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Parts of the Consolidated Report

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General questions. Parts I, XII and XIII

Part II

Part III

Part IV

Part V

Part VII

Part VIII

Part XI

Consolidated Report on the application by Romania of ILO Conventions Nos 24, 102, 168, 183 & the European Code of Social Security, 2020Consolidated Report on the application by Romania of ILO Conventions Nos 24, 102, 168, 183 & the European Code of Social Security, 2021

Consolidated information compiled from the following Government Reports on these instruments:

·         Sickness Insurance (Industry) Convention, 1927 (No. 24)

·         Social Security (Minimum Standards) Convention, 1952 (No.102)

·         Employment Promotion and Protection against Unemployment Convention, 1988 (No.168)

·         Maternity Protection Convention, 2000 (No.183)

·         European Code of Social Security

Additional information compiled from the following sources:

·       Biennial Report for the period from 1st July 2014 to 30th June 2016 made by the Government of Romania in accordance with Article 76 of the European Code on Social Security on the position of national law and practice in regard to the matters dealt with in Parts of the European Code of Social Security which have not been specified in the ratification of the Code or in a subsequent notification

·       Database of the MISSOC

·       The official website of the National Health Insurance House

Ø  Please enter any modifications or new information using TRACK CHANGES function in MICROSOFT WORD.

Ø  Where the text of the corresponding provisions of the ECSS and C102 has the same wording, the wording of C102 is taken as the basis, with eventual changes in the ECSS reproduced in brackets.

Ø  Questions of the Report Form on the European Code of Social Security (ECSS) or on ILO Conventions (e.g. RF/C102) for which information is lacking are reproduced in a box below the respective provisions.

Ø  Replies to pending questions raised by the CEACR may be provided in a box below the CEACR comments.

Part I. General provisions

The Part I “General provisions” comprises the following explanatory and procedural clauses:

§  Articles 1-6 C102

§  Articles 1-6 ECSS

§  Articles 1-6 C168

§  Articles 1-2, 7 C183

Article 1

1.             In this Code:

(a) the term "the Committee of Ministers" means the Committee 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 a 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.

If recourse is had to the provision of paragraph 2 of this Article , please furnish the information to show that certain branches covered by sub‑paragraph (a) exceed the standards of the Code in respect of this scope and/or their level of benefits, or exceed the standards of the Code supplementary services of advantages listed in Addendum 2 of the Code. Please supply this information in the order suggested by the Committee.

Article 3

Each Contracting Party shall specify in its instrument of ratifications 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 any such Part, that the relevant percentage is attained.

Article 6

For the purpose of compliance with Parts 11, 111, 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 recourse is had to the provisions of this Article, the information requested below should be given, with regard to each Part accepted, under the Article dealing with the persons protected in accordance with the provisions of the Part concerned (Articles 9, 15, 21, 27, 48, 55, 61).

1.             Please state whether the voluntary insurance scheme or schemes concerned are:

                i. subsidised or supervised by the public authorities; or

ii. administered in accordance with prescribed standards by joint operation of employers and workers.

Law no. 95/2006 on health care reform, republished, as further completed and amended, regulates art. 219 para. (4) - (6), the possibility of concluding voluntary health insurance, which may be offered voluntarily by the insurance bodies authorized according to the law. In this respect, the following are regulated:

“ART. 219

    (4) Other forms of health insurance may operate in various special situations. These insurances are not compulsory and can be offered voluntarily by the insurance bodies authorized according to the law.

    (5) Voluntary supplementary or supplementary health insurance may cover individual risks in special situations and / or in addition to the services covered by social health insurance.

    (6) Voluntary health insurance does not exclude the obligation to pay the contribution for social health insurance. "

We mention the fact that voluntary health insurance is regulated in Title X of Law no. 95/2006, republished, as further completed and amended.

In accordance with the provisions of art. 348 para. (1) of the above normative act, the voluntary health insurances represent an optional system through which an insurer constitutes, on the principle of mutuality, an insurance fund, through the contribution of a number of insured persons exposed to the risk of illness, and indemnifies them, in accordance with the clauses stipulated in the insurance contract, those who suffer a damage, from the fund made up of the premiums collected, as well as from the other incomes resulted as a result of the activity carried out by the insurer and are part of the range of optional insurances according to Law no. 136/1995 on insurance and reinsurance in Romania, as further completed and amended.

Thus, voluntary health insurance can be:

 a) Voluntary complementary health insurance that involves a co-payment due by the insured, in accordance with the law. The co-payment, defined in art. 221 para. (1) lit. j) of Law no. 95/2006, republished, as further completed and amended, is the amount that represents the payment of the insured's monetary contribution, in order to benefit from the medical services from the basic services package, within the social health insurance system, in the amount and under the conditions established by the framework contract on the conditions for providing medical assistance within the social health insurance system.

    b) Voluntary health insurance of additional type in which the payment is totally or partially supported for any type of services not included in the package of basic medical services, a certain medical staff is chosen, a second medical opinion is required, superior hotel conditions or other medical services specified in the insurance policy.

In accordance with the provisions of art. 351, corroborated with art. 356 and art. 358 of the above-mentioned normative act, the package of medical services for voluntary health insurance, medical services provided in the form of a subscription, as well as the manner and conditions of their provision are approved by Government decision, and the provision of services is provided only by providers medical services authorized by the Ministry of Health, based on the regulations in force, and the supervision of the activity of insurers authorized to practice voluntary health insurance is performed by the Financial Supervision Authority.

Considering the legislative provisions invoked above, we specify that the voluntary health insurance systems regulated in Romania fall into the category of those supervised by public authorities, respectively by the Ministry of Health, which authorizes providers for the provision of medical services in voluntary health insurance and the Financial Supervision Authority, which has responsibilities for supervising the activity of insurers authorized to practice voluntary health insurance.

In the public pension system in Romania, apart from the persons compulsorily insured by the effect of the law, any person may be insured in the public pension system on the basis of a social insurance contract, in order to obtain the old-age pension or to supplement the insured income used in the calculation of this category of pension (art. 6 (2) of Law no. 263/2010 on the unitary public pension system, with subsequent amendments and completions).

The National House of Public Pensions ensures the record, at national level, of the social insurance rights and obligations in the case of social insurance contracts, based on the personal numerical code.

2.             Please indicate the wage of the skilled manual male employee computed in accordance with the provisions of Article 65 (see Title 1 under that Article).

2019

Average monthly gross income obtained in month October 

Economic activity (NACE rev. 2 Section level)

Reference period

Major occupational group (ISCO-08 1 digit level)

Average monthly gross income obtained in October (lei/employee)

Total employees

of which: men

Manufacturing

October 2019

MG7 (Craft and related trades workers)

4004

4344

MG9  (Elementary occupations)

3079

3255

Data source: Statistical survey on salaries in month October – based on administrative data(the statement on compulsory payments of social contributions, taxes on income and the nominal records of insured persons (D112), managed by the National Tax Administration Agency and the General register of employees (REGES) managed by Labour Inspection).

3.      Please furnish, in accordance with paragraph 1 (b) of Article 74 the following statistical information on the number of persons protected by voluntary insurance:

A.            Number of employees (or economically active persons) protected by the voluntary insurance scheme or schemes concerned, whose earnings do not exceed the wage of the skilled manual male employee computed in accordance with the provisions of Article 65:[1]

i. Scheme ............................................................            .............................................

ii. Scheme ..........................................................            .............................................

    ..........................................................................            .............................................

                                                                                                                                                      

iii.                               Total ...............................            .............................................

B.            Total number of employees (or of economically active persons) protected by the voluntary insurance scheme or schemes concerned:1

i. Scheme ............................................................            .............................................

ii. Scheme ..........................................................            .............................................

    ..........................................................................            .............................................

                                                                                                                                                      

iii.                               Total ...............................            .............................................

C.             Number of persons insured whose earnings do not exceed the wage of the skilled manual male employee (A.iii)

per cent of the total number of persons insured (B. iii).

The number of insured persons in the public pension system in Romania based on a social insurance contract was on 30.05.2021 of 30.138 persons.


Part II. Medical Care

Romania has accepted the obligations resulting from C24, Part II of C102 and Part II of the ECSS.

Category

Information available

Information missing / questions raised by the CEACR

II-1. Regulatory framework

Art.7 C102/ECSS

II-2. Contingencies covered

Art.8 C102/ECSS

II-3. Persons protected

Art.9 C102/ECSS*

II-4. Types of benefits

Art.10(1) C102/ECSS (and Part VIII (Maternity benefits), in conjunction with Article 68 of the Code. Reduction of medical care)

II-5. Cost-sharing

Art.10(2) C102/ECSS

Art.4,5 C24

II-6. Objectives of Medical Care

Art.10(3) C102/ECSS

II-7. Promotion of the general health service

Art.10(4) C102/ECSS

II-8. Qualifying period

Art.11 C102/ECSS

II-9. Minimum duration of benefit

Art.12 C102/ECSS

II-10. Suspension of benefit

Art.69 C102

Art.68 ECSS

II-11. Right of complaint and appeal

Art.70 C102

Art. 69 ECSS

II-12. Financing and Administration

Art.72 C102

Art.71 ECSS

Art.71 C102

Art.70 ECSS*

* Please update statistical data, in accordance with the Report form for C102/ECSS.

List of applicable legislation

·       Law No 95/2006 on healthcare reform, republished, as further completed and amended (the initial form published in the Official Gazette no 372 of 28 April 2006, the republished form published in the Official Gazette no 652 of 28 August 2015) – Title VIII „Health Social Insurance";

·       Governmental Decision No 140/2018 approving services packages and The Framework Agreement for regulationg the conditions for providing medical asistance, medicines and medical devices in the social health insurance system for 2018 – 2019, as further completed and amended, with effect from 1 April 2018 until 30 June 202131 December 2020; (Part II – Medical care)

·       Joint Order No. 397/836/2018 of the Minister of Health and NHIH President approving the Methodological Norms for the application in 2018 of the Government Decision no. 140/2018 for the approval of service packages and the framework contract governing the conditions for the provision of medical care, medicines and medical devices within the health insurance system for the years 2018 - 2019, as further completed and amended, applicable from 1 April 2018 until 30 June 2021 31 December 2020 (Part II – Medical care)

·       Order of the President of the National Health Insurance House No. 581/2014 on the approval of the methodological regulations related to the establishment of the documents in proof required to acquire the quality of insured person (initial form published in the Official Gazette no. 685, dated September 19th, 2014), with effect until 5 December 2018  (Part II – Medical care);

·       Order of the President of the National Health Insurance House No. 1549/2018 on the approval of the methodological Normes for for establishing the supporting documents regarding the acquisition of the quality of insured (initial form published in the Official Gazette no. 1036 dated December 6th 2018), applied since December 6th 2018 (Partea II – Medical care);

·       Governmental Decision no. 720/2008 for the approval of the list including the common international denomination pertaining to the medication the insured persons take advantage of, with or without personal contribution, based on a medical prescription, within the health insurance system, with the subsequent amendments and supplements (initial form published in the Official Gazette no. 523, dated July 10th, 2008, (Part II – Medical care),

·       Order of the President of the National Health Insurance House No. 1081/2018  on the approval of the methodology to establish the reference prices and lease amounts corresponding to the medical device classes and types intended to the outpatient recovery of organic or functional disabilities,  within the health insurance system (initial form published in the Official Gazette no 535 dated June 28th 2018), applied since July 1th 2018 (Partea II – Medical care);

·       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; 

II – 1. Regulatory framework

Article 7. C102 and ECSS

Each Member (Contracting Party) for which this Part of this Convention (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.

Database of the MISSOC:

Basic principles.

Compulsory social insurance scheme for all inhabitants financed mainly by contributions. Benefits-in-kind system.

Insured people benefit from a basic package of medical services.

Uninsured people benefit from a minimal package of medical services.

II - 2. Contingencies covered

Article 8. C102 and ECSS

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

II - 3. Persons protected

Article 9. C102 and ECSS

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 state to which of the sub‑paragraphs of this Article recourse is had.

B.            Please indicate the classes of persons protected in accordance with the provisions of this Article.

C.            Please furnish statistical information under this Article as follows:

i. if recourse is had to sub‑paragraph (a), in the form set out in Title I under Article 74 below: or

                ii. if recourse is had to sub‑paragraph (b),in the form set out in Title II under Article 74 below, or

iii. if recourse is had to sub‑paragraph (c), in the form set out in Title III under Article 74 below.

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

E.             If recourse is had to Article 6 above (voluntary insurance), for all or any of the schemes concerned, please furnish information under this Article in the form set out under Article 6.

Not applicable

Sub-paragraph c) of Article 9 applies to the health insurance system in Romania.

According to the provisions of the Law no. 95/2006, republished, as further completed and amended, the following persons are insured within the health insurance system in Romania:

                

ART. 222

(1) According to the present law, the insured persons are:

   a) all Romanian citizens domiciled or residing in the country; 

  b) foreign citizens and stateless persons who have applied for and have obtained the right to temporary stay or have their domicile in Romania;

   c) citizens of EU Member States, EEA and Swiss Confederation who do not have insurance in another Member State that has effect in Romania, who have applied for and obtained the right of residence in Romania for a period of more than 3 months; 

  d) persons from EU Member States, EEA and Swiss Confederations fulfilling the conditions of a frontier worker, meaning who are employed or self-employed in Romania and who reside in another Member State in which they return usually daily or at least once a week ; 

  e) pensioners in the public pension system who are no longer domiciled in Romania and who establish their residence in the territory of an EU Member State, of a state belonging to the EEA or of the Swiss Confederation, respectively domiciled in the territory of a state with which Romania applies an agreement bilateral social security with provisions for sickness-maternity insurance.   

(2) In the case of the persons mentioned in par. (1) falling within the category of those who make the incomes provided under art. 155 par. (1) lit. a) of Law no. 227/2015, as subsequently supplemented or amended, the quality of insured in the social health insurance system and the right to the basic package is granted from the date of initiation of the work / service relationship.

(3) The persons referred to in paragraph (1) falling within the category of those who make the incomes provided under art. 155 par. (1) lit. b) - h), as well as for the ones stipulated in art. 180 of Law no. 227/2015, as subsequently supplemented or amended, acquire the quality of insured in the social health insurance system and have the right to the basic package from the date of filing the declaration, stipulated in art. 147 par. (1) or art. 174 par. (3) of the Law no. 227/2015, as subsequently supplemented or amended, as the case may be.

 (4) For the persons mentioned in par. (1) who fall within the category of those who have the status of taxpayers to the social health insurance system, according to the Law no. 227/2015, as subsequently supplemented or amended and which did not pay the contribution to the fund within the time limits provided by the same law, the outstanding amounts are recovered by A.N.A.F. in accordance with the law, including fiscal tax liabilities due for tax receivables.

(5) The insured and the insurance rights cease:  

  a) for the persons referred to in paragraph (1) lit. a) with the loss of the right of domicile or residence in Romania, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be;  

  b) for the persons mentioned in par. (1) lit. b) with the loss of the right of residence in Romania, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be;     c) for the persons referred to in par. (1) lit. c) with the loss of the right of residence in Romania, for a period of more than 3 months, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be; 

   d) for the persons mentioned in par. (1) lit. d), together with the loss of the status of frontier worker, and under the conditions of art. 267 par. (2) and (2 ^ 2) as appropriate. 

   (6) The supporting documents regarding the acquisition of the quality of the insured shall be established by an order of the CNAS president.

Article 267

 (2) For the persons who realize the incomes stipulated in art. 155 par. (1) lit. a) of Law no. 227/2015, as subsequently amended and supplemented, the quality of the insured shall cease within 3 months from the date of termination of the employment / service relationship.  

 (2 ^ 1) For the categories of persons insured without payment of the contribution provided under art. 224 par. (1), the quality of the insured shall cease within 1 month from the date when the persons no longer belong to these categories of insured persons.    (2 ^ 2) For the persons who realize the incomes provided under art. 155 par. (1) lit. b) - h), as well as for the persons referred to in art. 180 par. (1) lit. a) of Law no. 227/2015, with the subsequent amendments and completions, the quality of the insured shall cease on the date when the legal term of filing of the declaration, stipulated in art. 174 par. (3) of the Law no. 227/2015, with subsequent amendments and completions, unless they submit a new declaration for the next period. 

  (2 ^ 3) For the persons referred to in art. 180 par. (1) lit. b) and c) of Law no. 227/2015, as subsequently amended and supplemented, the quality of the insured shall expire at the expiration of 12 months from the date of filing the declaration provided in art. 174 par. (3) of the same law if they do not file a new statement for the next period.    (2 ^ 4) After the expiry of the periods provided for in paragraph (2) - (2 ^ 3), for persons who do not prove the quality of insured, the provisions of art. 232, in the sense that they only benefit from the minimal package of medical services.

Art. 268(5) Foreigners benefiting from a form of protection according to Law no. 122/2006 on asylum in Romania, with subsequent amendments and completions, acquire the quality of insured in the social health insurance system as follows:    

a) from the date of starting the labor / service relations, in the case of natural persons who realize incomes from the category of those provided in art. 155 para. (1) lit. a) of Law no. 227/2015, with subsequent amendments and completions;  

  b) from the date of submitting the declaration, in the case of the natural persons who realize the incomes provided in art. 155 para. (1) lit. b) - h), as well as in the case of the persons provided in art. 180 of Law no. 227/2015, with subsequent amendments and completions

  

ART. 224*)

(1) The following categories of persons benefit from the insurance, without payment of the contribution, under the conditions of art. 154 of Law no. 227/2015, as subsequently supplemented or amended:

a) children up to the age of 18, young people from 18 years up to the age of 26, if they are students, including high school graduates, until the beginning of the academic year, but not more than 3 months after the completion of the studies, apprentices or students, doctoral students under the doctoral studies contract, within 4-6 conventional teaching hours per week as well as those who follow the individual training module based on their request to become soldiers or professional graduates; 

b) young people under the age of 26 coming from the child protection system;

(c) the spouse, the spouse and the parents without own income, who are dependent on an insured person;  

d) persons whose rights are established by Decree-Law no. 118/1990 regarding the granting of rights to persons persecuted for political reasons by the dictatorship established from March 6, 1945, as well as to those deported abroad or constituted in prisoners, republished, as subsequently supplemented or amended, by Law no. 51/1993 on the granting of certain rights to magistrates who have been removed from justice for political reasons during the years 1945-1989, as subsequently supplemented or amended, by Government Ordinance no. 105/1999 regarding the granting of certain rights to the persons persecuted by the regimes established in Romania from September 6, 1940 to March 6, 1945 for ethnic reasons, approved with amendments and completions by Law no. 189/2000, as subsequently supplemented or amended, by Law no. 44/1994 on war veterans, as well as some rights of invalids and widowers of war, republished, as subsequently supplemented or amended, 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 between 1950 and 1961, as subsequently supplemented or amended, as well as the persons stipulated in art. 3 par. (1) lit. b) point 1 of the Law of Gratitude for the Victory of the Romanian Revolution of December 1989, for the anticommunist workers 'revolt in Braşov in November 1987 and for the anticommunist workers' revolt in the Jiu Valley - Lupeni - August 1977 no. 341/2004, as subsequently supplemented or amended, for the monetary rights granted by these laws;

e) persons with disabilities, for the incomes obtained under Law no. 448/2006 on the protection and promotion of the rights of disabled persons, republished, as subsequently supplemented or amended;  

 f) patients with diseases included in the national health programs established by the Ministry of Health, until the healing of the respective condition;

  g) Pregnant women and women lately confined; 

  h) natural persons who are on sick leave for temporary incapacity for work due to accidents at work or occupational diseases, as well as those who are on medical leave granted according to the Government Emergency Ordinance no. 158/2005 on sickness leave and indemnities, approved with amendments and completions by Law no. 399/2006, as subsequently supplemented or amended;

   i) persons who are on leave, according to the Law no. 273/2004 on adoption procedure, republished, on parental leave according to the Government Emergency Ordinance no. 111/2010 on parental leave and indemnity, approved with amendments by Law no. 132/2011, as subsequently supplemented or amended;  

j) persons who execute a custodial sentence or are under preventive arrest in the penitentiary units, as well as the persons who are in the process of carrying out a measure of education or security deprivation of liberty, namely persons who are in the period of postponement or interruption the execution of the custodial sentence;

    k) persons receiving unemployment benefit or, as the case may be, other social protection rights provided from the unemployment insurance budget, according to the law; 

  l) detained, arrested or detained persons in pre-trial detention and detention centers, aliens in accommodation centers for return or expulsion, and those who are victims of trafficking in human beings who are in the process of establishing identity and are housed in specially arranged centers according to the law; 

  m) natural persons benefiting from social aid according to the Law no. 416/2001 on the minimum guaranteed income, as subsequently supplemented or amended; 

  n) natural persons who have the status of pensioners, pension revenues, and income from intellectual property rights; 

  o) Romanian citizens who are victims of trafficking in human beings for a maximum of 12 months; 

  p) the monastic staff of the recognized denominations, in the records of the State Secretariat for Cults;

   q) volunteers who work under voluntary emergency services under the Voluntary Contract during their participation in emergency interventions or training to participate in them, in accordance with Government Ordinance no. 88/2001 on the establishment, organization and functioning of community public services for emergency situations, approved with amendments and completions by Law no. 363/2002, as subsequently supplemented or amended.

    (1 ^ 1) Persons who have acquired the quality of insured under para. (1) lit. c) and q) can not themselves be co-insured.   

 (2) The categories of persons not provided in par. (1) have the obligation to ensure, according to the present law, and to pay the contribution to health insurance under the conditions of Law no. 227/2015, as subsequently supplemented or amended.

The persons which are not classified in the aforementioned categories have the duty to become insured and to pay the contribution to the health insurance services, according to the law.

The persons with no insurance are entitled to a minimum service package including health care, medicines and sanitary materials only in case of medical-surgical emergencies and potentially endemic-epidemic diseases, for the purpose of monitoring the pregnancy and post-partum period, family planning services, prevention services and community healthcare.

       31

Dec.20192020

Total number of insured persons registered on the lists of family doctors (taking advantage of the basic medical package)

16.454.108

17.551.619

The total number of uninsured persons, persons registered on family doctors’ lists (taking advantage of the minimum package of medical services)

3.810.350

3.812.886

The total number of people taking advantage of medical services packages registered on family doctors’ lists

20.264.458

21.364.505

The population of Romania (according to the National Statistics Institute[2])

19.328.838 22.242.738 (resident population 2020)

According to the provisions of Law No 95/2006, republished, as further completed and amended, the following shall take advantage of the medical insurance, without paying the contribution:

- all the children up to the age of 18;

- spouse and parents with no income, dependant on an insured person.

31 Dec. 20192020

Number of children up to the age of 18

4.110.254

3.670.114

Number of insured persons belonging to the category of spouse and parents with no income, depndent on an insured person

545.005

664.279

II - 4. Types of Benefit

§1. Article 10. C102 and ECSS

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.

A.            Please state in detail the nature of the benefits provided under each scheme concerned, with reference to paragraph 1 of this Article, specifying, more particularly, the pharmaceutical supplies provided and the services provided in case of hospitalisation.

B.             If recourse is had to paragraph 2 please indicate, for each type of benefit enumerated in paragraph 1 (a), the extent to which the patient or the breadwinner is required to share in the cost of the medical care received. Please state what measures are taken to ensure that cost‑sharing does not involve hardship.

C.            Please confirm that, in accordance with paragraph 2, cost‑sharing is not required in the case of pregnancy and confinement and their consequences. If the scheme provides for the reimbursement of the expenses which the beneficiary or her breadwinner was obliged to incur in order to obtain the benefits stipulated in paragraph 1 (b) please furnish any available information to show that the beneficiary or her breadwinner does not share in the cost of such benefits.

D.            Please state in detail what measures are taken to give effect to the provisions of paragraphs 3 and 4 of this Article.

1.   a)    In Romania, the insured persons take advantage of the services foreseen in the basic service package, in case of illness or accident, starting from the first day of illness or from the accident date and until cured, as provided by the medical services providers contracted by the Health Insurance House (as foreseen by the provisions of Title VIII of Law No 95/2006, republished, as further completed and amended). The insured persons are entitled to:

-       to take advantage of the reimbursement of all expenses undertaken during hospitalization for the medication, sanitary materials and paraclinical investigations they were entitled to, with no personal contribution, according to the requirements of the framework agreement;

-       to carry out prophylactic check-ups, according to the requirements established in the framework agreement;

-       to take advantage of preventive medical assistance services and health promotion, including for the purpose of early identification of conditions;

-       to take advantage of ambulatory medical care and in the hospitals with a contract concluded with the health insurance houses;

-       to take advantage of emergency medical services;

-       to take advantage of several dental care services;

-       to take advantage of physical therapy and recovery treatment;

-       to take advantage of the medical devices;

-       to take advantage of medical care services at the residence;

-       to take advantage of leaves and health security benefits, according to the law.

The service packages granted on various medical care levels within the health insurance system are foreseen by Government Decision no 140/2018, as further completed and amended and the Order no 397/839/2018 , as further completed and amended(applicable from 1 April 2018) and Government Decision no 140/2018 (applicable from 1 April 2018 until 31 December 2019).  

 For persons not proving the payment of the contribution to the Unique National Health Insurance Fund, medical care related to the minimum medical services package is provided according to the provisions of Law no. 95/2006, republished, as further completed and amended, which contains health care services, medicines and medical supplies only in the case of medical and surgical emergencies and endemic epileptic diseases, monitoring of pregnancy and confinement, family planning services, prevention and community health care services, as:

-          primary medical assistance;

-          clinical specialized outpatient medical assistance;

-          dental outpatient assistance;

-          hospitalized medical assistance.

By Government Emergency Ordinance no. 18/2018 of 15 March 2018 regarding the adoption of fiscal-budgetary measures and for the modification and completion of some normative acts published in the Official Gazette of Romania no. 260 of 23 March 2018 was regulated as for the persons referred to in art. 222 par. (1) who fall within the category of those who have the status of taxpayers to the social health insurance system, according to the Law no. 227/2015, as subsequently amended and supplemented and which did not pay the contribution to the fund within the time limits provided by the same law, the outstanding amounts are recovered by A.N.A.F. under the terms of the law, including tax deductions due for tax receivables.

i) The primary medical care is provided by the family physician as follows: 

o  for individuals not proving the payment of the contribution to the Unique National Social Health Insurance Fund, as medical care related to the minimal medical services package;

o  for insured individuals proving the payment of their contributions to the Unique National Social Health Insurance Fund, as  medical care related to the basic medical services package;

o  for any individuals benefiting of emergency medical care services (regardless of whether they are registered or not on the list of the family physician providing the emergency medical care services).

The basic medical services package contains:

I.                   Curative medical services for medical-surgical emergencies, acute, sub-acute conditions, acute exacerbation of chronic illnesses and for chronic illnesses.

 1. A single consult for each individual, for each established emergency case is settled during the entire reporting period.

2. Consults for acute/sub-acute conditions or acute exacerbation of chronic illnesses are settled during the entire reporting period.

3. Consults for chronic illnesses are settled, during the entire reporting period, for:

·      Illness evolution monitoring;

·      Continued therapy;

·      Screening of complications;

·      Training of the insured person on self-care;

4. Active monitoring consults by an integrated management plan  based on scheduling, for chronic illnesses with major impact on the illness burden regarding: high cardiovascular risk (HTA), dislipidemia and type II sugar diabetes, bronchial asthma, chronic obstructive respiratory illness (BPOC), chronic kidney illness, that include:

The initial assessment of the newly identified case after the first quarter of registration;

        -      The patient monitoring.

II.    Preventive and prophylactic medical services

1. Preventive consultations are periodic active consultations for people aged 0-18 on growth and development, nutrition status and nutritional practices, detection and consequent intervention for age / gender specific risks, preventive services for children on age and gender groups,

2. Monitoring the evolution of pregnancy and lice: (see Part VIII, Article 49)

3. Individual risk assessment for the asymptomatic adult - Active family doctor consultations are actively advised to adults in the general population - no signs of disease,

4. Surveillance and detection of diseases with endemic-epidemic potential,

5. Family planning services:

a) women's counseling on family planning;

b) indicating a contraceptive method for people at risk.

III.    House calls – they are granted by the family physician to the insured person registered on his/her own list.

IV.   Additional medical services represent services provided on an optional basis in the medical practices of the family physicians, exclusively to the insured individuals on their lists. These services are:

·      Between July 1st 2019  and June 30st 2020 - gGeneral ultrasound – abdomen and pelvis

           

V.    The support activities are represented by releasing the following documents:  

-  for the period July 1st 2019  and June 30st 2020: sick leave; sending tickets; medical prescriptions; medical certificates for children in case of illness; medical documents necessary for the children for whom a special protection measure has been established, according to the law; medical certificates for enrollment in the college - issued at the annual examination of the preschool and pupils' balance sheet and only on enrollment in each educational cycle and epidemiological opinions for (re) entry into the collectivity, according to the Order of the Minister of Education, Research, Youth and Sport, Minister of Health no. 5298/1668/2011 for the approval of the Methodology for examining the health status of preschoolers and pupils in authorized and accredited state and private education establishments, regarding the provision of free medical care and the promotion of a healthy lifestyle, as subsequently amended and supplemented; medical certificate of death, as a result of the examination for the determination of death, except for suspected cases requiring medical forensic expertise, according to the Order of the Minister of Justice and Minister of Health no. 1134 / C-255/2000 for the approval of the Procedural Norms on the conduct of expert opinions, findings and other forensic work; the synthetic medical record required for children with disabilities for grading and re-evaluation in grade of disability, according to the Order of the Minister of Labor, Family, Social Protection and the Elderly, Minister of Health and Minister of National Education no. 1985/1305/5805/2016 regarding the approval of the methodology for the evaluation and the integrated intervention in order to accommodate disabled children with disabilities, the school and professional orientation of the children with special educational needs, as well as for the empowerment and rehabilitation of children with disabilities and / or special educational requirements; employment certificates for unemployed beneficiaries of the basic package; issuance of medical documents, according to the field of competence, necessary for the evaluation and re-evaluation in order to be classified as disabled.

VI. Services of drug administration:

- for the period July 1st 2019  and June 30st 2020 - intramuscularly, subcutaneously, intradermally, intravenously or infusions, as appropriate, for medications recommended by family doctors as a result of their own medical treatment, are given to policyholders on their family doctor's list during their cabinet work.

b. administration of the DOT for the confirmed TB patient is given to the insured on the family doctor's list, during the working hours in the cabinet, in compliance with the provisions of the Order of the Minister of Health no. 6/2018 amending and supplementing the Order of the Minister of Health 1171/2015 for the approval of the Methodological Guide for the implementation of the National Program for Tuberculosis Prevention, Supervision and Control.

ii)  Specialized medical assistance in ambulatory clinical is provided by specialized physicians with other specialized medical personnel and other personnel categories, as well as with the authorized and certified personnel, as applicable, to provide health care services related to the medical practice and for acupuncture by physicians obtaining competencies / complementary studies certificate for acupuncture and for outpatient palliative care services by doctors who have obtained competence / certificate of complementary studies for palliative care certified by the Ministry of Health and who work exclusively in this activity and conclude a contract with health insurance houses based on the complementary study certificate / certificate.

Starting April 1, 2018, the outpatient palliative care services were introduced into the basic package, which is provided to doctors who have obtained competency / attestation of complementary palliative care studies certified by the Ministry of Health and who work exclusively in this activity, and concludes a contract with the health insurance houses based on the complementary study certificate / certificate.

The basic medical services package includes:

Medical services for medical-surgical emergencies:

1.   Consults for acute / sub-acute illnesses and acute exacerbation of chronic illnesses

2.   Consults for chronic illnesses

3.   Consults for the identification of potentially endemic-epidemic illnesses

Consults for granting the family planning services

4. Diagnostic services (simple diagnostic procedure, complex and complex complexity) and therapeutic services / surgical and medical treatments, psychiatric therapies and genetic counseling,

5. Health services related to the medical act may be the subject of contracts concluded by health insurance houses with specialized doctors; these are provided by psychologists, speech therapists and kinetotherapists.

6. Pregnancy and confinement surveillance services (see Part VIII, Article 49)

7.  Starting April 1, 2018 - Outpatient Palliative Care

8. Starting April 1, 2018 - Medical services with diagnostic – case purpose; these services are day-care services and are given in outpatient clinic specialty.

9. Acupuncture - treatment consultations and treatment.

Exempts from the obligation to present the medical sending note are the urgency and illnesses that allow direct presentation to the specialized outpatient clinic for the clinical specialties provided in Annex 13 of the Order no. 196/139/2017 and in Annex 13 to Order no. 397/836/2018, as further completed and amended,  family planning services, as well as medical services for diagnostic- case purposes.

Specialized outpatient medical services for clinical medical recovery specialty are provided by medical doctors specialized in medical recovery, together with other medical-sanitary specialized staff and other categories of staff. 

The basic medical services package includes consults and treatment cures.

The consult at the specialized physician in outpatient clinic and specialized outpatient clinic for medical recovery is carried out based on the referral from the family physician or another specialized physician, only if the insured individual had an initial referral released by the family physician where he/she is registered and only if the referring physician has a contract concluded with the health insurance house.

The dental medical assistance is provided by dental doctors and dentists together other medical-sanitary specialized staff and other categories of staff. The basic medical services package includes dental treatment services.  

For providing dental medical services not referral document is required.

The basic ambulatory/outpatient specialist care assistance services package for paraclinical specializations  includes:

1.  Paraclinical investigations and laboratory analyses:

§  Hematology;

§  Biochemistry – seric and urinary;

§  Microbiology;

§  Imunology;

§  Testing of the sensitivity to antimicrobial and antifungal substances;

§  Hystopathological and cytological examinations.

                            

2. Radiological paraclinical investigations: medical imagistic, nuclear medical investigations and functional examinations

§  Radiology – Medical imagistic:

§  Ionizing radiation based investigations

§  Non-irradiating based investigations

§  High-performance investigations

§   Functional examinations

§  Nuclear medicine.

- for the period July 1st 2019  and June 30st 2020

Radiological paraclinical investigations: medical imagistic, nuclear medical investigations

§   Radiology – Medical imagistic:

·          Ionizing radiation based investigations

·          Non-irradiating based investigations

·          High-performance investigations

§  Nuclear medicine.

The paraclinical medical investigations are granted only based on referral documents, provided the medical doctor releasing the referral document was under a contracting relationship with the same health insurance house that contracted also the paraclinical medical services provider. StartingDecember 1th, 2020, the paraclinical medical services provider based on the referral document, regardless of the health insurance house with which the doctor who issued it is in a contractual relationship.

The basic services package for home medical care includes: measuring physiological parameters; medication administration; urinary tract catheterism, urinary tract care; artificial feeding / passive feeding / parenteral nutrition; eviscerating closure; vaginal scrubbing; therapeutic maneuvers; wound / escare / stoma / fistula / drain tube / tracheal cannula care; applying plexus, basin, urinary condom, urine absorption aid; non-invasive ventilation; kinetotherapy.

The basic package of palliative care services at home includes(as of 1 April 2018):

1. Medical services performed by a physician or under the supervision of a physician: holistic evaluation, stage palliative diagnosis, communication, care plan, education and counseling of the patient and family in the care plan, patient and family support in therapeutic and decision making care, diagnostic and therapeutic maneuvers, medication prescription, application and monitoring of pharmacological and non-pharmacological treatment suitable for symptom management, support activities;

2. Care services provided by the nurse: care needs assessment, patient monitoring - vital, vegetative, escape, lymphedema, stomach, excretory tumors, medication, non-pharmacological methods of treatment of symptoms, education of the patient, carers;

3. Physical therapy services provided by balneophobicokinetotherapists, kinetotherapists and medical physical culture teachers;

4. Psychological assistance services provided by the psychologist.

The medical devices intended to the outpatient organic or functional recovery are granted for a determined or undetermined period of time, based on medical prescriptions released by the specialized medical doctor contracted by the health insurance house. The basic medical services package includes ENT prosthesis devices for stomas, urinary incontinency, lower limb, upper limb, orthosis (for the back bone, the upper limb and the lower limb), orthopedic shoes, oxygen therapy and non-invasive ventilation devices, motor devices and devices for saline aerosol therapy, external breast prosthesis.

iii) The persons insured take advantage, under outpatient regime, of medication with or without personal contribution, based on medical prescription released by the medical doctors having contracts concluded with the health insurance houses.

The medication prescription and release method is foreseen in the G.D. no 140/2018, as further completed and amended (applied since April 1th 2018 until June 30th 2021December 31th 2020) and in their related Methodological Implementation Norms above mentioned.

The list of medication (DCI) the insured persons are entitled to, with or without personal contribution, is drafted by the Ministry of Health and National Health Insurance House, with the consultation of the College of Pharmacists in Romania and approved by Government Decision. The list can only include the medication specified in the products classification. (Article 242 of the Law no. 95/2006, republished, as further completed and amended).

The medication with or without personal contribution in the ambulatory treatment and some specific sanitary materials granted for the ambulatory treatment of the patients included in national health programmes for curative purpose, are released by pharmacies belonging to medical units through which run those programs, or pharmacies authorized by the Ministry of Health, assessed according to the legal regulations in effect.

The list of the international common denominations included in the Nomenclature of drugs for human use, destined to insured individuals for ambulatory treatment, with or without personal contribution, based on medical prescription is foreseen by the Government Decision no. 720/2008 for the approval of the list including the common international denominations pertaining to the drugs for insured individuals, with or without personal contribution, based on medical prescription, in the social health insurance system, as well as the common international denominations of the drugs granted within the national health programmes, republished, with the subsequent supplements and amendments.

As of April 1, 2021, drug providers have the obligation to issue drugs from the medical prescriptions to the insured, regardless of the health insurance house where the insured is registered, regardless of whether or not the doctor who issued the prescription is in a contractual relationship with the same health insurance house with which the pharmacy has a contractual relationship; Exceptions are medicines that are the subject of cost-volume-result contracts that are issued regardless of the health insurance company where the insured is registered, provided that the drug provider is in contract with the same health insurance house as the doctor who issued the prescription.

iv) The medical care in hospitals is provided in sanitary units with beds, authorized and assessed according to the law.

1.  The hospital medical services are preventive, curative, recovery, medical rehabilitation, palliative type of services and include: specialized medical consults, investigations, diagnosis, medical and/or surgical treatments, care, recovery, medication, monitoring and supervision, accommodation and meals, depending on the type of hospitalization.

 2.     According to the hospital accommodation, the medical care in the hospital is granted as:

 a) continuous hospitalization: includes care provided in the hospital includes acute and chronic care, granted in compliance with the following admittance criteria:

ü child delivery;

ü medical-surgical emergencies and situations in which patient’s life is endangered or which might put the patient's life in danger and requiring continuous monitoring;

ü illnesses with endemic-epidemic potential requiring isolation and treatment;

ü medically ill included under the articles 109, 110, 124 and 125 from the Law no. 286/2009 regarding the Penal Code, with the subsequent amendments and supplements and, in the cases ordered by order of the District Attorney during the trial or criminal prosecution, requiring isolation or mandatory admission and the treatment of prisoners for which the trial court ordered the sentence to be executed in a prison hospital and the treatment of patients in prisons whose illnesses require supervision and reassessment in the prison hospitals; patients requiring long term hospital care – years;

ü illnesses for which the diagnosis and/or treatment can not be supervised in ambulatory care or day-time hospitalization.

·      The patients with a hospital admission referral for continuous hospitalization will be scheduled for admission, according to the illness and seriousness of the signs and symptoms and the availability of the services provided by the requested hospital unit.

·      The prevention of continuous hospitalization classified as avoidable will be carried out by early diagnosis, approach, treatment and supervision, namely adequate monitoring in ambulatory care and day-time hospitalization, as applicable.

In Annex 22 to Order no. 397/836/2018 , as further completed and amended)(applied since April 1th 2018 until December 31th 2020) provides the list of hospital medical services provided under day-care regime.

b) day-time hospitalization: includes acute and chronic care, granted in compliance with the following admittance criteria:

ü  medical-surgical emergencies requiring medical supervision up to 12  hours only in the sanitary units with beds which also provide hospital care under continuous hospitalization;

ü  the diagnosis can not be established and the treatment can not be applied and/or monitored in ambulatory care.

·      The necessary services for the patient diagnosis, treatment and monitoring carried out during the day-time hospitalization, may have a multiple specialized and /or multidisciplinary nature, can be invasive, followed by adverse reactions or emergency risks during their performance or correlated with the patient's health state, requiring medical monitoring which can not be carried out in ambulatory care.

·      Medical services under continuous and day-care hospitalization are granted on the basis of the internment ticket.

·      Doctors who can issue internment tickets are:

-       family doctor;

-       the specialist doctor in ambulatory health establishments, regardless of the form of organization;

-       doctors in the medical-social care units;

-       physicians from private dialysis centers in contract with health insurance houses / National Health Insurance House, as the case may be;

·      doctors working in TB dispensaries, in mental health laboratories, respectively mental health centers and psychiatric psychiatrists, in dental clinics that are not in a contractual relationship with health insurance companies and which are located in the structure of hospitals as units without legal personality;

·      There are situations where an internment ticket is not required:

- for continuous hospitalization: medical / surgical birth / emergencies / endemoepidemic potential diseases requiring isolation and treatment / illnesses under Art. 109, 110, 124 and 125 of Law no. 286/2009, with the subsequent amendments and completions, and in the cases ordered by the prosecutor's ordinance during trial or prosecution, requiring isolation or compulsory confinement, and the treatment of persons deprived of their liberty for which the court ordered the execution of the sentence in a hospital-penitentiary and the treatment of patients in prisons whose diseases require monitoring and re-evaluation in hospital penitentiaries for patients requiring long-term hospital care - years / cases that have a hospital admission recommendation following a medical letters provided by physicians in the integrated ambulatory of that hospital, in a contractual relationship with health insurance institutions / in-hospital transfer when the type of care / in-hospital transfer / patients who have a medical letter in discharge with rehabilitation indication for hospitalization / patients with haemophilia in the national haemophilia program / and confirmed oncology patients in the National Oncology Program.

- in daily hospitalization for: medical / surgical emergency / chemotherapy / radiotherapy / medication corresponding to ICDs marked with (1), (**) 1b and (**) 1Ω, provided for in the Government Decision no. 720/2008, republished, with subsequent modifications and completions / monitoring of HIV / AIDS patients / dynamic evaluation of viroimmunologic response, monitoring and treatment of patients with thalassemia / monitoring of oncological patients / treatment administration for rabies prophylaxis / monitoring of primary genital syphilis and syphilis secondary skin and mucous membranes / solving cases that have a recommendation for hospitalization in a hospital following a medical letter given by the physicians in the integrated ambulatory of the respective hospital, in a contractual relation with the health insurance houses / the patients who have a medical letter at discharge with return indication for admission / patients with haemophilia in the national haemophilia program.

ü Those insured individuals are provided with those hospital medical services until their full cure.

Medical assistance for medical recovery and physical medicine and rehabilitation in sanatoriums and preventers is provided in sanatoriums / sanatoria sections for adults and children, preventives, with or without legal personality, including providers constituted according to the Companies Law no. 31/1990, republished, with the subsequent modifications and completions, which are approved by the Ministry of Health as sanatoriums or have in the structure approved by the Ministry of Health spas.

The services are provided on the basis of referral tickets for treatment of physical medicine and rehabilitation in balneal sanatoriums, issued by family doctors, outpatient specialists and hospital doctors, in contractual relations with health insurance houses. Criteria for delivery of referral tickets for physical and rehabilitation treatment refer to the specific pathology and associated conditions of the insured with the balneary treatment specificity.

II - 5. Cost-sharing

Article 4. C24

1. The insured person shall be entitled free of charge, as from the commencement of his illness and at least until the period prescribed for the grant of sickness benefit expires, to medical treatment by a fully qualified medical man and to the supply of proper and sufficient medicines and appliances.

2. Nevertheless, the insured person may be required to pay such part of the cost of medical benefit as may be prescribed by national laws or regulations.

3. Medical benefit may be withheld as long as the insured person refuses, without valid reason, to comply with the doctor's orders or the instructions relating to the conduct of insured persons while ill, or neglects to make use of the facilities placed at his disposal by the insurance institution.

Article 5. C24

National laws or regulations may authorise or prescribed the grant of medical benefit to members of an insured person's family living in his household and dependent upon him, and shall determine the conditions under which such benefit shall be administered.

§2. Article 10. C102 and ECSS

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.

The medical services for which co-payment is collected are the medical services provided in the sanitary units with beds by continuous hospitalization and the medical services provided in the specialized ambulatory recovery, physical medicine and balneology; the minimum co-payment level is 5 lei and the maximum level is 10 lei. The value of the co-payment is determined by each health unit based on its own criteria.

According to the provisions of Title VIII of Law no. 95/2006, republished, as further completed and amended, the following categories of peoplepolicyholders are exempt from the co-payment and benefits from insurance, without paying the contribution, under the conditions of art. 224, as follows:

a) children up to the age of 18;

b) young people aged between 18 and 26, if they are students, high school graduates, until the beginning of the academic year, but no more than 3 months, the apprentices or students;

c) patients with diseases included in the national health programs established by the Ministry of Health, for the medical services related to the basic disease of the respective disease, if they do not earn income from work, pension or other resources;

d) natural persons with pension and social benefits for pensioners, up to and including 900 lei / month, whether or not they make other income;

e) all pregnant and confinement women, for medical services related to the evolution of pregnancy, and those who have no income or have income below the minimum basic salary in the country, for all medical services;

f) Romanian citizens who are victims of trafficking in human beings;

g) detained, arrested or detained persons in pre-trial detention and detention centers, if they do not earn income from work, pension or other resources.

The personal contribution is charged for dental medical services, medicines, medical recovery services in hydropathical and medical recovery sanatoriums and in other sanatoriums and preventoria, medical devices in ambulatory, as follows:

-       Dental medical services, which include dental medical treatments, are provided for:

ü children aged 0 to 18 years, for whom the health insurance house offsets 100% of the maximum medical service rate;

ü insured individuals aged more than 18 years, for whom the health insurance house offsets percentages of the maximum medical service rate; for emergency services, 100% of the maximum rate is settled.

ü insured individuals benefiting of special laws (Law No 51/1993, Law no 44/1994, Law No 341/2004), for whom 100% is offset if the services are provided in State-owned civil or military medical units, otherwise, the offsetting percentage being of 60%;

ü other categories of insured individuals, beneficiaries of special laws, for whom the health insurance houses offset 100% of the medical service prices;

ü for the services in the minimum package, health insurance houses reimburse 100% of the maximum medical services tariff.

-       Drugs with or without personal contribution, for treatment in ambulatory 

According to G.D. No 720/2008, republished, as further amended and supplemented:

The offsetting percentage of the medication pertaining to the DCIs foreseen on sub-list A is 90% of the reference price, of the ones in sub-list B is 50% of the reference price, of the ones in sections C1 and C3 from the sub-list C is 100% of the reference price and of the ones in sub-list D is 20% of the reference price.

For pensioners with only retirement income of up to 700 lei / month, the amount of compensation for medicinal products corresponding to the international common denominations in sublot B is 90% of the reference price, of which 50% is covered by the budget of the Unique National Insurance Fund social health and 40% of the transfers from the budget of the Ministry of Health to the budget of the National Health Insurance Fund, for the prescriptions whose price for the reference / prescription price is up to 330 lei per month.

Starting with September 1, 20192020, the beneficiaries of the Program for 90% offsetting the reference price of the medicines are pnesioners with pension income and social allowance for pensioners up to and including 1.1391.299  lei/month, regardless of whether realize or not other income, according to G.D. no 436/2017.

The maximum amount born by the health insurance houses from the Fund is that resulting from the application of the offsetting percentage to the reference price of the drugs in question.

Medical prescriptions for medicines without personal contribution is issued in the following situations:  

ü for children aged up to 18 years, pregnant and confinement women, young people from 18 years up to age 26, if they are pupils, including high school graduates to the beginning of the academic year, but not more than 3 months, apprentices or students;

ü for chronic diseases related to certain groups of diseases according to the legal provisions in force;

ü for individuals specified in the special laws, in compliance with prescribing medicines provisions.

-       Sanitary units with beds

The hospitals, from the amounts contracted with the health insurance houses, bear the amount related to the standard hotel services (standard accommodation and meals at the level of the food allowance) for the companions of sick children up to 3 years old, as well as for the companions of people with severe disabilities . emphasized.

Insured bear the value of hotel services (accommodation and / or meals) with a high degree of comfort, above the standard comfort, granted at their request

The value of the high level comfort hotel services  is established by each hospital unit providing hospital services, with the obligation to ensure the access of the insured to hospital care provided under standard hotel conditions.

-       Physical and rehabilitation medical services in sanatoriums, including Sanatoriums and Prevenitors

In the balneary sanatoriums/sanatorium wards from hospitals, the personal contribution of the insured individuals represents 35% of the daily hospitalization rate negotiated.

For medical rehabilitation and recovery services provided in sanatoriums other than the balneary ones and preventoria, no contribution is charged to the insured individuals.

-       Medical devices designed to recover obstructive organic or functional deficiencies

-       The maximum amount born by the health insurance houses from the Fund for each medical device or medical device type intended to the organic or functional disability in ambulatory, within the health insurance system, is represented by the reference price or the lease price, as the case may be. The reference price and the lease amount are established according to a methodology approved by the President of the National Health Insurance House. If the retail selling price or the lease amount for the medical device is higher than the reference price or the lease amount established according to a methodology approved by the President of the National Health Insurance House, the difference shall be born by the insured individual through a personal contribution to be paid directly to the relevant supplier.

In the case of pregnancy, birth and consequences, the beneficiary of the medical services or its maintenance does not bear the costs of the medical services, and according to the provisions of Law no. 95/2006, republished, as further completed and amended, all pregnant women and chil- dren are exempt from pregnancy, medical services related to the evolution of pregnancy, and those who have no income or income below the minimum gross national salary for all medical services.

The value of prescription drugs for pregnant women and chil- dren is borne by the fund at the reference price.

In addition to the above, we make it clear that in the social health insurance system pregnant women benefit from insurance without the payment of the contribution under the conditions of art. 154 of Law no. 227/2015. In case they realize the incomes stipulated in art. 155 of the Law no. 227/2015, this income is due to the social health insurance contribution according to the regulations specific to each category of income.

II - 6. Objectives of Medical Care

§3. Article 10. C102 and ECSS

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.

According with the Law no. 95/2006, republished, as further completed and amended, for the purpose of preventing the illness, the early identification of illnesses and preserving the health, the insured individuals, directly or through the service providers with contracts concluded with the insurance houses, will be permanently informed by the insurance houses on the means to preserve their health, to reduce and avoid the causes of illness and on the dangers they expose to in case of drugs, alcohol and tobacco consumption.

The official website of the National Health Insurance House: www.cnas.ro

The National Health Insurance Fund (NHIF) is a public autonomous institution of national interest with legal personality whose main activity is to provide unitary and coordinated functioning of the system of social health insurance in Romania.

II - 7. Promotion of the general health service

§4. Article 10. C102 and ECSS

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.

II - 8. Qualifying period

Article 11. C102 and ECSS

The benefit specified in Article 10 shall, in a contingency covered, be secured at least to a person protected who has completed, or whose breadwinner has completed, such qualifying period as may be considered necessary to preclude abuse.

Please state, for each scheme concerned, the length of the qualifying period which has been considered necessary to preclude abuse. Please summarise the rules concerning the computation of the qualifying period.

§1(f) Article 1. C102, §1(i) Article 1. ECSS

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.

The legislation regulating the social health insurance system does not regulate a mandatory qualification period for the insured individual and the co-insured person.  The individual is considered to be insured from the moment when the contribution is paid to the Unique National Health Insurance Fund.

II - 9. Minimum duration of Benefit

Article 12. C102 and ECSS

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 state, for each scheme concerned, whether the duration of all or any of the medical benefits referred to in paragraph 1 (a) of Article 10 is limited; if so, please specify:

(a) the limit or limits fixed, in general, for each type of benefit;

(b) the limit or limits fixed in case of diseases recognised as entailing prolonged care.

2.             Please indicate, with reference to Article 68, the provisions, if any, for the suspension of the medical benefits referred to in Article 10, under each scheme or schemes concerned.

i) Primary care

-  The basic package includes:

I. Medical curative services for medical-surgical emergencies, acute, subacute diseases, accidents of chronic diseases and chronic diseases

1. emergency situation: - a single consultation per person is given for each identified emergency.

2. acute / subacute illness or aggravation of chronic conditions:

- maximum two consultations are given for each disease episode.

3. chronic disease

- for all chronic / insured conditions a monthly consultation is given.

4. active monitoring through an integrated management plan

- Initial assessment of the newly diagnosed case in the first trimester after an outbreak - an episode that may include: 3 family doctor consultations within a maximum of 3 consecutive months.

- Patient monitoring includes 2 scheduled appointments including disease control assessment, complications screening, patient education, paraclinical investigations and treatment, and a new follow up after 6 consecutive months, calculated over the month of the second consultation previous case management monitoring.

II. Preventive and prophylactic medical services:

1. Preventive consultations are regular, as follows:

a) at discharge from maternity and at one month (at the child's home)

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

c) Once a year from 4 to 18 years.

2. Monitoring the evolution of pregnancy and confinement: (see Part VIII, Article 49)

3. Preventive consultations for policyholders aged over 18:

- Individual risk assessment for the asymptomatic adult:

- All people aged 18 to 39 - every 3 calendar years. A maximum of 2 consultations / insurances are granted in the year of the individual risk assessment. For people aged 18-39 high risk - maximum 2 consultations / insured per year are given. As of 1 April 2018, the second consultation shall be given within 90 days of the first consultation.

- All persons aged> 40 years - maximum 2 consultations / insured per year. As of 1 April 2018, the second consultation shall be given within 90 days of the first consultation.

4. Surveillance and detection of diseases with endemic-epidemic potential

- one person per consultation is given for each suspected and confirmed endemic-epidemic disease, including the newly discovered TB patient actively diagnosed by the family doctor.

Family planning services: - maximum of two consultations per calendar year, on the insured person

III. Home consultation - is granted as follows:

- up to 2 consultations for each acute / subacute / chronic illness episode, up to 4 consultations / year for chronic diseases and a consultation for each emergency.

- Consultations at the home of the insured - maximum 42 consultations per month per physician with a list of registered insured persons but no more than three consultations per day.

IV. Additional medical services

Maximum number of additional services - general ultrasound - abdomen and pelvis - that can be performed and given in one hour, can not be more than 3.

V. Support activities - limits imposed by the specificity of each document provided in the basic package.           

I. Medicines administration services - at the doctor's recommendation.

ii) Clinical outpatient care

Payment of ambulatory medical care services for clinical specialties, acupuncture, family planning and outpatient palliative care is done by medical service quoted in points or medical service - consultation / case in lei.

Health insurance houses reimburse to medical specialists in clinical specialties the amount of medical services settled by the tariff expressed in points provided in the package, if these services are performed in the medical offices where they operate and are interpreted by the respective doctors, 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 clinic specialists, family planning and outpatient palliative care can not exceed the number of points earned according to the work schedule, according to the provisions of Annex 8 to Order no. 397/836/2018, as further completed and amended.

The basic package includes:

1. Medical services for medical and surgical emergencies:

- a single consultation per person is given for each identified emergency situation for which first aid has been granted or has been resolved at the level of the medical cabinet, with the exception of children aged 0-18 years for which a maximum of 2 consultations are settled.

2.  Acute and subacute illnesses as well as acute illnesses of chronic diseases

- For the same episode of acute / subacute illness / chronic illness, maximum 3 consultations are given to the insured within a maximum of 60 calendar days from the date of the first consultation required to establish the diagnosis, treatment and progression of the case.

3. Chronic conditions

- For clinical and paraclinical evaluation, treatment prescribing and follow-up of chronic illnesses for one or more chronic diseases treated within the same specialty, a maximum of 4 consultations / quarter / insured, but no more than 2 consultations per month.

4. Detection of diseases with endemic-epidemic potential

- one person per insured person is counted for each suspected and confirmed endemic-epidemic disease.

5. Family planning services:

- 4 consultations per calendar year, for insured.

6. Palliative Care Services - Palliative Care Medical Consultations:

- for a clinical and paraclinical assessment, the elaboration of the palliative care plan, prescribing the treatment and following the evolution of the insured with need for palliative care, a maximum of 4 consultations / quarter / insured, but no more than 2 consultations per month.

7. Simple and complex diagnostic services and therapeutic services / surgical and medical treatments - the total number of points reported for consultations, medical services provided by clinic specialists, for a doctor / cabinet work schedule of 35 hours / week , cannot exceed the number of points achieved according to the work schedule, according to the above - ii)

        

8. Medical services related to the medical act - The score for health-related health services that can be reported to one or more insured persons regardless of type of related service by the specialist doctor who has requested them can not exceed 90 points in average daily, due to the one / persons providing them, except for the specialist pediatric psychiatrist for whom the score can not exceed 360 points on average per day.

9. Pregnancy and confinement surveillance services (see Part VIII, Article 49)

10. Acupuncture - Insured persons are entitled to a maximum of 2 counseling / cures / year for the insured (one consultation for each treatment cure). A cure represents an average of 10 days of treatment and an average of 4 procedures / day.

11. Medical services diagnostic - case: day hospitalization services, are given in outpatient clinic and are settled only if all mandatory services have been performed.

o  Surveillance of a normal pregnancy (in pregnant women who do not have medical records demonstrating the existence in the pathological personal history of rubella, toxoplasmosis, CMV infection) * 1

o  Surveillance of a normal pregnancy (in the case of pregnant women who have medical documents proving the existence of a personal history of rubella, toxoplasmosis, CMV infection) * 1)

o  Prenatal screening (S11 - S19 + 6 days) * 2)

o  Surveillance of other high-risk pregnancies (gestational edema) * 3)

o  Surveillance of other high-risk pregnancies (mild pregnancy hystereasis) * 3)

o  Surveillance of other high risk pregnancies (evaluation of pregnant uterus in 3rd trimester) * 3)

o  Early detection of precancerous breast lesions * 4)

o  Early detection of precancerous breast lesions with mammographically identified suspicion * 5)

o  Early detection and diagnosis of dysplastic cervical lesions * 6)Early detection and diagnosis of dysplastic cervical lesions with cytology * 7)

o  Early diagnosis of dysplastic cervical lesions - Performed by doctors of obstetrics and gynecology * 8)

o  Excisional or ablative treatment of precancerous lesions of the cervix * 9) - It is performed by doctors in the specialty of obstetrics-gynecology

* 1) The services of items 1 and 2 can not be performed and reported simultaneously to a patient for a pregnancy. It contracts only with the obstetrics-gynecology specialty hospitals and with the other sanitary units with beds, which have in the structure of obstetrics-gynecology and neonatology departments or hierarchy compartments at level 3 or 2 according to the provisions of the Order of the Minister of Health no. 1881/2006 on the hierarchy of hospital units, sections and departments of obstetrics-gynecology and neonatology, with subsequent modifications and completions.                                                                                                               A single package of medical services per pregnant woman is settled, as evidenced by the obstetric-gynecology specialist.

Where medical services corresponding to items 1 and 2 are granted during S11 - S19 + 6 days, they may be granted concurrently with the medical services corresponding to item 3.

* 2) Contracts only with the obstetrics-gynecology specialist hospitals and with the other sanitary units with beds, which have in the structure of obstetrics-gynecology and neonatology departments or hierarchy compartments at level 3 according to the provisions of the Order of the Minister of Health no. 1881/2006, as subsequently amended and supplemented.

A single package of medical services per pregnancy is settled between S11 - S19 + 6 days of pregnancy.

* 3) Contracts only with the obstetrics-gynecology specialist hospitals and with the other sanitary units with beds, which have in the structure of obstetrics-gynecology and neonatology departments or hierarchy compartments at level 3 or 2 according to the provisions of the Order of the Minister of Health no. 1881/2006, as subsequently amended and supplemented.

* 4) Eligibility criteria: Asymptomatic women in the 50-69 age group who:

     1. have no confirmed breast cancer diagnosis;

     2. are asymptomatic;

     3. have no suggestive history of breast cancer pathology.

It is performed every two years by presenting to the specialist obstetric-gynecology specialist or general surgery for the early diagnosis of breast dysplasia. In case of a negative result, the investigation is repeated over 2 years.

The services of items 7 and 8 can not be performed and reported concurrently with a patient.

* 5) Eligibility Criteria: Asymptomatic women in the 50-69 age group with positive mammography results who:

     1. have no confirmed breast cancer diagnosis;

     2. are asymptomatic;

     3. have no suggestive history of breast cancer pathology.

It is done once every two years by presenting to the specialist obstetrician gynecology or general surgery, for the early diagnosis of dysplasia of the breast. In case of a negative result, the investigation is repeated over 2 years.

The services of items 7 and 8 can not be performed and reported concurrently to a pacient.

* 6) Eligibility criteria: Asymptomatic women in the 35-64 age group for the early detection of dysplasia of the cervix and for women in the 25-34 age group, asymptomatic, with positive results in the cytological examination and who :

            1. Do not have a confirmed diagnosis of cervical cancer;

            2. are asymptomatic;

            3. have no history of cervical cancer pathology.

It is done by presenting to the specialist obstetric-gynecology specialist.

In the case of a positive result in women aged 35-64, cytological triage is indicated.

In case of a negative result, it is repeated over 5 years.

Exclusion criteria: Women who:

     1. presents the congenital absence of the cervix;

     2. show complete hysterectomy for benign conditions;

            3. Have established diagnosis of cervical cancer;

It is done by presenting to the specialist obstetric-gynecology specialist.

In the case of a positive result in women aged 35-64, cytological triage is indicated.

In case of a negative result, it is repeated over 5 years.

Exclusion criteria: Women who:

1. presents the congenital absence of the cervix;

2. show complete hysterectomy for benign conditions;

3. Have established diagnosis of cervical cancer;

4. have established diagnosis for other forms of genital cancer.

The services of items 9, 10 and 11 can not be performed and reported concurrently to a patient.

* 7) It is performed in women with a positive result in HPV testing.

The services of items 9, 10 and 11 can not be performed and reported concurrently to a patient.

* 8) It is performed in women with a positive result in cytology.

The services of items 9, 10 and 11 can not be performed and reported concurrently to a patient.

* 9) It is performed in women in the age group 25 - 64 years, with a positive result at the early examination of dysplastic lesions of the cervix from positions 9 and 10.

Medical assistance in the specialized ambulatory for the clinical specialty of physical and rehabilitation medicine

The basic medical package includes:

1. Specialized medical consultation - initial,

2. The reassessment consultation,

3. The series of specific physician and rehabilitation procedures established by the physician for recovery, physical medicine and balneology, given to an insured person, includes a maximum of 4 procedures / day of treatment.

The period for which the specific physical and rehabilitation procedures are granted is 21 days / year / provided for both children and adults except for children aged 0-18 with a confirmed diagnosis of cerebral palsy, when specific medical procedures are provided for physiotherapy and rehabilitation for a maximum of 42 days per year / insured, these periods may be divided into up to two fractions, depending on the basic condition at the recommendation of the physician in the field of physical medicine and rehabilitation.

For each series of specific procedures, an initial consultation and a reassessment consultation are provided.

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

Dental care

The dental health care package - the services for which it is foreseen the range to be granted are:

- a single consultation is given over a 12-month period for an insured person over the age of 18 and a 6-month consultation for children under the age of 18,

- The arcade mobilizer acrylic is given once every 4 years,

- Prosthesis repair, prosthesis rebasing - is given once a year,

- sealing / tooth - a 2 year settled procedure.                  

Medicines with and without personal outpatient contribution

Periods for which medications can be prescribed are up to 7 days in acute conditions, from 8 to 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 may be prescribed for cost-volume / cost-volume-result contracts is up to 30-31 days.

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

(a)     for Substrates A, B and D - a prescription / multiple monthly prescriptions not exceeding in cumulative 7 different medications on all one month's prescriptions. The total amount of drugs in Sublist B, calculated at the reference price level, is up to 330 lei per month;

(b)     if, in a month, a medicine of sublist B marked #, with a maximum treatment value per month, calculated at the reference price level, greater than 330 lei, is not prescribed in the month and other medicines in Sub-List B;

(c)     for pensioners with pension incomes and social allowance for pensioners, up to 1.139  lei / month inclusive, regardless of whether or not they make other income, the provisions of subsection a) and b); they may benefit from a prescription / multiple monthly prescriptions that do not cumulatively exceed 7 medicines in Subparts A, B and D; in this situation, for a maximum of 3 medicines in Sublist B, with a reference price of up to 330 lei per month / prescription, a single separate prescription with 90% offset of the reference price is made;

(d)    for sublot C section C1 - for each disease code, one prescription / maximum two monthly prescriptions, with a maximum of 3 drugs;

(e)     for sub-list C section C3 - a single monthly prescription with up to 4 medicines.

From 1 October 2020, for chronic diseases, doctors may prescribe to an insured person medicines with and without personal contribution, subject to the following conditions:

a) for sublists A, B and D - one prescription / several prescriptions per month, not to cumulatively exceed 7 different medicines on all prescriptions related to a month. The total value of the medicines from sublist B, except for those from sublist B that are the object of cost-volume contracts, calculated at the level of the reference price, is up to 330 lei per month;

    b) in case a medicine from sublist B marked with # is prescribed in a month, with a maximum value of the treatment for a month, calculated at the level of the reference price, higher than 330 lei, it is no longer prescribed in the month and other medicines in sub-list B; the exception is the situation in which in a month is prescribed a medicine from sublist B marked with # which is the subject of cost-volume contracts, with a maximum value of treatment for a month, calculated at the reference price higher than 330 lei, situation in which other drugs from sublist B may be prescribed in the respective month, under the conditions provided in let. a);

    c) a single distinct prescription with compensation 90% of the reference price, for a maximum of 3 drugs from sublist B whose equivalent value at the level of the reference price is up to 330 lei per month / prescription, for pensioners with income from pensions and social allowance for retirees up to 1,299 lei / month inclusive, regardless of whether or not they earn other incomes; for the difference up to the maximum number of 7 drugs that can be prescribed from sublists A, B and D, the regulations from letter a) and b);

    d) for sublist C section C1 - on each disease code, one prescription / maximum two prescriptions per month, with maximum 3 drugs;

    e) for sublist C section C3 - one prescription per month, with a maximum of 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 narcotic, psychotropic, narcotic and psychotropic substances and preparations, as subsequently amended and supplemented, several prescriptions may be issued to 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:

Physical and rehabilitation services - 14 - 21 days / year / insured provided in a single episode comprising at least 4 procedures / day  for at least 5 days / week.

The medical rehabilitation services provided in sanatoriums other than balneary sanatoriums and preventers are services provided in hospitalization for periods and according to a rate established by specialized doctors operating in these units

II - 10. Suspension of Benefit

Article 69. C102, Article 68. ECSS

A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed:

(a) as long as the person concerned is absent from the territory of the Member;

(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 any portion of the benefit in excess of the value of such maintenance 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 beneficiaries;

Insured persons are required to pay a monthly health insurance contribution. In case of non-compliance, these persons benefit from medical services within a minimum package of medical services, according to the provisions of Law no.95 / 2006, republished, as further completed and amended.

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

• the national health insurance card,

• the insured certificate with a validity of 3 months, for persons who expressly refuse, for religious or conscience reasons, the receipt of the national card,

• the insured certificate issued by the insurance house to which the insured person is registered,

• the documents provided in art. 223 par. (1) of the Law no. 95/2006 republished, as further completed and amendedas subsequently amended and supplemented (the insured certificate issued by the care of the insurance company to which the insured person is registered or the document resulting from the access by the providers in contractual relations with the health insurance houses of the electronic instrument provided by NHIH).

Insured persons who have not been issued with the national health insurance card may benefit from medical services without presenting it.

According to the provisions of art. 342 and 343 of Law no. 95/2006, republished, as further completed and amendedas subsequently amended and supplemented, the insured persons over the age of 18 have the obligation to present the national health insurance card, or the documents mentioned above, as the case may be.

RF/C102/ECSS: please indicate the provisions, if any, for the suspanesion of the medical benefits reffred to in Article 10, under each scheme or schemes concerned.

-  The persons who are obliged to pay the social health insurance contribution, as well as the way of setting, the deadlines for declaring and paying the contribution are stipulated in the Law no. 227/2015 regarding the Fiscal Code, as subsequently supplemented or amended.

 ART. 222

(1) According to the present law, the insured persons are:

a) all Romanian citizens domiciled or residing in the country; 

b) foreign citizens and stateless persons who have applied for and have obtained the right to temporary stay or have their domicile in Romania;

c) citizens of EU Member States, EEA and Swiss Confederation who do not have insurance in another Member State that has effect in Romania, who have applied for and obtained the right of residence in Romania for a period of more than 3 months; 

d) persons from EU Member States, EEA and Swiss Confederations fulfilling the conditions of a frontier worker, meaning who are employed or self-employed in Romania and who reside in another Member State in which they return usually daily or at least once a week ; 

e) pensioners in the public pension system who are no longer domiciled in Romania and who establish their residence in the territory of an EU Member State, of a state belonging to the EEA or of the Swiss Confederation, respectively domiciled in the territory of a state with which Romania applies an agreement bilateral social security with provisions for sickness-maternity insurance.   

(2) In the case of the persons mentioned in par. (1) falling within the category of those who make the incomes provided under art. 155 par. (1) lit. a) of Law no. 227/2015, as subsequently supplemented or amended, the quality of insured in the social health insurance system and the right to the basic package is granted from the date of initiation of the work / service relationship.

(3) The persons referred to in paragraph (1) falling within the category of those who make the incomes provided under art. 155 par. (1) lit. b) - h), as well as for the ones stipulated in art. 180 of Law no. 227/2015, as subsequently supplemented or amended, acquire the quality of insured in the social health insurance system and have the right to the basic package from the date of filing the declaration, stipulated in art. 147 par. (1) or art. 174 par. (3) of the Law no. 227/2015, as subsequently supplemented or amended, as the case may be.  (4) For the persons mentioned in par. (1) who fall within the category of those who have the status of taxpayers to the social health insurance system, according to the Law no. 227/2015, as subsequently supplemented or amended and which did not pay the contribution to the fund within the time limits provided by the same law, the outstanding amounts are recovered by A.N.A.F. in accordance with the law, including fiscal tax liabilities due for tax receivables.

(5) The insured and the insurance rights cease:  

a) for the persons referred to in paragraph (1) lit. a) with the loss of the right of domicile or residence in Romania, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be;  

b) for the persons mentioned in par. (1) lit. b) with the loss of the right of residence in Romania, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be;    

c) for the persons referred to in par. (1) lit. c) with the loss of the right of residence in Romania, for a period of more than 3 months, as well as under the conditions of art. 267 par. (2) - (2 ^ 2), as the case may be; 

d) for the persons mentioned in par. (1) lit. d), together with the loss of the status of frontier worker, and under the conditions of art. 267 par. (2) and (2 ^ 2) as appropriate. 

 (6) The supporting documents regarding the acquisition of the quality of the insured shall be established by an order of the CNAS president.

ART. 224*)

(1) The following categories of persons benefit from the insurance, without payment of the contribution, under the conditions of art. 154 of Law no. 227/2015, as subsequently supplemented or amended:

a) children up to the age of 18, young people from 18 years up to the age of 26, if they are students, including high school graduates, until the beginning of the academic year, but not more than 3 months after the completion of the studies, apprentices or students, doctoral students under the doctoral studies contract, within 4-6 conventional teaching hours per week as well as those who follow the individual training module based on their request to become soldiers or professional graduates; 

b) young people under the age of 26 coming from the child protection system;

(c) the spouse, the spouse and the parents without own income, who are dependent on an insured person;  

d) persons whose rights are established by Decree-Law no. 118/1990 regarding the granting of rights to persons persecuted for political reasons by the dictatorship established from March 6, 1945, as well as to those deported abroad or constituted in prisoners, republished, as subsequently supplemented or amended, by Law no. 51/1993 on the granting of certain rights to magistrates who have been removed from justice for political reasons during the years 1945-1989, as subsequently supplemented or amended, by Government Ordinance no. 105/1999 regarding the granting of certain rights to the persons persecuted by the regimes established in Romania from September 6, 1940 to March 6, 1945 for ethnic reasons, approved with amendments and completions by Law no. 189/2000, as subsequently supplemented or amended, by Law no. 44/1994 on war veterans, as well as some rights of invalids and widowers of war, republished, as subsequently supplemented or amended, 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 between 1950 and 1961, as subsequently supplemented or amended, as well as the persons stipulated in art. 3 par. (1) lit. b) point 1 of the Law of Gratitude for the Victory of the Romanian Revolution of December 1989, for the anticommunist workers 'revolt in Braşov in November 1987 and for the anticommunist workers' revolt in the Jiu Valley - Lupeni - August 1977 no. 341/2004, as subsequently supplemented or amended, for the monetary rights granted by these laws;

e) persons with disabilities, for the incomes obtained under Law no. 448/2006 on the protection and promotion of the rights of disabled persons, republished, as subsequently supplemented or amended;  

f) patients with diseases included in the national health programs established by the Ministry of Health, until the healing of the respective condition;

g) Pregnant women and women lately confined; 

h) natural persons who are on sick leave for temporary incapacity for work due to accidents at work or occupational diseases, as well as those who are on medical leave granted according to the Government Emergency Ordinance no. 158/2005 on sickness leave and indemnities, approved with amendments and completions by Law no. 399/2006, as subsequently supplemented or amended;

i) persons who are on leave, according to the Law no. 273/2004 on adoption procedure, republished, on parental leave according to the Government Emergency Ordinance no. 111/2010 on parental leave and indemnity, approved with amendments by Law no. 132/2011, as subsequently supplemented or amended;  

j) persons who execute a custodial sentence or are under preventive arrest in the penitentiary units, as well as the persons who are in the process of carrying out a measure of education or security deprivation of liberty, namely persons who are in the period of postponement or interruption the execution of the custodial sentence;

k) persons receiving unemployment benefit or, as the case may be, other social protection rights provided from the unemployment insurance budget, according to the law; 

l) detained, arrested or detained persons in pre-trial detention and detention centers, aliens in accommodation centers for return or expulsion, and those who are victims of trafficking in human beings who are in the process of establishing identity and are housed in specially arranged centers according to the law; 

m) natural persons benefiting from social aid according to the Law no. 416/2001 on the minimum guaranteed income, as subsequently supplemented or amended; 

n) natural persons who have the status of pensioners, pension revenues, and income from intellectual property rights; 

o) Romanian citizens who are victims of trafficking in human beings for a maximum of 12 months; 

p) the monastic staff of the recognized denominations, in the records of the State Secretariat for Cults;

q) volunteers who work under voluntary emergency services under the Voluntary Contract during their participation in emergency interventions or training to participate in them, in accordance with Government Ordinance no. 88/2001 on the establishment, organization and functioning of community public services for emergency situations, approved with amendments and completions by Law no. 363/2002, as subsequently supplemented or amended.

 (1 ^ 1) Persons who have acquired the quality of insured under para. (1) lit. c) and q) can not themselves be co-insured.   

 (2) The categories of persons not provided in par. (1) have the obligation to ensure, according to the present law, and to pay the contribution to health insurance under the conditions of Law no. 227/2015, as subsequently supplemented or amended.

Access to basic services packages for all medical care, medicines and medical devices ceases in the situations provided by art. 222 par. (5) of the Law no. 95/2006 on the health reform, republished, as subsequently supplemented or amended and the non-observance of the obligation to pay the contribution to health social insurance under the conditions of Law no. 227/2015, as subsequently supplemented or amended.

Persons who do not prove the quality of insured benefit from medical services within a minimal package of medical services, according to the provisions of Law no. 95/2006, republished, as further completed and amended, which includes: health care services, medicines and sanitary materials only in the case of medical and surgical emergencies and diseases with endemoepidemic potential, monitoring of pregnancy and lactation, family planning services, prevention and care services of Community health care in the following assistance:- primary care- specialized ambulatory for clinical specialties,- specialized dentistry ambulatory,- hospital care.

2019 CEACR’s conclusions - Pending

Part II (Medical care), Article 10(1) in conjunction with Article 68 of the Code; Part VIII (Maternity benefits), Article 49 of the Code. Reduction of medical care.  The Committee notes the information provided by the Government in the consolidated report, which indicates that, according to the provisions of Law No. 95/2006, insured persons with income are required to pay a monthly health insurance contribution amounting to 10 per cent of their earnings. Those who are not in compliance are not entitled to the basic package of medical services, but only to a minimum medical package of emergency and public health related care. This does not only apply in situations where no contributions have been deducted by the employer, but also in situations not attributable to employees, where contributions have been deducted from wages but not transferred to the National Health Insurance Fund (CNAS), i.e. where it is the employer only who fails to fulfil his or her obligation to their employees and to the social insurance institutions. The Committee notes that, in such cases, the Law provides for sanctions to be imposed on the employer. The Committee observes that this does not alter the fact that the non-payment of contributions also affects the entitlement of workers to full medical care and, in this connection, points out once again that workers’ social security rights cannot depend on whether or not their employer fulfils his or her obligations. Recalling the 2018 and 2019 resolutions of the Committee of Ministers, the Committee once again requests the Government to take measures to ensure that the National Health Insurance Fund does not reduce medical care benefits to the minimum package with respect to the persons whose employers have failed to pay their health insurance contributions to the Fund in particular where this happened without the consent or connivance of, or is attributable to any negligence on the part of the insured person in respect of whom the contribution is payable.

Please provide a reply to the Committee’s request.

According to the provisions of art. 27 para. (1) of Government Ordinance no. 86/2003, with subsequent amendments and completions, starting with January 1, 2004, the activity regarding the declaration, ascertainment, control, collection and settlement of appeals for the social insurance contribution, the unemployment insurance contribution, the social health insurance contribution and the contribution for accidents at work and occupational diseases, as well as other contributions due by legal persons and natural persons who have the status of employer or entities assimilated to the employer, hereinafter referred to as social contributions, are made by the Ministry of Public Finance and its subordinate units, which they also have the quality of budgetary creditor.

In accordance with the provisions of the Government Emergency Ordinance no. 125/2011 for the amendment and completion of Law no. 571/2003 on the Fiscal Code, with subsequent amendments and completions, starting with July 1, 2012, the competence to administer the mandatory social contributions due by individuals belonged to the National Agency for Fiscal Administration.

2020 CEACR’s conclusions – Pending

Part II (Medical care), Article 10(1) and Part VIII (Maternity benefits), in conjunction with Article 68 of the Code. Reduction of medical care. In its previous comments, the Committee requested the Government to take measures to ensure that the National Health Insurance Fund did not reduce medical care benefits to the minimum package for protected persons whose employers had failed to pay the health insurance contributions due on their behalf to the Fund, in particular where this happened without the consent or connivance of the person concerned, or due to his or her negligence. The Committee notes that the only indication provided by the Government in its reply on this matter is that the competence and responsibility for the correct collection of contributions lies with the Ministry of Public Finances and the National Agency for Fiscal Administration.

Recalling that it has been raising this issue since 2017, the Committee urges the Government to take the necessary measures to ensure that the full entitlement of protected persons to medical care benefits, including maternity medical care benefits, under Parts II and VIII of the Code, is maintained in its entirety, regardless of the failure by their employer to fulfil its obligation to deduct and remit the health insurance contributions due on their behalf to the National Health Insurance Fund, in particular when this happened without the consent or connivance of the insured persons concerned, or when it is not attributable to negligence from their part.

Please provide a reply to the Committee’s request.

Ø  Regarding the revenues included in the Budget of the Single National Health Insurance Fund, there was an increase in the amounts collected by 2.1 billion lei in addition to the first semester of 2020, the degree of realization of the program resulting from the annual budget law being 101.9%.

As for the controls performed by the control bodies of the National Agency for Fiscal Administration, they are performed on the basis of risk analysis, which allows the identification of both non-compliance areas and taxpayers with real risk of non-compliance, which leads to actions of targeted fiscal control over those taxpayers identified as at risk of non-compliance. This way of investigating inappropriate tax behavior increases the efficiency of revenue collection in the general consolidated budget.

Thus, by way of example, the situation regarding the amounts additionally established, as a result of the fiscal inspections in the social security contribution account, in the period 2019 - sem I 2021, shows as follows:

Year        Additional amounts of the social insurance contribution (billion lei)

2019       314,030,471

2020       465,751,475

2021       330,569,667 (Ist semester)

Total      1,110,351,613

At the National Agency for Fiscal Administration level, studies and analyzes are permanently performed in order to estimate the fiscal gap (tax gap) at the level of mandatory social contributions.

Ø  According to art. 222 para. (2) of Law no. 95/2006, republished, as further as further completed and amended, the quality of insured in the social health insurance system and the right to the basic package is granted from the date of starting the employment / service relations.

At the same time, through art. 267 para. (2) of the same normative act, for the employed persons, the quality of insured ceases within 3 months from the date of termination of the employment / service relations.

Therefore, the acquisition of the quality of insured is not conditioned by the payment of the social health insurance contribution by the employer, as the employee acquires the quality of insured from the date of starting the employment / service relations with the employer and loses this quality only after a period of 3 months. from the date of termination of employment / service relations.

II - 11. Right of complaint and appeal

Article 70. C102, Article 69. ECSS

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 Convention (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.

According to Article 451 of Law No 95/2006, republished, as further completed and amended, in case of benefit rejection or benefit type or amount contestation, the insured individuals are entitled to lodge a complaint to the College where the relevant physician is member, and if such complaint is rejected, the insured individual may submit a complaint to a court of law.

II - 12. Financing and Administration

Article 71. C102, Article 70. ECSS          

See under Part XIII-3. Common provisions.

Article 72. C102, Article 71. ECSS

1. The Member (Contracting Party) shall accept general responsibility for the proper administration of the institutions and services concerned in the application of the Convention (Code).

2. Where the administration is not entrusted [to an institution regulated by the public authorities or – C102] 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.

According to the provisions of Law No 95/2006, republished, as further completed and amended, the social health insurance system is the main fund financing the population health condition protection that ensures the access of the insured persons to a basic medical services package.

Other forms of health insurances can be effective in special situations. These insurances are not mandatory and can be provided voluntarily by insurance bodies certified according to the law.

The voluntary health insurance does not exclude the duty to pay the contribution for the social health insurance.

Database of the MISSOC:

Decentralisation and autonomy in the administration of the Health Insurance Fund.

There is free competition between providers dealing with contracts with the health insurance houses.

The official website of the National Health Insurance House:

The National Health Insurance Fund (NHIF) is a public autonomous institution of national interest with legal personality whose main activity is to provide unitary and coordinated functioning of the system of social health insurance in Romania.

NHIF 's mission is to provide a system of health insurance modern and efficient, placed permanently in the public interest and the insured, which aims to improve the health of the population.

NHIF operates under its own statute and must:

·      Provide logistics for the unitary and coordinated functioning of the system of social health insurance;

·      pursue the collection and efficient use of the Fund;

·      use appropriate means of media representation, information and support the interests of policyholders they represent;

·      to meet the needs of health services of persons within the limits of available funds.

Part III. Sickness Benefit

Romania has accepted the obligations resulting from C24, Part III of C102 and Part III of the ECSS.

Category

Information available

Information missing / questions raised by the CEACR

III-1. Regulatory framework

Art.13 C102/ECSS

Art.1 C24

III-2. Contingencies covered

Art.14 C102/ECSS

III-3. Persons protected

Art.15 C102/ECSS *

Art.2(1) C24

III-4. Level and Calculation of benefit

Art.16 C102/ECSS*

III-5. Qualifying period

Art.17 C102/ECSS,

Art.3(2) C24

III-6. Minimum duration of benefit

Art.18 C102/ECSS, Art.3(1,2) C24

III-7. Suspension of benefit

Art.69 C102, Art.68 ECSS

Art.3(3,4) C24

III-8. Right of complaint and appeal

Art.70 C102, Art.69 ECSS

Art.9 C24

III-9. Financing and Administration

Art.72 C102

Art.71 ECSS

Art.71 C102, Art.70 ECSS*

Art.6,7 C24

* Please update statistical data, in accordance with the Report form for C102/ECSS.

List of applicable legislation

·         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 29th, 2005), as further completed or amended;

·         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.

III - 1. Regulatory framework

Article 1. C24

Each Member of the International Labour Organisation which ratifies this Convention undertakes to set up a system of compulsory sickness insurance which shall be based on provisions at least equivalent to those contained in this Convention.

Article 13. C102 and ECSS

Each Member (Contracting Party) for which this Part of this Convention (Code) is in force shall secure to the persons protected the provision of sickness benefit in accordance with the following Articles of this Part.

 MISSOC Database:

Basic principles.

Compulsory social insurance scheme for employees and self-employed providing an earnings-related benefit.

III - 2. Contingency covered

Article 14. C102 and ECSS

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.

III - 3. Persons protected

§1. Article 2. C24

The compulsory sickness insurance system shall apply to manual and non-manual workers, including apprentices, employed by industrial undertakings and commercial undertakings, out-workers and domestic servants.

Article 15. C102 and ECSS

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 state to which of the sub‑paragraphs of this Article recourse is had.

B.            Please indicate the classes of persons protected in accordance with the provisions of this Article, unless

recourse is had to sub‑paragraph (c).

C.            Please furnish statistical information under this Article, as follows:

i. if recourse is had to sub‑paragraph (a), in the form set out in Title I under Article 74 below; or

ii. if recourse is had to sub‑paragraph (b), in the form set out in Title II under Article 74 below; or

iii. if recourse is had to sub‑paragraph (c), in the form set out in Title IV under Article 74 below.

D.            If recourse is had to Article 6 above (voluntary insurance) for all or any of the schemes concerned, please furnish information under this Article in the form set out under Article 6.

Within the social insurance system, to the leave allowance and health security benefits is applicable the sub-paragraph b) of Article 15 of C102 and the ECSS.

According to the legal provisions in force since 01.01.2018, the persons protected under this article are insured persons, Romanian citizens, foreign citizens or stateless persons, who, according to the law, reside in Romania, in particular:

- individuals who earn income from an activity based on an individual employment contract, service report, posting or statutory status, as well as other income assimilated to salaries (both private and public employees from the budget environment);

- individuals receiving unemployment benefit, according to the law;

- individuals, other than employees, who can insure themselves in the social health insurance system in order to benefit from holidays and sickness insurance benefits, based on an insurance contract for holidays and social health insurance indemnities.

III - 4. Level and Calculation of Benefit

Article 16. C102 and ECSS

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 either 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 - ECSS].

A.            If recourse is had to sub‑paragraphs (a) or (b) of Article 15 for determining the persons protected please state whether recourse is had, for the calculation of the benefit, to the provisions of Article 65 or to those of Article 66.

Please furnish information under this Article as follows:

i. if recourse is had to Article 65, in the form set out in Titles I, II, and V under Article 65 below;

ii. if recourse is had to Article 66, in the form set out in Titles I, II and V under Article 66 below.

B.            If, under Article 15, recourse is had to sub‑paragraph (c) for determining the persons protected please furnish under this Article information in the form set out in Titles I and II under Article 67 and in Title I under Article 66 below.

If recourse is had to sub‑paragraph (d) of Article 67 please furnish information in the form set out in the different Titles under Article 67 below.

C.            Please state what measures are taken to guarantee, without means test, a prescribed benefit to the prescribed classes of persons determined in accordance with Article 15 (a) or (b).

The Government applies Article 65 of C102/ECSS.

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 monthly amount of the maternity allowance, as well as of the allowance for the care of the sick child is 85% of the 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 gross amount of the monthly indemnity for quarantine or isolation allowance represents 100% of the calculation basis.

III - 5. Qualifying period

§2. Article 3. C24

The payment of this benefit may be made conditional on the insured person having first complied with a qualifying period and, on the expiry of the same, with a waiting period of not more than three days.

Article 17. C102 and ECSS

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 state, for each scheme concerned, the length of the qualifying period which has been considered necessary to preclude abuse. Please summarise the rules concerning the computation of the qualifying period.

§1(f) Article 1. C102, §1(i) Article 1. ECSS

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.

The insurance 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.

The minimum insurance period entitling to rights is 6 months of insurance

 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 insurance period requirement in case of medical – surgical emergencies, tuberculosis, infectious-contagious diseases of group A, neoplasia and HIV, as well as in the case of infectious diseases for which the isolation measure provided in art. 8 para. (1) of Law no. 136/2020 on the establishment of measures in the field of public health in situations of epidemiological and biological risk.

III - 6. Minimum duration of Benefit

§1§2. Article 3. C24

1. An insured person who is rendered incapable of work by reason of the abnormal state of his bodily or mental health shall be entitled to a cash benefit for at least the first twenty-six weeks of incapacity from and including the first day for which benefit is payable.

2. The payment of this benefit may be made conditional on the insured person having first complied with a qualifying period and, on the expiry of the same, with a waiting period of not more than three days.

Article 18. C102 and ECSS

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, [in which event it – C102] [and - ECSS] need not be paid for the first three days of suspension of earnings.

1. Please state, for each scheme concerned, whether the duration of sickness benefit is limited and, if so, specify the limit or limits fixed and indicate how they are determined. Please state whether a waiting period is provided for and, if so, indicate the length of such period and the rules concerning its computation.

2. Please indicate, with reference to Article 68 below, the provisions, if any, for the suspension of sickness benefit under the scheme or schemes concerned.

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).

III - 7. Suspension of benefit

§3§4. Article 3. C24

3. Cash benefit may be withheld in the following cases:

(a) where in respect of the same illness the insured person receives compensation from another source to which he is entitled by law; benefit shall only be wholly or partially withheld in so far as such compensation is equal to or less than the amount of the benefit provided by the present Article;

(b) as long as the insured person does not by the fact of his incapacity suffer any loss of the normal product of his labour, or is maintained at the expense of the insurance funds or from public funds; nevertheless, cash benefits shall only partially be withheld when the insured person, although thus personally maintained, has family responsibilities;

(c) as long as the insured person while ill refuses, without valid reason, to comply with the doctor's orders, or the instructions relating to the conduct of insured persons while ill, or voluntarily and without authorisation removes himself from the supervision of the insurance institutions.

4. Cash benefit may be reduced or refused in the case of sickness caused by the insured person's wilful misconduct.

Article 69. C102, Article 68. ECSS

A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed--

(a) as long as the person concerned is absent from the territory of the Member;

(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 any portion of the benefit in excess of the value of such maintenance 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 beneficiaries;

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.

III - 8. Right of complaint and appeal

Article 9. C24

A right of appeal shall be granted to the insured person in case of dispute concerning his right to benefit.

Article 70. C102, Article 69. ECSS

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 Convention (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.

RF/C102/ECSS: please state whether every claimant has a right of appeal in case of refusal of the sickness benefit or campliant as to its quality and quantity. Please summarise the rules which apply in the case of an appleal.

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III - 9. Financing and Administration

Article 6. C24

1. Sickness insurance shall be administered by self-governing institutions, which shall be under the administrative and financial supervision of the competent public authority and shall not be carried on with a view of profit. Institutions founded by private initiative must be specially approved by the competent public authority.

2. The insured persons shall participate in the management of the self-governing insurance institutions on such conditions as may be prescribed by national laws or regulations.

3. The administration of sickness insurance may, nevertheless, be undertaken directly by the State where and as long as its administration is rendered difficult or impossible or inappropriate by reason of national conditions, and particularly by the insufficient development of the employers' and workers' organisations.

The official website of the National Health Insurance House: www.cnas.ro

The National Health Insurance Fund (NHIF) is a public autonomous institution of national interest with legal personality whose main activity is to provide unitary and coordinated functioning of the system of social health insurance in Romania.

RF/C24:

1. Please indicate the constitution and functions of the self-governing institutions entrusted with the administration of sickness insurance.

2. Please indicate the constitution and functions of the authorities entrusted with the administrative and financial supervision of such self-governing institutions.

3. Please indicate the conditions under which the insured persons are enabled to participate in the management of the self-governing insurance institutions, stating in particular the proportion of seats or of votes assigned to them in the organs of these self-governing institutions.

Article 7. C24

1. The insured persons and their employers shall share in providing the financial resources of the sickness insurance system.

2. It is open to national laws or regulations to decide as to a financial contribution by the competent public authority.

RF/C24:

1. Please indicate the conditions under which the insured persons and their employers must share in providing the financial resources of the sickness insurance system.

2. Please state whether the national legislation provides for a financial contribution by the competent public authority.

Article 3 of GEO no.158 / 2005 

The right to sickness leave and sickness benefits, to which insured persons who earn salary or salary income are entitled, is subject to the payment of the labor insurance contribution intended to cover these allowances, regulated by the Fiscal Code. Persons receiving unemployment benefit, according to the law, are insured in the social health insurance system for holidays and social health insurance indemnities without a contribution.    The entitlement to sickness leave and sickness benefits to which insured persons are entitled under an insurance contract for sickness and maternity leave is subject to the payment of a contribution to leave holidays and allowances of 1%, applied to the chosen monthly income included in the insurance contract, which is made to the budget of the National Social Health Insurance Fund.

Article 71. C102, Article 70. ECSS

1. The cost of the benefits provided in compliance with this Convention (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 Member (Contracting Party) 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 Member (Contracting Party) in compliance with this Convention (Code), except family benefit and, if provided by a special branch, employment injury benefit, may be taken together.

3. The Member (Contracting Party) shall accept general responsibility for the due provision of the benefits provided in compliance with this Convention (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.

Article 72. C102, Article 71. ECSS

1. The Member (Contracting Party) shall accept general responsibility for the proper administration of the institutions and services concerned in the application of the Convention (Code).

2. Where the administration is not entrusted [to an institution regulated by the public authorities or – C102] 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.

See under Part II-12. Medical Care. Financing and Administration, under Part XIII-3. Common provisions.

Part V. Old-age Benefit

Romania has accepted the obligations resulting from Part V of C102 and Part V of the ECSS.

Category

Information available

Information missing / questions raised by the CEACR

V-1. Regulatory framework

Art.25 C102/ECSS

V-2. Contingency covered

Art.26 C102/ECSS

V-3. Persons protected

Art.27 C102/ECSS*

V-4. Level and calculation of benefit

Art.28 C102/ECSS*

V-5. Adjustment of benefit

Art.65(10),66(8) C102/ECSS

V-6. Qualifying period

Art.29 C102/ECSS

V-7. Duration of benefit

Art.30 C102/ECSS

V-8. Suspension of benefit

Art.69 C102, Art.68 ECSS

V-9. Right of complaint and appeal

Art.70 C102, Art.69 ECSS

V-10. Financing and Administration

Art.72 C102 , Art.71 ECSS

Art.71 C102, Art.70 ECSS*

* Please update statistical data, in accordance with the Report form for C102/ECSS.

List of applicable legislation on the public pension scheme:

§  Law no. 263 of 16 December 2010on the Unitary System of Public Pensions, with subsequent amendments and completions;

§  Government Decision no. 257 of 20 March 2011 for approving the Norms for the enforcement of the provisions of Law no. 263/2010 on the Unitary System of  Public Pension, with subsequent amendments and completions;

§  Law no. 196 of 29 May 2009 for the approval of Government Emergency Ordinance no. 6/2009 on the establishment of the guaranteed minimum social pension;

§   Constitutional Court Decision no. 632/2018, published in the Official Journal no. 995 of 26 November 2018;

§   Government Emergency Ordinance no.114 of 28 December 2018 published in the Official Journal  no. 1116 of 29 December 2018 , with subsequent amendments and completions.

§  Law no. 127/2019 on public pension system, published in the Official Journal no. 563 of July 9, 2019, with subsequent amendments and completions;

§  Law no. 6/2020 on the state social insurance budget for 2020, published in the Official Journal no. 3 of January 6, 2020;

§  Law no. 16/2021 on the state social insurance budget for 2021, published in the Official Journal no. 238 of March 9, 2021;

§  Constitutional Court Decision no. 702/2019, published in the Official Journal no. 96 of February 10, 2020.

§  Government Emergency Ordinance no.114 of 28 December 2018 on setting certain measures in the field of public investments  and certain fiscal-budgetary measures, amendment and completion of certain normative acts and on certain deadlines extension, published in the Official Journal  no. 1116 of 29 December 2018 , with subsequent amendments and completions;

§  Government Emergency Ordinance no.135 of 18 August 2020 on the state budget rectification for the year 2020, the amendment of some normative acts and on setting of some budgetary measures, published in the Official Journal  no. 751 of 18 August 2020, with subsequent amendments and completions;

§  Government Emergency Ordinance no.163 of 24 September 2020 on supplementing art. 159 of Law no. 263/2010 on the unitary public pension system, as well on adopting some measures concerning individuals insurance within the public pension system, published in the Official Journal  no. 883 of 28 September 2020;

List of applicable legislation on special pension schemes:

§  Law no. 223 of 4 July 2007 regarding the status of civil aeronautical professional civil aviation in Romania, with subsequent amendments and completions;

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

§  Law No. 216 of  21 July 2015on 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, with subsequent amendments and completions;

§  Law No. 567 of 9 December 2004on 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 and completed;

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

§  Law No. 47 of May 1992 on the organization and functioning of the Constitutional Court, with the subsequent amendments and completions.

§  Law No. 223 of 24 July 2015on the state military pensions, with the subsequent amendments and completions.

List of applicable legislation on other regulations on retirement conditions:

·       Law no. 1 of 5 January 2011 – Law of national education, with the subsequent amendments and completions;

§  Law no. 95 of 14 April 2006on healthcare reform, with the subsequent amendments and completions;

§  Government Emergency Ordinance no. 144 of 28 October 2008 on the exertion of the profession of nurse, midwife and medical assistant, as well as the organization and functioning of The Order of the Nurses, Midwives and Medical Assistants in Romania, with the subsequent amendments and completions;

§  Law no. 319 of 8 July 2003 on the Statute of Research and Development Staff, with the subsequent amendments and completions.

V - 1. Regulatory framework

Article 25. C102 and ECSS

Each Member (Contracting Party) for which this part of this Convention (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.

Database of the MISSOC:

Basic principles.

Romania’s pension system is based on a compulsory social insurance (PAYG) scheme, with defined-benefits, financed by contributions, covering employees and self-employed, and providing earnings-related pensions depending on the length of contribution period and the level of earnings to which the contributions were paid.

V - 2. Contingency covered

Article 26. C102 and ECSS

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

2. The prescribed age shall be not more than 65 years or 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 - ECSS] as may be fixed by the competent authority with due regard to the working ability of elderly persons in the country concerned

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 state, for each scheme concerned the age for title to old‑age benefit. If this age is more than 65, please indicate the number of residents having attained that age per cent of the total number of residents under that age but over 15 years of age.

According to Law no. 263 of 16 December 2010 on the Unitary System of Public Pensions, as amended and supplemented, 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 pensions system.

The insured also can choose between Early Retirement Pension or Partial Early Retirement Pension provided they exceeded the full contribution period or even achieve it. Starting January 1st 2011, the Partial Early Retirement Pension is granted up to 5 years before the standard retirement age to a person who exceeds the full contribution period by up to 8 years while the Early Retirement Pension is granted up to 5 years before the standard retirement age to a person who exceeds the Full Contribution Period by at least 8 years.

Starting from January 2015 the standard retirement age is 65 years for men and 60 years for women. As provided by the present legislation, the standard retirement age for women is due to increase to 63 years by 2030. The minimum contribution period is 15 years for both men and women.

 
For the reference period year 1 July 2018 2020 -30 June 20192021, the standard retirement ages qualifying a person to draw an old-age pension, are the following:

Men: 65 years

Women:

July 20192020

61 years and 1 4 months

September - November 20192020:  

61 years and 2 5 months

January - March 20202021

61 years and 3 6 months

May - June 20202021

61 years and 4 7 months

Within the public pension scheme, individuals are entitled to old‑age benefit at the standard retirement age stated above. However, based on considerations related to the shortfall of qualified staff in certain fields and given due consideration to the specificities of certain profesions, there are derogathory provisions in place as regards the retirement age. For instance, physicians can opt to retire at request at age 67 instead of retiring at standard retirement age (provisions under Law no. 95 /2006) while research and development staff and also nurses, midwives and medical assistants retire at age 65, irrespective of gender (provisions under Law no. 319/2003 & Government Emergency Ordinance no. 144 /2008).

Along with the main public pension scheme, several other schemes coexist that generally apply lower retirement ages compared to the PAYG scheme:

-        For military personnel, police and national security system personnel the age for title to old‑age benefit  is 60;

-        For magistrates the age for title to old‑age benefit  is 60 or less;

-        For specialised auxiliary personnel from the courts and prosecutor’s offices the age for title to old‑age benefit  is 60;

-        For workers in civil aeronautics the age for title to old‑age benefit  is 50 or 52, as the case may be;

-        For parliamentary civil servants the age for title to old‑age benefit  is  the standard retirement age in the main PAYG scheme or less (but not lower than 60), depending on the case;

-        For Court of Accounts personnel the age for title to old‑age benefit  is  the standard retirement age in the main PAYG scheme;

-        For diplomats the age for title to old‑age benefit is 60.

Special conditions apply to some categories of people such as:

·      people who contributed under special or difficult working condi­tions;

·      people with handicap;

·      the blind;

·      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 these special conditions, the person is entitled to an old-age pension with reduced standard retirement age.

Following the enactment of Law 134/2014, published in the Official Gazette no. 753 of 16 october  2014, old-age pensioners may cumulate, starting 19 October 2014,  their  pension with  earnings from professional activities for which insurance is mandatory irrespective of their amounts (as prior of the law enactment, the cumulation was limited to  the value of the average gross earning).

According to the pension law, the following categories of pensioners may cumulate pension with incomes arising from situations where insurance is compulsory, regardless of the income level:

·         old-age pensioners;

·         blind people;

·         the 3rd degree invalidity pensioners, as well as the children classified within the 3rd degree of invalidity who receive survivor pension,  if they don’t exceed half of the full working time for incomes from dependent activities provided in art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010 (failure to comply with this requirement results in pension suspension);

·         the children  who receive survivor pension, respectively those up to the age of 16 and those who continue their studies in an educational institution organized under the law, until their graduation, but without exceeding the age of 26 years;

·         the surviving spouse may cumulate the survivor pension with earnings from activities provided in art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010, with subsequent amendments and completions, if they do not exceed 35% of the average gross wage earning (failure to comply with this requirement results in pension suspension);

·         local and county counselors.

In the public pension system, all cathegories of pensioners can cummulate their pension with incomes from independent activities and intellectual property rights, as regulated by the Fiscal Code, regardless of their level.

According to the Law no. 263/2010,  as amended and supplemented, pension payment is suspended from the month following the month in which the beneficiary of an early retirement  pension or a partial early retirement pension engages is in a gainfull activity under an employment contract or as a public servant or a cooperative member of a craft cooperative organization, carries activity in elective positions or is appointed within the executive, legislative or judicial authority. Same rule of suspension applies for Ist and II degree invalidity pension recipients and survivor pensioners classified with Ist and II degree invalidity.

V - 3. Persons protected

Article 27. C102 and ECSS

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 state to which of the sub‑paragraphs of this Article recourse is had.

B.            Please indicate the classes of persons protected in accordance with the provisions of this Article, unless recourse is had to sub‑paragraph (c).

C.            Please furnish, under this Article, statistical information as follows:

i. if recourse is had to sub‑paragraph (a), in the form set out in Title I under Article 74; or

ii. if recourse is had to sub‑paragraph (b), in the form set out in Title II under Article 74; or

iii. if recourse is had to sub‑paragraph (c), in the form set out in Title IV under Article 74.

D.            If recourse is had to Article 6 (voluntary insurance) for all or any of the schemes concerned, please furnish, under this Article, information in the form set out under Article 6.

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.

Persons protected under this Article are : 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,

·         persons whose incomes are treated as wages,persons who earn incomes from independent activities and / or from intellectual property rights,  i.e. RON 2,230 in 2020, and 2,300 starting with January 2021

·       other persons, including the voluntarily insured persons.

Also, can be insured in the public pension system Romanian citizens, citizens of other countries and stateless persons who are not domiciled or resident in Romania, under the terms of international legal instruments to which Romania is a party.

The number of people active at national level, insured in the overall system (public pensions and other social insurance rights) during the reference period was 5,897,899 (31.03.2021)5.703.639   (employees and other persons insured).

In accordance with Article 76 of Title II of the Report, the purpose of protection is fulfilled as follows:

The number of economically active persons protected: 5,897,8995,703,639

The total number of residents:                                           19,328,83819,405,000

Percentage:                                                                            30.5%29,39%

V - 4. Level and Calculation of Benefit

Article 28. C102 and ECSS

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 recourse is had to sub‑paragraph (a) or (b) of Article 2 7 for defining the scope of protection, please state whether recourse is had to the provisions of Article 65 or to the provisions of Article 66for calculation of the old-age benefit.

Please furnish under this Article statistical information as follows:

i. if recourse is had to Article 65, in the form set out in Titles 1, 111 and V under Article 65; or

ii. if recourse is had to Article 66, in the form set out in Titles I, III and V under Article 66.

B.            If recourse is had to sub-paragraph (c) of Article 27 for defining the scope of protection please furnish under this Article information in the form set out in Titles I and Ill under Article 67 and in Title I under Article 66.

If recourse is had to the provisions of sub-paragraph (d) of Article 67 please furnish information in the form set out in the different Titles under Article 67.

C.            Whether recourse is had to Article 65, Article 66 or Article 67, please furnish information on the review of the amount of old-age benefit in the form set out in Title V1 under Article 65.

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

In the public system, social security benefits substitute the 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 provided by the public pension system is paid on a monthly basis and calculated using a point system.

It is determined by the length of contribution period and the level of earnings (which vary among individuals), as well as the pension point value (which is a constant for all pensioners).

The Old-Age Pension formula is:

OAP = PPV *AAS

Where:  

OAP           =    Old-Age Pension

PPV           =    Pension Point Value

AAS           =    Annual Average Score =  AS/FCP

AS              =    Annual Score =  MS/12

FCP           =    Full Contribution Period

MS             =    Monthly Score = RE/AGE

RE             =    Reference earnings

AGE           =    Average Monthly Gross Earnings (‘realised’ – i.e. the actual outturn - at national level as reported by the National Institute of Statistics)

The monthly score is equal to the person's monthly gross earnings divided by the average gross earnings.

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 number of years corresponding to the full contribution period provided by the law at the date of retirement.

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 pension, the amount is re­duced in relation to the length of contribution period and the number of months by which the standard retirement age is reduced. The monthly penalty ranges between 0.50% for a person who exceeded the full contribution period by up to 1 year and 0.15% for a person who exceeded the full contribution period by 7 to 8 years.

The insured person, who continues to contribute to the public system of pensions after becoming eligible for receiving an old-age pension, is entitled to an increased score achieved in this period by 0.5% per month. The increase of the monthly score won’t be granted for the periods when the pension is cumulated with wage incomes.

According to art. 31 of Government Emergency Ordinance no. 114/2018, by way of derogation from the provisions of art. 102 par. (2) of the Law no. 263/2010 on the unitary pension system, with subsequent amendments and completions, starting with 1st September of 2019,  the pension point value was increased to 1,265 RON [art. 86 para. (2). letter a) of Law no. 127 of 8 July 2019 concerning the public pensions system, published in the Official Journal no. 563 of 9 July 2019.

Starting with 01.09.2020, the value of the pension point is RON 1,442 according to art. 42 of Government Emergency Ordinance no. 135/2020.

According to Government Emergency Ordinanceno. 8/2021 starting with 2022 the value of the pension point increases with the average annual inflation rate, to which is added at most 50% of the real increase of the average gross earnings achieved, definitive indicators, known in the current year for the calendar year previously communicated by the National Institute of Statistics. The increase and the date of granting are established annually by the law of the state social insurance budget.

The evolution of the pension point value, starting 2011, is presented below.

2011

1 January-31 December

732,8

2012

1 January-31 December

732,8

2013

1 January-31 December

762,1

2014

1 January-31 December

790,7

2015

1 January-31 December

830,2

2016

1 January-31 December

871,7

2017

1January-30 June

917,5

2017

1 July-31 December

1,000

2018

1January-30 June

1,000

2018

1 July-31 December

1,100

2019

1 January – 31 August

1,100

1-September -31 December

1,265

2020

since 1st of January -  31 Augustonward

1,265

1 September -31 December

1,442

2021

1 January onward

1.442

According to art. 31 of Government Emergency Ordinance no. 114/2018, starting with 1 September 2019, the pension point value is increased by 15% and is Ron 1,265.

Starting with 01.09.2020, the value of the pension point is RON 1442 according to of Government Emergency Ordinance no. 135/14.08.2020.

According to Government Emergency Ordinance no. 8/2021 starting with 2022 the value of the pension point increases with the average annual inflation rate, to which is added at most 50% of the real increase of the average gross earnings achieved, definitive indicators, known in the current year for the calendar year previously communicated by the National Institute of Statistics. The increase and the date of granting are established annually by the law of the state social insurance budget.

In the national legislation sub-paragraph of paragraph 6 of Art. 65, which can be applied in national law is (c).

Old age pension calculation for the standard beneficiary

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

Starting with 1st September of 20192020, the pension point value was 1,2651,442  RON according to GEO no. 135/14.08.2020.[art. 86 para. (2). letter a) of Law no. 127 of 8 July 2019.

The average gross wage used at the establishment of the state social security budget for the year 2020, according to art. 15 of Law no. 6/2020, is 5,4295,565 RON. We consider that the sum of 5,4295,565 lei representing the gross average wage gain used to for the establishment of the state social security budget for the year 2020 has no relevance in determining the replacement rate, therefore the replacement rate will be calculated using the net average wage gain for 2020 of 3,1763,411 lei.

Applying Article 65, paragraph 6, letter c) of the Code: the reference income of a standard beneficiary is 125% of net average salary (3,1763,411 RON in 2020), i.e. 1.25 * 3,1763,411 = 3,9704,264  RON in 2020.

The calculation of the replacement rate for old-age pension after 30 years of insurance (under Title I and III of Article 65 of the report):

June 2020

C. Standard wage of a skilled manual male employee      3,9704,264 RON  

D. Amount of old-age pension granted after 30 years of insurance 1442*1.25 RON = 18031,355 RON

G. Replacement rate D./. C = 1,3551,803 RON/3,9704,264 RON = 34,13 42,28 %

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. Later on, the phrase "guaranteed minimum social pension" was substituted by syntagma "social allowance for pensioners".

Since 2010, the social allowance 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.

Starting 1stof September 2019 2020 the level of social allowance for pensioners is RON 704 800 (Art. 32 41 of GEO Nono.114135/20182020).

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

The social allowance 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.

2019 CEACR’s conclusions

Part V (Old-age benefit), Article 28 of the Code. Calculation of the pension replacement rate.  In its previous conclusions, the Committee requested the Government to take measures to guarantee the level of old-age benefit required by the Code. The Committee notes that the Government has recalculated the replacement rate of an old-age pension for a standard beneficiary by comparing the standard pension attained after 30 years of contributions with the net wage instead of the gross wage of a skilled manual male employee determined in accordance with Article 65(6)(c), of the Code. In this case, the recalculated replacement rate would attain 38 per cent in 2018, which is still below the level of 40 per cent prescribed by the Code. The Committee therefore concludes that Romania still does not comply with Article 28 of the Code and reiterates its request to the Government to take measures to increase the level of old-age benefits up to the level required by the Code. Moreover, it requests the Government to specify in more detail the way the standard old-age benefit has been calculated indicating in particular the amount of the assumed annual average score, of the correction index applied and of the pension point value. In addition, the Committee requests the Government to explain whether old-age pensioners are liable to pay income tax and/or any social security contributions.

Please provide a reply to the Committee’s request.

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. 17 of Law no. 3/ 2018 on the social insurance budget for 2018, since 1 January 2018 the correction index was 1.15.
Since 1 January 2019, the correction index was 1.20, according to the provisions of art. 33 of Government Emergency Ordinance no. 114/2018.

Since 1 January 2020, the correction index was 1.41, according to the provisions of art. 17 of Law no. 6/ 2020 on the social insurance budget for 2020.

According to the Fiscal Code provisions, 10% income tax applies to pensions bigger than RON 2,000. The quota applies only to the amount that exceeds the RON 2,000 threshold.

Also, pension income is exempted from the payment of 10% social insurance contribution for health.

Furthermore, all benefits financed from the state social insurance budget are exempted from the payment of pension insurance contribution.

2020 CEACR’s conclusions

Part V (Old-age benefit), Article 28, in conjunction with Article 65 and the Schedule to Part XI of the Code. Calculation of the old-age pension replacement rate. In its previous conclusions, the Committee requested the Government to take measures to guarantee the level of old-age benefit required by the Code. The Committee notes, from the information provided by the Government in reply to its request, that the replacement rate of old-age pension for a standard beneficiary is calculated by comparing the standard pension attained after 30 years of contributions (Romanian lei, RON 1,355) with the net wage (RON 3,970) of a skilled manual male employee determined in accordance with Article 65(6)(c) of the Code. The Committee notes that this is possible because standard old-age pensioners are not liable to pay income tax and/or any social security contributions. The Committee observes, however, that the resulting replacement rate of the old-age pension corresponds to 34.13 per cent in 2020, which is below the level of 40 per cent prescribed by the Code. The Committee is therefore bound to conclude that Romania is not in compliance with Article 28 of the Code and requests the Government to take the necessary measures to increase the rate of old-age benefit up to the level required by the Code, i.e. 40 per cent of the reference wage for a standard beneficiary, as specified in Article 65 and the Annex to Part XI of the Code.

V - 5. Adjustment of benefits

§10 Article 65, §8 Article 66. C102 and ECSS

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.

     

Pensions are increased by way of raising the pension point value. The increase of the pension point value is one of the social protection measures with positive impact for the beneficiaries of the public pension system as regards improving their standard of living. To reflect changes in the cost of living, starting 2022, the value of the pension point will be adjusted with the average annual inflation rate, to which is added at most 50% of the real increase of the average gross earnings. Up until this rule was legislated, the pension benefit indexation relied on ad – hoc decisions.

Correction Index

According to art. 170 of Law No. 263/2010 on the unitary public pension system, in conjunction with art. 17 of Law no. 6/2020 on the social insurance budget on 2020, iIn 2020 and 2021, in line with the provisions of art. 170 of Law no. 263/2010 on the unitary pension system, the index of correction is stood at 1.41.

The correction index is used to lift the first pension in line with wages.

Thus, the average gross wage earned in 20172019, namely the final one, known in 2018 2020 – prior to the year in which pension entitlement is opened - 20192021, communicated by the National Institute of Statistics, is 3,2234,853 lei.

2018 CEACR’s conclusions

Article 65(10) of the Code. Adjustment of long-term benefits to the cost of living. The Committee notes the information provided by the Government in reply to its previous request concerning adjustment of long-term benefits to the cost of living.

Please provide a reply to the Committee’s request.

RF/C102/ECSS:

1. Please state the methods adopted for giving effect, where necessary, to the provisions of paragraph 10 of Article 65 or of paragraph 8 of Article 66 of C102 and the ECSS.

2. Please give the following information:

Period under review

Cost-of-living index

Index of earnings[3]

A. Beginning of period[4] ………………………..

B. End of period[5]………………………………..

C. Percentage A…………………………………

                           B

….………………………...

…….……………………..

…………………………

………………………..

……………………….

………………………..

3. Please state whether the amount of the periodical payments has been reviewed during the period of reference. If so, please indicate the changes made in the level of benefits and furnish the following information:

Period under review*

Benefit

Average per beneficiary**

I

Benefit for standard beneficiary**

II

Other estimates of benefit levels**

III

A. Beginning of period ………

B. End of period …………………

C. Percentage A…………………

                           B

….………………………...

…….………………………

…………………………….

….………………………...

…….………………………

…………………………….

……………………………

……………………………

……………………………

* This period should, as far as possible, coincide with the period referred to in the table under paragraph 2.

** Please give such data in columns I, II and III as will show the percentage variation of the benefit.

Year

Average monthly pension (RON)

Year

Average monthly pension (RON)

2011

753

2016

948

2012

773

2017

1069

2013

805

2018

1172

2014

846

2019

15631292

2015

892

2020

1500

2021 Ist trimester

1650

Source: National Institute of Statistics ( https://insse.ro/cms/ro/tags/comunicat-numarul-de-pensionari-si-pensia-medie-lunara)

V-6. Qualifying period

Article 29. C102 and ECSS

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 scheme concerned, the nature and the length of the minimum qualifying period or the minimum average yearly number of contributions, as the case may be, which entitles the persons protected to a pension.

Please summarise the rules concerning the computation of such qualifying period.

Please state whether recourse is had to paragraphs 1 and 2 or paragraphs 3 or 4 of this Article.

2. If recourse is had to paragraphs 1 and 2 the benefit the amount ofwhich is shown under Article 28 should be the benefit granted during the time basis to a standard beneficiary who has completed 30 years ofcontribution or employment, or 20 years of residence. Please indicate, under this Article, how the reduced benefit is calculated to which a standard beneficiary is entitled who has completed a qualifying period of 15 years ofcontribution or employment or in respect of whom half the yearly average number of contributions prescribed for title to full benefit has been paid.

3. If recourse is had to paragraph 3 the benefit the amount of which is shown under Article 28 should be the benefit granted during the time basis to a standard beneficiary who has completed 10 years of contribution or employment or 5 years of residence.

4. Ifrecourse is had to paragraph 4 the benefit the amount of which is shown under Article 28 should be the benefit granted during the time basis to a standard beneficiary: who has completed a qualifying period of more than 10 years, but less than 30 years of contribution or employment. Please state the length of the qualifying period in question.

5. Please state what measures have been taken to give effect to the transitional provisions provided for in paragraph 5 of this Article, and indicate the minimum amount of the reduced benefit guaranteed in this case.

§1(f) Article 1. C102, §1(i) Article 1. ECSS

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.

Starting 1st January 2015, the minimum contribution period both which entitles the persons protected to an old-age pensionfor women and men is 15 years, irrespective of gender.

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 1st of January 2005, from leave for temporary working incapacity due to work accidents and occupational diseases,

·      benefited, during 1st April 2001 – 1st January 2006 of social insurance indemnities, provided in the terms set by law,

·      benefited, starting with 1st 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 old-age pension is granted upon reaching the pensionable age and meeting the minimum contributory period. A complete standard contributory period and reaching the pensionable age entitle beneficiaries to a full pension benefit. Individuals can take early retirement five years prior to the pensionable age under two different regimes: early retirement (ER), when the contribution period of an individual is at least eight years higher than the standard contribution period and partial early retirement (PER), when the contribution period has been completed or exceeded by less than eight years (with penalties for each missing year until the standard retirement age). Once the pensionable age is reached, beneficiaries of partial early retirement become automatically entitled to a full old age benefit.

V -7. Duration of Benefit

Article 30. C102 and ECSS

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

Please indicate, with reference to Article 68, the provisions, if any, for the suspension of the old-age benefit under the scheme or schemes concerned.

In the public pension system, social security benefits substitute the total or partial loss of insured income as a result of old age, invalidity or death. When these  insured risks occur (invalidity, old age and death), the institutions of the public system of pensions grant social insurance benefits to the insured, in compliance with the provisions of the law.

With reference to Article 68, of the old-age benefit granted within the public system of pensions shall be suspended starting from the month following the one in which one of the pensioner has established his domicile in the territory of another state, with which Romania has signed a reciprocity convention in the field of social insurance, if, according to its provisions, the pension is paid by the other State.

V - 8. Suspension of Benefit

Article 69. C102, Article 68. ECSS

A benefit to which a person protected would otherwise be entitled in compliance with any of Parts II to X of this Convention may be suspended to such extent as may be prescribed--

(a) as long as the person concerned is absent from the territory of the Member;

(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 any portion of the benefit in excess of the value of such maintenance 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;

According to Article 114 of Law no. 263/2010, as further amended and supplemented, pension payment is suspended from the month following the month in which:

§  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;

§  Beneficiary of an early retirement or a partial early retirement pension is found in one of the situations provided in art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010, with subsequent amendments and completions;

§  the disability pensioner, and the survivor pensioners  provided by the law did not attend the compulsory medical re-examination, the convening of the National Institute of Medical Expertise and Recovery of Work Capacity or the regional centres of medical expertise of work capacity, or did not attend the rehabilitation programmes;

§  first or second degree invalidity pensioner, as well as the beneficiaries of survivor pension classified with 1st or 2nd degree disability is found in one of the situations provided in art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010, with subsequent amendments and completions;;

§  third degree degree invalidity pensioner, as well as the child in the third degree of disability who is the beneficiary of a survivor pension, earn monthly income being in one of the situations provided by art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010, with subsequent amendments and completions, exceeding half of the normal work schedule for that job;

§  the child who receives survivor pension has reached the age of 16 and does not make proof of continuing education;

§  the surviving spouse, who is beneficiary of a survivor pension is found in one of the situations provided in art. 6 par. (1) point I lit. (a) and (b) or point II of Law No.263/2010, with subsequent amendments and completions and earns monthly gross incomes above 35% the average gross earnings;

§  the surviving spouse, who is the beneficiary of a survivor pension, has remarried;

§  the surviving spouse, who is the beneficiary of a pension within the public system of pensions, opts for another pension, under the  law, within the same system, or within another social insurance system, not-integrated into the public pension system.

§  the children of  soldiers, policeman or civil servants with special status deceased following specific actions they were involved, to whome the right to a survivor's pension has been opened in the public pension system, opt for another pension, according to art. 55 para. (1 ^ 1) of Law no. 223/2015 on state military pensions, with subsequent amendments and completions.     

§                                                                                                                                                        

Resumption of the suspended pension payment is made on demand and is granted starting with the next month subsequent to the month in which the suspension cause has ceased, if the application was filed within 30 days since the cause of suspension was terminated or from the month following the application’s date, if the submission was made after the expiry of the period above mentioned.

V - 9. Right of complaint and appeal

See under Part XIII-2

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.

The decision is communicated to the person who claimed the benefit within 5 days from the date of its issuance.

The pension decisions issued by the territorial pension houses may be appealed to the competent court, within 45 days following of the notification.The undisputed pension decisions are definitive.

V - 10. Financing and Administration

Article 71. C102, Article 70. ECSS          

See under Part XIII-3. Common provisions.

The public pension system in Romania is managed and guaranteed by the State and it has a compulsory character. The public system of pensions, based on intergenerational solidarity is organised and operates based on the principle of contributiveness, according to which the social insurance funds are set up on the contributions owed by the natural and legal persons, participants in the public pension system, while the social insurance rights are rendered under the social insurance contributions paid.

The public pension system is based on the "pay‑as‑you‑go" principle, with the social insurance contributions representing the main source of revenue to the system. Social insurance contributions rates depend on the working conditions set for the employees and are established by the Fiscal Code.

As provided by law, the employer or the assimilated employers must calculate and pay, on monthly basis, the social security contributions owed to the state social insurance budget, together with the individual contributions retained from the insured.

For the year 2019 2020 and 20202021, social insurance contribution rates were established as follows: 

Contribution for 2019 2020 and 20202021

Employees:

· Calculation base: gross earnings; no ceiling.

· Rate: 25% (including 3.75% for Pillar 2 (i.e. the supplementary compulsory funded social insurance scheme as conventionally defined)).

· Exemption between January 2019 and December 2028: 21.25% for construction sector employees (no contribution to Pillar 2).

Employer:

· Calculation base: total gross earnings; no ceiling.

· Rate: the contribution rate varies with the working conditions:

Working                       Rate

conditions                     (%)

Normal                                0

Difficult                              4

Special                                 8

· Exemption:  Construction sector


Part VII. Family Benefit

Romania has accepted the obligations resulting from Part VII of C102 and Part VII of the ECSS.

Category

Information available

Information missing / questions raised by the CEACR

VII-1. Regulatory framework

Art.39 C102/ECSS

VII-2. Contingency covered

Art.40 C102/ECSS

VII-3. Persons protected

Art.41 C102/ECSS*

VII-4. Types of benefits

Art.42  C102/ECSS

VII-5. Qualifying period

Art.43  C102/ECSS

VII-6. Level and Calculation of benefit

Art.44  C102/ECSS*

VII-7. Duration of benefit

Art.45 C102/ECSS

VII-8. Suspension of benefit

Art.69 C102, Art.68 ECSS

VII-9. Right of complaint and appeal

Art.70 C102, Art.69 ECSS

VII-10. Financing and Administration

Art.71,72 C102

Art.70,71 ECSS

* Please update statistical data, in accordance with the Report form for C102/ECSS.

List of applicable legislation

§  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. 111/2010 on parental leave and monthly indemnity for raising the children published in the Official Gazette of Romania, Part I, no.830 of December 10, 2010, 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.

§  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 nursery vouchers, published in the Official Gazette of Romania, Part I, no.446 of May 23, 2006, as amended and supplemented;

§  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.

§  Emergency Ordinance no. 70/2010regarding 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.

VII - 1. Regulatory framework

Article 39. C102 and ECSS

Each Member (Contracting Party) for which this Part of this Convention (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 were 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.

The Minimum Inclusion Income (MII) will represent the main supporting instrument/program for preventing and combating poverty and the risk of social exclusion, being granted from the state budget, as a difference between the level of benefits regulated by the law and the net income of the family or single person, earned during a certain period of time. The purpose of the program is to guarantee a minimum level of income to every person in Romania. The MII project regulates the categories of financial support, which are the components of the minimum inclusion income: inclusion aid, allowance for families with children, dwelling supplement. The inclusion aid covers the food poverty of the family, a component which is currently regulated by the guaranteed minimum income (GMI), the allowance for families with children covers the additional needs of a family with childcare responsibilities, a component which is currently regulated by the family support allowance (FSA), the dwelling supplement covers fuel poverty, a component which is currently regulated by the heating benefits (HB). The income of the family is calculated according to the dimension of the family by using equivalence coefficients reflecting the distribution of consumption (1 for the first adult in the family and 0,5 for each of the other members of the family = equivalent adult). The new program establishes a single minimum threshold of 260 lei per equivalent adult, this amount targeting the poorest 10% of the population. Also, the amount of the inclusion aid for the single person will be increased by 83% compared to the current situation and the pro-work component of the new program will be strengthened, by introducing financial incentives in all components of the MII and exempting part of the earnings from work, in such a way that the social action changes its outcome from a reactive intervention to a proactive one.

Fight against poverty and social exclusion continues to be a national priority and the reform of the minimum income program is planned to be finalized in April 2021. In October 2016 the Romanian Parliament adopted the Minimum Inclusion Income Law no. 196/2016, but  the implementation of the Minimum Inclusion Income (MII) is currently postponed.The Government approved the prorogation of MII law, until April 2022, according to the Government Emergency Ordinance no. 226/2020 on some fiscal-budgetary measures and on amending and supplementing normative acts and prorogation of deadlines.which will enter into force starting from April 2019. According to the Government Emergency Ordinance no. 82/2017 was approved the prorogation of the implementation of the minimum inclusion income law until April 2019 in order to ensure that all the administrative measures for the implementation of this law will be ready.

The implementation of the Law no. 196/2016 depends on the elaboration of the National Information System for Social Assistance and also, on the capacity of the local public administration authorities to ensure data processing of the beneficiaries and to verify the eligibility criteria. All the applications forms and all the justifying documents which will be submitted by the beneficiaries in order to receive the minimum inclusion aid, has to be electronically processed by the Local Council staff using the National Information System for Social Assistance.

In November 2018, the Government approved the prorogation of Minimum Inclusion Income law, until 2021, according to the Government Emergency Ordinance no. 96/2018. The decision was to maintain the application of the actual means-tested benefits, namely: the minimum income guaranteed program (Law no. 416/2001 on mínimum income guaranteed, with subsequent amendments), the family support allowance (Law no. 277/2010 on family support allowance, with subsequent amendments) and the house heating benefits (Government Emergency Ordinance no. 70/2011 on social protection measures during the cold season, with subsequent amendments),Law no. 416/2001 on Minimum Guaranteed Income, with subsequent amendments and completions, for a period of at least 2 years, in order to have time to develop and test the IT system, to be sure that it will take over all the actual payments, without affecting the actual rights of the beneficiaries.

Also, within the National Recovery and Resilience Plan (PNRR) Romania has assumed the implementation for the next period of the program on the minimum inclusion income (MII). As a general objective, the reform proposal envisages the revision and application of the provisions of Law no. 196/2016 on the minimum income for inclusion, as well as the development of the National Integrated Social Assistance System and provision of logistical support for the implementation of MII.

VII - 2. Contingency covered

Article 40. C102 and ECSS

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

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

§1(e) Article 1. C102, §1(h) Article 1. ECSS

The term “child” means a child under school leaving age or under 15 years of age, as may be prescribed.

Family benefits are granted to the family and take into account childbirth, education and childcare. The eligibility conditions for each family benefit are presented below.  The types of family benefits granted during 1 July 2011 2020 to 30 June, 20202021:

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.

According to Government Emergency Ordinance no. 123/2020 for amending article 3 from Law no. 61/1993 regarding the state allowance for children, with subsequent amendments and completions the  amounts of state allowance for children were increased in two stages, the first increase during August -December 2020 and another increase starting with 1st of January 2021.

State allowance is given in different amounts, as  follows (amounts for 20202021, starting with 1st of January):

o  156 214 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  311 427 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 2011 - May 20145

(lei)

June 2015 – March 2019

(lei)

April - December 2019

(lei)

January –June July 2020

(lei)

August -Decembrie 2020

January –June 2020-

State allowance for children (amounts incresead starting from  June 2015)


children >  2 years

42

42/ 84 (June 2015)

150

156

185

214

Child with disability> 3 years

42

84/200 (June 2015)

300

311

369

427

children < 2 years

200

200

300

311

369

427

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 of placement allowance for 2016 - 2019 2021 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, according 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 2011 - 2013

(lei)

2014

(lei)

January 2015 - June 20192021

(lei)

Placement monthly allowance (amounts increased starting from December 2014)

97/145 (for child with disability)

97/145 (for child with disability) amounts increased starting from December 2014

600/900 (for child with disability)

600/900 (for child with disability)

The allowance for family support replacethe 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) 82 RON for families with one child;

     b) 164 RON for family with 2 children;

     c) 246 RON for family with 3 children;

     d) 328 RON for family of 4 or more children.

·             Allowance for two parent families with incomes between 201-530 RON/person:
     a) 75 RON for families with one child;

     b) 150 RON for family with 2 children;

     c) 225 RON for family with 3 children;

     d) 300 RON for family of 4 or more children.

·             Allowance for single parent with incomes between 0-200 RON/person:
     a) 107 RON for families with one child;

     b) 214 RON for family with 2 children;

     c) 321 RON for the family with 3 children;

     d) 428 RON for family of 4 or more children.

·             Allowance for single parent with incomes between 201-530 RON/person:
     a) 102 RON for families with one child;

     b) 204 RON for family with 2 children;

     c) 306 RON for the family with 3 children;

     d) 408 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 2011 - 2012

(lei)

2013

(lei)

2014

(lei)

2015 – Sem. I 2020 (lei)

                        The allowance for family support

Two parent families  (incomes >200 lei)

starting from July  2013 increased with 30% compared to 2012

Starting from November 2014 Increased  with 105%  compared to 2013

 - families with  1 child

30

40

82

82

--families with 2 children

60

80

164

164

 -families with 3 children

90

120

246

246

 -famillies with 4 and more children

120

160

328

328

 Two parent families  (incomes between 201 - 370 lei) starting from July 2013 (incomes between 201 - 530 lei)

starting from July  2013 increased with 30% compared to 2012

Starting from November 2014 Increased  with 127%  compared to 2013

Increased  with 127%  compared to 2013

 - families with  1 child

25

33

75

75

-families with 2 children

50

66

150

150

 -families with 3 children

75

99

225

225

 -famillies with 4 and more children

100

132

300

300