social security budget for the year 2017, according to art. 16 of Law no. 7/2017, is 3.131 RON.
By applying Article 65, paragraph 6, subparagraph c) of the Code, the reference income of a standard beneficiary is 125% of average gross wage, ie 1.25 * 2.681 = 3351,25 per month in 2016 and 1.25*3.131 = 3.913,75 per month in 2017.

Calculation of the replacement rate of an old-age pension after 30 years of insurance (in accordance with Title I and III under Article 65 of the Report Form):

1^st July 2016 – 30^th  June 2017

C. Standard wage of a skilled manual male employee (3351,25+3.913,75)/2 =  3.632,5 RON

D. Amount of old-age pension granted after 30 years of insurance (871,7*1,25*30/35) + (917,5*1,25*30/35) / 2 = 959 RON

G. Replacement rate D./. C = 26,40 %

Article 29

1.    The benefit specified in Article 28 shall, in a contingency covered, be secured at least:

a.     to a person protected who has completed, prior to the contingency, in accordance with prescribed rules, a qualifying period which may be 30 years of contribution or employment, or 20 years of residence; or

b.    where, in principle, all economically active persons are protected, to a person protected who has completed a prescribed qualifying period of contribution and in respect of whom while he was of working age, the prescribed yearly average number of contributions has been paid.

2.    Where the benefit referred to in paragraph 1 of this article is conditional upon a minimum

period of contribution or employment, a reduced benefit shall be secured at least:

a.     to a person protected who has completed, prior to the contingency, in accordance with prescribed rules, a qualifying period of 15 years of contribution or employment; or

b.   where, in principle, all economically active persons are protected, to a person protected who has completed a prescribed qualifying period of contribution and in respect of whom, while he was of working age, half the yearly average number of contributions prescribed in accordance with paragraph 1.b of this article has been paid.

3.    The requirements of paragraph 1 of this article shall be deemed to be satisfied where a benefit calculated in conformity with the requirements of Part XI but at a percentage of ten points lower than shown in the Schedule appended to that part for the standard beneficiary concerned is secured at least to a person protected who has completed, in accordance with prescribed rules, ten years of contribution or employment, or five years of residence.

4.    A proportional reduction of the percentage indicated in the Schedule appended to Part XI may be effected where the qualifying period for the benefit corresponding to the reduced percentage exceeds ten years of contribution or employment but is less than 30 years of contribution or employment; if such qualifying period exceeds 15 years, a reduced benefit shall be payable in conformity with paragraph 2 of this article.

5.    Where the benefit referred to in paragraphs 1, 3 or 4 of this article is conditional upon a minimum period of contribution or employment, a reduced benefit shall be payable under prescribed conditions to a person protected who, by reason only of his advanced age when the provisions concerned in the application of this part come into force, has not satisfied the conditions prescribed in accordance with paragraph 2 of this article, unless a benefit in conformity with the provisions of paragraphs 1, 3 or 4 of this article is secured to such person at an age higher than the normal age.

1.      Please indicate for each system, the nature and duration of minimum qualification periods or, where appropriate, the minimum annual average number of contributions that  entitles the protected persons to receive pension.

2.     Please summarize the rules for calculating these qualifying periods. Please indicate if applicable paragraphs 1 and 2 or paragraphs 3 and 4 of this Article.

When applying paragraphs 1 and 2 the benefit amount of which is presented in Article 28 should be granted over the basic period to standard beneficiary who has completed 30 years of contribution or employment or 20 years of residence.  Please indicate, in accordance with this article,how is calculated reduced benefit for the standard beneficiary who has completed a period of 15 years of contribution or employment or for whom they were paid half the annual average number of contributions established for entitlement to full benefit.

3.   If paragraph 3 applies the benefit whose amount is shown in Article 28 should the benefit granted for the basic period of a standard beneficiary that has achieved 10 years of contribution or employment or five years of residence.

4.   If applicable, paragraph 4, the benefit amount of which is shown in Article 28 should be paid for the basic period for the standard beneficiary who has completed a period of more than 10 years but less than 30 years of contribution or employment. Please indicate the duration of that qualification period.

5.   Please indicate what measures have been taken to implement the transitional provisions set out in paragraph 5 of this Article and indicate the minimum guaranteed reduced benefit in this case.

Men and women do have the same minimum contribution period, i.e. 15 years.

When calculating old-age pension is taken into account the gross income for which the social security contributions were paid by the insured throughout the period of activity, establishing, for each month of contribution, a number of points calculated as the ratio between the monthly gross earnings of the insured/or insured monthly income and the monthly average gross earnings of the respective month. The monthly score for an insured person who also contributed to the second pillar shall be adjusted by the ratio between the contribution rate (employer and employee for normal working conditions) due to the public system of pensions and the contribution rate (employer and employee for normal working conditions) due to both the public system of pensions and the second pillar. The annual score is equal to the sum of the monthly scores obtained during one year divided by twelve. The annual average score is equal to the sum of the annual scores divided by the full contribution period. Binding the annual average score to the complete contribution period leads to the consequence that a smaller contribution period will result into a lower amount of pension. The amount of the old-age pension is calculated as the annual average score multiplied by the pension point value.

When determining the old-age pension, besides the contributory periods, certain non-contributory periods, called“assimilated periods”are taken into consideration, when the insured person:

·      benefited from invalidity pension,

·      pursued full-time university courses, on the condition of graduation with diploma,

·      served military service, were mobilised or were war prisoners,

·      benefited starting with 1^st of January 2005 from leave for temporary working incapacity due to work accidents and occupational diseases,

·      benefited during 1^st April 2001 – 1^st January 206 of social insurance indemnities, provided in the terms set by law,

·      benefited starting with 1^st of January 2006 from leave for child upbringing up to 2 years old, or up to 3 years old in the case of disabled child,

The insured person who attended several higher forms of education benefits from a single period of study assimilated as contribution period, at choice.

The national legislation guarantees a minimum pension amount. Law no.196/2009 approved G.E.O. No.6/2009, establishing the guaranteed minimum social pension. Law no. 118/2010 replaced the phrase "guaranteed minimum social pension" with syntagma "social indemnity for pensioners".

Since 2010, the social indemnity for pensioners is established annually by the state budget law and can be increased only by the laws amending the state budget, based on changes of the macroeconomic indicators and financial resources.

Law No. 339/2015 on the state budget for  2016 set the social indemnity for pensioners in  2016 at the level of RON 400 RON.

Since 1 March 2017 the social indemnity for pensioners increased to 520 lei, according to the article 2 of Government Emergency Ordinance no.2/ 2017.

The level of social indemnity for pensioners is set annually by the budgetary laws and may be modified in relation with the macroeconomic indicators and the financial resources.

The beneficiaries of the social indemnity for pensioners are the pensioners of the public pension system who reside in Romania, regardless of the date of retirement, whose quantum of pension is below the social indemnity for pensioners.

The social pension is calculated as the difference between the amount of social allowance for pensioners and the pension amount due or paid, combined with any other entitlements paid under special laws.

Index of Correction

According to art. 170 of Law no. 263/2010 on the unitary public pension:

"(1) For the registered pensioners, from the date of entry into force of this law, the average annual score determined in terms of art. 95 is applied a correction index calculated as the ratio of 43.3% of the gross average earnings in the preceeding year and the pension point value in force at the time.
(2) Paragraph (1) is applied only once, at the initial enrollment in retirement. "

According to the provisions of art. 193 para. (2) of Law no. 263/2010 on the unified public pension system, with subsequent amendments, the provisions of art. 170 were envisaged to come into force on January 1, 2012 and according to art. 16 of Ordinance no. 80/2010, approved with the amendments and supplements to the Law no. 283/2011, the time of entry into force of art. 170 of Law no. 263/2010 was extended until January 1, 2013. Article 44 paragraph 1 of Law No.153/2017 repealed article 16 of Ordinance no. 80/2010.

The Government Emergency Ordinance (G.E.O.) no. 1/2013 amending and supplementing Law no. 263/2010 on the unified public pension system has changed art. 170 of the Law no.263/2010, given the fact that the indicators in relation with which the value of the annual pension point is increased and the correction index is calculated, achieved during the previous year, are not known at the beginning of the calendar year in order to correlate them with the provisions of Law no. 263/2010, with the date on which the competent institutions shall disclose the values ​​of indicators used to determine the pension point value and the index correction and for entitlements provided by the law.
Thus, according to para. (2) point 3 of article I of G.E.O. no 1/2013: "Since 2013, the average gross wage, is the one definited, known in the year before the year when it opens the entitelment  to a pension for the previous calendar year, issued by the National Institute of Statistics."

According to the provisions of art. 18 of Law no. 340/ 2015 on the social insurance budget for 2016, since 1 January 2016 the correction index was 1.09.
Between 1 January 2017 and 30 June 2017, the correction index was 1.14,according to the provisions of art. 18 of Law no. 7/ 2017 on the social insurance budget for 2017.

    

Article 30

The benefits specified in Articles 28 and 29 shall be granted throughout the contingency.

Please indicate, on Article 68, if there are provisions for suspension of benefits in case of old age, for each system.

According to Law no.263 of 16 December 2010 on the Unitary System of Public Pensions, the payment of the pension shall be suspended starting with the next month following the establishment of the pensioner’s domicile on the territory of another State which has concluded a social security agreement with Romania, if the agreement stipulates that the pension is to be paid by the other State.

Article 39

Each Contracting Party for which this part of the Code is in force shall secure to the persons protected the provision of family benefit in accordance with the following articles of this part.

The social assistance system in Romania was reformed in 2011 and in the same time all the programs targeted to families with children/vulnerable persons have been revised. The new Law of social assistance no. 292/2011 establishes the new principles of organising, functioning and financing of the social assistance system in Romania. The purpose of this reform was to improve the social assistance system and to increase the efficiency of all the measures in this field, by targeting all vulnerable persons.

According to Law of social assistance no. 292/2011, the national social assistance system is a set of institutions, measures and actions, through which the state, represented by central and local government authorities and civil society intervene to prevent, limit or remove the effects of temporary or permanent situations that can lead to marginalization and social exclusion of the person, family, groups or communities. The national system of social assistance intervenes subsidiary or, where appropriate, complementary to social security systems and consists of social benefits system and social services system.

Social assistance, through specific measures and actions, aims to develop individual, group or collective capacities to provide social needs, increase the quality of life and promote cohesion principles and social inclusion.

  

According to Law of social assistance no. 292/2011, social assistance benefits, depending on their purpose, are classified as follows:

    a) social benefits for the prevention and combating poverty and social exclusion risk;

    b) social assistance benefits for child and family support;

    c) social assistance benefits to assist people with special needs;

    d) social assistance benefits for special situations.

Article 40

The contingency covered shall be responsibility for the maintenance of children as prescribed.

Please indicate briefly the conditions of eligibility for benefits under Article 42 of the protected persons (number of children, age limit for children).

Family benefits are granted to the family and take into account childbirth, education and children maintenance. The types of family benefits granted during 1 July 2016 to 30 June 2017:

State allowance for children is a universal right, granted by the State for all children up to age 18, without discrimination. Young people, after age 18, attending high school or professional school, are entitled to state allowance for children up to the completion of these studies. Also children of residing foreign citizens and stateless persons enjoy this right under the law in Romania. State allowance is given in different amounts, as  follows (amounts for 2016 -2017):

o       84 lei for children with the age between 2 years and 18 years old, and also for young people after the age of 18 until they finish the educational courses or vocational educational courses.

o       200 lei for children with the age up to 2 years old or up to 18 years old, in the case of children with disability.

Type of benefit	Age of the children	July 2016-June 2017 (lei)
State allowance for children	children >  2 years	84
	Child with disability> 3 years	200
	children < 2 years	200
	Child with disability < 3 years

Placement monthly allowance, is given in support of the person or legal representative of the family who took in placement one or more children. Allowance is granted from the state budget for each child or young person who benefits from the measure of placement to a person, family, guardian, foster parent or to residential care organized by an authorized private body.

Monthly amounts for 2016-2017 of placement allowance is 600 lei and for children with disabilities this amount is increased by 50%, reaching 900 lei. This allowance is paid until the age of 18 years old of the child and after 18, if the measure of placement is continued after this age, acoording to Law no. 272/2004.  On request of the young person, expressed after the age of 18, if he/she continues studying on daily courses, the placement measure is granted for the whole period of studies, up to the age of 26.

Type of benefit	July 2016-June 2017 (lei)
Placement monthly allowance	600/900

The allowance for family support replace the former allowance for family support starting with 2011 and is given differently depending on family structure and revenues. The allowance is granted to families consisting of husband, wife and dependent children aged up to 18 years who live together. Families whose members are Romanian citizens residing in Romania benefit from this allowance, as well as foreign citizens or stateless persons resident or, if applicable, residing in Romania. Adopted children, children in foster care or custody or guardianship for which tutorship was established,  are considered as part of the family.

These allowances are granted to families with children who have net monthly income per family member up to 530 RON. The amounts of these benefits varied by type of family and number of children as follows:

·             Allowance for two parents families with incomes between 0-200 RON/person:
     a) 40 RON for families with one child;

     b) 80 RON for family with 2 children;

     c) 120 RON for family with 3 children;

     d) 160 RON for family of 4 or more children.

·             Allowance for two parent families with incomes between 201-530 RON/person:
     a) 33 RON for families with one child;

     b) 66 RON for family with 2 children;

     c) 99 RON for family with 3 children;

     d) 132 RON for family of 4 or more children.

·             Allowance for single parent with incomes between 0-200 RON/person:
     a) 65 RON for families with one child;

     b) 130 RON for family with 2 children;

     c) 195 RON for the family with 3 children;

     d) 260 RON for family of 4 or more children.

·             Allowance for single parent with incomes between 201-530 RON/person:
     a) 60 RON for families with one child;

     b) 120 RON for family with 2 children;

     c) 180 RON for the family with 3 children;

     d) 240 RON for family of 4 or more children.

Families who have dependent children of school age receive family support allowance, given that children are in organized education. Therefore, the program increases the children's education by introducing the school attendance conditionality for school children from beneficiary families; the amount of the allowance can be adjusted or diminished based on their school absences.

Type of benefit	Type of family, level of income and number of children	July 2016 – June 2017 (lei)
Allowance for family support	Two parent families  (incomes >200 lei)
	- families with  1 child	82
	--families with 2 children	164
	-families with 3 children	246
	-famillies with 4 and more children	328
	Two parent families  (incomes between 201 - 370 lei) starting from July 2013 (incomes between 201 - 530 lei)
	- families with  1 child	75
	-families with 2 children	150
	-families with 3 children	225
	-famillies with 4 and more children	300
	Single parent families  (incomes >200 lei)
	- families with  1 child	107
	-families with 2 children	214
	-families with 3 children	321
	-famillies with 4 and more children	428
	Single parent families  (incomes between 201 - 370 lei) starting from July 2013 (incomes between 201 - 530 lei)
	- families with  1 child	102
	-families with 2 children	204
	-families with 3 children	306
	-famillies with 4 and more children	408

Parental leave and child raising indemnity (GEO no. 111/2010) is a categorical program, and was changed by Law no. 66/2016 which established new eligibility criteria for parental leave and child raising indemnity and for monthly insertion incentive. Starting from July 2016 the child raising indemnity and the insertion incentive are granted to the persons who, during the last two years prior to childbirth, earned for 12 months incomes subject to taxation according to Fiscal Code (incomes from wages, self-employed activities and agriculture activities, , including from similar periods, according to the law). Currently there is only one type of parental leave and the  child raising indemnity is a compensation, paid from the state budget, for the parents who interrupt their professional careers and take parental leave to raise children under the age of 2 years or, if a disabled child, up to 3 years.

The minimum amount of child raising indemnity has been increased from 600 lei, to 85% of the minimum gross wage which is 1.450 lei (1.233 lei) starting from February 2017. The maximum amount of the child raising indemnity has been established to 85% of the average professional net income earned by the parent, without any limitation.

People who are entitled to receive child raising indemnity, but still work, earning professional incomes subject to income taxation, will receive a monthly incentive insertion. The monthly insertion incentive is granted until the age of 3 years old in a monthly amount of 650 lei (starting from 1^st of April 2017), if the parent decides to come back to work 60 days before the child fulfils the age of 2 years old. This incentive is in fact a measure of stimulating the parents returning to work before the child reaches the age of 2 or 3 years, if disabled child.

Has the right to the child raise indemnity and to the insertion incentive, optionally, any of the parents and also one of the persons who adopted the child, who has a child entrusted for adoption, who has a child in placement or in emergency placement, excepting the foster care person, and also the guardian person. The two benefits are granted for each birth or, as the case may be, for any of the situations aforementioned. 

Benefits and aids for raising the children with disability (articles 31 and 32 from Government Emergency Ordinance no.111/2010 on parental leave and child raising benefits, with subsequent amendments). Granted to persons with children with disabilities, up to the age of 7 years old or granted to the persons with disability who became a parent. According to Law no.66/2016, the amount of the child raising indemnity, for parents who take care of a child with disability, aged between 3 and 7years old, who are entitled to parental leave, has been increased from 450 lei to 1.233 lei, starting from February 2017.Also, the amounts of benefits and aids granted to persons/parents who take care of children with disabilities and also those granted to persons with disabilities who take care of children, have been increased.Amounts between 185 lei and 555 lei.

-  monthly benefit for raising the child with disability, in amount of 1.233 lei, granted to the persons who take care of children with disabilities, aged between 3 and 7 years old, who benefited from the rights established by GEO no. 111/2010 and who choose to continue with the parental leave until the age of 7 years old of the child.

-  monthly aid  for raising the child with disability, in amount of 555 lei (45% from the minimum amount of child raising indemnity), granted to persons with high/pronounced disabilities, who take care of children with disabilities, aged between 0 and 3 years old, who don’t earn any income besides the social assistance benefits for disabled persons.

-  monthly aid  for raising the child with disability, in amount of 432 lei (35% from the minimum amount of child raising indemnity), granted to persons with high/pronounced disabilities, who take care of children with disabilities, aged between 3 and 7 years old, who don’t earn any income besides the social assistance benefits for disabled persons.

-  monthly aid for raising the child with disability, in amount of 432 lei (35% from the minimum amount of child raising indemnity), granted to persons who take care of children with disabilities, aged between 0 and 3 years old, who do not fulfil the conditions established by GEO no. 111/2010 for parental leave and child raising indemnity.

-  monthly aid for raising the child with disability, in amount of 185lei (15% from the minimum amount of child raising indemnity), granted to persons who take care of children with disabilities, aged between 3 and 7 years old, who do not fulfil the conditions established by GEO no. 111/2010 for parental leave and child raising indemnity.

-  monthly aid for raising the child, in amount of 555 lei (45% from the minimum amount of child raising indemnity), granted to persons with high/pronounced disabilities, who take care of children aged between 0 and 2 years old, who do not fulfil the conditions established by GEO no.  111/2010 for parental leave and child raising indemnity.

-  monthly aid for raising the child, in amount of 185 lei (15% from the minimum amount of child raise benefit), granted to persons with high/pronounced disabilities, who take care of children aged between 2 and 7 years old, who do not fulfil the conditions established by GEO no.  111/2010 for parental leave and child raise benefit.

The new legal provision has been also setting up a new type of benefit for parents who take care of a child with disability and who are active on the labor market, having a part time contract.  The new benefit will be 50% from the minimum child raising indemnity (616 lei) and can be cumulated with the salary.

In addition to that, the amounts of allowances and aids granted to persons/parents who take care of children with disabilities and also those granted to persons with disabilities who take care of children, have been also increased, according to articles 31 and 32 from GEO no. 111/2010.

Type of benefit	July 2016 – January 2017 (lei)	February 2017- June 2017 (lei)
Child raising  benefit	85% from the average of the  net incomes earned in the last 12 months from the the last two years prior to  child birth date, which cannot be less than 85% of the minimum gross wage (1.063 lei until 30 January 2017)	85% from the average of the  net incomes earned in the last 12 months from the the last two years prior to  child birth date, which cannot be less than 85% of the minimum gross wage (1.233 lei from 1st February 2017
Benefits and aids for raising the children with disabilities (granted to persons who take care of children with disabilities or for persons with disabilities who take care of children)	159/372/478	185/432/555
Insertion incentive	532	616/650  from 1st April 2017

Gift vouchers and nursery vouchers are value vouchers given by employers to employees who do not take parental leave and do not benefit from parental indemnity to raise children, but receive services in nurseries. The monthly amount given in the form of nursery vouchers, is 440 lei during the period July 2016 – June 2017(according to the Order of the Minister of Labour, Family, Social Protection and Elderly no. 933/2016 and order of the Minister of Labour and Social Justice no. 626/2017). These sums are paid by the employer, within the limits approved for staff salaries.

Type of benefit	July 2016 –June 2017 (lei)
Nursery vouchers	440

Special benefits for disabled children (art. 58 from Law no.448/2006):

The family or the legal representative of a child with severe, pronounced or medium disability are entitled to a monthly complementary budget, provided regardless of incomes, during the period in which the child is upbrought, in care or supervision. The amounts (2016) are differentiated by the degree of disability of the child a follows:

a)    106 lei, granted to the adult with severe disability and to the family or legal representative of the child with severe disability, regardless of their income ;

b)   79 lei, granted to the adult with pronounced disability and to the family or legal representative of the child with pronounced disability, regardless of their income;

c)    39 lei, granted to the adult with medium disability and to the family or legal representative of the child with medium disability, regardless of their income.

Type of benefit	July 2016-June 2017 (lei)
Monthly complementary budget	106/79/39

Article 41

The persons protected shall comprise, as regards the periodical payments specified in Article 42:

a      prescribed classes of employees, constituting not less than 50 per cent of all employees; or

b     prescribed classes of the economically active population, constituting not less than 20 per cent of all residents.

A.     Please indicate which sub-paragraph of this Article shall apply.

B.     Please indicate the classes of persons protected under this Article provisions.

C.     Please provide statistical information related to this Article, as follows:

i.      if subparagraph (a), applies as Title I of Article 74;

ii.    if subparagraph (b),applies as Title II of Article 74.

In accordance with Law no. 292/2011 on social assistance all Romanian citizens who are on the Romanian territory, domicile or residence in Romania, citizens of EU Member States, of the European Economic Area and Swiss Confederation, foreigners and stateless persons domiciling or residing in Romania are entitled to social assistance under the Romanian law and the EU regulations as well as the agreements and treaties to which Romania is a party, without any discrimination. The aforementioned persons have the right to be informed on the content and modalities for granting social assistance measures and actions. The right to social assistance is granted on request or ex officio, as the case may be, in accordance with the law.

The social assistance system, according to the Romanian legislation, is a component of the social protection system, and includes social services and social assistance benefits, based on the non-contributory principle.

With the entry into force of Law no. 292/2011, the syntagm "social benefits" was replaced by that of "social assistance benefits", in line with the terminology currently used in the field at European level.

Based on all these provisions, one may conclude that the reporting regarding the ECSS’ chapter on family benefits is done under subparagraph b) of Article 41.

The resident population in January 2016, according to TEMPO Online, was 19.760.314 persons. Based on TEMPO Online, economically active population in the third quarter of 2016: 9.144.694persons and in the fourth quarter of 2016: 8.878.989 persons. In Romania economically active population represents about 45% of all resident population.

The average number of beneficiaries of child state allowance in the second semester of 2016 was 3.623.992 which represents about 18,3 % of all resident population.

The number of  beneficiaries of social benefits granted at national level during July 2016 - June 2017:

	FAMILY BENEFITS	Monthly average  number of beneficiaries Sem .II 2016	Monthly average  number of beneficiaries January - May 2017
1.	State allowance for children Total, of which :	3.623.992	3.685.785
	200 RON< 2 ani  (3 ani child with disability)	337.799	340.919
	200 RON disability > 3 ani	59.322	58.863
	84 RON>2 ani	3.226.871	3.286.003
2.	Allowance for family support	266.918	265.366
3.	Placement allowance	40.743	41.928
4.	Child raising indemnity	143.281	155.291
5.	Insertion incentive	43.759	62.412
6.	Special allowances to raise a disabled child Total, of which:	8.719	8.847
	Allowance to raise a disabled child, for children with disabilities aged 3 to 7 years;	3.919	3.980
	Monthly allowance given to a person with severe disabilities who do not make any income, until the child reaches the age of 3 years;	115	119
	Monthly allowance given to a person with severe disabilities who do not make any income, for children aged 3 to 7 years;	133	114
	Monthly allowance paid to the person that does not qualify for the parental leave and monthly allowance to raise a child, until the child reaches the age of 3 years;	161	145
	Monthly support paid to the person that does not qualify for the parental leave and monthly allowance to raise a child, for children aged 3 to 7 years.	750	726
	Monthly allowance paid to a person with severe disabilities that does not qualify for the parental leave and monthly allowance to raise a child, until the age of 2 years	975	936
	Monthly allowance paid to a person with severe disabilities that does not qualify for the parental leave and monthly allowance to raise a child, for children aged 2 to 7 years	2.649	2.765
	Monthly benefit paid for parents who take care of a child with disability and who are active on the labor market, having a part time contract.	17	62
7.	Monthly complementary budget for children	61.361	-*
	Total, of which:		-
	Children with severe disability	33.476	-
	Children with pronounced disability	13.146	-
	Children with pronounced disability	14.739	-

*no available data for the first semester of 2017

Article 42

The benefit shall be:

a      a periodical payment granted to any person protected having completed the prescribed qualifying period; or

b     the provision to or in respect of children of food, clothing, housing, holidays or domestic help; or

c      a combination of the benefits provided for in sub‑paragraphs a and b of this article.

The specific legislation regulating the system of family allowances provides for the amount of money allocated from the state budget on a mounthly basis.

	FAMILY BENEFITS	Amounts   (lei) 2016, 2nd Semester	Amounts (lei) 2017, 1st Semester	Periodicity
1.	State allowance for children: Up to 2 years or 3 years for children with disabilities After 3 years (children with disabilities) After 2 years	200 200 84	200 200 84	Monthly
2.	Allowance for family support			Monthly
3.	Allowance for two parents families with incomes between 0-200 RON/person: ·       families with one child ·       families with two children ·       families with three children ·       families with four or more children	82 164 246 328	82 164 246 328	Monthly
4.	Allowance for two parents families with incomes between 201-530 RON/person: ·      families with one child ·      families with two children ·      families with three children ·      families with four or more children	75 150 225 300	75 150 225 300	Monthly
5.	Allowance for single-parent family with incomes between 0-200 RON/person: ·      families with one child ·      families with two children ·      families with three children ·      families with four or more children	107 214 321 428	107 214 321 428	Monthly
6.	Allowance for single-parent family with incomes between 201-530 RON/person: ·       families with one child ·       families with two children ·       families with three children ·       families with four or more children	102 204 306 408	102 204 306 408	Monthly
7.	Placement allowance - for disabled children	600 900	600 900	Monthly
8.	Child raise indemnity	Minimum 1.063	Minimum 1.233 From 1st February 2017	Monthly
9.	Insertion incentive	532	616/650 from 1st April 2017	Monthly
10.	Special benefits/aids for raising the disabled child Monthly benefit for raising the child with disability, granted to the persons who take care of children with disabilities, aged between 3 and 7 years old, who benefited from the rights established by GEO no. 111/2010 and who choose to continue with the parental leave; Monthly aid for raising the child with disability granted to persons with high/pronounced disabilities, who take care of children with disabilities, aged between 0 and 3 years old, who don’t earn any income besides the social assistance benefits for disabled persons; Monthly aid  for raising the child with disability granted to persons with high/pronounced disabilities, who take care of children with disabilities, aged between 3 and 7 years old, who don’t earn any income besides the social assistance benefits for disabled persons. Monthly aid for raising the child with disability, granted to persons who take care of children with disabilities, aged between 0 and 3 years old, who do not fulfil the conditions established by GEO no. 111/2010 for parental leave and child raising indemnity. Monthly aid for raising the child with disability, granted to persons who take care of children with disabilities, aged between 3 and 7 years old, who do not fulfil the conditions established by GEO no. 111/2010 for parental leave and child raising indemnity. Monthly aid for raising the child, granted to persons with high/pronounced disabilities, who take care of children aged between 0 and 2 years old, who do not fulfil the conditions established by GEO no.  111/2010 for parental leave and child raising indemnity; Monthly aid for raising the child, granted to persons with high/pronounced disabilities, who take care of children aged between 2 and 7 years old, who do not fulfil the conditions established by GEO no.  111/2010 for parental leave and child raise benefit.	1.063 478 372 372 159 478 159	1.233 From 1st February 2017 555 from 1st February 2017 432 from 1st February 2017 432 from 1st February 2017 185 from 1st February 2017 555 from 1st February 2017 185 From 1st February 2017	Monthly
10.	Complementary monthly budget - child with severe disability - child with pronounced disability - child with medium disability	106 79 39	106 79 39	Monthly

	Family benefits	Payments 2nd Semester, 2016 - mil. lei -	Payments January - May 2017 - mil. lei -
1.	State allowance for children	2.193,37	1.846,73
2.	Allowance for family support	266,56	212,86
3.	Allowance for family placement	161,85	137,36
4.	Child raise indemnity	1.238,41	1.338,59
5.	Monthly insertion incentive	144,54	192,21
6.	Special benefits/aids for raising a disabled child	30,39	30,52
7.	Complementary monthly budget for children	30,97	30,97 *
	TOTAL	4.066,09	3.789,24

*no available data for  the first semester of  the year 2017

Article 43

              

The benefit specified in Article 42 shall be secured at least to a person protected who, within a prescribed period, has completed a qualifying period which may be one month of contribution or employment, or six months of residence, as may be prescribed.

Please indicate for each system, the nature and duration of qualification periods, if any, to be entitled to benefits under this Article provisions. Please summarize the rules for periods of qualification aggregation.

Allocation of family benefits covers all persons living in Romania without requiring a period of residence. The only condition of eligibility is to have the residence in Romania, no matter the period of residence. Only for the child raising benefit and for the monthly insertion incentive another condition of eligibility is to earn for 12 months incomes subject to taxation according to Fiscal Code. We should mention that the system of social assistance, family allowances/benefits as part of it, is a non-contributory system and all the family benefits are paid from the state budget, including the child raising indemnities and the insertion incentive.

Article 44

      

The total value of the benefits granted in accordance with Article 42 to the persons protected shall be such as to represent 1.5 per cent of the wage of an ordinary adult male labourer as determined in accordance with the rules laid down in Article 66, multiplied by the total number of children of all residents.

Please provide for this article, the information in the form shown in Title I of Article 66.

A.     Please provide the following information:

1.      total amount of cash benefits for children of persons protected, as indicated in Article 41;

2.     total value of benefits in kind provided for children of persons protected, as set out in Article 41;

3.     Total value of benefits in cash and in kind for children of persons protected ( B1 + B2).

C.     Please provide:

i.      the total number of children of all residents;

ii.    total value of benefits in cash and in kind (B.3) percentage of adult male worker wage  (A) multiplied by the total number of children of all residents (C.i)

This report is taking into account the average monthly gross incomes in manufacturing economic activity, data source: INS, 2015, Statistical Survey on salaries in month October.

Based on the administrative data provided by INS the average monthly gross income obtained in month October, 2015 was 1.611 lei/man employee in elementary occupations.

There are no available data for 2016- 2017. The data for 2016 will be available at the earliest by the end of the year 2017.

The total number of all resident children aged 0-18 years, the resident population  at 1st of January on age groups, data source TEMPO, INS:

	2014	2015	2016
Age groups	Number of children	Number of children	Number of children
0- 4 years	963.275	957.202	953.912
5- 9 years	1.064.818	1.069.067	1.061.963
10-14 years	1.066.516	1.054.815	1.049.118
15-18 years	863.594	865.371	872.042
Total	3.958.203	3.946.455	3.937.035

Year 2014: 1,5% X 1.405 lei X 3,958,203 = 83,419,128.22 lei

Year 2015:  1,5% X 1.611 lei X 3,946,455 = 95,366,085.07 lei

Year 2016:  1,5% X 1.611 lei* X 3,937,035 = 95,138,450.77 lei

*We have used the same income reported for the year 2015 because NIS didn’t publish yet the average monthly gross income in month October for 2016.

Article 45

Where the benefit consists of a periodical payment, it shall be granted throughout the contingency.

State allowance for children is a universal right, granted by the State for all children up to age 18, without discrimination. Young people, after age 18, attending high school or professional school, are entitled to state allowance for children up to the completion of these studies.

Please indicate, if any, referring to Article 68, provisions for the suspension of family benefits in the respective system.

The procedure for suspension of payments for family benefits is provided in special legislation regulating the system.

Payment of state child allowance is suspended when within 3 months the child's legal representative has not cashed the due rights. Resumption of payment, including payment of arrears is made on request in writing by the child's legal representative. In the event that the child's legal representative changes, state child allowance payments shall be suspended until the establishment of the new legal representative, the payment will be made, including the period of suspension.

Payment of allowance for family support shall be suspended in the month following the one when it is ascertained  one of the situations bellow:

·      during the placement or emergency placement of the child in a residential care service.

·      in case the paying institution (county agency for payments and social inspection) finds out that the right to family support allowance was established  based on inaccurate data on income or family composition or changes have occurred during their grant;

·      for a period of 3 consecutive months there were registered money orders returned for the holder of the family support allowance.

·      following the control of the social inspectors or of the representatives of the Court of Accounts have been found erroneous data on family composition or incomes of the beneficiaries.

Payment of the child raising indemnity and of the monthly insertion incentive can be suspended from the month following the one when it is ascertained one of the situations bellow:

a)        the recipient is deprived of parental rights;

b)        the recipient is removed by law from exercising guardianship;

c)        the recipient no longer meets the conditions prescribed by law for custody of the child for adoption;

d)       the recipient no longer meets the conditions prescribed by law to maintain the measure of placement;

e)        the recipient is executing a sentence of imprisonment or detention in custody for more than 30 days;

f)         the child is abandoned or is placed in a public or private care institution;

g)        the beneficiary (parent) has deceased;

h)        it is found that for 3 consecutive months money orders sent by post are returned.

i) beneficiary earns incomes subject to income tax by  pursuing a professional activity during the parental leave and during a calendar year the level of these incomes exceeds three times the minimum amount of child raise indemnity (3*1.233 lei=3.699 lei)

Payment of rights representing child raising indemnity and monthly insertion incentive can be suspended also when the person/beneficiary no longer meets the conditions stipulated at article 12 from GEO no. 111/2010, namely:

a)           is a Romanian citizen, foreign person or stateless person;

b)           has, by law, the domicile or the residence in Romania;

c)           is lives in Romania with the child/children for whom is requesting the rights and is  in charge with his/their growth and care.

Payment of the monthly insertion incentiveis also suspended from the day after the beneficiary request the right to the parental leave and no longer gets professional income subject to income tax.

Payment of the special indemnities/aids for raising a disabled child can be suspended from the month/day following the one when it is ascertained one of the situations bellow:

a) the recipient is deprived of parental rights;

b) the recipient is removed by law from exercising the guardianship;

c) the recipient no longer meets the conditions prescribed by law for custody of the child for adoption;

d) the recipient no longer meets the conditions prescribed by law to maintain the measure of placement;

e) the recipient is executing a sentence of imprisonment or detention in custody for more than 30 days;

f) the child is abandoned or is placed in a public or private care institution;

g)        the beneficiary has deceased;

h) the child doesn’t have a degree of disability or, the entitled persons is assigned to another degree of disability;

i)     it is found that for 3 consecutive months money orders sent by post are returned.

  

Payment of placement allowance can be suspended from the month following the one when it is ascertained one of the situations bellow:

a)    the young person who accomplished 18 years old didn’t present the evidence of continuing the studies, day courses form, from 6 to 6 months. 

b)   the young person for whom a placement measure was established has accomplished 18 years old and didn’t present the evidence of continuing the measure of placement, acoording to law.

c)    is found that for 3 consecutive months money orders sent by post are returned.

Payment of allowance is suspended from the day after the recipient gets professional income subject to income tax and incentive pay is suspended from the day after the recipient no longer gets professional income subject to income tax.

Payment of family benefits: they are given as long as people meet the eligibility requirements under national law and EU regulations in the field of family benefits.

Article 46

              

Each Contracting Party for which this part of the Code is in force shall secure to the persons protected the provision of mater­nity benefit in accordance with the following articles of this part.

Article 47

                                               

The contingencies covered shall include pregnancy and confinement and their consequences, and suspension of earnings, as defined by national law.

According to the Law no. 95/2006, republished, the pregnant women are insured like any other Romanian citizen with the residence in Romania and proves the payment of the social health insurance contribution to the Fund.    

Pregnant women with no income or with income lower than the national minimum wage, will take advantage of the health insurance without the payment of the contribution.    

The law no. 138/2012 regarding the approval of EGO no. 103/2011, regulating several measures in the health field, supplementing the provisions of Article 213¹ of the Law no.  95/2006, republished, by the inclusion in the categories of insured individuals exempted from co-payment 'all the pregnant and post-delivery women for medical services related to the pregnancy evolution, as well as all pregnant and post-delivery women with no income, which do not obtain an income under the national minimum wage for all the types of medical services'.  

Pregnant women will take advantage of the basic service contract granted in the same requirements as any insured persons in the health social insurance system in Romania.    

The content of the basic service package and the requirements for obtaining it are established in the Framework Agreement regarding the requirements for the supply of medical services in the health social insurance system, namely G.D. no. 400/2014.    

Among the prophylactic medical services whose costs are covered from the Unique National Health Insurance Fund there are the monitoring of pregnancy and post-delivery evolution, no matter the status of the insured individual – this service being granted by the primary medical care supplier.  The basic service package also includes specific medical services for pregnant women (medical laboratory investigations, hospitalization services, etc.).  

Considering the aforementioned aspects, we consider that the basic service package pregnant women and the women who gave birth are entitled to, includes all types of medical services foreseen by Article  49 of the Law no.  116/2009 approving the European Social Insurance Code, adopted in Strasbourg in April 16^th, 1964, with the subsequent amendments and supplements.  

Regarding the circumstances in which the non-insured women are bound to contribute to the pre-natal care costs, delivery and post-delivery care, the non-insured women take advantage of the minimum medical services package for monitoring the pregnancy and post-partum period. 

Thus, no matter the insurance status a woman in the health insurance system, the women receive prenatal care services, medical services during child delivery and postnatal medical services within the basic health services package, namely the minimum medical services package.    

Article 48

The persons protected shall comprise:

a.     all women in prescribed classes of employees, which classes constitute not less than 50 per cent of all employees, and, for maternity medical benefit, also the wives of men in these classes; or

b.    all women in prescribed classes of the economically active population, which classes constitute not less than 20 per cent of all residents, and, for maternity medical benefit, also the wives of men in these classes.

A. Please, indicate which sub-paragraph of this Article shall apply.

B.  Please, indicate the classes of employees or active population protected under this Article.

C. Please, provide statistical information related to this article, as follows:

i.      if  sub-paragraph (a) applies in the form of Title I of Article 74;

ii.    if  sub-paragraph (b) applies in the form of Title II I of Article 74.

A.  Please state which of the letters of this article is being used.

For medical benefits granted in the case of maternity, sub-paragraph b) of Art. 48 is applied.

B.  Please declare classes of employees or economically active population protected in accordance with the provisions of this article.

Regarding the medical benefits, according to the provisions of Law no. 95/2006,

-       Pregnant women are insured persons like any other Romanian citizen who has a residence in Romania and proves the payment of the social health insurance contribution to the Fund.

-       Pregnant women and women that have recently given birth, if they have no income or income below the minimum basic salary in the country, benefit from insurance without paying the contribution to the National Health Insurance Fund.

C. Please, provide statistical information related to this article, as follows:

            i. if sub-paragraph (a) applies in the form of Title I of Article 74; or

Reply: N/A

            ii. if sub-paragraph (b) applies in the form of Title II I of Article 74.

Reply:

 a. Number of protected individuals economically active (dependants protected by the right of their wage earners should not be included in this number): there are no data concerning the number of insured individuals benefiting of maternity medical leaves and indemnities;

 b. Overall number of residents (including children and elderly)

 c. Overall number of protected individual economically active (A iii.) as percentage of the overall number of residents (B).

N/A

D. Please confirm that dependent wives of men in protected classes are entitled to the medical benefits provided for in Articles 49, in accordance with the provisions of this article.

In accordance with the provisions of Law no. 95/2006, the wife without own income, in the care of an insured person, benefits from insurance, without payment of the contribution.

E.   If above Article 6 is applicable (voluntary insurance) for all or each of the systems in question, please provide information according to this Article, in the form established according to Article 6. 

N/A

E.

  

Article 49

1. In respect of pregnancy and confinement and their consequences, the maternity medical benefit shall be medical care as specified in paragraphs 2 and 3 of this article.

2     The medical care shall include at least:

               a  pre‑natal, confinement and post‑natal care either by medical practitioners or by qualified midwives; and

               b  hospitalisat­ion where necessary.

3.    The medical care specified in paragraph 2 of this article shall be afforded with a view to maintaining, restoring or improving the health of the woman protected and her ability to work and to attend to her personal needs.

4.    The institutions or government departments administering the maternity medical benefit shall, by such means as may be deemed appropriate, encourage the women protected to avail themselves of the general health services placed at their disposal by the public authorities or by other bodies recognised by the public authorities.

A.     Please indicate in detail the benefits provided under each system, on paragraph 2 of this Article, specifying in particular services that are provided for hospitalization.

B.     Please, confirm that the beneficiary or her supporter, under this Article, is not required to participate in bearing the cost of medical benefits provided. If the scheme provides for reimbursement of costs the beneficiary or her supporter had to incur to obtain the benefits provided for in paragraph 2, please provide all available information to show that the beneficiary or her supporter does not participate in the cost of these benefits.

C.     Please, indicate in detail what steps were taken to implement the provisions of paragraphs 3 and 4 of this Article.

A.  Please indicate in detail the nature of benefits granted under each scheme in question, with reference to paragraph 2 of this Article, specifying in particular the services provided in case of hospitalization.

In compliance with the provisions of Law no. 95/2006,

-          All pregnant women and women who have recently given birth are exempt from co-payment for health services related to the evolution of the pregnancy, and for all healthcare services for those who do not have any income or have earnings below the gross national minimum wage.

In contractual relationships with the health insurance house, medical services suppliers are required to give priority to care for pregnant women and infants (obligation provided in all contracts concluded by the health insurance house with medical services suppliers).

a)  Healthcare services reimbursed by the unique National Social Security Fund are the following:

  √ monitoring of the evolution of pregnancy and recently given birth women in primary healthcare:

       a) registration in the first trimester; consultation provided;

       b) monthly surveillance , starting from the 3^rd month until  the 7^th one consultation/ month provided;

       e) twice on month surveillance, from the  7^th including the 9^th month; two consultations/month provided;

       d) monitoring of the recently given birth woman on discharge from maternity –outpatient care; one    consultation provided;

       e) monitoring of the recently given birth woman, 4 weeks from birth, one consultation provided.

Within the surveillance of the pregnant woman it is also promoted the exclusive breastfeeding of the child up to 6 months of age and continuing to a minimum of 12 months, testing for HIV, hepatitis of viral aetiology with B and C virus, and HIV and lues disease pre and post testing counselling for pregnant women, as well as other necessary paraclinical investigations, from those provided in the basic package.

√ surveillance services of  the pregnant and recently given birth women in ambulatory care for clinical specialities - a consultation provided for each trimester of pregnancy and one consultation provided after the first trimester after childbirth.

For the monitoring consultations of the evolution of pregnancy and recently given birth women, the consultation can be made directly by the obstetrics-gynaecology specialised doctor from the ambulatory, without the submission of a referral note.

  √ the basic healthcare package of services for ambulatory care for paraclinical specialities: in addition to the investigations the insured persons  are entitled to,  pregnant women benefit of the following laboratory tests:

-     Assesment in pregnancy of the ABO blood group (may be recommended by family physician as well as by the specialised doctor from the ambulatory care),

-     Assesment in pregnancy of the Rh blood group, (may be recommended by family physician as well as by the specialised doctor from the ambulatory care),

-     Specific anti- Rh bodies in pregnancy, (recommendation made by the specialised doctor from the ambulatory care),

-     Anti-HA V IgM -(may be recommended by family physician as well as by the specialised doctor from the ambulatory care),

-     HBsAg  (screening) - (may be recommended by family physician as well as by the specialised doctor from the ambulatory care),

-     Anti HCV - (may be recommended by family physician as well as by the specialised doctor from the ambulatory care),

-     HIV testing in pregnancy (may be recommended by family physician as well as by the specialised doctor from the ambulatory care).

The list of radiology laboratory investigations – medical imaging, nuclear medicine and functional exploration includes also the following investigations without radiation exposure, specific for pregnancy:

          o Obstetric abnormalities echography for II trimester and

          o Obstetric abnormalities echography with NT for I trimester.

 

b) the basic healthcare package for hospitalization includes prenatal, intra-natal and postnatal care, where necessary.

Amniocentesis, corial vilocities biopsy  are part of the basic package for hospital care and pregnancy assessment for pregnancy-induced infections (for rubella, toxoplasmosis, CMV infection, hepatitis B and C) and is  provided under day hospitalization.

Biopsy of corial vilocities is reimbursed for pregnant women in the I trimester and amniocentesis for the II trimester of pregnancy, performed only by obstetrics-gynaecology specialised doctor with over-specialization in maternal-fetal medicine, for cases with imagistic confirmed major abnormalities  prior to the procedure or in the case of genetic pathology with transference risk to descendants - at the recommendation of the geneticist, of aneuploidy risk higher than 1/100 at the time of examination calculated using the Fetal Medicine Foundation algorithm; these also include the  processing the taken samples - DNA analysis by PCR of chromosomes 13, 18, 21, X and Y for the diagnosis of Down syndrome, Edwards, Patau, and fetal sex and numerical abnormalities of sex chromosomes.

Hospital healthcare in the case of childbirth are grated without admission note, regardless of the insured status of the patient and is supported by unique National Social Security Fund.

Insured persons have the obligation to pay monthly cash contribution for health insurance. In case of non - compliance, these persons benefit from healthcare services within a minimum package according to the provisions of Law no. 95/2006, republished, which includes family planning services with primary care, monitoring the evolution of pregnancy and recently given birth woman in primary and ambulatory care for clinical specialties, birth.

B. Please confirm that, in accordance with the provisions of this Article, the beneficiary or the sponsor is not required to share the cost of the medical benefit granted. If the Scheme provides for the reimbursement of the costs that the beneficiary or the maintainer has had to bear in order to obtain the benefits accrued in paragraph 2, please provide the available information showing how the beneficiary or the maintainer does not share the cost of such benefits.

In the case of pregnancy, birth and their consequences, the beneficiary of the medical services or its provider does not bear the costs of medical services, and according to the provisions of Law no. 95/2006, republished, all pregnant women and women who have recently given birth are exempt from co-payment for medical services related to the evolution of pregnancy and those who have no income or income below the minimum basic salary per country are exempted for all medical services.

The value of prescription drugs for pregnant women and women who have recently given birth is borne from the fund at the reference price level.

C. Please indicate in detail what measures are being taken to implement the provisions of paragraphs (3) and (4) of this Article.

In compliance with the provisions of Law no. 95/2006, republished, for the purpose of prevention, early detection of disease and preservation of health, the insured persons will be permanently informed, directly or through the service providers, with which the insurance houses are in contractual relations, upon the means of preserving the health, of reducing and avoiding the causes of diseases and on the dangers to which they are exposed in case of drug use, alcohol and tobacco.

   

Article 50

In respect of suspension of earnings resulting from pregnancy and from confinement and their consequences, the benefit shall be a periodical payment calculated in such a manner as to comply either with the requirements of Article 65 or with the requirements of Article 66. The amount of the periodical payment may vary in the course of the contingency, subject to the average rate thereof complying with these requirements

A.     Please indicate whether for the calculation of the benefit have been applied the provisions of Article 65 or Article 66.

B. Please provide information under this Article as follows:

i.      if applicable Article 65, as set out in Title I and V of Article 65;

ii.     whether Article 66 applies, as set out in Title I and V of Article 66.

A. Please indicate whether for the calculation of the benefit have been applied the provisions of Article 65 or Article 66.

To calculate the maternity indemnity, the provisions or Article 65 are applied.

B. Please provide information under this Article as follows:

   i. if applicable Article 65, as set out in Title I and V of Article 65; or

The calculation basis of the indemnity is established as an average monthly income during the past six months of 12 which represents the qualifying period, up to the limit of 12 national minimum wages, used to calculate the contribution for leaves of absence and indemnities.

The amount of the maternity indemnity is established by applying the 85% at the calculation basis established by the law.

The qualifying period in the health insurance system is obtained by summing the periods for which the contribution for medical leave allowance and indemnities is paid by the employer or insured individual, as the case may be, respectively, by the Fund in case of work accidents or occupational diseases, or from the unemployment insurance budget.

The minimum qualifying period entitling to rights is one month worked during the last 12 months previous to the month of medical leave.

Women no longer insured individuals, due to reasons not attributable to them, shall take advantage of same rights if they deliver within 9 months as of the date of loosing their health insurance. Losing the health insurance due to causes not attributable to the pregnant woman shall be proved by official acts issued by her employers or other similar officers, and the indemnity shall be settled, from the National Unique Health Insurance Fund, by the health insurance houses having contracts with the relevant family physician.

ii. whether Article 66 applies, as set out in Title I and V of Article 66, the work incapacity is likewise to be permanent or persistent after the depletion of the sickness benefit.

N/A

 

Article 51

The benefit specified in Articles 49 and 50 shall, in a contingency covered, be secured at least to a woman in the classes protected who has completed such qualifying period as may be considered necessary to preclude abuse, and the benefit specified in Article 49 shall also be secured to the wife of a man in the classes protected where the latter has completed such qualifying period.

Benefits referred to in Articles 49 and 50, in a contingency covered, must be given at least to a women in the protected classes who have completed such qualifying periods necessary to prevent abuse; benefits specified in Article 49 shall also be given to the wife of a man in the classes protected where the latter has completed such qualifying period.

Please indicate for each system, the nature and duration of the qualifying period as may be considered needed to prevent abuse.

Please summarize the rules for calculating these qualifying periods.

The insured women are entitled to maternity indemnity if they previously contributed to the unforeseen event for at least 6 months during the past 12 months representing the qualifying period, up to the limit of 12 national minimum wages, used to calculate the contribution for leaves of absence and indemnities.

The minimum qualifying period entitling to maternity indemnity is one month (22 business days) worked during the last 12 months previous to the month of the unforeseen event

Article 52

The benefit specified in Articles 49 and 50 shall be granted throughout the contingency, except that      the periodical payment may be limited to 12 weeks, unless a longer period of abstention from work is required or authorised by national laws or regulations, in which event it may not be limited to a period less than such longer period.

1.      Please specify for each system, if duration of all medical benefits referred to in Article 49 are guaranteed throughout the contingency. Also, please specify:

a)   the period for which periodic payments under Article 50 are given and;

b)   duration of any period of absence from work  required or authorized by national legislation.

 2. Please indicate, on Article 68, if there are provisions for suspension of maternity benefits for each system.

1. The maternity indemnity is granted on the entire period in which the insured women take advantage of leave of absence for pregnancy and post-delivery, more precisely a period of 126 calendar days, for example, 63 days before birth and 63 days post delivery, with the possibility to compensate those periods, depending on the doctor recommendation and the individual option, so that the minimum duration of confinement leave as mandatory, to be 42 calendar days.

2. Please indicate, on Article 68, if there are provisions for suspension of maternity benefits for each system. 

The payment of indemnities shall cease starting with the date next to the day on which:

    a)  the beneficiary has deceased;

    b)  the beneficiary does no longer meet the legal requirements for granting the indemnities;

    c) the beneficiary has established the domicile on the territory of a State other than Romania not having any social security convention concluded with Romania;

    d) the beneficiary has established the domicile on the territory of a State other than Romania having any social security convention concluded with Romania, when such convention provided for the payment of indemnities by the other relevant State.

Article 65

1.    In the case of a periodical payment to which this article applies, the rate of the benefit, increased by the amount of any family allowances payable during the contingency, shall be such as to attain, in respect of the contingency in question, for the standard beneficiary indicated in the Schedule appended to this part, at least the percentage indicated therein of the total of the previous earnings of the beneficiary or his breadwinner and of the amount of any family allowances payable to a person protected with the same family responsibilities as the standard beneficiary.

2. The previous earnings of the beneficiary or his breadwinner shall be calculated according to prescribed rules, and, where the persons protected or their breadwinners are arranged in classes according to their earnings, their previous earnings may be calculated from the basic earnings of the classes to which they belonged.

3. A maximum limit may be prescribed for the rate of the benefit or for earnings taken into account for the calculation of the benefit, provided that the maximum limit is fixed in such a way that the provisions of paragraph 1 of this article are complied with, where the previous earnings of the beneficiary or his breadwinner are equal to or lower than the wage of a skilled manual male employee.

4. The previous earnings of the beneficiary or his breadwinner, the wage of the skilled manual male employee, the benefit and any family allowances shall be calculated on the same time basis.

5. For the other beneficiaries, the benefit shall bear a reasonable relation to the benefit for the standard beneficiary.

6. For the purpose of this article, a skilled manual male employee shall be:

a.     a fitter or turner in the manufacture of machinery other than electrical machinery; or

b.    a person deemed typical of skilled labour selected in accordance with the provisions of paragraph 7 of this article; or

c.     a person whose earnings are equal to 125 per cent of the average earnings of all the persons protected.

7. The person deemed typical of skilled labour for the purposes of paragraph 6.b of this article shall be a person employed in the major group of economic activities with the largest number of economically active male persons protected in the contingency in question, or of the breadwinners of the persons protected, as the case may be, in the division comprising the largest number of such persons or breadwinners; for this purpose, the international standard industrial classification of all  economic activities, adopted by the Economic and Social Council of the United Nations at its Seventh Session on 27th August 1948, and reproduced in Addendum 1 to this Code, or such classification as at any time amended, shall be used.

8. Where the rate of benefit varies by region, the skilled manual male employee may be determined for each region in accordance with paragraphs 6 and 7 of this article.

9. The wage of the skilled manual male employee selected in accordance with paragraph 6.a and b

of this article shall be determined on the basis of the rates of wages for normal hours of work fixed

by collective agreements, by or in pursuance of national laws or regulations, where applicable, or by

custom, including cost‑of‑living allowances if any; where such rates differ by region but

paragraph 8 of this article is not applied, the median rate shall be taken.

10. The rates of current periodical payments in respect of old age, employment injury (except in case of incapacity for work), invalidity and death of breadwinner, shall be reviewed following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.

TITLE VI

(Article 28, 369 ; 56 and 62)

1.    Please indicate the methods adopted to apply, if necessary, the provisions of paragraph 10 of Article 65 or paragraph 8 of Article 66.

2.    Please provide the following information:

               

                        Consumer price index (Ipc)    

                                                                                                                    Dec.2011=100-

January 2012	100.36
October 2012	104.28
December 2012	104.95

                       

      Dynamics of the real incomes in 2012

                                                                                                                  Year 2011=100-

	Total households
Total incomes	99, 1
Cash incomes	100,0
Incomes in kind	95,0

3.    Please indicate if the amount of periodic payments was revised during the reporting period. If yes, please indicate changes in level of benefits and provide the following information.

       Article 66

1. In the case of a periodical payment to which this article applies, the rate of the benefit, increased by the amount of any family allowance payable during the contingency, shall be such as to attain, in respect of the contingency in question, for the standard beneficiary indicated in the Schedule appended to this part, at least the percentage indicated therein of the total of the wage of an ordinary adult male labourer and of the amount of any family allowances payable to a person protected with the same family responsibilities as the standard beneficiary.

2. The wage of the ordinary adult male labourer, the benefit and any family allowances shall be calculated on the same time basis.

3. For the other beneficiaries, the benefit shall bear a reasonable relation to the benefit for the standard beneficiary.

4. For the purpose of this article, the ordinary adult male labourer shall be:

a.     a person deemed typical of unskilled labour in the manufacture of machinery other than electrical machinery; or

b.    a person deemed typical of unskilled labour selected in accordance with the provisions of the following paragraph.

5. The person deemed typical of unskilled labour for the purpose of paragraph 4.b of this article shall be a person  employed in the major group of economic activities with the largest number of economically active male persons protected in the contingency in question, or of the breadwinners of the persons protected, as the case may be, in the division comprising the largest number of such persons or breadwinners; for this purpose the international standard industrial classification of all economic activities, adopted by the Economic and Social Council of the United Nations at its Seventh Session on 27th August 1948, and reproduced in Addendum 1 to this Code, or such classification as at any time amended, shall be used.

6.   Where the rate of benefit varies by region, the ordinary adult male labourer may be determined for each region in accordance with paragraphs 4 and 5 of this article.

7.   The wage of the ordinary adult male labourer shall be determined on the basis of the rates of wages for normal  hours of work fixed by collective agreements, by or in pursuance of national laws or regulations, where applicable, or by custom, including cost‑of‑li­ving allowances if any; where such rates differ by region but paragraph 6 of this article is not applied, the median rate shall be taken.

8.   The rates of current periodical payments in respect of old age, employment injury (except in case of incapacity for work), invalidity and death of breadwinner, shall be reviewed following substantial changes in the general level of earnings where these result from substantial changes in the cost of living.

Note: The information requested below in Titles IV, are required to prove that, in accordance with paragraph 1 (b) of Article 74 are met the conditions of Article 66 relating to statistical terms and will be provided for each party, as shown on each article of each Part.

Article 67

In the case of a periodical payment to which this article applies:

               a  the rate of the benefit shall be determined according to a prescribed scale or a scale fixed by the competent public authority in conformity with prescribed rules;

               b  such rate may be reduced only to the extent by which the other means of the family of the beneficiary exceed prescribed substantial amounts or substantial amounts fixed by the competent public authority in conformity with prescribed rules;

               c  the total of the benefit and any other means, after deduction of the substantial amounts referred to in sub‑paragraph b of this article, shall be sufficient to maintain the family of the beneficiary in health and decency, and shall be not less than the corresponding benefit calculated in accordance with the requirements of Article 66;

               d the provisions of sub‑paragraph c) of this article shall be deemed to be satisfied if the total amount of benefits paid under the part concerned exceeds, by at least 30 per cent, the total amount of benefits which would be obtained by applying the provisions of Article 66 and the provisions of:

                  i   Article 15.b for Part III;

                  ii  Article 27.b for Part V;

                  iii Article 55.b for Part IX;

                  iv Article 61.b for Part X.

NOTE: The information requested below in Titles IV, are required to demonstrate that, in accordance with paragraph 1 (b) of Article 74 are met the conditions of Article 67 relating to statistical terms and will be provided for each party, as shown on each article of each Part.

F. The total amount of benefits that would be payable under Article 66 = percentage shown in the table in Part XI multiplied   by the standard salary calculated as stated in Title I of Article 66, multiplied by E24 .

Schedule to Part XI

      

Periodical payments to standard beneficiaries

Part	Contingency	Standard beneficiary	Percentage
III	Sickness	Man with wife and two children	45
IV	Unemployment	Man with wife and two children	45
V	Old age	Man with wife of pensionable age	40
VI	Employment injury : Incapacity for work Total loss of earning capacity Survivors	Man with wife and two children Man with wife and two children Widow with two children	50 50 40
VIII	Maternity	Woman	45
IX	Invalidity	Man with wife and two children	40
X	Survivors	Widow with two children	40

As regards unemployment benefits. according to Art.5 V of Law No.76/2002, with its subsequent changes and complements, the contribution period is the period for which the unemployment insurance contribution is due both by the insured person and the employer or, as the case may be, only by the insured person, as well as the period for which the persons insured in the unemployment insurance system by concluding an unemployment insurance contract are due and have paid their unemployment insurance contribution.

As clearly stated in Art.34 (1) of the said legal document, the unemployed provided in Art.17 (1) of the law benefit from unemployment indemnity if they cumulatively meet a number of conditions, including a period of contribution to the unemployment insurance system of at least 12 months in the 24 months prior to the date when their unemployment application is registered.

According to Art.39 (1) of the said law, the unemployment indemnity is granted to the unemployed provided in Art.17 (1) of the law, over different periods, function of their period of contribution, as follows:

a)                  6 months, for persons with a period of contribution of at least 1 year;

b)                  9 months, for persons with a period of contribution of at least 5 years;

c)                  12 months, for persons with a period of contribution of at least 10 years.

According to para.(2) of the same Article, the unemployment indemnity provided in para.(1) is an amount granted monthly that varies function of the period of contribution, as follows:

a)                  75% of the value of the reference social indicator for unemployment insurance and employment stimulation in force, for persons with a period of contribution of at least 1 year;

b)                  the amount provided in para.a) to which is added an amount calculated by applying, to the average gross monthly wage over the last 12 months of contribution, a percentage quota differentiated function of the period of contribution.

As provided in para.(3) of the same Article, the percentage quotas differentiated function of the period of contribution, provided in para.(2) b), are as follows:

a)                  3% for persons with a period of contribution of at least 3 years;

b)                  5% for persons with a period of contribution of at least 5 years;

c)                  7% for persons with a period of contribution of at least 10 years;

d)                 10% for persons with a period of contribution of at least 20 years.

According to Art.39 (4) of Law No.76/2002, with its subsequent changes and complements, for the persons who had been insured based on an unemployment insurance contract, the monthly income declared in the unemployment insurance contract will be taken into account upon determining the amount calculated by applying a percentage quota differentiated function of the period of contribution, provided in para.(2) b) of the same Article.

According to Art.19¹ (1) of the Methodological Norms for implementing Law No.76/2002, approved by Decision of the Government No.174/2002, with its subsequent changes and complements, the term gross base monthly salary over the past 12 months of contribution period, provided in Art.39 (2) b) of the law, represents the monthly basis for calculating the individual contribution to the Unemployment Insurance Fund, provided in Title IX² «Compulsory social contributions» of Law No.571/2003 on the Fiscal Code, with its subsequent changes and complements, over the last 12 months of the period of contribution.

According to para.(2) of the same Article, for the persons who had been insured based on an unemployment insurance contract, upon determining the amount calculated by applying a percentage quota differentiated function of the period of contribution, provided in Art.39 (2) b) of the law, will be taken into account the monthly income declared in the unemployment insurance contract, under the law, and for which the contributions due to the Unemployment Insurance Fund, provided in Art.28 of the law, have been paid.

According to Art.164 (1) of Law No.53/2003 – the Labour Code, re-published, with its subsequent changes and complements, the minimum guaranteed base gross salary at national level, for normal working hours, is set by Decision of the Government, following consultations with the trade unions and employer organisations. In case the normal working hours are, according to the law, less than 8 hours a day, the hourly minimum base gross salary is calculated as a ratio between the minimum base gross salary at national level and the average monthly working hours, according to the approved legal working hours.

Part XII – Common provisions

                

Article 68

 

A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Code may be suspended to such extent as may be prescribed:

               a  as long as the person concerned is absent from the territory of the Contracting Party concerned;

               b  as long as the person concerned is maintained at public expense, or at the expense of a social security institution or service, subject to a portion of the benefit being granted to the dependants of the beneficiary;

               c  as long as the person concerned is in receipt of another social security cash benefit, other than a family benefit, and during any period in respect of which he is indemnified for the contingency by a third party, subject to the part of the benefit which is suspended not exceeding the other benefit or the indemnity by a third party;

               d where the person concerned has made a fraudulent claim;

               e  where the contingency has been caused by a criminal offence committed by the person concerned;

               f  where the contingency has been caused by the wilful misconduct of the person concerned;

               g  in appropriate cases, where the person concerned neglects to make use of the medical or rehabilitation services placed at his disposal or fails to comply with rules prescribed for verifying the occurrence or continuance of the contingency or for the conduct of the beneficiaries;

               h  in the case of unemployment benefit, where the person concerned has failed to make use of the employment services placed at his disposal;

               i   in the case of unemployment benefit, where the person concerned has lost his employment as a direct result of a stoppage of work due to a trade dispute, or has left it voluntarily without just cause; and

               j   in the case of survivors' benefit, as long as the widow is living with a man as his wife.

Information on applying this Article shall be provided for each part, as to Article of the Part concerned (see Articles 12, 18, 24, 30, 38, 45, 52, 58 and 64).

According to Law no. 263/2010, pension payment is suspended from the month following the month in which:

     a) Pensioner shall establish domicile in a country with which Romania has concluded social security agreement, if it stipulates that the pension is paid by the other State;

     b) Beneficiary of an early pension or an early partial retirement pension lies in one of the situations referred to in art. 5 para. (1) Sections I and II, except persons who shall act as local adviser or county councellor;

     c) Invalidity pensioner or the invalid survivor pensioner do not participate at the periodical mandatory medical review;
     d) Invalidity pensioner do not attend individual recovery program set by  social security expert doctor for him/her;
     e) Pensioner with category I or II invalidity pension accumulate pension with income from work, except as a local or county counsellor;
     f) Pensioner with category III invalidity pension accumulate pension with income from work, exceeding half the normal working time;
     g) Survivor pensioner has attained the age of 16 and does not prove continuing education;
     h) The surviving spouse beneficiary of a survivor's pension earns a monthly gross income exceeding 35% of average gross earnings as projected for the annual state social insurance budget, i.e. RON 1,096;
     i) The surviving spouse beneficiary of a survivor's pension remarries;
     j) The surviving spouse beneficiary of a pension from the public pension system, chooses for a pension granted from another pension system;
     k) Pensioner no longer meets the conditions provided by law on the accumulation of pension income from work.                                                                                                                                                        

Resumption of the suspended pension payment is made on demand and is granted starting with the next month subsequent the month in which the suspension cause has ceased, if the application was filed within 30 days since the cause of suspension was terminated.

In terms of medical healthcare, there are legislative provisions that would lead to the suspension of medical benefits referred to in Article 10.

In terms of social benefits, including the family ones, they are given as long as people meet the eligibility requirements under national law and EU regulations in the field of family benefits.

Article 69

1                Every claimant shall have a right of appeal in case of refusal of the benefit or complaint as to its quality or quantity.

2                Where in the application of this Code a government department responsible to a legislature is entrusted with the administration of medical care, the right of appeal provided for in paragraph 1 of this article may be replaced by a right to have a complaint concerning the refusal of medical care or the quality of the care received investigated by the appropriate authority.

3                Where a claim is settled by a special tribunal established to deal with social security questions and on which the persons protected are represented, no right of appeal shall be required.

I.                   Please specify for each Part and each target system, where each claimant has the right to appeal in case of refusal of benefit or the right to complain regarding its quality or quantity, as stipulated in paragraph 1 of this article. Please, list the rules that apply to an appeal.

As social benefits are concerned, in case that the solicitant or, where applicable, the beneficiary of social rights consider themselves wronged by the decision issued by a public institution with regard to his/her right, he/she may address a complaint in the attention of the following institutions: the President of Romania, the Romanian Government, the Ministry of Labour and Social  Justice (the Directorate General for Social Assistance), the National Agency for Payments and Social Inspection, the county agencies for payments and social inspection, the local public authorities (city halls, county councils, prefectures).

As regards family benefits, Part VII of the ECSS, the jurisdiction is regulated by Law no. 47/2006 on the national system of social assistance which provides in Article 46 that decision establishing the right to social services and social benefits can be contested before the Board of Social Mediation.

The Board of Social Mediation is obliged to rule within 30 days from the date of filing the request for mediation.

Article 47 stipulates that the Board of Social Mediation is organized and operates in the decentralized structures of the Ministry of Labour and Social Justice.

Furthermore, Article 48 provides that the applications submitted to the courts in relation with the provision of social services and social benefits are exempt from judicial taxes.

II.                Please specify if applicable, paragraph 2 of this Article and, if so, what measures are taken to ensure that every person protected is entitled to complain of denial of care or quality of care received investigated by the competent authority.

It is the competence of the territorial houses of pensions to decide on accepting or rejecting the retirement requests. The retirement decisions have to be issued within 45 calendar days following application date and include the factual and legal grounds on which each decision has been made.

Acceptance or rejection decisions are to be communicated in writing both to the person entitled and to his/her employer.

Within 30 days from notification the retirement decision may be appealed to the Central Appeals Committee, functioning at the National House of Public Pensions.

The decisions issued by the Central Appeals Committee are transmitted both to the entitled persons and the concerned house of pensions within 5 days after the issuance date and may be contested at the competent court of law, during 30 days following the notification. Uncontested decisions become definitive.

Jurisdiction of social security is achieved by courts and courts of appeal.

The date of entry into force of Law no. 19/2000 departments of social security are organized or, where appropriate, specialized sections for social security in the courts and courts of appeal.

The courts settle disputes in the first instance:

    a) calculation and submission of social security contribution;

    b) ways to establish the delay penalties;

    c) registration, records and certification  of social security contribution;

    d) decisions issued by Central Committee of Appeals and the other boards of appeal above mentioned;

    e) decisions on complaints regarding work capacity;

    f) unjustified refusal to resolve an application for social security rights;

    g) the setting and payment of pensions, allowances and other social insurance rights;

    h) complaints against the reports of offenses concluded under this law;

    i) appeals against enforcement measures, arranged under this law;

    j) other social insurance rights and obligations arising under this law.

Claims against CNPP or against the territorial pension houses address the court in whose jurisdiction the applicant resides or has office. Other requests are addressed to the court in whose jurisdiction the defendant has its domicile or headquarters.

Against decisions of courts can make appeal to the competent court of appeal.

Appellate decisions, and decisions of courts, not challenged by appeal in due time, are final and irrevocable.

If the applicant's rights or, where appropriate, the beneficiary's rights to social benefits, consider himself wronged by the decision issued by a public institution regarding his/her rights, he/she may address intimations / complaints / claims to the following institutions: President of Romania, the Romanian Government, Ministry of Labour and Social Justice, to other central and, local authorities (Municipalities, County Councils, Prefectures).

If the recipient of the benefit received a negative response from the Central Committee of Appeal he/she has made the complaint he/she can then address the courts to settle disputes; he/she is exempt from judicial tax.

Article 70

1                The cost of the benefits provided in compliance with this Code and the cost of the administration of such benefits shall be borne collectively by way of insurance contributions or taxation or both in a manner which avoids hardship to persons of small means and takes into account the economic situation of the Contracting Party concerned and of the classes of persons protected.

2                The total of the insurance contributions borne by the employees protected shall not exceed 50 per cent of the total of the financial resources allocated to the protection of employees and their wives and children. For the purpose of ascertaining whether this condition is fulfilled, all the benefits provided by the Contracting Party concerned in compliance with this Code, except family benefit and, if provided by a special branch, employment injury benefit, may be taken together.

3     The Contracting Party concerned shall accept general responsibility for the due provision of the benefits provided in compliance with this Code, and shall take all measures required for this purpose; it shall ensure, where appropriate, that the necessary actuarial studies and calculations concerning financial equilibrium are made periodically and, in any event, prior to any change in benefits, the rate of insurance contributions, or the taxes allocated to covering the contingencies in question.

I.                   Please indicate, for each part, each system resources concerned, and in particular percentage or amount of income used to finance the system, determined by the type of insurance contributions or taxes.

II.                If the requirements of Part VI about occupational diseases have been accepted, please, indicate whether this benefit is granted for a special branch.

III.             Please provide, according to Article 74, paragraph 1 (b) the following statistics for each of the Parties for which have been accepted the Code obligations.

Parties subject to acceptance	Resources allotted from the annual FNUASS Fund (A) th. RON
Part II – Medical care (materials and providing medical services) Part III – Sickness benefit (social assistance in case of illness) Part VIII – Maternity benefit (family social assistance and child social assistance)	RON 20.894.607,2 thousand RON 874.678,44 thousand RON 601.057,40 thousand

*Remarks: the data in the table comply with the period July 1st, 2013 - March 31st, 2014

The state social insurance budget concerns both the incomes and the expenditures of the public pension system.

The incomes of the state social insurance budget come from:

a) social insurance contributions, interests and late payment penalties and other incomes according to the law,

b) amounts from the state budged for balancing the state social insurance budget, which is approved by budgetary laws yearly.

The expenditures of the state social insurance budget are intended to cover the social insurance benefits paid by the public system of pensions, as well the organizational and operational costs and other expenditures stipulated by the law. 

Article 71

1.Where the administration is not entrusted to a government department responsible to a legislature, representatives of the persons protected shall participate in the management, or be associated therewith in a consultative capacity, under prescribed conditions; national laws or regulations may likewise decide as to the participation of representatives of employers and of the public authorities.

2. The Contracting Party concerned shall accept general responsibility for the proper administration of the institutions and services concerned in the application of this Code.

Please, indicate whether protected persons participate in system administration or systems concerned, or if their representatives are associated with it. If yes, please specify how it is ensured participation or association.

The unitary and coordinated operation of the social insurance system in Romania is insured by law by the National Health Insurance House, referred to as CNAS, has health insurance houses under its management, along with the Health Insurance House in Bucharest and the Health Insurance House of the Defense, Public Order, National Security and Court Authority.   

CNAS, a public institution, autonomous and of national interest, with legal personality, is a specialized body of the central public administration, managing the health insurance system and provides the application of policies and Government programmes under the coordination of the Ministry of Health.  

CNAS has the following management bodies:

a)                  assembly of representatives;

b)                 board of directors;

c)                  president;

d)                 committee of directors;

e)                  vice-president;

f)                   General Manager

The representatives’ assembly is created for a period of four years and includes:

a)                        the representatives of the insured individuals assigned by the county councils and the General Council of the Bucharest Municipality, one for each county and two for the Bucharest municipality;  

b)                         31 assigned members as follows:  2 by the President of Romania, 3 by the Prime Minister, at the proposal of the Minister of Health, 3 by the Senate, at the proposal of the specialty committee, 3 by the Chamber of Deputies, at the proposal of the specialty commission, a representative of the Ministry of Labour, Family and Social Protection and Elderly Persons, a representative of the National House of Public Pensions, 5 by the owners' unions on national level, 5 by the syndicate organizations representative on national level, 7 representatives of the Ministries and central institutions with their own health insurance networks, namely a representative of the Ministry of Interior, Ministry of Defence, Ministry of Justice, Ministry of Transportation and Tourism, Romanian Intelligence Service, External Information Services and Special Telecommunication Service and a representative of the National Council of Elderly Persons.   

The CNAS Board of Directors includes seven members, with a 4 year mandate, as follows:  

a)                  4 representatives of the State, among which one is assigned by the President of Romania and three are assigned by the Prime Minister at the proposal of the Ministry of Health;

b)                 a member assigned by the owners’ confederations representative on national level;

c)                  a member assigned by the syndicate confederations representative on national level;

d)                 a member assigned by the Prime Minister, in consultation with the National Council of the Elderly Persons.  

The management bodies of the insurance houses are the Board of Directors and President – General Manager.

The Board of Directors of the county health insurance houses and of the Bucharest Municipality includes 11 assigned members, as follows:  

a)                  one assigned by the county council, namely by the General Council of Bucharest Municipality;

b)                 one assigned by the prefect, at the proposal of the county public health authority, namely of the Bucharest municipality;

c)                  3 assigned by the representative of the owners’ confederations representative on national level, assigned by consensus;

d)                 3 assigned by the representative of the syndicate confederations representative on national level, assigned by consensus;

e)                  2 assigned by the county councils of elderly persons, namely of the Bucharest municipality;

f)                   the President, which is the general manager of the health insurance house.  

National House of Public Pensions (NHPP) is a public institution of national interest, with legal personality, a specialized body of the central public administration that manages the public system of pensions, under the authority of the Ministery of Labour and Social Justice.

The management of the CNPP is provided by the president and the board of directors, consisting of 23 people, including 4 members who are representatives of the pensioners, appointed by the national pensioners' organizations.

                     

Article 72

This Code shall not apply to:

a      contingencies which occurred before the coming into force of the relevant part of the Code for the Contracting Party concerned;

b     benefits in contingencies occurring after the coming into force of the relevant part of the Code for the Contracting Party concerned in so far as the rights to such benefits are derived from periods preceding that date.

Article 73

The Contracting Parties shall endeavour to conclude a special instrument governing questions

relating to social security for foreigners and migrants, particularly with regard to equality of

treatment with their own nationals and to the maintenance of acquired rights and rights in course of

acquisition.

Article 74

1     Each Contracting Party shall submit to the Secretary General an annual report concerning the

application of this Code. This report shall include:

               a  full information concerning the laws and regulations by which effect is given to the provisions of this Code covered by the ratification; and

               b  evidence of compliance with the statistical conditions specified in:

                  i   Articles 9.a, b or c; 15.a or b; 21.a; 27.a or b; 33; 41.a or b; 48.a or b; 55.a or b; 61.a or b, as regards the number of persons protected;

                  ii  Articles 44, 65, 66 or 67, as regards the rates of benefit;

                  iii Article 24, paragraph 2, as regards duration of unemployment benefit; and

                  iv Article 70, paragraph 2, as regards the proportion of the financial resources constituted by the insurance contributions of employees protected. Such evidence shall as far as possible be presented in such general order and manner as may be suggested by the Committee.

       2     Each Contracting Party shall furnish to the Secretary General, if so requested by him,

further information of the manner in which it has implemented the provisions of the Code covered

by its ratification.

       3     The Committee of Ministers may authorise the Secretary General to transmit to the

Consultative Assembly copies of the report and further information submitted in accordance with

paragraphs 1 and 2 of this article respectively.

4     The Secretary General shall send to the Director General of the International Labour Office the  

report and further information submitted in accordance with paragraphs 1 and 2 of this article

respectively, and shall request the latter to consult the appropriate body of the International Labour

Organisation with regard to the said report and further information and to transmit to the Secretary

General the conclusions reached by such body.

5     Such report and further information and the conclusions of the body of the International

Labour Organisation referred to in paragraph 4 of this article shall be examined by the Committee

which shall submit to the Committee of Ministers a report containing its conclusions.

Note: The information requested below is necessary to show that, in accordance with paragraph 1 (b) of Article 74, specific statistical requirements are met in the corresponding Articles of each Part, as indicated in the corresponding Article of each Part.

Title I

(Articles 9(a); 15(a); 21(a); 27(a); 33; 41(a); 48(a); 55(a) and 61(a))

A.                 Number of employees protected 26 :

1.                  In the social health insurance system, the number of active persons (employees and other insured persons) was in the reference period, of.

Article 75

1     After consulting the Consultative Assembly, if it considers it appropriate, the Committee of

Ministers shall, by a two-thirds majority in accordance with Article 20, paragraph d, of the Statute

of the Council of Europe, decide whether each Contracting Party has complied with the obligations

of this Code which it has accepted.

2            If the Committee of Ministers considers that a Contracting Party is not complying with its

obligations under this Code, it shall invite the said Contracting Party to take such measures as the Committee of Ministers considers necessary to ensure such compliance.

Article 76

Each Contracting Party shall report every two years to the Secretary General on the state of its law

and practice in regard to any of Parts II to X of the Code which such Contracting Party has not

specified in its ratification of the Code pursuant to Article 3 or in a notification made subsequently

 pursuant to Article 4.

Article 77

1     This Code shall be open to signature by the member States of the Council of Europe. It shall be

subject to ratification. Instruments of ratification shall be deposited with the Secretary General,

provided that the Committee of Ministers in appropriate cases has previously given an affirmative

decision as provided for in Article 78, paragraph 4.

2     This Code shall enter into force one year after the date of the deposit of the third instrument of

ratification.

3     As regards any Signatory ratifying subsequently, this Code shall enter into force one year after

the date of  deposit of its instruments of ratification.

Article 78

       1     Any Signatory wishing to avail itself of the provisions of Article 2, paragraph 2, shall, before ratification, submit to the Secretary General a report showing to what extent its system of Social Security is in conformity with the provisions of this Code.

Such report shall include a statement of:

               a  the relevant laws and regulations; and

               b  evidence of compliance with the statistical conditions specified in:

                  i   Articles 9.a, b or c; 15.a or b; 21.a; 27.a or b; 33; 41.a or b; 48.a or b; 55.a or b; 61.a or b, as regards the number of per­sons pro­tected;

                  ii  Articles 44, 65, 66 or 67, as regards the rates of bene­fits;

                  iii Article 24, paragraph 2, as regards duration of unemployment benefit; and

                  iv Article 70, paragraph 2, as regards the proportion of the financial resources constituted by the insurance contributions of employees protected; and

               c  all elements which the Signatory wishes to be taken into account, in accordance with Article 2, paragraphs 2 and 3.

Such evidence shall, as far as possible, be presented in such general order and manner as may be

suggested by the Committee.

       2     The Signatory shall furnish to the Secretary General, if so requested by him, further information on the manner in which its system of Social Security is in conformity with the provisions of this Code.

       3     Such report and further information shall be examined by the Committee which shall take into account the provisions of Article 2, paragraph 3. The Committee shall submit to the Committee of Ministers a report containing its conclusions.

       4     The Committee of Ministers shall, by a two‑thirds majority in accordance with Article 20, paragraph d, of  the Statute of the Council of Europe, decide whether the system of Social Security of such Signatory is in conformity with the requirements of this Code.

3            If the Committee of Ministers decides that the said Social Security scheme is not in conformity with the provisions of this Code, it shall so inform the Signatory concerned and may make recommendations as to how such conformity may be effected.

Article 79

 

1     After the entry into force of this Code, the Committee of Ministers may invite any non‑member

State of the Council of Europe to accede to the Code. The accession of such State shall be subject to

the same conditions and procedure as laid down in the Code with regard to ratification.

2     A State shall accede to this Code by depositing an instrument of accession with the Secretary

General. The  Code shall come into force for any State so acceding one year after the date of deposit

of its instrument of accession.

3            The obligations and rights of an acceding State shall be the same as those provided for in

this Code for a Signatory which has ratified the Code.

Article 80

1.This Code shall apply to the metropolitan territory of each Contracting Party. Each Contracting

Party may, at the time of signature or of the deposit of its instrument of ratification or accession, specify, by declaration addressed to the Secretary General, the territory which shall be considered to be its metropolitan territory for this purpose.

      

2     Each Contracting Party ratifying the Code or each acceding State may, at the time of deposit of

its instrument of ratification or accession, or at any time thereafter, notify the Secretary General that

this Code shall, in whole or in part and subject to any modifications specified in the notification,

extend to any part of its metropolitan territory not specified under paragraph 1 of this article or to

any of the other territories for whose international relations it is responsible. Modifications

specified in such notification may be cancelled or amended by subsequent notification.

3.Any Contracting Party may, at such time as it can denounce the Code in accordance with

Article 81, notify the Secretary General that the Code shall cease to apply to any part of its metropolitan territory or to any of the other territories to which the Code has been extended by it in accordance with paragraph 2 of this article.

Article 81

Each Contracting Party may denounce the Code or any one or more of Parts II to X thereof only at the end of a period of five years from the date on which the Code entered into force for such Contracting Party, or at the end of any successive period of five years, and in each case after giving one year's notice to the Secretary General. Such denunciation shall not affect the validity of the Code in respect of the other Contracting Parties, provided that at all times there are not less than three such Contracting Parties.

Article 82

The Secretary General shall notify the member States of the Council of Europe, the government of

any acceding State and the Director General of the International Labour Office:

               i   of the date of entry into force of this Code and the names of any members who ratify it;

               ii  of the deposit of any instrument of accession in accordance with Article 79 and of such notifications as are received with it;

               iii of any notification received in accordance with Articles 4 and 80; or

               iv of any notice received in accordance with Article 81.

Article 83

The Annex to this Code shall form an integral part of it.

In witness whereof the undersigned, being duly authorised thereto, have signed this Protocol.

Done at Strasbourg, this 16th day of April 1964, in French and English, both texts being equally

authoritative, in a single copy which shall remain deposited in the archives of the Council of

Europe, and of which the Secretary General shall send certified copies to each of the signatory and

acceding States and  to the Director General of the International Labour Office.

Annex and Addenda 1 and 2

ANNEX

 Article 68.i

It shall be understood that Article 68.i of this Code is to be interpreted in accordance with the

national legislation of each Contracting Party.

ADDENDUM 1

International standard indus­trial classification of all eco­nomic activities

List of divisions and major groups

Division 0 – Agriculture, for­estry, hunting and fishing:

               01. Agriculture and livestock production

               02. Forestry and logging

               03. Hunting, trapping and game propagation

               04. Fishing

Division 1 – Mining and quarrying:

               11. Coal mining

               12. Metal mining

               13. Crude petroleum and natural gas

               14. Stone quarrying, clay and sand pits

               19. Non‑metallic mining and quarrying not elsewhere classified

Divisions 2–3 – Manufacturing:

               20. Food manufacturing industries, except beverage industries

               21. Beverage industries

               22. Tobacco manufactures

               23. Manufacture of textiles

               24. Manufacture of footwear, other wearing apparel and made‑up textile goods

               25. Manufacture of wood and cork, except manufacture of furniture

               26. Manufacture of furniture and fixtures

               27. Manufacture of paper and paper products

               28. Printing, publishing and allied industries

               29. Manufacture of leather and leather products, except footwear

               30. Manufacture of rubber products

               31. Manufacture of chemicals and chemical products

               32. Manufacture of products of petroleum and coal

               33. Manufacture of non‑metallic mineral products, except products of petroleum and coal

               34. Basic metal industries

               35. Manufacture of metal products, except machinery and transport equipment

               36. Manufacture of machinery, except electrical machinery

               37. Manufacture of electrical machinery, apparatus, appliances and supplies

               38. Manufacture of transport equipment

               39. Miscellaneous manufacturing industries                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 

                

ADDENDUM 2

       Supplementary services or advantages

       Part II – Medical care

       1     Care outside hospital wards by general practitioners and specialists, including domiciliary visiting, without limit of duration, provided that the beneficiary or his breadwinner may be required to share in the cost of the care received to the extent of 25 per cent.

       2     Essential pharmaceutical supplies, without limit of duration, provided that the beneficiary or his breadwinner may be required to share in the cost of the care received to the extent of 25 per cent.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          

       3     Hospital care, including maintenance, care by general practitioners or specialists, as required, and all auxiliary services required in respect of prescribed diseases requiring prolonged care, including tuberculosis, for a duration which may not be limited to less than 52 weeks per case.

       4     Conservative dental care, provided that the beneficiary or his breadwinner may be required to share in the cost of the care received to the extent of one‑third.

       5     Where cost‑sharing takes the form of a fixed sum in respect of each case of treatment or each prescription of pharmaceutical supplies, the total of such payments made by all persons protected in respect of any one of the types of care referred to in Items 1, 2 or 4 above shall not exceed the specified percentage of the total cost of that type of care within a given period.

               Part III – Sickness benefit

       6     Sickness benefit at the rate specified in Article 16 of this Code, for a duration which may not be limited to less than 52 weeks per case.

               Part IV – Unemployment benefit

       7     Unemployment benefit at the rate specified in Article 22 of this Code, for a duration which may not be limited to less than 21 weeks within a period of 12 months.

               Part V – Old age benefit

       8     Old age benefit at a rate of at least 50 per cent of the benefit specified in Article 28:

               a  under Article 29, paragraph 2, or, where the benefit specified in Article 28 is conditional upon a period of residence and the Contracting Party concerned does not avail itself of Article 29, paragraph 3, after ten years of residence; and

               b  under Article 29, paragraph 5, subject to prescribed conditions regarding the previous economic activity of the person protected.

               Part VII – Family benefit

       9     Family benefit in cash, in the form of periodical payments, until the eligible child continuing its education attains a prescribed age which may not be less than 16 years.

               Part VIII – Maternity benefit

       10   Provision of maternity benefit without qualifying period.

               Part IX – Invalidity benefit

       11    Invalidity benefit at a rate of at least 50 per cent of the benefit specified in Article 56:

               a  under Article 57, paragraph 2, or, where the benefit specified in Article 56 is conditional upon a period of residence and the Contracting Party concerned does not avail itself of Article 57, paragraph 3, after five years of residence; and

               b  for a person protected who, by reason only of his advanced age when the provisions concerned in the application of this part come into force, has not satisfied the conditions prescribed in accordance with Article 57, paragraph 2, subject to prescribed conditions regarding the previous economic activity of the person protected.

               Part X – Survivors' benefit

       12   Survivors' benefit at a rate of at least 50 per cent of the benefit specified in Article 62:

               a  under Article 63, paragraph 2, or, where the benefit specified in Article 62 is conditional upon a period of residence, and the Contracting Party concerned does not avail itself of Article 63, paragraph 3, after five years of residence; and

               b  for persons protected whose breadwinner had not satisfied the conditions prescribed in accordance with Article 63, paragraph 2, by reason only of his advanced age when the provisions concerned in the application of this part came into force, subject to prescribed conditions regarding the previous economic activity of the breadwinner.

               Parts II, III or X

       13   Funeral benefits amounting to:

               i   twenty times the daily previous earnings of the person protected which serve, or would have served, for the calculation of the survivors' benefit or sickness benefit, as the case may be, provided that the total benefit need not exceed twenty times the daily wage of the skilled male manual employee, determined in accordance with the provisions of Article 65; or

               ii  twenty times the daily wage of the ordinary adult male labourer, determined in accordance with the provisions of Article 66.