16TH ANNUAL REPORT OF THE REPUBLIC OF

SLOVENIA

 ON THE APPLICATION

OF THE EUROPEAN CODE OF SOCIAL SECURITY



REPORT

for the period from 1 July 2020 to 30 June 2021 made by the Government of the Republic of Slovenia in accordance with Article 74 of the European Code of Social Security on the measures taken to give effect to the accepted provisions of the Code whose instruments of ratification or of accession were deposited on 26 February 2004.

I.   Please give the list of the legislation and administrative regulations, etc., which apply the provisions in respect of which obligations of the Code have been accepted in accordance with Article 2. Please specify in each case to which of the Parts of the Code the texts concerned relate. Please forward copies of the said legislation, etc.

Please give any available information concerning the extent to which these laws and regulations have been enacted or modified to permit of, or as a result of, ratification.

II.  Please indicate in detail, for each of the following Articles of the Parts of the Code to which ratification applies, the provisions of the above-mentioned legislation and administrative regulations, etc., or other measures, under which each Article is applied.

If in your country ratification of the Code gives the force of national laws to its terms please state by virtue of what constitutional provisions the ratification has had this effect. Please also specify what action has been taken to make effect those provisions of the Code which require a national authority to take certain specific steps for its implementation, such as measures to define exact scope and the extent to which advantage may be taken of the permissive exceptions provided for in regard to each Part of the Code, and to establish or supervise the several financial or technical bodies entrusted with the administration of the benefits stipulated.

If the Secretary General has requested further information on the manner in which your country has implemented the provisions of the Code, or if the Committee of Ministers has invited your country to take measures to comply with your obligations, please supply the information asked for or indicate the action taken by your Government to settle the points in question.


PART II

MEDICAL CARE

The Constitution of the Republic of Slovenia (CRS) defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of Republic of Slovenia have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof. Article 51 of the Constitution of Republic of Slovenia (the right to health care) stipulates among other things that everybody has the right to health care under the conditions laid down by law.

Primary legislation:

·         Health Care and Health Insurance Act (Official Gazette RS, no. 9/92, 13/93, 9/96, 29/98, 77/98 Odl US, 6/99, 56/99-ZVZD, 99/01, 42/02-ZDR, 60/02, 11/03 Skl. US, 126/03, 20/04-UPB1, 62/05 Odl US, 76/05, 100/05-UPB2, 100/05 Odl. US, 21/06 Odl. US, 38/06, 72/06-UPB3, 114/06-ZUTPG, 91/07, 71/08, 76/08, 118/08 Skl. US, 62/10-ZUPJS, 87/11, 40/12-ZUJF, 21/13-ZUTD-A, 91/13, 99/13- ZUPJS-C, 99/13-ZSVarPre-C, 111/13-ZMEPIZ-1, 95/14-ZUJF-C, 47/15-ZZSDT), 61/17-ZUPŠ, 64/17-ZZDej-K, 36/19, 189/20-ZFRO, 51/21);

·         Health Services Act (Official Gazette RS, no. 9/92, 26/92 corr., 37/95, 8/96, 59/99, 90/99, 98/99, 31/00, 36/00, 45/01, 131/03, 135/03, 2/04, 36/04-UPB1, 80/04, 23/05-UPB2, 15/08-ZPacP, 23/08, 58/08-ZZdrS-E, 77/08-ZDZdr, 40/12-ZUJF, 14/13, 88/16-ZdZPZD, 64/17, 1/19-odl. US, 73/19, 82/20, 152/20-ZZUOOP in 203/20-ZIUPOPDVE);

·         Pharmacies Act (Official Gazette RS, no. 85/16, 77/17, 73/19);

·         Social Security Contributions Act (Official Gazette RS, no. 5/96, 18/96-ZDavP, 34/96, 87/97, 3/98, 106/99-ZPIZ-1, 81/00-ZPSV-C, 97/01-ZSDP, 97/01, 62/10 Odl. US, 40/12-ZUJF, 96/12-ZPIZ-2, 91/13-ZZVZZ-M, 99/13-ZSVarPre-C, 26/14-ZSDP-1);

·         Health Care Databases Act (Official Gazette RS, no. 65/00, 47/15, 31/18, 152/20-ZZUOOP, 175/20-ZIUOPDVE, 203/20-ZIUPOPDVE).

Secondary legislation:

·         Rules on Compulsory Health Insurance (Official Gazette RS, no. 79/94, 73/95, 39/96, 70/96, 47/97, 3/98, 3/98, 51/98 Odl. US, 90/98, 6/99 corr., 109/99 Odl. US, 61/00, 64/00 corr., 59/02, 11/03 Skl. US, 18/03, 30/03, 35/03 corr., 78/03, 84/04, 44/05, 86/06, 90/06 corr., 64/07, 33/08, 71/08, 118/08 Skl. US, 7/09, 88/09, 30/11, 49/12, 106/12, 99/13-ZSVarPre-C, 25/14 Odl. US, 25/14, 85/14, 10/17-ZČmIS, 64/18, 4/20, 42/21-odl. US, 61/21);

·         Statute of the Health Insurance Institute of Slovenia (Official Gazette RS, no. 87/01, 1/02 corr.);

·           Rules on Carrying Out Preventive Health Care at the Primary Level (Official Gazette RS, no. 19/98, 47/98, 26/00, 67/01, 33/02, 37/03, 117/04, 31/05, 83/07, 22/09, 17/15, 47/18, 57/18, 57/18, 57/21).

National programmes:

·         Resolution on National Health Care Plan 2016-2025 (Official Gazette RS, no. 25/16).

Basic features of legal arrangements

The health insurance in the Republic of Slovenia is regulated by two pieces of legislation, the Health Care and Health Insurance Act (HCHIA) and the Rules of compulsory health insurance.

The health insurance in the Republic of Slovenia can be:

-          compulsory and

-          voluntary (Article 12 of the HCHIA).

a) Compulsory health insurance

Compulsory insurance (Article 13 of the HCHIA) comprise:

·         Insurance against sickness and injuries outside work;

·         Insurance against injuries at work and occupational sickness.

Insured persons are provided, in an amount determined by law:

·         pay for health services (benefits in kind);

·         sickness benefit in lieu of pay during temporary absence from work (sickness benefit);

·         reimbursement of travel expenses in connection with receiving health services.

b) Voluntary health insurance

Voluntary health insurance covers the insured person's costs of health care and related services, provision of medicines and assistive devices and payments of the agreed financial compensation in case of illness, injury or a special health condition. In the area of the Republic of Slovenia such insurance may be provided by insurance companies which meet the prescribed conditions according to this act and the Insurance Act.

Voluntary health insurance is classified as a type of health insurance and, more broadly speaking, belongs to the group of property insurance. Insurance companies may introduce the following types of voluntary health insurance:

1.      Complementary health insurance which covers, when exercising rights to health care services according to procedures and conditions prescribed in the compulsory health insurance, the difference between the value of health care services pursuant to Article 23 of the Health Care and Health Insurance Act (HCHIA) and the share of this value which is covered from compulsory health insurance pursuant to the same Article, or a part of this difference when the co-payment refers to the right to medicinal products with the highest recognized value and to assistive devices;

2.      Substitute insurance which, up to the extent of the compulsory health insurance standard, covers costs of health care and related services and provision of medicinal products and assistive devices to persons who cannot be included in compulsory insurance in accordance with regulations of the Republic of Slovenia;

3.      Supplementary health insurance which covers costs of health care, related services, provision of medicinal products and assistive devices and payments of financial benefits which are not an integral part of compulsory health insurance rights and which is considered neither complementary nor substitute health insurance;

4.      Parallel health insurance which covers costs of health care and related services and provision of medicinal products and assistive devices which are otherwise a right pursuant to compulsory health insurance, but which the insured persons exercise through other procedures and under other conditions than prescribed by the compulsory health insurance system.

Insurance companies may also introduce combinations of different types of voluntary health insurance, but these may not include complementary insurance (Article 61 of the HCHIA).

Article 9

A. Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of the Republic of Slovenia, the recourse is had to sub-paragraph (a) of this Article.

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

According to the Health Care and Health Insurance Act (HCHIA), persons covered by the compulsory health insurance (insured persons) are:

-          those insured (insurees) and

-          their family members (Article 14 of the HCHIA).

Those insured are (Article 15 of the HCHIA):

1.      Persons who are employed in the Republic of Slovenia;

2.      Persons employed by an employer with their principal office in the Republic of Slovenia and sent to work or for professional training abroad, if they are not compulsorily insured in the country to which they have been sent;

3.      Persons employed by foreign and international organisations and institutions, foreign consular and diplomatic representations based in Slovenia, unless otherwise provided by treaty;

4.      Persons with permanent residence in the Republic of Slovenia employed by a foreign employer and not insured with a foreign health insurance provider;

5.      Persons who independently perform commercial or professional activities in the territory of the Republic of Slovenia as their only or main occupation;

6.      Persons who are owners of private companies in the Republic of Slovenia if they are not insured elsewhere;

7.      Farmers, members of their establishments and other persons performing farming activities in the Republic of Slovenia as their only or main occupation;

8.      Top sportsmen and chess players – members of physical training and chess organisations in the Republic of Slovenia who are not insured elsewhere;

9.      Unemployed persons who receive unemployment benefit from the employment institute;

10.  Persons with permanent residence in the Republic of Slovenia who receive pensions in compliance with the regulations of the Republic of Slovenia or maintenance in compliance with the regulations on maintenance for farmers;

11.  Persons with permanent residence in the Republic of Slovenia who receive pensions from a foreign provider of pension insurance unless otherwise provided by treaty;

12.  Persons with permanent residence in the Republic of Slovenia insured with a foreign health insurance provider who during their stay in the Republic of Slovenia cannot exercise their rights under that insurance;

13.  Family members of a person insured with a foreign health insurance provider and having permanent residence in the Republic of Slovenia but not being insured as family members with the foreign health insurance provider;

14.  Foreigners pursuing studies or training in the Republic of Slovenia who are not insured elsewhere;

15.  Persons with permanent residence in the Republic of Slovenia who are recipients of disability benefit according to the regulations on disabled military personnel and disabled civilian victims of war, who have rights according to the regulations on protection of war veterans, victims of wartime aggression and participants of other wars and recipients of national benefits for their services, if they are not insured elsewhere;

16.  Persons with permanent residence in the Republic of Slovenia who receive benefits in compliance with the act governing social protection for mentally and physically challenged adults, if they are not insured elsewhere;

17.  Persons with permanent residence in the Republic of Slovenia who receive permanent financial assistance and persons which were accorded a refugee status by the Republic of Slovenia or subsidiary protection according to regulations on international protection, unless otherwise insured;

18.  Persons with permanent residence in the Republic of Slovenia who enjoy recognition payments according to regulations on the care of participants in war if they are not insured elsewhere;

19.  Military personnel with permanent residence in the Republic of Slovenia who are performing civilian service in place of military service;

19.a Military conscripts with permanent residence in the Republic of Slovenia during their military service or during their training in the police reserve;

20.  Persons with permanent residence in the Republic of Slovenia who do not fulfil conditions for insurance pursuant to one of the points under this paragraph and they pay their contributions themselves;

21.  Citizens of the Republic of Slovenia with permanent residence in the Republic of Slovenia who are not insured elsewhere;

22.  Detainees who were not otherwise ensured before the detention or whose insurance is suspended during the period of detention, sentenced persons serving the sentence of imprisonment in penal institutions and correction homes, minors undergoing re-education in a juvenile correction facility, persons in protective detention in health institutes in connection with psychiatric disorders and persons sentenced to compulsory psychiatric treatment for alcoholism and drug dependence.

23.  Persons who acquire a right pursuant to the act regulating parental protection, namely:

-          Beneficiaries of parental compensation whose employment relationship was terminated during parental leave,

-          One of the parents who based on his/her business activity pays social security contributions for a minimum of 20 hours per week and nurses and looks after a child up to three years of age;

-          One of the parents who leaves the labour market due to caring for four or more children;

24.  Children up to 18 years of age who continue formal education and are not insured as family members since they are not maintained by their parents or their parents do not fulfil the conditions for compulsory insurance;

25.  Home care assistants according to the law governing social security.

Compulsory insurance includes persons under points 1 and 5 of the previous paragraph, who reside in the Republic of Slovenia and are in an employment relationship or independently perform an economic or professional activity as their only or main occupation in another or several member states of the European Union, European Economic area or Swiss confederation. The same rights and obligations apply to these persons as to persons under points 1 and 5 of the previous paragraph.

Insured persons under point 7 include:

Persons under points 1, 2, 3, 5, 6, 8, 19, 19a, 22 and 25 of the first paragraph of the Article 15 are insured against employment injury and occupational disease. Insured persons under point 22 are insured against employment injury and occupational disease if they are actually included in work.

Persons under point 7 of the first paragraph of the Article 15 are insured against employment injury and occupational disease if they pay contributions from the threshold determined for pension and disability insurance. Those persons under point 7 who do not pay such contributions acquire, in the event of employment injury or occupational disease, rights in the extent determined for instances of sickness or injury outside work (Article 16 of the HCHIA).

The following are also insured against employment injury and occupational disease:

1.      Students taking part in practical studies, performing production work or work experience and on professional field trips;

2.      Children and young people who are physically and mentally challenged and children and young people with accidental head injuries and brain damage taking part in practical studies with training organisations or at compulsory practical work;

3.      Persons participating in voluntary work experience after completing their formal education, irrespective of whether they receive remuneration for their work;

4.      Military disabled, civilians disabled in war and other disabled persons in occupational rehabilitation and training during practical work and exercises;

5.      Persons performing work on the basis of a work contract;

6.      Secondary school students or students of colleges and universities in performing work via authorised organisations;

7.      Unemployed persons performing public work organised under the regulations on employment;

8.      Volunteers;

9.      Persons performing generally beneficial and other activities under the rules regulating criminal matters;

10.  Persons performing activities as a secondary occupation

11.  Persons performing humanitarian and similar activities under the employment regulations

12.  Persons performing short-term work under regulations preventing undeclared work and employment (Article 17 of the HCHIA).

The following are also insured against employment injury:

1.      Persons participating in organised public works of a general nature, in rescue actions or in protection and rescue and help during natural and other disasters;

2.      Participants in youth camps in the Republic of Slovenia;

3.      Persons performing work or tasks of military service or alternative civilian service, civil protection, surveillance and intelligence services, general rescue services or in communications units and in training for defence and protection, rescue and help;

4.      Persons assisting interior affairs bodies and the authorised persons of these bodies in performing their tasks in compliance with the law;

5.      Persons performing tasks of interior affairs bodies as reservists in the composition of interior affairs bodies;

6.      Persons on the request of state and other authorised bodies performing public and other social functions or civic duties;

7.      Sportsmen, trainers or organisers participating in sports events as part of an organised sporting activity;

8.      Persons who are members of operational units of volunteer fire fighting organisations performing tasks in the extinguishing of fires, protection and rescue during other disasters, in training, protection at fire-risk locations and at public events, tasks in public appearances and demonstrations with the demonstration of exercises and in teaching people about fire safety;

9.      Persons who are members of mountain rescue services, underwater or cave rescue services or rescue dog-handler units performing tasks of protection, rescue and help or averting or preventing danger that directly threatens the lives or property of citizens (Article 18 of the HCHIA).

Under the conditions determined by the HCHIA, the following are insured as family members of the insured person:

a)      the close family members:

1.      spouse,

2.      children (both from and out of wedlock and those placed in a foster family in order to be adopted);

b)      the wider family members:

1.      stepchildren whom the insured person maintains,

2.      grandchildren, brothers, sisters and other children without parents, whom the insured person has taken in and maintains, under the conditions determined by this act for children,

3.      parents (father and mother, stepfather and stepmother and adoptive parent) who live with the insured person in a common household and whom the insured person maintains, and who do not possess sufficient means of their own for maintenance and who are permanently and completely incapable of working, except parents of the insured persons pursuant to the above-mentioned point 24 of the first paragraph of the Article 15. 

Children without parents also include those who have parents that are completely and permanently incapable of working, or if as a result of other circumstances they cannot care for such children and maintain them.

Family members are insured if they have permanent residence in the Republic of Slovenia, unless otherwise provided by treaty for close family members (Article 20 of the HCHIA).

Spouses are insured as family members if they are not themselves insured. On this condition insurance cover is also provided for a divorced spouse for whom a court order has decreed maintenance. Insurance for spouses also covers persons who live with an insured person in a relationship which according to the Family Code is legally equated with marriage (Article 21 of the HCHIA).

Children are insured as family members up until the age of 15 years, or until they are 18, and after this age if they are continuing formal education up until the end of full-time education, but no longer than until the end of the school/academic year in which they reach 26 years of age. Children who become completely and permanently incapable of working prior to reaching age 18 or before the end of full-time education, are insured as family members for as long as such incapacity lasts, if the insured person is maintaining them or if they are not themselves an insured person under the point 16 of the first paragraph of the Article 15 of the HCHIA (Article 22 of the HCHIA).

C. Please furnish statistical information under this Article as follows: Title I under Article 74

TITLE I

A.  Number of employees protected[1]:

Persons in paid employment = 817.005[2]

self-employed persons (podjetniki) =76.493

farmers = 11.176

B. Total number of employees[3]:

For the year= = 904.674

C: Number of employees protected (A iii.) per cent of total number of employees (B):

All employed persons in Slovenia are protected.

D. Please confirm that the dependent wives and children of the person protected are also entitled to the medical benefits stipulated in Article 10, in accordance with the provisions of this Article. Please state, when possible, the number of dependent wives and children protected.

As already mentioned under Article 9 / B / 2, according to the Health Care and Health Insurance Act (HCHIA), persons covered by the compulsory health insurance are those insured (insured persons) and their family members.

Under the conditions determined by the HCHIA, the following are insured as family members of the insured person:

a)      the close family members:

1.      spouse,

2.      children (both from and out of wedlock and those placed in a foster family in order to be adopted);

b)      the wider family members:

1.      stepchildren whom the insured person maintains,

2.      grandchildren, brothers, sisters and other children without parents, whom the insured person has taken in and maintains, under the conditions determined by this act for children,

3.      parents (father and mother, step father and step mother and adoptive parent) who live with the insured person in a common household and whom the insured person maintains, and who do not possess sufficient means of their own for maintenance and who are permanently and completely incapable of working, except parents of the insured persons under point 24 of the first paragraph of Article 15 of the HCHIA. 

Children without parents also include those who have parents that are completely and permanently incapable of working, or if as a result of other circumstances they cannot care for such children and maintain them.

As it is set forth in the HCHIA, family members are insured if they have permanent residence in the Republic of Slovenia, unless otherwise provided by treaty for close family members (Article 20 of the HCHIA).

Spouses are insured as family members if they are not themselves insured. On this condition insurance cover is also provided for a divorced spouse for whom a court order has decreed maintenance. Insurance for spouses also covers persons who live with an insured person in a relationship which according to the Family Code is legally equated with marriage (Article 21 of the HCHIA).

Children are insured as family members up until the age of 15 years, or until they are 18, and after this age if they are continuing formal education up until the end the school/academic year in which they reach the age of 26. Children, who become completely and permanently incapable of working prior to reaching age 18 or before the end of full-time education, are insured as family members for as long as such incapacity lasts, if the insured person is maintaining them or if they are not themselves an insured person under the point 16 of the first paragraph of the Article 15 of the HCHIA (Article 22 of the HCIA).

Statistical data on the dependent wife and children solely is currently not available.

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.

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Article 10

A. Please state in detail the name 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 service provided in case of hospitalisation.

According to the Health Care and Health Insurance Act, the right arising from compulsory health insurance is the right to health services (benefits in kind).

Pursuant to the Article 22 of the Rules on compulsory health insurance, the right to health services includes:

·         health services:

-          on a primary care level,

-          on a level of specialists,

-          dental care,

-          pharmacies,

-          hospital care,

-          health resort treatments and medical treatments on a tertiary level,

-          medical care;

·         health services of preventive nature according the adopted national programme;

·         diagnostics services;

·         treatment and medical rehabilitation of those who are ill or injured;

·         health services in connection with childbirth, termination of pregnancy, artificial fertilisation and sterilisation;

·         rehabilitation, organisation of training for living with a certain disease by following special programmes;

·         urgent and other transportation with ambulance and other vehicles;

·         prescription medications in accordance with categorisation of medicines;

·         foodstuffs for particular nutritional use, prescribed according to classification in the lists determined by the institution;

·         orthopaedic and other aids.

Services provided in case of hospitalisation are:

-          providing professional, technological and organisational services (services that cannot be performed on a primary care level, in specialist-ambulant practices or in health resorts);

-          medical care during the hospitalisation;

-          maintenance during the hospitalisation (accommodation and food);

-          hospital accommodation and food only during the daytime (daytime hospital);

-          providing medication and material for dressing wounds;

-          medical aids (instruments) needed for performing services due to which the person in question has been accepted for health treatment.

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

Article 23 of the HCHIA defines the rights to health services deriving from compulsory insurance. Through compulsory insurance, insured persons are provided payment for the following health services:

1. in their entirety (100%):

·         regular and other preventive check ups for children, schoolchildren and students up to 26 years of age, women in connection with pregnancy and other adults in accordance with a programme, except for check ups provided by employers on the basis of law;

·         prevention, screening and early discovering of disease;

·         counselling, education, training and assistance in changing an unhealthy lifestyle;

·         treatment and rehabilitation of children, schoolchildren and students in full-time education and children and young people who are physically and mentally challenged and children and young people with accidental head injuries and brain damage;

·         women’s health care in connection with family planning, contraception, pregnancy and childbirth;

·         prevention, discovery and treatment of the HIV infection and infectious diseases as determined by law;

·         compulsory vaccination, immunoprohylaxis and chemoprohylaxis according to a programme;

·         treatment and rehabilitation of malignant diseases, muscular and neuro-muscular diseases, paraplegia, tetraplegia, cerebral palsy, epilepsy, haemophilia, mental illness, developed forms of diabetes, multiple sclerosis and psoriasis;

·         comprehensive care with treatment and rehabilitation of blindness and low vision in compliance with the valid classification of the World Health Organization, completely or seriously hearing impaired according to the International classifications of impairments, disabilities and handicaps of the World Health Organization (1980), cystic fibrosis and autism and persons with acquired head injury and brain disorder;

·         treatment and rehabilitation as a result of occupational sickness and injuries at work;

·         health care in connection with the donation and exchange of tissue and organs for transplanting into other persons;

·         emergency medical assistance including emergency ambulance transportation;

·         help-in-the-home visits, treatment and care in the home and in social security institutes;

·         prescription medication from the positive list in connection with treatment under the above indents 4 to 13e, orthopaedic and other aids in connection with treatment under the above indents;

·         medication and foodstuffs for particular nutritional use from the positive and intermediate list for children, schoolchildren, apprentices and students and for persons with disorder in their physical and mental development;

·         foodstuffs for particular nutritional use with adapted composition of nutrients for treatment of insured persons with congenital digestive disorders;

·         cohabitation of one parent in a health care institution with their sick child aged up to 15 years (and older in some cases);

·         preliminary and periodical medical examinations for sportspersons who participate in official competitions of national sector unions;

2. at least 90% of the value:

·         organ transplants and other highly complex surgery;

·         treatment abroad;

·         intensive therapy, radiotherapy, dialysis and other highly complex diagnostic, therapeutic and rehabilitation treatment;

3. at least 80% of the value:

·         treatment of low fertility, artificial fertilisation, sterilisation and termination of pregnancy;

·         specialist-ambulant, hospital and health resort services as a continuation of hospital treatment, except for injuries outside work;

·         the non-medical portion of care in hospitals and health resorts as a continuation of hospital treatment, except for injuries outside work;

·         services in primary care level that are not covered in point 1 and treatment of dental and oral diseases;

·         orthopedic, orthotic, hearing and other aids except in cases from points 1 and 4 of this paragraph;

4. at least 70% of the value:

·         specialist-ambulant, hospital and health resort services as a continuation of hospital treatment and non-medical portion of care in hospitals and health resorts as a continuation of hospital treatment, orthopaedic, orthotic and other accessories in connection with treatment of injuries outside work;

·         medication from the positive list except for cases from point 1 of this paragraph;

5. at most 60% of the value:

·         non-urgent rescue transportation of insured persons who are immovable or need transportation to and from dialysis, or in other cases where transportation by means of public transport or car would be harmful to their health or who, due to their health condition, need escort by a medical worker;

·         health resort treatment that is not a continuation of hospital treatment;

6. at most 50% of the value:

·         medication and foodstuff for particular nutritional use from the intervening list;

·         dental prosthesis for adults;

·         visual aids for adults.

Military disabled persons and civilians disabled in war are provided with payment in its entirety for health care services, with the difference being made up from the national budget (Article 24 of the HCHIA).

The Republic of Slovenia covers the difference to the full value of health care services from budgetary funds in compliance with points 2 to 6 for insured persons referred to in point 22 of the first paragraph of Article 15 of the HCHIA.

The Republic of Slovenia covers the difference to the full value of health care services from budgetary funds in compliance with points 2 to 6 for insured persons and their family members referred to in the first paragraph of Article 15 of the HCHIA, provided that the relevant rights are not fully provided to them under compulsory health insurance from another entitlement and if they are eligible to obtain financial social assistance.   

In respect to the provisions of the first paragraph of article 23 of the HCHIA, payment in full is also guaranteed for services under points 2, 3 and 4, when it concerns urgent treatment of persons who are not voluntarily insured for the difference in the costs of these services:

-          of invalids and other persons with the right to the assistance of another person for the implementation of the majority or all of their existential functions according to special regulations; invalids who have at least 70% physical disability according to regulations on pension and invalid insurance, and insurees under point 16 of the first paragraph of article 15 of HCHIA, and persons over 75 years old;

-          persons who fulfil the income conditions for obtaining a benefit according to regulations on social security;

-          persons whose expenses for payment of these services exceeds per calendar year the cost defined by the Institute. This cost is dependent on the income of the family member of the insured person and must not be less than two years premium for voluntary insurance for such cases.

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 the 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. 

As mentioned above, according to the Slovenian legislation, cost-sharing in the case of pregnancy, confinement and their consequences is not required. Through compulsory health insurance, insured persons are provided payment in their entirety for the following health services (Article 23 of the HCHIA):

·         regular and other preventive check-ups for women in connection with pregnancy;

·         women’s health care in connection with family planning, contraception, pregnancy and childbirth.

According to the Article 27 of the Rules on Compulsory Health Insurance (Rules), preventive check-ups for women include:

-          check-ups and counselling with regard to family planning, pregnancy, sexually transmitted infections and subsequent infertility;

-          contraception;

-          up to 10 systematic check-ups during pregnancy and 2 check-ups with ultrasound;

-          discovering carriers of HBs antigen, infected with toxoplasmos and syphilis;

-          one home visit to a pregnant woman in the second half of pregnancy;

-          medical check-ups six weeks after confinement or three weeks after spontaneous or artificial miscarriage;

-          disensibilisation of Rh negative women with gamaglobulyns after the confinement or after the termination of pregnancy;

-          indirect Coomb’s test for every pregnant women and Rh disensibilisation in 28th weeks of pregnancy;

-          a check-up for early detection of cervical cancer, carried out once every three years for women between 20 and 75 years of age, if two results of the PAP test in one-year period are negative;

-          clinical breast examinations once every three years for women between 20 and 50 years of age and once every two years for women after 50 years of age;

-          amniocentesis and cariotypesation with positive transplantation test, paid by the pregnant woman herself, for pregnant women under the age of 35;

-          transplantation test for pregnant women aged between 35 – 37, and in case of the test being positive also amniocentesis and cariotypesation;

-          chorion biopsy or amniocentesis for cariotypesation for pregnant women above 37 years of age;

-          advisory preventive community nursing visit for women who after three years fail to respond to the invitation for preventive examination (27 October 2002)

-          first counselling and prescribing hormone replacement preparations for women without chronic diseases;

-          mammography once every two years for women over 50 years of age and once a year for women who have taken hormone replacement preparations for more than 5 years;

-          ultrasound assessment of endometrium thickness once a year for women who continuously take hormone replacement preparations (Article 27).

According to the Article 38 of the Rules, insured persons (pregnant female) have the right to the hospital treatment (hospitalisation) which includes:

-          providing more demanding professional, technological and organisational services (services that cannot be performed on a primary care level, in specialist-ambulant practices or in health resorts);

-          medical care during the hospitalisation;

-          maintenance during the hospitalisation;

-          hospital accommodation and food only during the daytime (daytime hospital);

-          providing medications and material for dressing wounds;

-          accessories required for medical treatment;

-          health services and health care related to confinement.

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

Insured persons can exercise their above-mentioned rights from compulsory health insurance in institutions and by doctors that are part of the public health service network.  On the basis of concessions public health service network entails public health care and other institutions and private doctors. Health Insurance Institute of Slovenia (HIIS) concludes a contract with providers which fulfil the tender requirements. HIIS supervises the implementation of the contract provisions on giving an assurance of the rights of the insured persons under the compulsory health insurance.

Health promotion where people live and work:

Article 11

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.

In the case of the compulsory health insurance, the insured person is entitled to the benefit (health services) from the first day of health insurance onwards (no qualifying period required) (Article 78 of the HCHIA).

The Health Insurance Institute of Slovenia may define conditions of prior insurance of up to 6 (six) months for the right to orthopaedic, eye, ear, orthodontic and other aids, except in the case of rights under point 1 of the first paragraph of the Article 23 of the HCHIA (health services which costs are covered entirely on the basis of compulsory health insurance – see above) (Article 23 of HCHIA).

Article 12

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 the 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.

All medical benefits (health services) stated above are provided for the whole time of a medical condition, which requires a certain health treatment (unlimited).

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.

Article 23 of HCHIA stipulates that insured persons referred to in point 22 of the first paragraph of Article 15 of the HCHIA (such as detainees, sentenced persons and other persons under point 22) have a limited right to freely choose a doctor in a health care institution, which they exercise in accordance with regulations governing the enforcement of penal sanctions. These insured persons have no right to treatment and care at home, treatment abroad, treatment in health establishments and compensation for temporary inability to work, even if they work in public utility units, to nurse a close relative and travel reimbursement related to the use of health care services. These insured persons also cannot have their close family members included in their insurance.  

Article 25 of the Rules on compulsory health insurance stipulates that the following rights are not arising from the compulsory health insurance:

- aesthetic surgery services, unless they are necessary to alleviate the consequences of injuries, impairments or diseases and are also connected with removal of functional impairments;

- services, connected to sobering after acute alcohol intoxication;

- services of non-obligatory vaccination;

- services of establishing the health condition of the insured person, carried out due to requirements or regulations in other domains or of other bodies (insurance companies, courts, in criminal proceedings, issuing of certificates for motor vehicle drivers, measures related to safety at work, etc.);

- services, necessary to exercise rights arising from pension and disability insurance, which exceed the scope of services defined in the list of obligatory medical documentation for exercising rights on the basis of disability and the remaining ability to work, and services required by the disability committee;

- services of alternative diagnostics, treatments or rehabilitation, which were not authorized by the minister of health;

- services carried out on the requirement of the insured person which are in opinion of the personal or referred doctor not necessary,

- services required for the suspension of damage caused by the insured person;

- transport costs of repatriating the insured person.


PART III

SICKNESS BENEFIT

The Constitution of the Republic of Slovenia defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof. Article 51 of the Constitution of RS (the right to health care) stipulates among other things that everybody has the right to health care under the conditions laid down by law.

Primary legislation:

·         Health Care and Health Insurance Act (Official Gazette RS, no. 9/92, 13/93, 9/96, 29/98, 77/98 Odl. US, 6/99, 56/99-ZVZD, 99/01, 42/02-ZDR, 60/02, 11/03 Skl. US, 126/03, 20/04-UPB1, 62/05 Odl. US, 76/05, 100/05-UPB2, 100/05 Odl. US, 21/06 Odl. US, 38/06, 72/06-UPB3, 114/06-ZUTPG, 91/07, 71/08, 76/08, 118/08 Skl. US, 62/10-ZUPJS, 87/11, 40/12-ZUJF, 21/13-ZUTD-A, 91/13, 99/13- ZUPJS-C, 99/13-ZSVarPre-C, 111/13-ZMEPIZ-1, 95/14-ZUJF-C, 47/15-ZZSDT), 61/17-ZUPŠ, 64/17-ZZDej-K, 36/19, 189/20-ZFRO, 51/21);

·         Health Services Act (Official Gazette RS, no. 9/92, 26/92 corr., 37/95, 8/96, 59/99, 90/99, 98/99, 31/00, 36/00, 45/01, 131/03, 135/03, 2/04, 36/04-UPB1, 80/04, 23/05-UPB2, 15/08-ZPacP, 23/08, 58/08-ZZdrS-E, 77/08-ZDZdr, 40/12-ZUJF, 14/13);

·         Pharmacies Act (Official Gazette RS, no. 9/92, 38/99, 2/04, 36/04-UPB1);

·         Social Security Contributions Act (Official Gazette RS, no. 5/96, 18/96-ZDavP, 34/96, 87/97, 3/98, 106/99-ZPIZ1, 81/00-ZPSV-C, 97/01-ZSDP, 97/01, 62/10 Odl. US, 40/12-ZUJF, 96/12-ZPIZ-2, 91/13-ZZVZZ-M, 99/13-ZSVarPre-C, 26/14-ZSDP-1);

·         Health Care Databases Act (Official Gazette RS, no. 65/00, 47/15);

·         Employment Relationship Act (Official Gazette RS, no. 21/13, 78/13- corr., 47/15-ZZSDT in 33/16-PZ-F).

Secondary legislation:

·         Rules on compulsory health insurance (Official Gazette RS, no. 73/95, 39/96, 70/96, 47/97, 3/98, 3/98, 51/98 Odl. US, 90/98, 6/99 corr., 109/99 Odl. US, 61/00, 64/00 corr., 59/02, 11/03 Skl. US, 18/03, 30/03, 35/03 corr., 78/03, 84/04, 44/05, 86/06, 90/06 corr., 64/07, 33/08, 71/08, 118/08 Skl. US, 7/09, 88/09, 30/11, 49/12, 106/12, 99/13-ZSVarPre-C, 25/14 Odl. US, 25/14, 85/14), 10/17-ZČmIS, 64/18, 4/20, 42/21-odl. US, 61/21);

·         Statute of the Health Insurance Institute of Slovenia (Official Gazette RS, no. 87/01, 1/02 corr.);

·         Rules on carrying out preventive health care at the primary level (Official Gazette RS, no. 19/98, 47/98, 26/00, 67/01, 33/02, 37/03, 117/04, 31/05, 83/07, 22/09).

National programmes:

·          Resolution on National Health Care Plan 2016-2025 (Official Gazette RS, no. 25/16).

Basic features of legal arrangements

The health insurance in the RS is regulated by two pieces of legislation, the Health Care and Health Insurance Act (HCHIA) and the Rules of compulsory health insurance.

The health insurance in the Republic of Slovenia can be:

-          compulsory and

-          voluntary (Article 12 of the HCHIA).

a) Compulsory health insurance

Compulsory insurance (Article 13 of the HCHIA) comprise:

·         Insurance against sickness and injuries outside work;

·         Insurance against injuries at work and occupational sickness.

Insured persons are provided, in an amount determined by law:

·         pay for health services (benefits in kind);

·         sickness benefit in lieu of pay during temporary absence from work (sickness benefit);

·         reimbursement of travel expenses in connection with receiving health services.

b) Voluntary health insurance

Voluntary health insurance covers the insured person’s costs of health care and related services, provision of medicines and assistive devices and payments of the agreed financial compensation in case of illness, injury or a special health condition. In the area of the Republic of Slovenia, such insurance may be provided by insurance companies which meet the prescribed conditions according to this act and the Insurance Act.

Voluntary health insurance is classified as a type of health insurance and, more broadly speaking, belongs to the group of property insurance. Insurance companies may introduce the following types of voluntary health insurance:

1.      Complementary health insurance which covers, when exercising rights to health care services according to procedures and conditions prescribed in the compulsory health insurance, the difference between the value of health care services pursuant to Article 23 of the HCHIA and the share of this value which is covered from compulsory health insurance pursuant to the same Article, or a part of this difference when the co-payment refers to the right to medicinal products with the highest recognized value and to assistive devices;

2.      Substitute insurance which, up to the extent of the compulsory health insurance standard, covers costs of health care and related services and provisions of medicinal products and assistive devices to persons who cannot be included in compulsory insurance in accordance with regulations of the Republic of Slovenia;

3.      Supplementary health insurance which covers costs of health care, related services, provision of medicinal products and assistive devices and payments of financial benefits which are not an integral part of compulsory health insurance rights and which is considered neither complementary nor substitute health insurance;

4.      Parallel health insurance which covers costs of health care and related services and provision of medicinal products and assistive devices which are otherwise a right pursuant to compulsory health insurance, but which the insured persons exercise through other procedures and under other conditions than prescribed by the compulsory health insurance system.

Insurance companies may also introduce combinations of different types of voluntary health insurance, but these may not include complementary insurance (Article 61 of the HCHIA).

Article 15

A. Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of Slovenia, the recourse is had to sub-paragraph (a) of this Article.

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

According to the Article 28 of the Health Care and Health Insurance Act (HCHIA), the right to benefit in lieu of pay during temporary absence from work (sickness benefit) is held by:

·         those insured under points 1, 2, 3, 4, 5, 6 and 8 of the first paragraph of Article 15 of the HCHIA,

·         those insured under point 7 of the first paragraph of Article 15 of the HCHIA, if they pay a contribution on the threshold determined for pension and disability insurance.

Those insured are:

  1. Persons who are employed in the Republic of Slovenia;
  2. Persons employed by an employer with their principal office in the Republic of Slovenia and sent to work or for professional training abroad, if they are not compulsorily insured in the country to which they have been sent;
  3. Persons employed by foreign and international organisations and institutions, foreign consular and diplomatic representations based in Slovenia, unless otherwise provided by treaty;
  4. Persons with permanent residence in the Republic of Slovenia employed by a foreign employer and not insured with a foreign health insurance provider;
  5. Persons who independently perform commercial or professional activities in the territory of the Republic of Slovenia as their only or main occupation;
  6. Persons who are owners of private companies in the Republic of Slovenia if they are not insured elsewhere;
  7. Farmers, members of their establishments and other persons performing farming activities in the Republic of Slovenia as their only or main occupation (if they pay a contribution on the threshold determined for pension and disability insurance);
  8. Top sportsmen and chess players – members of physical training and chess organisations in the Republic of Slovenia who are not insured elsewhere.

C. Please furnish statistical information under this Article as follows: Title I under Article 74

Please see Part II – Medical Care / Article 9 / question C.

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.

/

Article 16

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

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

Article 65 / paragraph 6 / (c): a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·         average wage (gross) in 2020 = 1856,20 EUR[4]

      average wage (net) in 2020 = 1208,65 EUR

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS - STANDARD WAGE:

      125 per cent of average wage (gross) in 2020 = 2320,25 EUR

            125 per cent of average wage (net) in 2020 = 1510,81 EUR

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (gross)

C:  Standard wage (net) in 2020 = 1510,81 EUR

(2) TITLE II

TIME BASIS: January 2021

D:  Amount of benefit granted during the time basis

·         man with wife and two children

·         assessment basis (net) = 1510,81 EUR[5]

In case of illness:

First 90 calendar days: 80% of the assessment basis = 80% of 1510,81 EUR = 1208,65 EUR

After 90 calendar days: 90% of the assessment basis = 90% of 1510,81 EUR = 1.359,73 EUR

In case of injury outside work:

First 90 calendar days: 70% of the assessment basis = 70 % of 1510,81 EUR = 1.057,56 EUR

After 90 calendar days: 80% of the assessment basis = 80% of 1510,81 EUR = 1208,65 EUR

E: Child benefit:

·         family: 1 (man) + 1 (wife) + 2 children

·         the income class[6]: 1510,81 / 4 = 377,70 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

F: Child benefit:

§  family: 1 (man) + 1 (wife) + 2 children

In case of illness:

       First 90 calendar days:

§  the income class: 1208,65 EUR / 4 = 302,16 EUR per family member

1st child = 100,08 EUR; 2nd child = 110,63 EUR; Σ = 210,71 EUR

        After 90 calendar days:

§  the income class: 1.359,73 EUR / 4 = 339,93 EUR per family member

1st child = 76,72 EUR; 2nd child = 85,25 EUR; Σ = 161,97 EUR

In case of injury outside work:

First 90 calendar days

§  the income class: 1.057,56 EUR / 4 = 264,39 EUR per family member

1st child = 100,08 EUR; 2nd child = 110,63 EUR; Σ = 210,71 EUR

       After 90 calendar days:

§  the income class: 1208,65 EUR / 4 = 302,16 EUR per family member

1st child = 100,08 EUR; 2nd child = 110,63 EUR; Σ = 210,71 EUR

G: (D + F) / (C + E)

In case of illness[7]:

First 90 calendar days:

(1208,65 EUR + 210,71 EUR) / (1510,81 EUR + 161,52 EUR) = 0,8487 – 84,9 %

After 90 calendar days:

(1.359,73 EUR + 161,97 EUR) / (1510,81 EUR + 161,52 EUR) = 0,9099 – 91,0 %

In case of injury outside work:

First 90 calendar days:

(1.057,56 EUR + 210,71 EUR) / (1510,81 EUR + 161,52 EUR) = 0,7583 – 75,8 %

After 90 calendar days:

(1208,65 EUR + 210,71 EUR) / (1510,81 EUR + 161,52 EUR) = 0,8487 – 84,9 %

B./

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 right to sickness benefit in lieu of pay during temporary absence from work (sickness benefit) is a right arising from the compulsory health insurance, which is governed by the Health Care and Health Insurance Act (HCHIA).

According to the HCHIA, the basis for the benefit is the average monthly wage and benefits or the average basis for payment of contributions in a calendar year prior to the year in which the temporary absence from work began (Article 31 of the HCHIA).

The basis for benefit for insured persons who have not received wages or have no basis for payment of contributions in the period, is the average monthly amount of pay or the basis for payment of contributions during the period of insurance prior to the start of absence from work.

Insured persons who are injured on the way to work before arriving at work and insured persons who after completing military service or after temporary leave from military service because of illness or injury cannot begin work, the calculation shall be based on the pay which they would have received if they had started work (Article 32 of the HCHIA).

Benefit is paid to the insured person on the basis of the opinion of the personal physician or competent physicians’ committee (Article 29 of the HCHIA):

·         from the first day of absence from work for transplant of living tissue and organs to benefit another person, as a consequence of giving blood, care of a close family member, isolation and attendance ordered by a physician and from injury sustained in circumstances from Article 18 of the HCHIA and of cohabitation with a sick child in a hospital or health resort;

·         from the 31st day of absence from work in all other cases (Note: as of 1 January 2003 this indent is not used in relation to the right to wage compensation in cases of the worker's inability to work due to an illness or injury which is not related to work – Employment Relationship Act (Official Gazette RS, no. 21/13, 78/13-popr., 47/15-ZZSDT, 33/16-PZ-F).

For the first 30 days of absence from work, his/her employer pays the benefit (wage compensation). The legal basis for it is the Employment Relations Act (ERA), which in this regard lays down the following provision: The employer shall pay wage compensation from own funds in cases of the worker's inability to work due to an illness or injury which is not related to work for up to 30 working days for individual absence from work but not more than for 120 working days in a calendar year. In cases of a worker's inability to work due to an occupational disease or employment injury, the employer shall pay the worker wage compensation from own funds for up to 30 working days for each individual absence from work. In case of longer absence from work, the employer shall pay wage compensation to the debit of health insurance. In case of two or more successive absences from work due to the same illness or injury which is not related to work in the duration of up to 30 working days, when the individual interruption between two absences lasts less than ten working days, the employer shall pay wage compensation for the period of subsequent absence after the interruption to the debit of health insurance. In case of the worker's absence form work due to an illness or injury which is not related to work, the wage compensation to be paid from the employer's funds shall amount to 80% of the worker's salary in the previous month for full-time working hours (Article 137 of the ERA).

According to the HCHIA the basis for benefit is the average monthly pay and benefit or average basis for payment of contributions in the calendar year prior to the year in which the temporary absence from work occurs (Article 31 of the HCHIA).

The first 90 days benefit (sickness benefit) amounts to:

·         90% of the basis in absence from work as a result of transplant of living tissue and organs to benefit another person, as a result of giving blood and quarantine ordered by a physician;

·         80% of the basis in absence from work through illness or in a case of cohabitation with a sick child in a hospital or health resort;

·         70% of the basis in absence from work as a result of injury outside work and attendance ordered by a physician.

After 90 days benefit (sickness benefit) amounts to:

·         100% of the basis in absence from work as a result of occupational disease, employment injury, transplant of living tissue and organs to benefit another person, as a result of giving blood and quarantine ordered by a physician;

·         90% of the basis in absence from work through illness;

·         80% of the basis in absence from work as a result of injury outside work, care of a family member and attendance ordered by a physician or in case of cohabitation with a sick child in a hospital or health resort.

Military disabled persons and civilians disabled in war have the right to benefit in the amount of 100% of the basis (in all cases), but first 90 days have the right to benefit in the amount of 90% of the basis in all cases except absence from work as a result of occupational disease, employment injury and care of a family member.

Benefit may not be less than the guaranteed pay and not higher than the pay that the insured person would receive if he/she was working or than the basis on which he/she is insured at the time of the absence from work.

Article 17

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.

The insured person is entitled to the sickness benefit from the first day of insurance (compulsory health insurance) onwards, meaning no qualifying period is required (Article 78 of the HCHIA).

Article 18

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.

As already mentioned above, according to the Article 29 of the HCHIA, the sickness benefit is paid to the insured person on the basis of the opinion of the personal physician or competent physicians’ committee:

·         from the first day of absence from work for transplant of living tissue and organs to benefit another person, as a consequence of giving blood, care of a close family member, quarantine and attendance ordered by a physician and from injury sustained in circumstances from Article 18 of the HCHIA or in case of cohabitation with a sick child in a hospital or health resort;

·         from the 31st day of absence from work in all other cases (Note: as of 1 January 2003 this indent is not used in relation to the right to wage compensation in cases of the worker's inability to work due to an illness or injury which is not related to work – Employment Relationship Act, Official Gazette RS, no. 21/13, 78/13-corr., 47/15-ZZSDT, 33/16-PZ-F).

Insured persons who are absent from work owing to temporary incapacity to work, are referred by their personal physician or physicians’ committee to a disability commission, if the physicians’ assessment is that there is no likelihood of a return of working ability (Article 34 of the HCHIA).

For the first 30 days of absencefrom work, his/her employer pays the benefit (wage compensation). The legal basis for it is the Employment Relations Act (ERA), which in this regard lays down the following provision:

The employer shall pay wage compensation from own funds in cases of the worker's inability to work due to an illness or injury which is not related to work for up to 30 working days for individual absence from work but not more than for 120 working days in a calendar year. In cases of a worker's inability to work due to an occupational disease or employment injury, the employer shall pay the worker wage compensation from own funds for up to 30 working days for each individual absence from work.

In case of longer absence from work, the employer shall pay wage compensation to the debit of health insurance. In case of two or more successive absences from work due to the same illness or injury which is not related to work in the duration of up to 30 working days, when the individual interruption between two absences lasts less than ten working days, the employer shall pay wage compensation for the period of subsequent absence after the interruption to the debit of health insurance.

In case of the worker's absence form work due to an illness or injury which is not related to work, the wage compensation to be paid from the employer's funds shall amount to 80% of the worker's salary in the previous month for full-time working hours (Article 137 of the ERA).

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

Article 35 of the HCHIA lays down that an insuree is not entitled to the sickness benefit during temporary absence from work if during that time he/she performs paid work.

Payment of the sickness benefit is withheld:

        i.      if without due cause an insuree does not report that he/she is ill to the employer or personal doctor within three days of the start of the illness;

      ii.      if without due cause an insuree refuses a medical examination or an examination by a health commission;

    iii.      if the authorised physician, health commission or supervisory agency ascertains that an insuree is not acting according to the instructions for treatment or if without the permission of the physician he/she leaves his place of permanent residence.

Payment of the sickness benefit is to be withheld until the insuree agrees to an examination or until he/she acts according to the instructions of the physician. The withheld sickness benefit is paid to the insuree for the entire time of justifiable absent from work.

Article 23 of the HCHIA inter alia stipulates that insured persons referred to in point 22 of the first paragraph of Article 15 of the HCHIA (such as detainees, sentenced persons and other persons from point 22) are not entitled to sickness benefit during temporary absence from work even if they work in public utility units. 


PART IV

UNEMPLOYMENT BENEFIT

The Constitution of the Republic of Slovenia defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof.

Primary legislation:

·      Labour Market Regulations Act (Official Gazette RS, no. 80/2010, 40/12-ZUJF, 21/13, 63/13, 100/13, 32/14-ZPDZC-1, 47/15-ZZSDT, 55/1775/1911/20 – odl. US, 189/20 – ZFRO and 54/21);

·      Social Security Contributions Act (Official Gazette RS, no. 5/96; 18/96 – ZDavP, 34/96, 87/97 – ZDavP-A, 3/98, 7/98 – odl. US, 106/99 – ZPIZ-1, 81/00 – ZPSV-C, 97/01 – ZSDP, 97/01, 62/10 – odl. US, 40/12 – ZUJF, 96/12 – ZPIZ-2, 91/13 – ZZVZZ-M, 99/13 – ZSVarPre-C and 26/14 – ZSDP-1);

·      Employment Relations Act (Official Gazette RS, no. 21/13, 78/13, 47/15 – ZZSDT and 33/16 – PZ-F).

Secondary legislation:

·         Statute of the Employment Service of Slovenia (Official Gazette RS, no. 34/08, 58/11 and 50/12);

·         Rules on Concessions for the provision of Services for Labour Market (Official Gazette RS, no. 65/11);

·         Rules on the Method of reporting about vacancy or type of work to the Employment Service of Slovenia, public announcement and the procedure of intervention of employment (Official Gazette RS, no. 53/17);

·         Rules on full or partial Debt relief, payment deferral and payment in instalments at financing labour market measures and performers (Official Gazette RS, no. 107/10 and 11/17);

·         Rules on the involvement of workers in the labour market measures during the notice period (Official Gazette RS, no. 57/13);

·         Rules on the registration and publication of the vacancy or type of work, the process of job placements and the content and method of data reporting to the Employment Service of Slovenia (Official Gazette RS, no. 105/10);

·         Rules on pursuing the activity of providing labour for user companies (Official Gazette RS, no. 15/14, 38/15 in 90/15);

·         Rules on registration and deregistration of records, employment plan, rights and obligations while seeking an employment and the supervision of persons registered in the records (Official Gazette RS, no. 106/10, 10/14, 98/15 and 82/18);

·         Rules on standards and norms for the provision of services for the labour market and methodology for pricing of these services (Official Gazette RS, no. 74/11 and 69/15).

National programmes:

·         Guidelines for the implementation of active employment policy measures for the period 2016–2020 (Government decision 13. 11. 2015);

·         Guidelines for the implementation of active employment policy measures for the period 2021–2025 (Government decision 7. 1. 2021);

·         Plan for the implementation of active employment policy measures for the year 2020 (Government decision 19. 12. 2019);

·         Plan for the implementation of active employment policy measures for the period 2021-2022 (Minister decision 2. 3. 2021);

·         Catalogue of active employment policy measures (published on the website of Ministry of Labour, Family, Social Affairs and Equal Opportunities).

Basic features of legal arrangements

On the statutory level, unemployment insurance is governed by the Labour Market Regulations Act (ZUTD).

ZUTD regulates government measures in the labour market with which the performance of public services in the field of employment and active employment policy measures as well as the functioning of the unemployment insurance system are provided, the providers of measures are determined, the conditions and procedures for exercising certain rights and services determined hereunder are prescribed, the method for financing measures, the monitoring, assessment and supervision of their implementation is determined, and shall also regulate the referral of workers to another user. These measures mentioned shall be carried out under the terms stipulated in the ZUTD for unemployed and employed persons, other job-seekers, employers and other persons seeking information and advice on the employment terms and possibilities in the Republic of Slovenia and European Union (Article 1 of ZUTD).

The following persons shall have compulsory unemployment insurance (Art. 54 of ZUTD):

-    persons who entered into an employment relationship with the Republic of Slovenia;

-    persons who upon termination of their employment relationship receive wage compensation during temporary absence from work from the Health Insurance Institute of the Republic of Slovenia according to regulations governing health insurance;

-    elected or nominated holders of a public or other office in the legislative, executive or judicial bodies in the Republic of Slovenia or in local self-government, if such persons receive salaries for their post;

-    citizens of the Republic of Slovenia, employed in the Republic of Slovenia by foreign and international organisations and institutes, foreign diplomatic missions and consulates, if not otherwise specified by an international agreement and persons employed by foreign employers for which the laws of the Republic of Slovenia apply in compliance with EU regulations;

-    self-employed persons;

-    home care assistant, beneficiary of partial payment for lost income in line with the regulations governing social security;

-    persons who based on the professional performance of foster placement have compulsory insurance in line with the law governing the pursuit of foster care, if not insured on some other basis;

-    beneficiaries of parental compensation whose employment relationship has been terminated during parental leave according to the law governing parental protection and family benefits;

-    parents who leave the labour market due to the childcare of four or more children for the period of eligibility for the payment of contributions according to the regulations governing parental protection;

-    recipients of the unemployment cash benefit;

-    benefit recipients who are not entitled to leave according to the regulations governing parental care;

-       recipients of partial payment for lost income according to the regulations governing parental care;

-    beneficiaries who work part-time due to parenthood in accordance with the regulations governing parental care.

If the person meets the conditions for compulsory insurance coverage at the same time on various grounds, he/she shall take out compulsory insurance on the basis listed before other options.

The following persons may have compulsory insurance voluntarily (Article 57 of the ZUTD):

-    Slovenian citizens employed by an employer in a foreign country who upon returning to their homeland cannot exercise their unemployment rights on other grounds;

-    spouses and unmarried partners of Slovenian citizens employed in a foreign country who were employed or self-employed immediately prior to their departure abroad (amendment from the ZUTD-A, Official Gazette RS, no. 21/13 from March 13, 2013);

-    persons during the employment contract suspension according to the regulations governing employment relationships;

-    spouses or unmarried partners of diplomats and other public servants assigned to work abroad if one year before their departure they had registered with the Employment Service as unemployed for at least six months;

-    spouses or unmarried partners of diplomats and other public servants assigned to work abroad if one year before departure abroad they had been included in the unemployment insurance for at least six months,

if such persons have no compulsory insurance hereunder.

The persons with voluntary insurance are entitled the same rights as person with compulsory insurance (Article 57 of the ZUTD).

The rights arising from unemployment insurance are (Article 58 of the ZUTD):

- the right to unemployment cash benefit;

- the right to pay compulsory social insurance contributions;

- the right to pay pension and disability insurance contributions one year before meeting the minimum conditions for obtaining the right to old-age pension according to the regulations governing pension and disability insurance (ZUTD-A Article 38 transitional provision: Notwithstanding the provision of the Article 68 of the Act, the insured, under the second paragraph of the Article 69 of the Act, that after the termination of the right to monetary compensation, does not qualify for a retirement pension in the accordance with the governing pension act and disability insurance, is entitled to payment of contributions for pension and disability insurance, given that the insured is about to meet the conditions for the retirement in prior than in two year period and is registered as an unemployed person; the right can be enforced until March, 1, 2018).

Unemployment insurance rights may be obtained by an unemployed person who was insured for at least ten months in the last 24 months before the unemployment occurred (first paragraph of the Article 59 of the ZUTD). Notwithstanding the first paragraph of Article 59 of the Act, an unemployed person, when at the age of less than 30 years, can acquire the rights from the unemployment insurance when, prior to unemployment, the insurance lasted at least six months in the last 24 months. An unemployed person may claim the right to the unemployment benefit for a period of two months).

Insurance rights shall be obtained by the insured person exclusively based on the contribution payments, if not otherwise determined hereunder for a specific event.

An unemployed person may claim the unemployment cash benefit lasting (Article 60 of the ZUTD):

- three months for the insurance period ranging from ten months to five years,

- six months for the insurance period ranging from 5-15 years,

- nine months for the insurance period ranging from 15-25 years,

- twelve months for the insurance period exceeding 25 years,

- nineteen months for insured persons older than 53 years of age and with the insurance period exceeding 25 years,

- twenty-five months for insured persons older than 58 years of age and with the insurance period exceeding 28 years,

According to Article 62 of the ZUTD the cash benefit shall be paid in the amount of 80% of the assessment basis for the first three months. In the following months the cash benefit shall be reduced to 60% of the basis. (amendment with the ZUJF - its provisions were transferred into the systemic regulation by ZUTD-A: 80 percent of the assessment basis is paid for the first three months and 60 percent for further nine months. 50 percent of t the assessment basis is paid after this period.). The lowest cash benefit amount shall not be lower than 530,19 EUR. The highest cash benefit amount shall not exceed the aforementioned amount by more than threefold (amendment with the ZUJF - its provisions were transferred into the systemic regulation by ZUTD-A: The maximum amount of unemployment benefit cannot be higher than 892.50 EUR (gross)).

Amendment with the ZUTD – F (Official Gazette RS no. 54/2021 from April 9, 2021) - adds a new fourth paragraph to Article 62. Notwithstanding the preceding paragraph, the unemployed person who has a permanent residence in the Republic of Slovenia and has travelled to or from another EU Member State, the EEA or the Swiss Confederation to work daily or at least once a week, and has acquired the entire insurance period referred to in the first paragraph of Article 59 of ZUTD, a cash benefit in the amount of EUR 1,785 shall be granted, whereby the maximum amount of cash benefit to an unemployed person determined in this way shall be granted:

•           for the first three months of receiving unemployment benefit.

•           for the first five months of receiving unemployment benefits, if an unemployed person has acquired at least 12 months of insurance in the last 24 months before becoming unemployed in that EU Member State, EEA or the Swiss Confederation and is entitled to unemployment benefits for a period of six months or more.

 

Article 20

Please give the definition of the contingency which, under national laws or regulations, give rise to unemployment benefit.

The aim of this Act is to assure security to insured persons if unemployment occurs through no fault of their own or against their will by providing an unemployment cash benefit in compliance with the reciprocity and solidarity principles (Article 3 of the ZUTD).

According to the Article 8 of the ZUTD, an unemployed person is a job-seeker, capable of work, registered with the Employment Service who actively seeks employment and is prepared to accept any appropriate or suitable employment offered by the Employment Service or other provider of employment brokerage services and:

- is not in an employment relationship;

- is not self-employed;

- is not a member of the management body in a partnership, single-member private limited liability company and institutes;

- is not a farmer;

- is not a pensioner;

- does not hold the status of a secondary-school student, apprentice, university student or person taking part in adult education of less than 26 years of age.

An unemployed person is also an alien with citizenship of a state which is not a member of the EU, EEA or Swiss Confederation and has a personal work permit valid for a period of three years or for an indefinite period, an alien holding a personal work permit issued to a person with temporary protection or to an international protection applicant, and an alien who based on the concluded international agreement or upon considering the reciprocity principle meets the terms for obtaining the right to cash benefit during unemployment, until such person keeps receiving the benefit (amendment with the ZZSDT 2015: Under this Act, an unemployed person is also a foreigner with the nationality of a country that is not a member of EU EGP of Swiss Confederation, having a free access to the Slovenian labour market, a foreigner with a valid single residence and work permit, issued on the consensus of employment, self-employment or work basis, a foreigner with the EU blue card and a foreigner, residing in Republic of Slovenia on the temporary residence permit or the certificate of in-time application for issuing a further residence permit and based on employment or self-employment qualifies to receive unemployment benefit in the Republic of Slovenia until receipt of this compensation.)

Unemployed persons also include a person which is involved in on-the-job training, the reason for which such person received unemployment insurance coverage, if he/she registers with the Employment Service to exercise his/her insurance rights and for the purpose of actively seeking other employment upon continuing his/her training. Such person is regarded as an unemployed person for the entire period for which the person receives cash benefit and upon the termination thereof until such person fulfils all the obligations borne by unemployed persons. An unemployed person is also a person who is enrolled in an education or training course during or after his/her unemployment cash benefit ceased until he/she actively seeks employment and fulfils all other obligations borne by unemployed persons.

Unemployment insurance rights may be obtained by an unemployed person who was insured for at least ten months in the last 24 months before the unemployment occurred (for unemployed persons, younger than 30 years of age – 6/24, paragraph 2 of the Article 59 of the ZUTD). A person who was insured based on an employment relationship shall also obtain unemployment rights, even though the employer as the person liable for payment of unemployment insurance contributions failed to pay the latter and this irrespective of their recovery possibility. In these cases, the entire duration of the employment relationship shall be included in the insurance period of such insured person (Article 59 of the ZUTD).

Unemployment insurance rights may be obtained by an unemployed person who was insured for at least ten months in the last 24 months before the unemployment occurred (Article 59 of the ZUTD) (for unemployed persons, younger than 30 years of age – 6/24, paragraph 2 of the Article 59 of ZUTD).

Article 129 of the ZUTD stipulates that the Employment Service shall cease to keep the person concerned in the register of unemployed persons:

- under the provisions of this Act the person is not unemployed anymore; 

- he/she de-registers from the register of unemployed persons and of persons participating in active employment policy programmes;

- he/she refuses to enter an active employment policy programme[8] or breaches an obligation arising from the contract on the entry in an active employment policy programme;

- he/she refuses to accept appropriate[9] or suitable employment[10] or during a job interview does not endeavour to get the job;

- he/she does not provide correct data regarding the eligibility for obtaining the status of the unemployed person or status of a participant in an active employment policy programme; 

- the prescribed procedure establishes existence of a reason due to which the person is temporarily unemployable;

- he/she is in detention that lasts for more than six months or starts serving the sentence of imprisonment of six months or more;

- it is established by the competent authority that he/she has been or is engaged in occasional or regular illegal employment;

- he/she is not an active job seeker, save exempted from this obligation by the employment plan;

- he/she refuses to sign the employment plan in accordance with this Act Article 113 paragraph six;

- a person who is a third-country national fails to pass the examination in the knowledge of the Slovene language at the entry level (level of difficulty A1) within the time limits specified in the first and fourth paragraphs of Article 8.a of this Act,

- a person is found to be temporarily unemployed in accordance with the fourth paragraph of Article 9 of this Act.

In the cases referred to in indents three, four and nine, the Employment Service shall remove the person concerned from the register of unemployed persons or from the register ofparticipants in ALMP programmes after the second violation of any of the obligations referred

to in the aforementioned indents.

Notwithstanding the provision of the preceding paragraph, the person who got part-time employment during the period of receiving unemployment benefit and exercised the right under the provision of Article 66 of this Act, shall be kept in the register of unemployed persons for the period he/she is being paid unemployment benefit and actively seeks full-time employment.

Participation in active employment policy programmes shall not be the reason for the termination of record keeping in the register of unemployed persons, save in cases when the person participates in an active employment policy programme which is implemented with the conclusion of employment contract.

In addition, performance of the contract on participation or expiry of the programme the person concerned participated in, shall be the reason for the termination of record keeping in the register of unemployed persons.

In accordance with the Article 63 of the ZUTD the rights to unemployment cash benefit shall not be exercised by an insured person who became unemployed through his/her own fault or volition.

Reasons referred to in previous paragraph include the termination of the employment contract:

- by written consensual agreement;

- due to ordinary termination submitted by the worker save for cases where the law regulating employment relationship specifies that the worker shall have the same rights equivalent to the employer terminating the employment contract for business reasons despite his/her ordinary termination;

- due to the employer’s ordinary termination submitted to the worker on fault-based grounds (culpability);

- due to the employer’s ordinary termination as a result of the worker not accepting the employer’s proposal to conclude a new employment contract for appropriate work and for an indefinite period;

- due to the employer’s extraordinary termination save for extraordinary termination for the failed probation period;

- due to the extraordinary termination by the employer-transferor because the worker rejected the transition and actual performance of work at the employer-transferee;

- due to the employer’s ordinary termination contrary to the provisions of the law regulating employment relationships which determine special protection of workers from termination with the worker not requesting arbitration or judicial protection to safeguard his/her rights;

- if an older worker determined as such by the law regulating employment relationships is not provided the right to unemployed cash benefit until he/she meets the minimum conditions for retirement (old-age) and he/she submitted written consent for termination of the employment contract for business reasons;

- due to the cessation of the position (office) or nomination of the holder of a public or other position in legislative, executive or judicial bodies in the Republic of Slovenia or in self-government bodies with the worker failing to enforce his/her right to return to work pursuant to regulations enabling this.

Amendment with the ZUTD 2013: (2) Among the reasons set out in the preceding paragraph the termination of the employment contract is based on:

- written consensual agreement;- due to ordinary termination submitted by the worker save for cases where the law regulating employment relationship specifies that the worker shall have the same rights equivalent to the employer terminating the employment contract for business reasons despite his/her ordinary termination;- due to the employer’s ordinary termination submitted to the worker on fault-based grounds (culpability);- due to the employer’s  termination for business reasons or in case of incompetence as a result of the worker not accepting the employer’s proposal to conclude a new employment contract for appropriate work and for an indefinite period;- due to the employer's extraordinary termination;- due to the extraordinary termination by the employer-transferor because the worker rejected the transition and actual performance of work at the employer-transferee;- due to the employer’s ordinary termination contrary to the provisions of the law regulating employment relationships which determine special protection of workers from termination with the worker not requesting arbitration or judicial protection to safeguard his/her rights;- if an older worker determined as such by the law regulating employment relationships is not provided the right to unemployment benefit until he/she meets the minimum conditions for retirement (old-age) and he/she submitted written consent for termination of the employment contract for business reasons;- if the worker unreasonably refuses new, appropriate work and for an indefinite period, offered by an employer during the notice period;- due to the cessation of the position (office) or nomination of the holder of a public or other position in legislative, executive or judicial bodies in the Republic of Slovenia or in self-government bodies with the worker failing to enforce his/her right to return to work pursuant to regulations enabling this.

Irrespective of provisions of the first and second indent of the previous paragraph, the following persons may enforce their right to the unemployment cash benefit (ZUTD, third paragraph of Article 63):

- the insured person who terminates his employment contract through ordinary termination or signs an agreement on terminating the employment contract due to the relocation and employment of his/her spouse or person with which he/she has lived for at least one year unmarried in another area which is more than an hour and a half drive one way with public transport from the residence of the insured person;

- the insured person who terminates his employment contract through ordinary termination due to the fact that his/her rights from the employment contract have deteriorated for objective reasons upon the change in employer pursuant to the law governing employment relationships;

- one of the parents who resigns through ordinary termination or reaches an agreement on employment contract termination due to the childcare of four or more children and who exercised his/her right to payment of contributions for social insurance pursuant to regulations governing parent protection once this right ceases.

Amendment with the ZUTD-E (Official Gazette RS no. 75/2019 December 12, 2019) a new fourth paragraph is added to Article 63:

The right to unemployment benefit may not be exercised by

- an insured person who meets the conditions for obtaining an old-age pension in accordance with the fourth paragraph of Article 27 of the Pension and Disability Insurance Act

- an insured person who meets the conditions for acquiring the right to an occupational pension in accordance with the regulations governing occupational insurance.

Insured persons who were not insured based on the employment relationship cannot exercise their right to the cash benefit if the de-registration from all types of social insurance is not a result of objective reasons. Objective reasons for the de-registration from the social insurance include a long lasting illness of the insured, insolvency, bankruptcy, natural disaster, substantial material damage to the assets of the insured, loss of commercial space or loss of a business partner to which business was mainly linked and other comparable objective reasons (ZUTD, fifth paragraph of Article 63).

Irrespective of the previous paragraph, insured persons who voluntarily entered the unemployment compulsory insurance shall not obtain the right to cash benefit if the de-registration from all types of social insurance was not a result of the cessation of the legal relationship providing the basis for the insurance but resulted from voluntary withdrawal (ZUTD, sixth paragraph of Article 63).

Article 21

A. Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of Slovenia, the recourse is had to sub-paragraph (a) of this Article.

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

The following persons shall have compulsory unemployment insurance (Art. 54 of ZUTD):

-    persons who entered into an employment relationship with the Republic of Slovenia;

-    persons who upon termination of their employment relationship receive wage compensation during temporary absence from work from the Health Insurance Institute of the Republic of Slovenia according to regulations governing health insurance;

-    elected or nominated holders of a public or other office in the legislative, executive or judicial bodies in the Republic of Slovenia or in local self-government, if such persons receive salaries for their post;

-    citizens of the Republic of Slovenia, employed in the Republic of Slovenia by foreign and international organizations and institutes, foreign diplomatic missions and consulates, if not otherwise specified by an international agreement and persons employed by foreign employers for which the laws of the Republic of Slovenia apply in compliance with EU regulations;

-    self-employed persons;

-    home care assistant, beneficiary of partial payment for lost income in line with the regulations governing social security;

-    persons who based on the professional performance of foster placement have compulsory insurance in line with the law governing the pursuit of foster care, if not insured on some other basis;

-    beneficiaries of parental compensation whose employment relationship has been terminated during parental leave according to the law governing parental protection and family benefits;

-    parents who leave the labour market due to the childcare of four or more children for the period of eligibility for the payment of contributions according to the regulations governing parental protection;

-    recipients of the unemployment cash benefit;

-    recipients of benefits who are not entitled to leave under the regulations governing parental care;

-    recipients of partial payment for lost income according to the regulations governing parental care;

-    beneficiaries who work part-time due to parenthood in accordance with the regulations governing parental care.

The following persons may have compulsory insurance voluntarily (Article 57 of the ZUTD):

-    Slovenian citizens employed by an employer in a foreign country who upon returning to their homeland cannot exercise their unemployment rights on other grounds;

-    spouses and unmarried partners of Slovenian citizens employed in a foreign country who were employed or self-employed immediately prior to their departure abroad (amendment from the ZUTD-A);

-    persons during the employment contract suspension according to the regulations governing employment relationships;

-    spouses or unmarried partners of diplomats and other public servants assigned to work abroad if one year before their departure they had registered with the Employment Service as unemployed for at least six months;

-    spouses or unmarried partners of diplomats and other public servants assigned to work abroad if one year before departure abroad they had been included in the unemployment insurance for at least six months, if such persons have no compulsory insurance hereunder.

C. Please furnish statistical information under this Article as follows: Title I under Article 74

Please see Part II – Medical Care / Article 9 / question C.

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.

/

Article 22

A. If recourse is had to sub- paragraphs (a) of Article 21 for defining the scope of protection, please state whether recourse is had to the provisions of Article 65 or those of Article 66 for the calculation of unemployment benefit.

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 bellow;

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

Article 65 / paragraph 6 / (c): a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·         average wage (gross) in 2020 = 1856,20 EUR[11]

average wage (net) in 2020 = 1208,65 EUR

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS - STANDARD WAGE: 125 per cent of average wage (gross) in 2020 = 2320,25 EUR

125 per cent of average wage (net) in 2020 = 1510,81 EUR

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average

earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (gross)

C:  Standard wage (net) in 2020 = 1510,81 EUR

(2) TITLE II

TIME BASIS: January 2021

D:  Amount of benefit granted during the time basis

·         man with wife and two children

·         time frame: 13 weeks (3 months)

·         assessment basis (net) = 1510,81 EUR [12]

80% of the assessment basis = 80% of 1510,81 EUR = 1208,65 EUR

Since this amount exceeds the maximum of unemployment benefit laid down by the ZUTD, the maximum amount in this case equals to 892,50 EUR gross which is 682,49 EUR net (the statutory maximum for the unemployment benefit in 2021).

E: Child benefit:

·         family: 1 (man) + 1 (wife) + 2 children

·         the income class[13]: 1510,81 / 4 = 377,70 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

F: Child benefit:

In case of receiving (max.) unemployment benefit:

·         the income class: 682,49 EUR / 4 = 170,62 EUR per family member

1st child = 117,05 EUR; 2nd child = 128,75 EUR; Σ = 245,80 EUR

G: (D + F) / (C + E)

 (682,49 EUR + 245,80 EUR) / (1.510,81 EUR + 161,52 EUR) = 0.55 – 55%

B. /

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 21 (a).

The cash benefit assessment basis shall be the average monthly salary received by an insured person eight months prior to the month of unemployment (Article 61, par. I of ZUTD – new sentence added: The basis for assessing unemployment benefit for the insured, listed in the seventh paragraph of the preceding Article is the average monthly salary received during the period of five months before the unemployment occurred). If an insured person during the period referred to in the previous paragraph was a recipient of salary compensation pursuant to regulations governing employment relationships, health insurance, pension and disability insurance or parental protection insurance, the cash benefit assessment basis shall include the average salary received in the last eight months. If the insured person received salary for a shorter period, the received cash benefit shall be taken into account for the missing months. The insured person who within the period referred to in the first paragraph of this Article worked for a shorter working time pursuant to regulations governing health insurance, pension and disability insurance or parental protection insurance, the cash benefit assessment basis shall include the received salary converted to full time work. The cash benefit assessment basis for the insured person who did not receive salary or salary compensation in the aforementioned period shall include the received salary for the last eight months or, if the insured person only received salary for a shorter period, his/her basic salary for the missing months increased by the seniority allowance which the person would have received if he/she had worked. The cash benefit assessment basis for the self-employed or persons who voluntarily entered compulsory insurance shall be the average basis from which contributions were paid for in the period referred to in the first paragraph of this Article or with voluntary insured persons for 11 months prior to the month the unemployment occurred). (ZUTD-A – new paragraph added: The basis for assessing unemployment benefit is determined on the tax deduction calculation basis, that taxpayers forward to the tax authority on prescribed forms (REK forms). In case of the taxpayer not forwarding the prescribed REK forms for the worker, the basis for assessing unemployment benefit is determined based on information provided by the institution at the request of the employer). (Article 61 of the ZUTD)

According to Article 62 of the ZUTD the cash benefit shall be paid in the amount of 80% of the assessment basis for the first three months. In the following months the cash benefit shall be reduced to 60% of the basis (amendment with the ZUJF - its provisions were transferred into the systemic regulation by ZUTD-A: 80 percent of the assessment basis is paid for the first three months and 60 percent for further nine months. 50 percent of the assessment basis is paid after this period.). The lowest cash benefit amount shall not be lower than 530,19 EUR. The highest cash benefit amount shall not exceed the aforementioned amount by more than threefold (amendment with the ZUJF - its provisions were transferred into the systemic regulation by ZUTD-A: The maximum amount of unemployment benefit cannot be higher than 892.50 EUR).

Amendment with ZUTD-F 2021 (Official Gazette of the RS No. 54/2021, April 9 2021):

Entitlement to unemployment benefits for frontier workers. Unemployed person who has a permanent residence in the Republic of Slovenia and has travelled to or from another EU Member State, the EEA or the Swiss Confederation to work daily or at least once a week, and has acquired the entire insurance period referred to in the first paragraph of Article 59 of ZUTD, a cash benefit in the amount of EUR 1,785 shall be granted, whereby the maximum amount of cash benefit to an unemployed person determined in this way shall be granted:

•           for the first three months of receiving unemployment benefit.

•           for the first five months of receiving unemployment benefits, if an unemployed person has acquired at least 12 months of insurance in the last 24 months before becoming unemployed in that EU Member State, EEA or the Swiss Confederation and is entitled to unemployment benefits for a period of six months or more.

Article 23

Please indicate, 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.

Unemployment insurance rights may be obtained by an unemployed person who was insured for at least ten months in the last 24 months before the unemployment occurred (or for unemployed persons, younger than 30 years of age – 6/24, paragraph 2 of the Article 59 of ZUTD). A person who was insured based on an employment relationship shall also obtain unemployment rights, even though the employer as the person liable for payment of unemployment insurance contributions failed to pay the latter and this irrespective of their recovery possibility. In these cases, the entire duration of the employment relationship shall be included in the insurance period of such insured person. (Article 59 of the ZUTD).

Article 24

1. Please state whether the duration of unemployment benefit is limited and, if so, which are the limit or limits fixed.

An unemployed person may claim the unemployment cash benefit lasting (Article 60 of the ZUTD):

- three months for the insurance period ranging from ten months to five years,

- six months for the insurance period ranging from five to fifteen years,

- nine months for the insurance period ranging from 15-25 years,

- twelve months for the insurance period exceeding 25 years,

- nineteen months for insured persons older than 53 years of age and with the insurance period exceeding 25 years,

- twenty-five months for insured persons older than 58 years of age and with the insurance period exceeding 28 years.

An unemployed person aged under 30 may be granted rights arising from unemployment insurance if prior to the onset of unemployment, he or she was insured for at least six months within the last 24 months. The unemployed person may exercise the right to unemployment benefit for a period of two months.

2. Please state whether recourse is had to paragraph 2 of this Article; if so, please give a summary of the rules concerning the computation of the benefit period, according to the length of the contribution period or according to the benefits previously received. Please also furnish information, in accordance with paragraph 1 (b) Article 74 showing that the average duration of benefit is at least 13 weeks within a period of 12 months.

For the rules concerning the computation of the benefit period, please see the answer to the previous question (Article 24 / question 1).

 

According to the ZUTD the minimum duration of the unemployment benefit is 3 months (Article 60 of the ZUTD).

Additional statistical information:

Recipients of unemployment benefit (UB), 2016-2020:

Year

No. of UB recipients(Dec)

UB growth index(previous year = 100)

Average duration of receipt of UB(months)

Average monthly no. of UB recipients

Proportion of UB recipients in monthly unemployment

2016

23.820

93,9

7,5

23.252

22,5

2017

22.207

93,2

7,5

12.813

24,6

2018

20.457

92,1

7,3

20.306

25,8

2019

18.464

90,2

7,6

19.664

26,5

2020

25.236

136,6

6,7

25.882

30,4

Source: Employment Service of Slovenia, MOLFSA

3. Please state whether a waiting period is provided for and, if so, state the length of such period and the rules concerning its computation. Please also state the maximum period of employment which is deemed temporary in the meaning of paragraph 3 of this Article.

The insured person shall be entitled to unemployment benefit as from the day, following the day of termination of legal relationship which was the basis for compulsory or voluntary unemployment insurance, provided the person concerned registers with the Employment Service and files an application claiming the right to unemployment benefit within 30 days of the termination of insurance. When the person concerned claims unemployment benefit after the expiration of this time limit, the total period of receiving unemployment benefit shall be reduced by the calendar days from the thirty-first day of the termination of compulsory or voluntary insurance to the date of filing the application.

In case employer deregistered a worker from compulsory insurance without informing the latter about the termination of employment, the time period referred to in the preceding paragraph shall commence on the day when the worker is informed about the termination of employment.

The time limit referred to in the preceding paragraph shall be suspended during:

- illness provided that after the termination of employment the insured person is not a recipient of unemployment benefit during temporary absence from work under regulations, governing health insurance;

- entitlement to parental allowance;

- military service and performing and/or training for civil protection and disaster relief on the call of the competent authority;

- detention and/or imprisonment or preventive or precautionary measure of up to six months.

The insured person, who commences employment within 30 days of the termination of insurance, shall acquire the right to unemployment benefit provided he/she registers at the Employment Service and files an application claiming the right prior to the commencement of new employment (Article 119 of the ZUTD).

4. Please state whether any special rules have been adopted as regards benefits for seasonal workers and, if so, what are these rules.

There are no special rules as regards benefits for seasonal workers in the ZUTD.

5. Please indicate, with reference to Article 68 below, more particularly sub-paragraphs (h) and (i), the provisions, if any, for the suspension of unemployment benefit, under the scheme or schemes concerned.

The right to unemployment benefit shall cease (ZUTD, first paragraph of Article 65):

- on the day the insured person concludes an employment contract, except in the case referred to in Article 66 of this Act;

- on the day the insured person starts work based on some other legal relationship representing the basis for inclusion in the compulsory unemployment insurance scheme;

- on the day the insured person is entered in the register as a self-employed person;

- on the day the insured person as a partner becomes a manager in a partnership and capital company, on the day the insured person as a founder becomes a manager of an institute, or on the day the insured person takes employment at a company or an institute;

- on the day when he reaches the age of 65 or when he meets the conditions for obtaining an old-age pension in accordance with the first indent of the fourth paragraph of Article 63 of this Act;

- from the day the decision by which his complete incapacity for work according to the regulations on pension and disability insurance is established becomes final;

- when six months of detention have elapsed and such detention continues, or on the day the insured person starts serving a prison sentence exceeding six months;

- on the first day of the month in which he waived the obligation to inform the institution of any basis for the payment of additional income, as specified in the fifth paragraph of Article 67 of this Act;

- on the day the reason referred to in the third or fourth indent of the first paragraph of Article 129 of this Act arises or on the day the body of the first instance finds again that there is a reason referred to in the ninth indent of the first paragraph of Article 129 of this Act;

- on the day the reason referred to in the tenth indent of the first paragraph of Article 129 of this Act arises or on the day the first instance body establishes that there is a reason referred to in the fifth or eighth indent of the first paragraph of Article 129 of this Act;

- on the day when he / she deregisters himself / herself from the register of unemployed persons.

The Employment Service shall decide on the early termination of the right to unemployment benefit ex officio within one month from the day when it became aware of the circumstance referred to in the first paragraph of Article 65. The decision on the termination of the right to unemployment benefit may be issued within 25 months from the day of the finality of the decision on the recognition of the right to unemployment benefit.

Besides instances determined in the law governing the general administrative procedure, the decision acknowledging the right to cash benefit shall be abrogated also if after the issuance of a decision it is established by a final judgement, judicial settlement or through mediation that the insured person’s employment relationship was unlawfully terminated and the employer must reinstate the worker or the employment relationship undergoes restitution by the date determined by the court when the court, pursuant to the law regulating employment relationships, makes a decision itself on the termination of the employment contract.

The provision of the previous paragraph abrogating the decision on acknowledging the cash benefit right shall also apply when the insured person in a labour dispute in which he/she requests the protection of his/her rights in compliance with the seventh and eighth indent of the second paragraph of Article 63 hereunder, withdraws the suit or concludes a judicial settlement or agreement not including the finding on the legality of the employment contract termination.

Irrespective of the third paragraph of this Article, the decision on acknowledging the cash benefit shall not be abrogated if the insured person succeeded in a labour dispute against the employer which is in the procedure of liquidation or bankruptcy pursuant to the law governing insolvency procedures, or if after a year since the start of the procedure imposing compulsory execution of the judgement, the latter has yet to be executed.

Amended with ZUTD - D (Official Gazette RS, no. 55/2017 from October 6, 2017) and ZUTD E (Official Gazette RS, no. 75/2019 from December 12, 2019) new Article 65a (Reduction in unemployment benefit prior to cessation of the right) was introduced: The recipient of unemployment benefit who violates the obligations referred to in the ninth indent of the first paragraph of Article 129 of ZUTD for the first time shall be invited by the Employment Service to a hearing, where he/she shall be able to make a statement and present evidence regarding the circumstances of the violation. If the recipient of unemployment benefit does not appear for justifiable reasons for the violation, the Employment Service shall issue a decision by which the unemployment benefit is reduced by 30 percent of the monthly amount of unemployment benefit for the next two months, notwithstanding the second paragraph of Article 62 of this Act, which was admitted to him on the day of the commission of the first infringement.

The right to cash benefit and the right to pay contributions until the retirement of the insured person shall be suspended if (Article 64 of the ZUTD):

- the insured performs compulsory or voluntary military service, alternative civil service or training to perform tasks in the police reserve, is enlisted as a contracted reserve of the Slovenian Armed Forces to perform military service in peace or is called or assigned to perform protection, rescue and relief operations as a contractor of the Civil Protection Service;

- he/she is detained, serving a prison sentence, preventive or precautionary (safety) measure due to which he/she is unavailable to the Employment Service for up to six months;

- he/she receives parental benefit or parental allowance pursuant to the law governing parental protection and family benefits;

- he/she is participating in the public work programme (indent amendment with the ZUTD-B, Official Gazette RS, no. 63/13 from July 26, 2013: - is working in the public works programme and his/her right to the unemployment benefit right is suspended for just a half of the time of the inclusion).

- he/she joins the vocational rehabilitation pursuant to the law governing pension and disability insurance;

- he/she does not live in the Republic of Slovenia unless otherwise determined by an international act;

- he/she performs tasks of a home care assistant for a period shorter than ten months if the cessation in performing these tasks is not a result of reasons which according to the law regulating social protection are equivalent to fault-based reasons for termination of an employment contract.

(2) The suspension period shall not be included in the duration of the right to which the insured person is entitled pursuant to provisions hereunder.


PART V

OLD-AGE BENEFIT

The Constitution of the Republic of Slovenia defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof.

Primary legislation:

·         Pension and Disability Insurance Act (Official Gazette of the RS, No. 96/12, 39/13, 99/13 – ZSVarPre-C, 101/13 – ZIPRS1415, 44/14 – ORZPIZ206, 85/14 – ZUJF-B, 95/14– ZUJF-C, 90/15 – ZIUPTD, 102/15, 23/17, 40/17, 65/17, 28/19, 75/19, 139/20, 189/20 – ZFRO and 51/21);

·         Official Records of Insured Persons and Beneficiaries of Pensions and Disability Insurance Act (Official Gazette of the RS, No. 111/13, 97/14);

·         Social Security Contributions Act (Official Gazette of the RS, No. 5/96, 18/96 – ZDavP, 34/96, 87/97 – ZDavP-A, 3/98, 7/98 – odl. US, 106/99 – ZPIZ-1, 81/00 – ZPSV-C, 97/01 – ZSDP, 97/01, 62/10 – odl. US, 40/12 – ZUJF, 96/12 – ZPIZ-2, 91/13 – ZZVZZ-M, 99/13 – ZSVarPre-C in 26/14 – ZSDP-1).

Secondary legislation:

·         Statute of the Pension and Disability Insurance Institute of Slovenia (Official Gazette of the RS, No. 52/14).

Basic features of legal arrangements

The system of pension and disability insurance is governed by the Pension and Disability Insurance Act (PDIA-2).

The system of pension and disability insurance in the Republic of Slovenia comprises (Article 1 of PDIA-2):

·         compulsory pension and disability insurance on the basis of inter-generational solidarity (compulsory insurance);

·         compulsory and voluntary additional pension and disability insurance;

·         pension and disability insurance on the basis of personal savings accounts.

The state ensures the functioning of the compulsory insurance by determining the rate of contributions, imposing the compulsory payment of contributions of Employers and Insured Persons, setting out rules governing the compulsory admission to the insurance, the mode of assessment, payment and recovery of contributions, and the conditions for the recognition, assessment and enjoyment of rights, by arranging the system of personal data records and supervision over securing individual rights (Article 5 of PDIA-2).

Also, in the event that the expenditure of the Pension and Disability Insurance Institute of Slovenia exceeds revenues from contributions from compulsory insurance, the state must guarantee the payment of pensions from compulsory insurance to eligible persons. In this case, the deficit is covered from the state budget or from other sources (Article 5 of PDIA-2).

Articles 162 (Co-financing from the state budget) and 163 (Ensuring the liquidity of the Institute) of the act also stipulate that the state must cover the difference between the revenues and expenditure of the Institute from the state budget or from other sources.

Compulsory insurance includes natural persons who meet the conditions laid down by the PDIA or a treaty (first paragraph of Article 6 of the PDIA-2).

Rights arising from the compulsory pension and disability insurance are rights to a pension; rights, arising from disability; the right to a yearly bonus and the right to an assistance and attendance allowance (Article 3 of PDIA-2).

Article 26

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 total number of residents under that age but over 15 years of age.

In accordance with the Article 27 of the PDIA-2 insured persons acquire the right to an old-age pension:

(1)   at the age of 65 years (men and women), if they have completed an insurance period of at least 15 years (the first paragraph of the Article 27 of the PDIA-2);

(2)   at the age 60 years, if they have completed 40 years of pension qualifying period without a purchased period[14] for men and women (the fourth paragraph of the Article 27 of the PDIA-2).

All transitional periods related to various conditions for entitlement to old-age retirement expired in 2020.

The fourth paragraph of Article 27 of the PDIA-2 allows men and women to acquire the right to old-age pension at a lower age (i. e. before the age of 65), counterbalancing it with a longer pension qualifying period. These persons may therefore retire at 60 years if they reach 40 years of pension qualifying period without a purchased period included. This quite restrictive condition was made less strict due to changes in legislation in 2017[15] and 2020[16]. Pension qualifying period without purchased period now also includes some periods that are not related to actual employment activity, such as periods of other compulsory inclusion in compulsory pension and disability insurance, periods of voluntary inclusion in compulsory insurance or purchased pension qualifying period until 31 December 2012, when contributions were actually paid, periods of agricultural activity, but without a purchased pension qualifying period after 1 January 2013 and without period of voluntary inclusion in compulsory insurance after 1 January 2013. Old-age retirement without deductions is available only to those insured persons who reach 40 years of the pension qualifying period without a purchased period, because such persons acquire the right to old-age pension and not early pension. 

After 2017 the pension rating base is calculated from the monthly average of an insured person’s bases for an individual year of insurance from which the compulsory insurance contributions were paid, in any consecutive 24 years of the insurance from 1 January 1970 onwards which are the most favourable for the insured person.

It is possible to lower the retirement age for the entitlement to an old-age pension due to caring for each born or adopted child in the first year of their life, due to serving the compulsory military service or due to inclusion in the insurance scheme before the age of 18, but only in exceptional circumstances (Article 28 of the PDIA-2[17]).

Early retirement

Legislation also provides for early retirement before the prescribed age of 65. An insured person may therefore acquire the right to an early pension at the age of 60, provided that he or she attains at least 40 years of the pension qualifying period. Due to the renewed system of permanent deductions, early retirement affects the amount of pension received. A pension, with regard to the pension qualifying period achieved, is lowered by 0.3% for each month (but not more than 18%) of the difference in meeting the conditions for old-age retirement.

Partial retirement

Insured persons have the right to a partial retirement which is also given to the self-employed, farmers and partners. In January 2020 an Act Amending the Pension and Disability Insurance Act (Official Gazette of the RS, no. 75/19 - PDIA-2G) came into force, with the aim to promote longer working life and to postpone retirement.

The PDIA-2G upgraded the institute of payment of 20% of the pension to 40% of the old-age pension for the first three years of further inclusion or full-time re-inclusion in compulsory insurance, and to 20% of the old-age pension after the expiration of the 3-year period. The amendments have also introduced a higher partial pension with the purpose of extending the partial activity of individuals for at least 4 hours a day or 20 hours a week.

Please state whether recourse is had to paragraph 3 of this Article and, if so, please summarise the rules concerning the suspension or the reduction of benefit where the beneficiary is engaged in any gainful activity.

Article 116 of the PDIA-2 determines re-entering the insurance. According to this Article a recipient of an old-age pension, an early retirement benefit, a widow/widower’s pension and a survivor’s pension who resumes work or activity in the territory of the Republic of Slovenia, shall regain the status of an insured person and the payment of their pension or benefit during this period shall be terminated. The payment of the pension or benefit shall cease as of the day of regaining the status of an Insured Person.

The recipients of an old-age pension, an early pension, a widow/widower’s pension and a survivor’s pension who resume work or activity in the territory of the Republic of Slovenia in the scope corresponding to a proportionate part of full-time or full-time insurance (however, in case of employees in employment relationships, not less than two hours daily or ten hours weekly and in case of self-employed persons, partners and farmers at least a quarter of the full-time insurance), shall have their pension paid in a proportionate part, as follows:

-     75% if the insured person works 2hours daily or the insurance time amounts to 10–14hours weekly;

-     62,5% if the insured person works 4hours daily or the insurance time amounts to 15–19hours weekly;

-     50% if the insured person works 3hours daily or the insurance time amounts to 20–24hours weekly;

-     37.5% if the insured person works 5hours daily or the insurance time amounts to 25–29hours weekly;

-     25% if the insured person works 6hours daily or the insurance time amounts to 30–34hours weekly; and

-     12.5% if the insured person works 7hours daily or the insurance time amounts to 35–39hours weekly.

PDIA-2G has brought some changes in this area, as it has introduced certain incentives for those retirees who choose to reactivate for at least 4 hours a day or 20 hours a week. In order to encourage this reactivation into compulsory insurance and thus prolong the employment of those who have already claimed an old-age pension, the law provides for an increase in the proportional part of the pension. Insured persons who receive a proportional part of the old-age pension and are compulsory included in the compulsory insurance for at least 4 hours a day or 20 hours a week, are entitled to an increase in the proportional part of the old-age pension by a proportional part of 40% (and after three years of 20%) of the old-age pension.

If the recipient of a disability pension resumes work or activity in the territory of the Republic of Slovenia in the scope causing the reinstatement of the status of an Insured Person, they shall lose the right to the pension as of the date the insurance obligation has been established.

The payment of the pension to the pension recipients who resume work or activity abroad, based on which they are covered by a foreign compulsory pension insurance, shall cease on the date the work or activity has been initiated.

Article 27

A. Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of Slovenia, the recourse is had to sub-paragraph (a) of this Article.

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

Persons insured under compulsory pension and disability insurance (Articles 14 to 19 of PDIA-2):

1.      employees in employment relationships;

2.      self-employed persons;

3.      partners and share-holders;

4.      farmers;

5.      persons in other legal relationships;

6.      persons, determined by other regulations (regulations governing the labour market - unemployed insured persons; regulations governing parental protection - parents entitled to parental allowance; regulations governing health insurance - persons entitled to a compensation due to their temporary incapacity for work after the termination of their employment relationship; regulations governing social security benefits – family assistants; regulations governing the pursuit of foster care - persons carrying out professional foster care; regulations governing religious freedom - persons engaged in a religious office as religious workers; regulations governing the protection against natural and other disasters  - the soldiers engaged in a voluntary military service and citizens during the voluntary training for protection and rescue, who are not covered by the Compulsory Insurance on some other grounds, persons entitled to a compensation during the occupational rehabilitation under PDIA-2 and are not covered by the Compulsory Insurance on some other grounds).

C. Please furnish, under this Article, statistical information as follows: Title I under Article 74

TITLE I:

A. Total number of employees protected

Ai) Total number of insured persons[18] for the year 2020 = 808.819

B. Total number of employees

Bi) Total number of employees for the year 2020 = 808.819

C: Number of employees protected (A iii.) per cent of total number of employees (B):

A / B = 808.819 / 808.819 = 100 %

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

/

Article 28

A. If recourse is had to sub- paragraphs (a) or (b) of Article 27 for defining the scope of protection, please state whether recourse is had to the provisions of Article 65 or to the provision of Article 66 for 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 I, II and V under Article 65; or

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

Article 65 / paragraph 6 / (c): a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·         average wage (gross) in 2020 = 1.856,20 EUR[19]

·         average wage (net) in 2020 = 1.208,57 EUR[20]

·         STANDARD WAGE: 125 per cent of average wage (net) in 2020 = 1.510,71 EUR

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS = 1.510,81 EUR

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (net)

C:  Standard wage (net) in 2020 = 1.510,71 EUR

(2) TITLE II

TIME BASIS: 1st May 2021

D:  Amount of benefit granted during the time basis

According to the PDIA-2, pension rating base is calculated from the monthly average salary received by the insured person, or the insurance base on which contributions were calculated, in any consecutive 24 years of insurance from the period between 1 January 1970 and the calendar year preceding the year in which the insured person acquires the right to a pension, which were the most favorable.

Revaluation of salaries

Revaluation of salaries from the previous years:

o   Salaries earned in previous years, which are accounted for in establishment of the pension rating base, are revalued with the revaluation coefficients so as to correspond to movement in average salaries and pensions in the calendar year preceding the year in which the insured person is asserting the right to pension.

o   The revaluation coefficients are re-determined annually and calculated in accordance with the following formula to three decimal places:

ASECPR

ASECY

·         ASECPR = average salary per Employee paid for the calendar year preceding the year for which the coefficients have been determined;

·         ASECY = average salary per Employee paid for an individual calendar year.

The average salary per Employee paid out for an individual calendar year from 1991 onwards is calculated by adjusting the average gross salary per Employee as established according to the data held by the Statistical Office of the Republic of Slovenia using the average rate of taxes and contributions (the third paragraph of Article 35 of the PDIA-2).

CALCULATION:

Basis:

-          Taking into account data on 125 % of average gross and net salaries in the Republic of Slovenia from 1990 to 2020 including;

-          Valorization of salaries from previous years to the 2020 level of salaries and old-age benefits;

Year

Salary

(net)

Valorization coefficients

Average valorized monthly salary in SIT

(net)

Average

valorized monthly salary

in EUR

1990

 84.855,00

51,197

362.026,79

1.510,71

1991

 155.549,52

27,929

362.028,55

1.510,72

1992

 462.829,70

9,400

362.549,93

1.512,89

1993

 693.032,79

6,269

362.051,88

1.510,82

1994

 889.036,71

4,886

361.986,11

1.510,54

1995

1.056.685,66

4,111

362.002,90

1.510,61

1996

1.218.296,41

3,566

362.037,08

1.510,75

1997

1.361.014,45

3,192

362.029,84

1.510,72

1998

1.491.383,93

2,913

362.033,45

1.510,74

1999

1.634.569,95

2,658

362.057,24

1.510,84

2000

1.808.400,95

2,402

361.981,40

1.510,52

2001

2.024.387,66

2,146

362.027,99

1.510,72

2002

2.221.345,81

1,956

362.079,37

1.510,93

2003

2.388.949,69

1,819

362.124,96

1.511,12

2004

2.524.542,40

1,721

362.061,46

1.510,86

2005

2.645.234,77

1,642

361.956,29

1.510,42

2006

2.781.373,61

1,562

362.042,13

1.510,78

2007 (EUR)

12.517,03

1,448

1.510,39

2008

13.494,73

1,343

1.510,29

2009

13.952,88

1,300

1.511,56

2010

14.498,85

1,250

1.510,30

2011

14.810,47

1,224

1.510,67

2012

14.871,02

1,219

1.510,65

2013

14.956,10

1,212

1.510,57

2014

15.082,15

1,202

1.510,73

2015

15.197,89

1,193

1.510,92

2016

15.452,88

1,173

1.510,52

2017

15.931,08

1,138

1.510,80

2018

16.390,08

1,106

1.510,62

2019

17.002,68

1,066

1.510,40

2020

18.128,52

1,000

1.510,71

FINAL CALCULATION: 36.259,34 EUR / 24 = 1.510,81 EUR

Old-age pension is assessed on the basis of the monthly average of salaries an insured person has received, i.e. the insurance bases according to which his contributions were calculated, in any one of the successive 24 years of insurance following 1 January 1970, whichever is the most favourable for the insured person (the pension rating base) (Article 30 of PDIA).

The pension rating base was calculated on the basis of salaries in the period from 1992 to 2015. The sum of valorised monthly salaries from this period amounts to36.259,34 EUR. If divided by 24, this gives the amount 1.510,81 EUR, which represents the pension rating base.

Old-age pension assessment from the already defined pension rating base in the amount of 1.510,81 EUR was carried out by taking account of the following assumptions:

-                      The insured person (male) was born on 1 January 1956,

-                      The insured person reached retirement 1 May 2021,

To the day of the retirement he completed 30 years of pensionable service, i.e. 46,70 % of the assessment basis (in 2021).

46,70 % of the assessment basis = 46,70 % of 1.510,81 EUR = 705,55 EUR

Old-age benefit, calculated at 46,70 % of the assessment basis 1.510,81 EUR would amount to 705,55 EUR.  Taking into account an adjustment of pension on 1. 1. 2021 by 2,5 %, it would amount to 723,19 EUR. 

E: Child benefit: 0 EUR

F: Child benefit: 0 EUR

G: (D + F) / (C + E)

 (723,19 EUR + 0 EUR) / (1.510,81EUR + 0 EUR) = 0,4786 – 47,86 %

B. /

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 VI under Article 65.

Article 65 / TITLE VI

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

The indexation of pensions is carried out once annually (in February) and is based on the growth in the average gross monthly salary and the average growth in consumer prices in the Republic of Slovenia, as determined and officially published by the Statistical Office of the Republic of Slovenia in the Official Gazette of the Republic of Slovenia (Uradni list Republike Slovenije). The basis for the indexation is the pension to which a beneficiary is entitled for the month preceding the month in which the indexation is performed, or the pension upon the assessment if implemented in the month of the indexation or later in an individual calendar year(Article 105 of PDIA-2).

Pensions are adjusted by 60% of the growth in average gross salary paid for the period from January to December of the previous year compared to the average gross salary paid for the same period in the year before, and by 40% of the average growth in consumer prices for the period from January to December of the previous year compared to the same period in the year before. The pension indexation is expressed as a percentage and shall constitute the sum of both established partial growths. The pension indexation may not be lower than the established half-growth in consumer prices (Article 105 and 106 of PDIA-2).

The PDIA-2 also contains a provision concerning the possibility of an extraordinary pension indexation upon the fulfillment of statutory conditions. At the proposal of the Pension and Disability Institute’s Council and with the agreement of the Government of the Republic of Slovenia, the Act provides that extraordinary pension indexation may be carried out in the year following the year when positive GDP growth is recorded, or in the year when for two consecutive years the growth of the minimum pension base is lower than the increase of consumer prices from January to December of the previous year compared to the same previous period.

The percentage applicable to the pension indexation also applies to the indexation of all allowances under disability insurance, notwithstanding whether they were granted or assessed according to the ZPIZ-2 or previous regulations.

Pension indexation:

In 2017, an increase of 1.15% on 1st January 2017;

In 2018, an increase of 2.2% on 1st January 2018; another extraordinary pension indexation by 1.1% on 1st April 2018;

In 2019, an increase of 2.7% on 1st January 2019; another extraordinary pension indexation by 1.5% on 1st December 2019;

In 2020, an increase of 3.2% on 1st January 2020; another extraordinary pension indexation by 2% on 1st December 2020 (according to Act Regulating Measures Relating to Salaries and Other Labour Costs for 2020 and 2021 and other Measures in the Public Sector and extraordinary adjustment of pensions);

In 2021, an increase of 2.5% on 1st January 2021 (Due to the temporary higher growth of the average monthly gross salary with allowances paid in the conditions of the epidemic, the legal formula was exceptionally not used to adjust pensions; the percentage of indexation was determined by the Act on the Execution of the Budget of the Republic of Slovenia).

2.      Please give the following information:

Period under review

Cost-of-living index

(Ø 2019 = 100)

Index of earnings*

(Ø 2019 = 100)

A. Beginning of period 2016

B. End of period 2020

C. Percentage A/B

97,07

99,90

97,17 %

90,35

105,84

85,37%

* The index of earnings should correspond to the classes of employees or economically active persons shown under the Article dealing with persons protected (Article 27, 33 or 61). If no index of earnings is available, the index of money wages may be substituted.

Source: Statistical Office of the Republic of Slovenia

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

Old-age pension

Benefit for standard beneficiary**

II

Old-age pension

Other estimates of benefit levels**

III

A. Beginning of period 2016

B. End of period 2020

C. Percentage A/B         

               

612,64

688,84

88,94 %

571,27

723,19

78,99 %

/

*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.

Source: Institute for Pension and Disability Insurance of Slovenia

Article 29

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.

In accordance with the Article 27 of the PDIA-2, the minimum qualifying period for acquiring the right to an old-age pension is 15 years of insurance period.

Insurance period is a period in which the insured person was covered by compulsory or voluntary pension and disability insurance and periods for which contributions have been paid.

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

In the case of Slovenia, recourse is had to paragraphs 1 and 2 of the Article 29.

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

On 1 January 2020 PDIA-2G entered into force. One of the key amendments it was an introduction of ahigher accrual rate for 40 years of pension period for both sexes. The old-age pension is assessed from the pension base in a percentage depending on the length of the pension period. For 15 years of insurance period, it is assessed in the amount of 29.5% of the base. For each subsequent year, however, 1.36% is added, with no upper limit. For a 40-year completed pension period, the pension is set at 63.5% of the pension base for both sexes. For men, a four-year transitional period was introduced (with PDIA-2I in May 2021) for increasing of the assessment for 40 years of pension period from the previous 57.25% to 63.5%. The assessment scale for men and women will therefore be equalized as early as 1 January 2023.

According to above mentioned legal changes the old-age pensions are calculated from the pension rating base at rates depending on the accumulated pension qualifying period as follows: for insured persons with an insurance period of 15 years, at 29,5 % of the pension rating base (men and women), followed by an additional 1.36 % for each additional year of the pension qualifying period. If the years of pensionable service do not amount to one year but to at least six months, the assessment percentage is 0.68% (Article 37 of PDIA-2).  

Years of pensionable service (in years)

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

15

29.50

25

43.10

35

56,70

16

30,86

26

44.46

36

58.06

17

32,22

27

45.82

37

59,422

18

33,58

28

47.18

38

60,78

19

34,94

29

48.54

39

62.14

20

36,30

30

49,90

40

63.50

21

37,66

31

51.26

22

39,02

32

52.62

23

40,38

33

53,98

24

41.74

34

55.34

- Men who claimed an old-age pension in the period from 1 January 2020 to 31 December 2020 had their pension assessed from the Pension Rating Base in the percentage corresponding to the completed years of pensionable service. For an insurance period of 15 years, it amounted to 27%. For each subsequent year, it was increased by 1.26% without any ceilings. If the years of pensionable service do not amount to one year but to at least six months, the assessment percentage in this case was 0.63% (Article 37 of PDIA-2).

Years of pensionable service (in years)

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

15

27.0

25

39,60

35

52,20

16

28,26

26

40,86

36

53,46

17

29,52

27

42,12

37

54,72

18

30,78

28

43,38

38

55,98

19

32,04

29

44,64

64

39

57,24

20

33,30

30

45,90

90

40

58,50

21

34,56

31

47,16

22

35,82

32

48,42

23

37,08

33

49,68

24

38,34

34

50,94

- Men who claim an old-age pension in the period from 1 January 2021 to 31 December 2021 have their pension assessed from the Pension Rating Base in the percentage corresponding to the completed years of pensionable service. For an insurance period of 15 years, it amounts to 27,5%. For each subsequent year, it is increased by 1.28% without any ceilings. If the years of pensionable service do not amount to one year but to at least six months, the assessment percentage in this case was 0.64% (Article 37 of PDIA-2).

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

15

27.50

25

40.30

35

53.10

16

28.78

26

41.58

36

54.38

17

30.06

27

42.86

37

55.56

18

31.34

28

44.14

38

56.94

19

32.62

29

45.42

39

58.22

20

33.90

30

46.70

40

59.50

21

35.18

31

47.98

22

36.46

32

49.26

23

37.74

33

50.54

24

39.02

34

51.82

- Men who will claim an old-age pension in the period from 1 January 2022 to 31 December 2022 will have their pension assessed from the Pension Rating Base in the percentage corresponding to the completed years of pensionable service. For an insurance period of 15 years, the pension will amount to 28,5%. For each subsequent year, it will be increased by 1.32% without any ceilings. If the years of pensionable service will not amount to one year but to at least six months, the assessment percentage in this case will be 0.66% (Article 37 of PDIA-2).

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

Years of pensionable service

Assessment percentage (%)

15

28,50

25

41,70

35

54,90

16

29,82

26

43,02

36

56,22

17

31,14

27

44,34

37

57,54

18

32,46

28

45,66

38

58,86

19

33,78

29

46,98

39

60,18

20

35,10

30

48,30

40

61,50

21

36,42

31

49,62

22

37,74

32

50,94

23

39,06

33

52,26

,2653,58

24

40,38

34

53,58

Old-age pension is assessed on the basis of the monthly average of salaries an insured person has received, i.e. the insurance bases according to which his contributions were calculated, in any of the successive 24 years of insurance following 1 January 1970, which were the most favourable for the insured person (the pension rating base) (Article 30 of PDIA-2).

The transitional period for extending the calculation period from 18 to 24 years expired in 2018.

In a reference period, several measures were taken to improve social security for recipients of low pensions. The PDIA-2 amendment, which has been in force since 1 May 2021, sets three safeguard amounts (Article 39 of PDIA-2):

- The minimum (old-age, early or disability) pension is set at 29.5% of the minimum pension base and from 1 May 2021 amounts to EUR 279.56.

- The guaranteed pension for beneficiaries of an old-age or disability pension with at least 40 years of completed pension qualifying period without purchased period from 1 May 2021 onwards amounts to EUR 620.00.

- From 1 May 2021 onwards, the lowest disability pension is set at 41% of the minimum pension base, amounting to EUR 388.54.

All these three safeguard amounts will be adjusted in the same way as pensions.

- A yearly bonus

In the period from 2016 to 2021, pensioners and recipients of disability benefits were paid a special right to a yearly bonus each year.

In June 2021 a yearly bonus was paid out on the basis of Article 75 of the Republic of Slovenia Budget Implementation Act for 2021 and 2022 (Official Gazette of the RS, No. 174/20, ZIPRS-2122). A yearly bonus, which was received by 597,100 pensioners and 14,455 beneficiaries of disability insurance benefits, was paid out in five different rates. Beneficiaries of prorate pensions (on the basis of EU social security coordination rules or bilateral social security agreements) are entitled to a proportionate part of a yearly bonus. However, there is a novelty in the regulation of the regulation of the yearly bonus in 2021, namelyin certain cases it is not assessed in a proportionate part. If the basis for assessing the yearly bonus does not exceed 525 EUR, the yearly bonus in the amount of 445 EUR is paid in full, even if the basic benefit is assessed in proportion on the basis of international agreements or if a partial pension is paid due to a part-time employment. All other beneficiaries received a yearly bonus according to the proportional part of their basic benefit.

The amount of the yearly bonus depends on the amount of the pension and is determined in five different rates. In 2021 the amounts of yearly bonus are 5 EUR higher compared to previous year.

Amount of the pension in EUR

Amount of the yearly bonus in EUR for 2021

up to 525,00

445,00

from 525,01 to 630,00

305,00

from 630,01 to 745,00

245,00

from 745,01 to 900,00

195,00

above 900,00

135,00

3. /

4. /

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

As of 1 January 2012 it is possible to acquire similar right as state pension by nature, only for socially deprived people, according to Social Benefits Act.

Article 30

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.

Article 116 of the PDIA-2 determines re-entering the insurance. According to this Article a recipient of an old-age pension, an early retirement benefit, a widow/widower’s pension and a survivor’s pension who re-enters the employment or activity in the territory of the Republic of Slovenia, regains the status of an insured person and the payment of their pension during this period shall be terminated. The payment of the pension shall cease as of the day of regaining the status of an insured person.

Notwithstanding the above mentioned provision the recipients of an old-age pension, an early retirement benefit, a widow/widower’s pension and a survivor’s pension who resume work or activity in the territory of the Republic of Slovenia in the scope corresponding to a proportionate part of full-time or full-time insurance (however, in case of employees in employment relationships, not less than two hours daily or ten hours weekly and in case of self-employed persons, partners and farmers at least a quarter of the full-time insurance), shall have their pension paid in a proportionate part, as follows:

-     75% if the insured person works 2hours daily or the insurance time amounts to 10–14hours weekly;

-     62,5% if the insured person works 4hours daily or the insurance time amounts to 15–19hours weekly;

-     50% if the insured person works 4hours daily or the insurance time amounts to 20–24hours weekly;

-     37.5% if the insured person works 5hours daily or the insurance time amounts to 25–29hours weekly;

-     25% if the insured person works 6hours daily or the insurance time amounts to 30–34hours weekly; and

-     12.5% if the insured person works 7hours daily or the insurance time amounts to 35–39hours weekly.

The PDIA-2G has brought some changes in this area, as it has introduced certain incentives for those retirees who choose to reactivate for at least 4 hours a day or 20 hours a week. In order to encourage this reactivation into compulsory insurance and thus prolong the employment of those who have already claimed an old-age pension, the law provides for an increase in the proportional part of the pension. Insured persons who receive a proportional part of the old-age pension and are compulsory included in the compulsory insurance for at least 4 hours a day or 20 hours a week, are entitled to an increase in the proportional part of the old-age pension by a proportional part of 40% (and after three years of 20%) of the old-age pension.


PART VI

EMPLOYMENT INJURY BENEFIT

The Constitution of the Republic of Slovenia defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof.

Primary legislation:

·         Pension and Disability Insurance Act (Official Gazette of the RS, No. 96/12, 39/13, 99/13 – ZSVarPre-C, 101/13 – ZIPRS1415, 44/14 – ORZPIZ206, 85/14 – ZUJF-B, 95/14– ZUJF-C, 90/15 – ZIUPTD, 102/15, 23/17, 40/17, 65/17, 28/19, 75/19, 139/20, 189/20 – ZFRO and 51/21);

·         Vocational Rehabilitation and Employment of Disabled Persons Act (Official Gazette of the RS, no. 16/2007 UPB2, 87/11, 96/12 – ZPIZ-2 in 98/14);

·         Official Records of Insured Persons and Beneficiaries of Pensions and Disability Insurance Act (Official Gazette of the RS, no. 111/13, 97/14);

·         Social Security Contributions Act (Official Gazette of the RS, No. 5/96, 18/96 – ZDavP, 34/96, 87/97 – ZDavP-A, 3/98, 7/98 – odl. US, 106/99 – ZPIZ-1, 81/00 – ZPSV-C, 97/01 – ZSDP, 97/01, 62/10 – odl. US, 40/12 – ZUJF, 96/12 – ZPIZ-2, 91/13 – ZZVZZ-M, 99/13 – ZSVarPre-C in 26/14 – ZSDP-1);

·         Health Care and Health Insurance Act (Official Gazette of the RS, no. 9/92, 13/93, 9/96, 29/98, 77/98 Odl US, 6/99, 56/99-ZVZD, 99/01, 42/02-ZDR, 60/02, 11/03 Skl. US, 126/03, 20/04-UPB1, 62/05 Odl US, 76/05, 100/05-UPB2, 100/05 Odl. US, 21/06 Odl. US, 38/06, 72/06-UPB3, 114/06-ZUTPG, 91/07, 71/08, 76/08, 118/08 Skl. US, 62/10-ZUPJS, 87/11, 40/12-ZUJF, 21/13-ZUTD-A, 91/13, 99/13- ZUPJS-C, 99/13-ZSVarPre-C, 111/13-ZMEPIZ-1, 95/14-ZUJF-C, 47/15-ZZSDT, 61/17-ZUPŠ, 64/17-ZZDej-K, 36/19, 189/20-ZFRO, 51/21);

·         Health Care Activities Act (Official Gazette of the RS, no. 9/92, 26/92 corr., 37/95, 8/96, 59/99, 90/99, 98/99, 31/00, 36/00, 45/01, 131/03, 135/03, 2/04, 36/04-UPB1, 80/04, 23/05-UPB2, 15/08-ZPacP, 23/08, 58/08-ZZdrS-E, 77/08-ZDZdr, 40/12-ZUJF, 14/13);

·         Pharmacies Act (Official Gazette of the RS, no. 9/92, 38/99, 2/04, 36/04-UPB1).

Secondary legislation:

·         Statute of the Pension and Disability Insurance Institute of Slovenia (Official Gazette of the RS, 52/14);

·         Statute of the Health Insurance Institute of Slovenia (Official Gazette of the RS, no. 87/01, 1/02-corr.);

·         Rules on Compulsory Health Insurance (Official Gazette of the RS, no. 73/95, 39/96, 70/96, 47/97, 3/98, 3/98, 51/98 Odl. US, 90/98, 6/99 corr., 109/99 Odl. US, 61/00, 64/00 corr., 59/02, 11/03 Skl. US, 18/03, 30/03, 35/03 corr., 78/03, 84/04, 44/05, 86/06, 90/06 corr., 64/07, 33/08, 71/08, 118/08 Skl. US, 7/09, 88/09, 30/11, 49/12, 106/12, 99/13-ZSVarPre-C, 25/14 Odl. US, 25/14, 85/14, 10/17-ZČmIS, 64/18, 4/20, 42/21-odl. US, 61/21).

Basic features of legal arrangements

The employment injuries and occupational diseases insurance system is incorporated into two other systems of insurance, that is the system of health insurance and the system of pension and disability insurance. In line with that, this contingency is legally regulated as follows:

(1)   temporary incapacity for work: Health Care and Health Insurance Act, from which the right to payment of health services (benefits in kind) and the right to sickness cash benefit (sickness benefit in lieu of pay during temporary absence from work) are arising[21];

(2)   long-term incapacity for work: Pension and Disability Insurance Act, from which the right to disability pension  (cash benefit), right to reassignment, right to work on a part-time basis for no less than four hours daily or twenty hours weekly, right to disability benefit, right to a partial benefit, the right to occupational rehabilitation and the right to occupational rehabilitation benefit are arising[22].

Article 32

Please state whether national laws or regulations prescribe a minimum degree of loss of earning capacity that gives rise to the benefit stipulated in Article 34 and 36, and if so, indicate the degree.

Disability is recognised under the Pension and Disability Insurance Act (PDIA-2) if changes in state of health, which cannot be remedied by treatment or by measures of medical rehabilitation and which are determined in accordance with the PDIA-2, reduce the insured person's ability to secure or retain a work post or professional promotion (Article 63 of PDIA-2).

Disability is classified into the following categories:

-          CategoryI: if the insured person has lost the capacity to engage in an organised gainful employment or is not capable of performing his/her own occupation and has lost the remaining capacity for work;

-          CategoryII: if the insured person’s capacity for work in his/her own occupation is impaired by 50% or more;

-          CategoryIII: if the insured person has lost the capacity to work on a full-time basis, but is capable of working at a certain position on a part-time basis, for no less than four hours daily, or if an insured person’s capacity for work in his/her own occupation is impaired by less than 50%, or if an Insured Person can continue to work in his/her own occupation on a full-time basis, but has lost the capacity for work at the position of employment he/she has been assigned to (Article 63 of PDIA-2).

Causes for the onset of disability are:

·         occupational injury (Article 66 of PDIA-2),

·         occupational disease (Article 68 of PDIA-2),

·         illness,

·         injury outside work.

Please also state whether recourse is had to the last sentence of sub-paragraph (d) of Article 32, according to which, in the case of the widow, the right to benefit may be conditional on her being presumed to be incapable of self-support; if so specify the rules.

According to Article 53 of PDIA-2, the widow(er)’s pension can be claimed by the widows or widowers of deceased insured persons under the condition of:

-          reaching certain age(if, at the time of death of the insured person from whom the right derives, they had reached 58 years of age);

-          incapacity for work regardless of age (if, at the time of death of the insured person, they were completely incapacitated for work, or if they became so within one year of the death of the insured person), or

-          having children regardless of age (if, at the time of death of the insured person, they were left with one or more children with the right to survivor’s pension from the deceased insured person, whom they have the duty to maintain)

Article 33

A. Please indicate the classes of employees protected, in accordance with the provisions of this Article.

Temporary incapacity for work(health insurance):

According to the Health Care and Health Insurance Act (HCHIA), persons covered by the compulsory health insurance – employment injury and occupational disease are:

·         Persons who are employed in the Republic of Slovenia;

Farmers, members of their establishments and other persons performing farming activities in the Republic of Slovenia as their only or main occupation are insured against employment injury and occupational disease if they pay contributions from the threshold determined for pension and disability insurance. Those persons who do not pay such contributions acquire, in the event of employment injury or occupational disease, rights in the extent determined in case of sickness or injury outside work (Article 16 of the HCHIA).

The following are also insured against employment injury and occupational disease:

-          Students taking part in practical studies, performing production work or work experience and on professional field trips;

-          Children and young people who are physically and mentally challenged taking part and children and young people with acquired brain injuries in practical studies with training organizations or at compulsory practical work;

-          Persons participating in voluntary work experience after completing their formal education, irrespective of whether they receive remuneration for their work;

-          Military disabled, civilians disabled in war and other disabled persons in occupational rehabilitation and training during practical work and exercises;

-          Persons performing work on the basis of a work contract;

-          Secondary school students or students of colleges and universities in performing work via authorized organizations;

-          Unemployed persons performing public work organized under the regulations on employment;

-          Volunteers;

-          Persons doing community service work and other work in compliance with penal regulations;

-          Persons performing activities as a secondary occupation

-          Persons doing humanitarian and similar work in compliance with regulations on employment;

-          Persons doing short-term work in compliance with regulations on the prevention of illegal work and employment (Article 17of the HCHIA).

The following are also insured against employment injury:

-          Persons participating in organized public works of a general nature, in rescue actions or in protection and rescue during natural and other disasters;

-          Participants in youth camps in the Republic of Slovenia;

-          Persons performing work or tasks of military service or alternative civilian service, national protection, civil protection, surveillance and intelligence services, general rescue services or in communications units and in training for defense and protection;

-          Persons assisting interior affairs bodies and the authorized persons of these bodies performing their tasks in compliance with the law;

-          Persons performing tasks of interior affairs bodies as reservists in the composition of interior affairs bodies;

-          Persons on the request of state and other authorized bodies performing public functions or civic duties;

-          Sportsmen, trainers or organizers participating in sports events as part of an organized sporting activity;

-          Persons who are members of operational units of volunteer fire fighting organizations performing tasks in the extinguishing of fires, protection and rescue during other disasters, in training, protection at fire-risk locations and at public events, tasks in public appearances and demonstrations with the demonstration of exercises and in teaching people about fire safety;

-          Persons who are members of mountain rescue services, underwater or cave rescue services or rescue dog-handler unit performing tasks of saving lives or averting or preventing danger that directly threatens the lives or property of citizens (Article 18 of the HCHIA).

Long-term incapacity for work(pension and disability insurance):

In accordance with the PDIA-2 (Articles 14 to 19) persons insured under compulsory pension and disability insurance are:

-          active population (employees in employment relationships, self-employed persons, farmers, partners and shareholders, managing personnel, farmers and persons performing work on the basis of another legal relationship);

-          recipients of unemployment benefit whose contributions for the pension and invalidity insurance are paid by the Employment Service of the Republic of Slovenia;

-          parents specified in the regulations governing parental protection,

-          persons entitled to a compensation due to their temporary incapacity for work after the termination of their employment relationship pursuant to the regulations governing health insurance, if they are not covered by the Compulsory Insurance on some other grounds;

-          family assistants (according to Social Assistance Act);

-          persons carrying out professional foster care;

-          persons engaged in a religious office as religious workers;

-          soldiers engaged in a voluntary military service and citizens during the voluntary training for protection and rescue;

-          persons entitled to a compensation during the occupational rehabilitation hereunder and are not covered by the Compulsory Insurance on some other grounds (Articles 14 to 19 of PDIA-2)

In addition to above-mentioned categories of insured persons the PDIA-2 also foresees special cases of insurance for those compulsory insured for disability or death as a consequence of employment injuries or occupational disease.

1. Persons covered by the Compulsory Insurance in the event of a disability or death caused by an occupational injury or occupational disease are as follows:

-     persons who perform a gainful or other lawful activity in the scope of self-employment, but are not covered by the insurance pursuant to Article 15 hereof during the performance thereof;

-     persons who, within another legal relationship, perform work for remuneration arising from Article 18 hereof but are not covered by the insurance during this engagement pursuant to Article 16 or 18 hereof.

2. A person engaged in an agricultural or forestry activity and not covered by the insurance according to Article 17 hereof may take up the insurance for the event of a disability and death caused by an occupational injury or occupational disease incurred during the engagement in the said activity.

3. The following persons shall be covered by the Compulsory Insurance in the event of a disability or death caused by an occupational injury:

-     pupils and students during practical lessons, production work or industrial work placement, and expert excursions;

-     children and adolescents with physical and mental developmental disorders engaged in practical lessons at training organisations or in obligatory practical work;

-     persons engaged in voluntary practical work after the completed schooling, whether or not they receive remuneration for such practical work;

-     war-disabled servicemen, civilian war-disabled persons and other disabled persons engaged in occupational rehabilitation and/or training during practical work and exercises;

-     persons who, pursuant to the regulations governing the labour market or the regulations governing employment of disabled persons, undergo training by working for the provider of active employment policies or a provider of another measure or program, save for persons performing public works;

-     persons who, pursuant to the regulations governing minor offences and the enforcement of criminal sanctions, perform certain tasks in the general interest or in the interest of local communities;

-     persons serving a prison sentence which are not covered by the Compulsory Insurance hereunder, and minors against which the correctional measure of admittance into a correctional facility has been imposed, during work, vocational training and engagement in activities permitted by law;

-     persons who, notwithstanding the provision of paragraph 1 of Article 15 hereof, are not covered pursuant to Article 15 hereof, and according to the regulations on the catering industry, perform the activity of natural persons providing accommodation only occasionally up to five months in a calendar year, or through personal work without any employees perform handicraft and art craft according to the regulations governing this type of activity.

4. During their work, vocational training and engagement in lawful activities, persons serving a prison sentence and minors against which the correctional measure of admittance into a correctional facility has been imposed shall also be covered by the Compulsory Insurance hereunder in the event of a disability caused by an off-the-job injury incurred due to force majeure.

5. The following persons shall be covered by the Compulsory Insurance in the event of a disability or death caused by an occupational injury in cases of organised activities:

-     participants in organized work operations, rescue operations, or in protection and rescue operations in case of natural and other disasters;

-     participants of youth camps in the Republic of Slovenia who take part in the performance of tasks and assignments at such youth camps;

-     persons performing military service in the army reserve or permanent forces, alternative civil service or services for the Civil Protection Service, or undergoing training for the performance of these tasks based on civic duties, or undergoing training under contracts on service in the Slovenian Army Reserve, contracts on service in the Civil Protection Service or training for the completion of defence assignments and assignments associated with protection, rescue and relief;

-     persons who, as members of operational units of voluntary fire brigades or fire-fighting organisations, carry out assignments such as fire-fighting, protection, rescue and relief in the event of natural or other disasters, during the implementation of the fire watch or introduction of fire prevention measures in hot works, locations posing fire-hazard and at public events, at fire brigade exercises and other forms of training, or at public appearances and manifestations of the fire-fighting activity for the purposes of general public education and training;

-     persons who, as members of the mountain rescue service, cave rescue service, rescue dog-handler units or divers and other rescue units and operational force structures involved in protection, rescue and relief, pursuant to the regulations governing the protection against natural and other disasters, perform assignments associated with providing protection, rescue and relief to people at risk, or assignments associated with the protection and rescue of property, environment and cultural heritage, or undergo organised training for the said tasks;

-     persons who assist the police and the authorised officials of government authorities in the implementation of assignments in the field of protection of the constitutional system, personal security of citizens and protection of property, sustaining public order and peace, prevention and detection of criminal offences as well as in the detection and apprehension of offenders and protection against breaches of inviolability of the state borders;

-     persons who perform police tasks as members of the auxiliary police units;

-     persons who, when summoned by national and other competent bodies, perform public and other social tasks or a civic duty;

-     persons who participate in sports or chess events as sportsmen or chess players, trainers or organisers within the framework of organised sports or chess activities (Article 20 of PDIA-2).

B. Please furnish statistical information under this Article in the form set out in Title I under Article 74 below.

Temporary incapacity for work(health insurance):

Please see Part II – Medical Care / Article 9 / question C.

Long-term incapacity for work(pension and disability insurance):

Please see Part V – Old-age / Article 27 / question C.

Article 34

A. Please indicate in detail for each scheme concerned, the nature of the medical benefits provided referred to in paragraph 2.

Article 22 of the Rules on Compulsory Health Insurance (Rules) lays down the rights arising from the compulsory health insurance:

·         health services:

i.                    on a primary care level,

ii.                  dental care,

iii.                pharmaceutical services,

iv.                on a specialist care level,

v.                  hospital care,

vi.                spa treatments and medical treatments on a tertiary level,

vii.              medical care,

viii.            health services of preventive nature,

ix.                services with regard to diagnostics, health care and medical rehabilitation of ill and injured;

·         health services in connection with childbirth, termination of pregnancy, artificial insemination and sterilisation;

·         rehabilitation, organised training for a life with specific disease under the particular programmes,

·         urgent and other transportation with medical and other vehicles;

·         prescribed medications in accordance with categorisation of medicines;

·         foodstuffs for particular nutritional use, prescribed according to classification in the lists determined by the institution;

·         technical instruments (e.g. prosthetic appliances, eyeglasses).

 

B. Please confirm that, in accordance with the provisions of this Article, the beneficiary is not required to share in the cost of the medical care received. If the scheme provides for reimbursement of the expenses which the beneficiary was obliged to incur in order to obtain the benefits stipulated in paragraph 2 of this Article, please furnish all available information to show that the beneficiary does not share in the cost of such benefits.

Article 23 of the HCHIA defines the rights to health services deriving from compulsory health insurance. Through compulsory insurance, insured persons are provided payment in their entirety (100%) for:

·         treatment and rehabilitation as a result of occupational disease and employment injuries;

·         help-in-the-home visits, treatment and care in the home and in social security institutes;

·         prescription medication in accordance with the categorisation of medicines, orthopedic and other aids in connection with treatment and rehabilitation as a result of occupational disease and employment injuries.

C. Please state what measures are taken to give effect to paragraph 3 of this Article.

/

Article 35

Please state briefly what measures are taken to give effect to the provisions of this Article.

Occupational rehabilitation

Vocational Rehabilitation and Employment of Disabled Persons Act (hereinafter referred to as the ZZRZI) regulates the right to employment rehabilitation and some issues of employing persons with disabilities, and determines other forms, measures and incentives for employing persons with disabilities and the manner of financing these incentives. The purpose of the act is to increase employability of persons with disabilities and establish the conditions for their equal participation on the labour market by eliminating obstacles and creating equal possibilities.

The question of occupational rehabilitation is governed by the Pension and Disability Insurance Act (PDIA-2), which with regards to the actual purpose of occupational rehabilitation stipulates that occupational rehabilitation is a comprehensive process in which Insured persons are provided with a technical, physical and psycho-social training for another occupation or another job, so that they can be appropriately employed and reintegrated in the work environment, or trained for the same occupation or job through the adequate adaptation of their position of employment with appropriate technical aids (Article 70 of PDIA-2).

The right to an occupational rehabilitation shall be granted to an insured person:

-       who has been afflicted with a disability of categoryII;

-       who, as of the date of the occurrence of the disability, has yet to complete 55years of age; and

-       who, considering their remaining capacity for work, may be trained for another work performed on a full-time basis (Article 72 of PDIA-2).

The right to an occupational rehabilitation shall also be granted to an insured person:

-       who has been afflicted with a disability of categoryII;

-       who, as of the date of the occurrence of the disability, has yet to complete 50years of age; and

-              who, considering their remaining capacity for work, may be trained for another work performed on a part-time basis for no less than four hours daily (Article 72 of PDIA-2).

If the occupational rehabilitation of an insured person afflicted with a disability requires an adaptation of premises and working facilities, the Pension and Disability Insurance Institute (Institute) shall bear the costs of such adaptation. If the maintenance of the employment of an insured person afflicted with a disability requires an adaptation of premises and working facilities, the Institute shall partially or fully bear the costs of such adaptation. The Institute may earmark part of the Disability Insurance funds for the maintenance and promotion of the employment of Disabled Workers. The criteria and procedure for the assessment of the amount of the funds referred to in this Article shall be determined by the Institute (Article 73 of PDIA-2).

In line with the remaining work capacity of the insured person, occupational rehabilitation is conducted:

-     through participation in a short-term training and education;

-     through practical work at an appropriate position of employment provided by an Employer or in other forms of training for work;

-     through an off-the-job training, with the consent of the Insured Person who will undergo the training for another work to be performed on a full-time basis;

-     through education at appropriate schools and through other forms of education (Article 75 of PDIA-2).

Period of the insured person’s adaptation to the work for which they underwent the occupational rehabilitation is also considered as occupational rehabilitation if it is necessary, to enable them to perform another suitable work with a standard efficiency.(Article 76 of PDIA-2).

The form and mode of the occupational rehabilitation, periods associated with its commencement and duration, detailed conditions for an Insured Person’s training for work, terms and periods for the conclusion of an employment contract upon completing the occupational rehabilitation shall be determined in a contract concluded between the Institute, the Employer or the Employment Service and the Insured Person (Article 77 of PDIA-2).

Organisations involved in the training and employment of Disabled Persons, and the Employment Service shall participate in the occupational rehabilitation, training and employment of Insured Persons. (Article 77 of PDIA-2).

The Insured Person and the occupational rehabilitation provider shall be obliged to report to the Institute on the implementation and progress of the occupational rehabilitation no less than every six months. (Article 77 of PDIA-2).

If, due to the distance between the Insured Person’s residence and the school, sheltered organisation involved in the training and employment of Disabled Persons or the Employer where the occupational rehabilitation takes place, the use of transport means is absolutely vital, while the Insured Person, due to their state of disability, is unable to use public transport and no special transportation is made available to him, the Insured Person shall be entitled to accommodation at the expense of the Institute determined by the Institute (Article 78 of PDIA-2).

An insured person employed in the Republic of Slovenia shall be entitled to be provided with an occupational rehabilitation by the Employer where the Insured Person was employed upon the occurrence of the disability, while the Institute shall provide the occupational rehabilitation to other Insured Persons. The Employment Service may also cooperate with the Institute and the Employers in the provision of the occupational rehabilitation (Article 79 of PDIA-2).

In the period between the entitlement to an occupational rehabilitation and the completion thereof, the Insured Person referred to in paragraph 1 of Article 72 hereof who is not undergoing an off-the-job training shall be entitled to a cash benefit assessed in the amount of 130% of the disability pension they would be entitled to on the date the of the occurrence of the disability. In the period between the commencement and the completion of the occupational rehabilitation, the Insured Person undergoing an off-the-job training for another work to be performed on a full-time basis shall be entitled to a cash benefit assessed in the amount of 40% of the disability pension they would be entitled to on the date of the occurrence of the disability. (Article 80 of PDIA-2).

An insured person who, after the completion of the occupational rehabilitation, is entitled to a reassignment or to work on a part-time basis for no less than four hours daily or twenty hours weekly, shall be entitled to a temporary benefit until they start working at another position on a full-time basis or a part-time basis for no less than four hours daily or twenty hours weekly. Employees are entitled to a temporary benefit in the amount of the disability pension to which they would be entitled on the date of the occurrence of the disability until they start working at another position. All the other insured persons are entitled to a temporary benefit in the amount of 50% of the disability pension to which they would be entitled on the date of the occurrence of the disability until the date of reemployment, but only up to two years (Article 84 of PDIA-2).

The right to a reassignment is acquired by insured person:

-     after the completion of the occupational rehabilitation;

-     with the remaining capacity for work who has been afflicted with a disability of category II after completing 55years of age;

-     afflicted with a disability of category III, if their capacity for work in their own occupation has been reduced by less than 50%, or if they can continue to work in their own occupation on a full-time basis, but are not capable of working at the position of employment they have been assigned to.

An Insured Person employed in the Republic of Slovenia shall be guaranteed the right to the reassignment by the Employer (Article 81 of PDIA-2).

According to Vocational Rehabilitation and Employment of Disabled Persons Act services of occupational rehabilitation are as follows (Article 15):

·         Counselling, encouraging and motivating the disabled persons for more active role;

·         Preparation of opinion regarding the working ability, knowledge, working habits and occupational interest;

·         Assistance with accepting person’s own disability and learning about training and work possibilities;

·         Assistance with choosing appropriate occupational goals;

·         Developing social skills and expertise;

·         Assistance with searching for suitable employment;

·         Analysis of a concrete working place and environment of the person with disabilities;

·         Elaboration of working place and environment adjustment plan for the person with disabilities;

·         Elaboration of necessary equipment and facilities for work plan;

·         Training on the concrete working place or occupation;

·         Monitoring and providing expert assistance with training and education;

·         Monitoring the person with disabilities on the working place after his/her employment;

·         On-going evaluation of effectiveness of the rehabilitation process;

·         Evaluation of the achieved working results of the employed persons with disabilities; and

·         Performance of other services of vocational rehabilitation

Employment rehabilitation

ZZRZI has introduced the right of persons with disabilities to employment rehabilitation. The persons with disabilities have the right to employment rehabilitation in accordance with this Act if other regulations (e. g. Pension and Disability Insurance Act) do not enable those persons the rights to equal services. The main objective of employment rehabilitation is to offer persons with disabilities appropriate assistance so that they can identify their abilities, actively cooperate in planning the ways of solving their problems with the aim to retain employment or acquire a new employment. Employers consider guaranteeing employment rehabilitation services as the way for resolving social and work problems, and also investments in human resources and the satisfaction of employees.

The providers of employment rehabilitation, which is implemented as a public service, can be public institutions or concessioners within the network of employment rehabilitation services providers, adopted by the minister of labour, family and social affairs. Especially the following principles are considered in the process of forming the network of employment rehabilitation providers: rationality, economy equal accessibility for all persons with disabilities regardless of place of residence and type of disability, the network of service providers’ bases on connecting – integration – among the providers themselves as well as with the ordinary work environment. Service providers also have to connect with employers due to the possibilities of training and employing persons with disabilities and financial sustainability of the system.

Other incentives for the employment of persons with disabilities

Form of the support for sheltered workshops and employment centres, is in addition to technical adjustments to the workplace and the environment, professional support also subsidies wage of 5 to 70% of the minimum monthly wage – It depends on the level of disability and of the form of employment (Article 70 ZZRZI). ZZRZI also provides other incentives for the employment of people with disabilities such as supported employment (Article 37), payment of the costs for the accommodation and resources at work (Article 72).

Article 36

A.Please state whether recourse is had, under paragraph 1 of this Article, to the provisions of Article 65 or to Article 66, for the calculation of the benefit.

In the case of Slovenia, the recourse is had to the provisions of Article 65.

B. Please furnish under this Article, the following information, with separate reference to the different contingencies covered:

a)  Incapacity for work (sickness cash benefit)

Article 65 / paragraph 6 / (c) - a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·         average wage (gross) in 2020 = 1.856,20 EUR[23]

·         average wage (net) in 2020 = 1208,65 EUR

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS: 125 per cent of average wage (net) in 2020 = 1.510,81 EUR

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (net) = 1.510,81 EUR

C:  Standard wage (net) in 2020 = 1.510,81 EUR

(2) TITLE II

TIME BASIS: January 2021

D:  Amount of benefit granted during the time basis

·         man with wife and two children

·         assessment basis = 1.510,81 EUR [24]

100%[25] of the assessment basis = 100% of 1.510,81 EUR = 1.510,81 EUR

E: Child benefit:

·           family: 1 (man) + 1 (wife) + 2 children

·             the income class[26]: 1.510,81 EUR / 4 = 377,70 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

F: Child benefit:

·         family: 1 (man) + 1 (wife) + 2 children

·         the income class: 1.510,81 EUR / 4 = 377,70 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

G: (D + F) / (C + E)

 (1.510,81 EUR + 161,52 EUR) / (1.510,81 EUR + 161,52 EUR) = 1 = 100 %

b)  Total loss of earning capacity or corresponding loss of faculty likely to be permanent(Disability pension)

Article 65 / paragraph 6 / (c) - a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·         average wage in 2020 = 1.208,57 EUR[27] (net) = 1.555,89 EUR (gross)[28]

·         STANDARD WAGE (2020): 125 per cent of average wage in 2020 = 1.510,71 EUR (net) = 2.320,25 EUR (gross)

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS (net) = 1.510,81 EUR[29]

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (net)

C:  Standard wage in 2020 = 1.510,71 EUR (net) = 2.320,25 EUR (gross)

(2) TITLE II

TIME BASIS: May 2021

D:  Amount of benefit granted during the time basis

·         man with wife and two children

·         minimum period taken into account: 40 years of insurance

·         assessment basis = 1.510,81 EUR

59,5 %[30] of the assessment basis = 59,5 % of 1.510,81 EUR = 898,93 EUR (net)

Taking into account an (extraordinary) adjustment of pension on 1. 1. 2021 by 2,5 %, the disability pension would amount to 921,40 EUR.

E: Child benefit:

·         family: 1 (man) + 1 (wife) + 2 children

  • the income class: 1.510,71 EUR / 4 = 377,68 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

F: Child benefit:

  • family: 1 (man) + 1 (wife) + 2 children
  • the income class: 921,40 EUR / 4 = 230,35 EUR per family member

1st child = 100,08 EUR; 2nd child = 110,63 EUR; Σ = 210,71 EUR

G: (D + F) / (C + E)

(921,40 EUR + 210,71 EUR) / (1.510,71 EUR + 161,52 EUR) = 1.132,11 EUR / 1.672,23 EUR = 0,6770 –  67,70 %

c)  Death of the breadwinner(Survivor’s pension)

Article 65 / paragraph 6 / (c) - a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·       average wage in 2020 = 1.208,57 EUR (net) = 1.856,20 EUR (gross)

·         standard wage (2020): 125 per cent of average wage in 2020 = 1.510,71 EUR (net) = 2.320,25 EUR (gross)

·         ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS (net) = 1.510,81 EUR[31]

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (gross)

(2) TITLE II

TIME BASIS: May 2021

C:  Standard wage (gross) in 2020 = 1.510,71 EUR (net)

D:  Amount of benefit granted during the time basis

·               widow and two children

·   assessment basis = 1.510,81 EUR

59,5%[32] of the assessment basis = 59,5 % of 1.510,81 EUR = 898,93EUR (net)

Taking into account an (extraordinary) adjustment of pension on 1. 1. 2021 by 2,5 %, the disability pension would amount to 921,40 EUR (basis 1).

90% of the basis 1 = 90% of 921,40 EUR = 829,26 EUR (net)

E: Child benefit:

·   family: 1 (man) + 1 (wife) + 2 children

·                     the income class: 1.510,71 EUR / 4 = 377,68 EUR per family member

1st child = 76,27 EUR; 2nd child = 85,25 EUR; Σ = 161,52 EUR

F: Child benefit:

·                           family: widow + 2 children

·                           the income class: 921,40 EUR / 3 = 307,13 EUR per family member

1st child = 100,08 EUR; 2nd child = 110,63 EUR; Σ = 210,71 EUR

G: (D + F) / (C + E)

(921,40 EUR + 210,71 EUR) / (1.510,71 EUR + 161,52 EUR) = 1.132,11 EUR / 1.672,23 EUR= 0,6770 67,70 %

C. Please indicate what proportion of the benefit in respect of total loss of earning capacity is granted in case of partial loss of earning capacity likely to be permanent, or corresponding loss of faculty.

The PDIA-2 in its Article 82 sets forth the provisions concerning the right to part-time work and in Article 86 the right to partial benefit.

An insured person afflicted with a disability of category III who is no longer capable of working on a full-time basis and an insured person afflicted with a disability of category II after completing 55years of age who remains capable of working at the position they have been assigned to or at another position at least on a part-time basis is entitled to work on a part-time basis for no less than four hours daily or twenty hours weekly (Article 82 of the PDIA-2).

An insured person who was recognized the right to work on a part-time basis for no less than four hours daily or twenty hours weekly pursuant to paragraphs 1 and 2 of Article 82 hereof shall be entitled to a partial benefit (Article 86 of PDIA-2).

The partial benefit shall be assessed in the percentage corresponding to the reduction in full-time work from the disability pension the Insured Person would have been entitled to upon the occurrence of the disability, in the following amounts:

-     50% if the Insured Person works on a part-time basis for 4hours daily or 20hours weekly;

-     37.5% if the Insured Person works on a part-time basis for 5hours daily or 25hours weekly;

-     25% if the Insured Person works on a part-time basis for 6hours daily or 30hours weekly;

-     12.5% if the Insured Person works on a part-time basis for 7hours daily or 35hours weekly (Article 86 of PDIA-2).

The partial benefit assessed pursuant to the preceding paragraph shall be increased:

-     by 30% if the Insured Person is no longer capable of working at the position of employment they have been assigned to and has started working at another position;

-     by 30% if, after completing the occupational rehabilitation, the Insured Person has started working at another position;

-     by 40% if the Insured Person’s employment is terminated based on a positive opinion of the committee responsible for establishing the grounds for employment contract termination, or independent of their own will or fault (Article 86 of PDIA-2).

In its Resolution Resolution CM/ResCSS(2020)16 on the application of the European Code of Social Security by Slovenia the Committee of Ministers considered that the reductions of the partial benefit made in accordance with Article 86(5) of ZPIZ-2 were not compatible with Article 68 of the Code and requested the Government of the Republic of Slovenia to review the relevant provisions of its legislation so as to ensure conformity with the Code.

Regarding the Committee’s request to review section 86(5) of the PDIA-2 so as to ensure conformity with Part VI and Article 68 of the Code, the Government of the Republic of Slovenia explains:

The amendment to the PDIA-2 Act from 2019 (PDIA-2G) brought changes in the regulation of the assessment of the partial benefit in case, when an insured person’s employment is terminated based on a positive opinion of the committee responsible for establishing the grounds for employment contract termination, or independent of their own will or fault, or if they were unemployed or not covered by the Compulsory Insurance upon the occurrence of the disability. In such cases the partial benefit is assessed in the amount of 80% of the disability pension to which the Insured Person would be entitled on the date of the occurrence of the disability.

The PDIA-2G also brought changes in the regulation of the assessment of the partial benefit in case when the insured person’s employment has been terminated through their own will or fault. Instead of reducing the partial benefit by 30% as it was the case under the previous regime, the new provision of the fifth paragraph of Article 86 of PDIA-2 provides for the assessment of the partial benefit in the amount of 25% of the disability pension to which the insured person would be entitled on the date of the occurrence of the disability. 

The partial benefit is therefore no longer reduced depending on whether the person lost his/her job voluntarily or through his own fault, but it is assessed in the same way as the disability benefit under section 85(3) of the PDIA-2. In addition, the amount of partial benefit is no longer determined depending on the length of working hours of the insured person.

D. Please state whether recourse is had to paragraph 3 of Article 36.

In the case of Slovenia, the recourse is not had to paragraph 3 of Article 36.

Article 37

Please state whether, in accordance with the provisions of this Article:

a.      all employees protected who were employed in the territory at the time of the accident or at the time of contracting the disease are entitled to the benefits stipulated in Articles 34 and 36;

b.      the widow and children of an employee who was employed in the territory at the time of the accident or at the time of contracting the disease are entitled to the periodical payments stipulated in Article 36 without any conditions as to residence.

Temporary incapacity for work

Rights (benefits) arising from the compulsory health insurance (governed by the Health Care and Health Insurance Act) are guaranteed to all persons covered by health insurance (all persons working within the Slovenian territory are compulsory insured).

Long-term incapacity for work

Rights (benefits) arising from the compulsory pension and disability insurance (governed by the Pension and Disability Insurance Act) are guaranteed to all persons covered by pension and disability insurance (all persons working within the Slovenian territory are compulsory insured).

With regards to the survivor’s pension in connection with the condition of residency, the PDIA-2 sets forth the provision concerning payment of pensions abroad (Article 120). The PDIA-2 lays down that a beneficiary who has permanently emigrated abroad shall have their pension remitted abroad.

Article 38

1. Please confirm that, in accordance with provisions of this Article, the benefits stipulated in Articles 34 and 36 are granted throughout the contingency.

All rights, those arising from the compulsory health insurance as well as those arising from the pension and disability insurance, are in accordance with the legislation in force granted throughout the contingency.

2. Please state whether a waiting period is provided for in case of incapacity for work and, if so, indicate the length of such period.

Temporary incapacity for work

Health services: no waiting period (from the first day of health insurance onwards).

Cash benefit (Article 29 of HCHIA): Benefit is paid to the insured person on the basis of the opinion of the personal physician or competent physicians’ committee:

Ø  from the first day of absence from work for transplant of living tissue and organs to benefit another person, as a consequence of giving blood, care of a close family member, isolation and attendance ordered by a physician and from employment injury sustained in circumstances from Article 18 of the HCHIA[33] and of cohabitation with a sick child in a hospital or health resort;

Ø  from the 31st day of absence from work in all other cases (Note: as of 1 January 2003 this indent is not used in relation to the right to wage compensation in cases of the worker's inability to work due to an illness or injury which is not related to work – Employment Relationship Act (Official Gazette RS, no. 21/13, 78/13-popr., 47/15-ZZSDT, 33/16-PZ-F)). For the first 30 days of absence from work, the benefit is paid by the employer – on a basis of the labour legislation in force (Employment Relationships Act[34]).

Long-term incapacity for work

Disability pension: No waiting period (An insured person acquires a right under compulsory insurance on the day when the conditions for acquisition of this right have been fulfilled. The necessary condition for obtaining the right to a pension is the cessation of compulsory pension and disability insurance. A recipient is entitled to a pension from the first day following the cessation of insurance).

Family pension: No waiting period (A widow, a widower or another family member who has asserted the right to a widow/widower's or a family pension by virtue of a recipient of old-age or disability pension, has this pension paid as of the first day of the month following the cessation of payments of old-age or disability pension to the deceased person).

3. Please indicate, with reference to Article 68 below, the provisions, if any, for the suspension of benefits stipulated in Articles 34 and 36, under the schemes concerned.

For the answer, please see for:


PART VII

FAMILY BENEFIT

The Constitution of the Republic of Slovenia (CRS) in its Article 53 lays down that the state protects the family, motherhood, fatherhood, children and young people, and creates the necessary conditions for such protection. Furthermore, parents have the right and duty to maintain, educate and raise their children. This right and duty may be revoked or restricted only for such reasons as are provided by law in order to protect the child's interests. Children born out of wedlock have the same rights as children born within it (Article 54 of CRS).

Primary legislation:

·         Parental Care and Family Benefits Act (Official Gazette RS, no. 26/14, 90/15. 75/17 – ZUPJS-G, 14/18, 81/19, 158/20 and 92/21);

·         Family Code (Official Gazette RS, no. 15/1721/18 – ZNOrg, 22/1967/19 – ZMatR-C and 200/20 – ZOOMTVI);

·         Public Guarantee, Maintenance and Disability Fund of the Republic of Slovenia Act (Official Gazette RS, no. 78/06106/1239/1611/18 – ZIZ-L and 139/20)

·         Exercise of Rights to Public Funds Act (Official Gazette RS, no. 62/1040/1140/12 – ZUJF, 57/12 – ZPCP-2D, 14/1356/13 – ZŠtip-1, 99/1314/15 –ZUUJFO, 57/15,90/15 in 38/16 – odl. US, 51/16 – odl. US, 88/16, 61/17 – ZUPŠ, 75/17, 77/18, 47/19 and 189/20 - ZFRO)

Secondary legislation:

·         Rules on the criteria for exercising the rights of children who need special child care (Official Gazette RS, no. 89/14, 92/15, 18/17, 17/18 and 3/19);

·         Regulation on Procedure for exercising Rights to Family Benefits (Official Gazette RS, no. 89/2014).

Basic features of legal arrangements

Parental Care and Family Benefits Act (PCFBA-1) regulates parental care insurance and the rights arising from this insurance, family benefits, conditions and the procedure of exercising individual rights as well as other issues concerning the enactment of the law.

Under the principles of mutuality and solidarity this insurance grants the insured persons with rights in connection with parental responsibilities. If not enough funding has been accrued with the payments of contributions for parental care to pay for the rights arising from the insurance, then additional funding is provided from the budget.

Contributions for parental care are paid by the insured persons as well as by employers. The contribution amount is determined by law (Social Security Contributions Act). The contributions are paid into the budget of the Republic of Slovenia.

The rights granted under this law are as follows (Article 2 of the PCFBA-1):

·         rights arising from the parental care insurance,

·         rights to family benefits.

Family benefitsare forms of financial assistance and include (Article 57 of the PCFBA-1):

-          parental allowance;

-          childbirth grant;

-          child benefit;

-          large family allowance;

-          special child care allowance for a child in need of special care;

-          partial payment for the loss of income;

-          assistance in purchasing a vignette.

Article 40

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

As mentioned above, family benefits are governed by the Parental Care and Family Benefits Act (PCFBA), which sets forth the following forms of family benefits:

·         parental allowance;

·         childbirth grant;

·         child benefit;

·         large family allowance;

·         special child care allowance for a child in need of special care;

·         partial payment for the loss of income

·         assistance in purchasing a vignette.

The family benefit taken into consideration under the Article 42 of this convention is the child benefit.

Child benefit

The aim of child benefit is to provide parents or the child supplementary income for living, raising and education (Article 70 of the PCFBA-1).

The right to child benefit is granted to one of the parents or another person for a child who has a temporary residence and actually lives in the Republic of Slovenia (Article 73 of the PCFBA-1) until the age of 18.

The right to child benefit is granted for the period of maximum one year (Article 75 of the PCFBA-1).

Child benefit from 1 February 2020 amounts to (EUR per month):

 Income class

average monthly income per person (in EUR)

Amount of child benefit for each child until child finishes elementary school or until age of 18 (in EUR)

Amount of child benefit for each child for a child in secondary school, until age of (in EUR)

1. child

2. child

3. and subsequent child

1. child

2. child

3. and subsequent child

1

Up to 191,40

117,05

128,75

140,47

117,05

128,75

140,47

2

Over 191,41 to 319,01

100,08

110,63

121,12

100,08

110,63

121,12

3

Over 319,02 to 382,82

76,27

85,25

94,19

76,27

85,25

94,19

4

Over 382,83 to 446,62

60.16

68,64

77,28

60.16

68,64

77,28

5

Over 446,63 to 563,60

49,19

57,41

65,57

49,19

57,41

65,57

6

Over 563,61 to 680,56

31,17

39,01

46,81

31,17

39,01

46,81

7

Over 680,57 to 871,98

23,38

31,17

39,01

29,52

37,31

50,84

8

Over 871,99 to 1.052,75

20,36

28,16

35,95

23,43

31,23

40,85

When the child lives in a single-parent family, the individual amount of child benefit is to be increased by 30%. A single-parent family is a union of one parent and children, whereas the other parent had died and the child does not receive any support after the deceased parent, or if the other parent is unknown, or if the child does not receive any income support from the other parent. If a pre-school child who is under the age of four is not enrolled in pre-school education in accordance with the regulations governing pre-school institutions, the individual amount of child benefit shall be increased by 20 percent. (Article 72 of the PCFBA-1).

Other family benefits

A question of eligibility with respect to other family benefits:


      
Parental allowance:

Parental allowance is cash aid to parents, which is provided when they are not entitled to parental benefits after the birth of a child (Article 63 of the PCFBA-1).

The right to parental allowance is granted to mother 77 days after the birth of the child, if mother and child have permanent or temporary residence in the Republic of Slovenia and actually live in the Republic of Slovenia. After that the right to parental allowance is granted reasonably under equal conditions to one of the parents, depending on the written agreement between parents agreed before starting to exercise the right (Article 64 of the PCFBA-1).

In line with article 64 of the PCFBA-1 the father has a right to parental allowance 77 days after the birth of the child under equal conditions as mother if mother:

-          has died,

-          has left a child,

-          is permanently or temporarily unable to live and work independently on the basis of the opinion of competent doctor.

The right to parental allowance is reduced for as many days as is the child's age when father acquires the right to parental allowance.


If parents cannot agree on the use of the parental allowance or if their agreement is in contradiction with the child's good, the decision is adopted by the center taking into account the benefit of the child.


Other person has the right to parental allowance under equal conditions as parents if they take care of the child. The right is reduced for as many days as it has already been used by the child's parents.


      

The right to parental allowance lasts for 365 days after the birth of a child. The father or other person is entitled to parental allowance in the same duration as the mother, reduced by the number of days the mother has already used the right (Article 66 of the PCFBA).

In certain cases, the PCFBA-1 provides for the prolongation of parental allowance (birth of twins or simultaneous birth of several live-born children, birth of prematurely born children, birth of a child in need of special care, upon the childbirth if the parents are already taking care of and bringing up two children until they finish first grade of elementary school).

Parental allowance amounts to 402,18 EUR per month.


      
Childbirth grant:

      

Childbirth grant is a lump-sum benefit in cash intended for the purchase of equipment for the newborn baby (Article 68 of the PCFBA-1).

The right to newborn allowance is granted to every child whose mother or father have permanent or temporary residence in the Republic of Slovenia (Article 69 of the PCFBA-1) and actually live in the Republic of Slovenia.

The right to childbirth grant is also granted to adoptive parents and other persons, who takes care of the child.

Childbirth grant shall amount to 350 EUR.

Large family allowance:

      

Large family allowance is an annual benefit intended for families with several children (Article 77 of the PCFBA-1).

The right to large family allowance is granted to one of the parents if:

-          one of the parents and the children have joint permanent or temporary residence in the Republic of Slovenia and actually live in the Republic of Slovenia (Article 78 of the PCFBA-1).

For the purposes of the PCFBA-1 a large family is a family with three or more children until the age of 18, and over the age of 18, if they attend school for as long they have the status of a pupil, apprentice or student, but only until the age of 26 at the latest. The right to large family allowance may be also granted to other person when three or more children from the same family live without parents.


      

The right to large family allowance lasts for as long as the conditions under the PCFBA-1 are fulfilled.  It is considered that the conditions are fulfilled if they are met at least one day in the calendar year.


      

Large family allowance amounts for the family with three children amounts to 404,48 EUR and for the family with four or more children 491,52 EUR. It is paid as a lump sum payment.


      
Special Child Care Allowance for a Child in Need of Special Care:

      

Special child care allowance is a benefit in cash for a child who needs special care and is intended to cover higher costs of living the family has due to special care and nursing of such child (Article 79 of the PCFBA-1).

The right to special child care allowance is granted to one of the parents or to another person if the child has permanent or temporary residence in the Republic of Slovenia and actually lives in the Republic of Slovenia (Article 80 of the PCFBA-1).

This right is exercised on the basis of the opinion delivered by the medical board (Article 80 of the PCFBA-1).


      

The right to special child care allowance is granted:

-          for the period when the child is provided with special care due to medical reasons, or

-          until the age of 18. After that age the right to childcare allowance is granted if he or she attends school for as long he or she has the status of a pupil, apprentice or undergraduate student, but only until the age of 26 at the latest (Article 82 of the PCFBA-1).


      

The monthly amount of special child care allowance due to higher costs of living is 102,40 EUR. For children with severe disturbances in mental development and children with severe disability in movement who need special care[35], the allowance amounts to 204,80 EUR.


      
Partial payment for the loss of income:

      

In line with the Article 83 of the PCFBA-1 partial payment for lost income is personal benefit paid to one of the parents who has terminated his or her employment or started to work short time in order to care and safeguard a child/children with severe disturbance in mental development or severe disability in movement (hereinafter referred to as a child in need of special care). Partial payment for loss of income shall also be granted to a spouse or cohabiting partner who actually takes care of the spouse’s or cohabiting partner’s child if the right is not exercised by the mother or father and fulfils other conditions prescribed by this Act. The right referred to in the preceding paragraph shall also be granted to one of the parents or another person who takes care of two or more children with a moderate or severe mental disorder or a with moderate or severe physical impairment.

The right to partial payment for the loss of income is granted to one of the parents if the child and one of the parents have permanent or temporary residence in the Republic of Slovenia and actually reside in the Republic of Slovenia (Article 84 of the PCFBA-1).

This right is exercised on the basis of the opinion delivered by the medical board (Article 83 of the PCFBA-1).

The right to partial payment for the loss of income may be exercised by the person who meets set forth conditions if he or she has decided to leave the labour market or start working part-time in order to care for a child in need of special care.

The right to partial payment for the loss of income is granted to one of the parents until the conditions are fulfilled or until the child reaches the age of 18. If a child dies, the right is granted two more months after the child has died (Article 86 of the PCFBA-1).

When the medical board finds out on the basis of the opinion of the competent Centre for Social Work that the recipient of compensation for the loss of income does not provide the child with adequate care at home, the right is to be ceased on the first day of the following month after the finding was made (Article 86 of the PCFBA-1).


      

The monthly amount of partial payment for the loss of income is minimum wage gross. If one of the parents works part time, he or she is entitled to the proportional part of partial payment for lost income (Article 83 of the PCFBA-1). If one the parents care for two children with severe disturbance in mental development or severe disability in movement The monthly amount of partial payment for the loss of income is 30% higher.

Assistance in purchasing a vignette:

One of the parents or another person who owns or uses a vehicle which falls into the toll class 2B in accordance with the regulation governing toll roads and toll rates and who at the time of the last still valid registration of the vehicle, in accordance with the act governing the annual fee for the use of motor vehicles, exercised the right to a 50-percent reduced annual fee for large families for that vehicle shall, in the event of purchasing an annual vignette for that vehicle, be entitled to a one-off assistance in the amount of the difference exceeding the price of the annual vignette that is determined in the regulation governing the toll roads and toll rates for the toll class 2A.

Article 41

A. Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of Slovenia, the recourse is had to sub-paragraph (a) of this Article.

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

The aim of child benefit is to provide parents or the child supplementary income when the income per family member does not exceed the maximum limit of income class (Article 71 of the PCFBA-1)[36].

C. Please furnish statistical information under this Article as follows: Title I under Article 74.

TITLE I:

A. Number of employees protected:

Ai) For the year 2015 = cannot be determined[37]

B. Total number of employees:

For the year 2020 = 978.000[38]

C: Number of employees protected (A iii.) per cent of total number of employees (B):

A / B = cannot be determined / 978.000= / %

Parents and/or children (where one of the parents has their permanent residence in the Republic of Slovenia) are entitled to receive newborn allowance, child benefit, large family allowance and special childcare allowance for a child in need of special care. The mother or one of the parents shall have the right to parental allowance and partial compensation for the loss of income providing that the mother or one of the parents and the child have permanent residence in the Republic of Slovenia and they are both citizens of the Republic of Slovenia.

Article 42

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

In the case of Slovenia, the recourse is had to Article 42, paragraph (a).

If recourse is had to sub-paragraph (a) or (c) please state the amount of the periodical payment made in respect of each dependent child.

Child benefit from 1 February 2020 amounts to (EUR per month):

 Income class

average monthly income per person (in EUR)

Amount of child benefit for each child until child finishes elementary school or until age of 18 (in EUR)

Amount of child benefit for each child for a child in secondary school, until age of (in EUR)

1. child

2. child

3. and subsequent child

1. child

2. child

3. and subsequent child

1

Up to 191,40

117,05

128,75

140,47

117,05

128,75

140,47

2

Over 191,41 to 319,01

100,08

110,63

121,12

100,08

110,63

121,12

3

Over 319,02 to 382,82

76,27

85,25

94,19

76,27

85,25

94,19

4

Over 382,83 to 446,62

60,16

68,64

77,28

60,16

68,64

77,28

5

Over 446,63 to 563,60

49,19

57,41

65,57

49,19

57,41

65,57

6

Over 563,61 to 680,56

31,17

39,01

46,81

31,17

39,01

46,81

7

Over 680,57 to 871,98

23,38

31,17

39,01

29,52

37,31

50,84

8

Over 871,99 to 1.052,75

20,36

28,16

35,95

23,43

31,23

40,85

When the child lives in a single-parent family, the individual amount of child benefit is to be increased by 30%. A single-parent family is a union of one parent and children, whereas the other parent had died and the child does not receive any support after the deceased parent, or if the other parent is unknown, or if the child does not receive any income support from the other parent.
If a pre-school child who is under the age of four is not enrolled in pre-school education in accordance with the regulations governing pre-school institutions, the individual amount of child benefit shall be increased by 20 percent. (Article 72 of the PCFBA-1).

If recourse is had to sub-paragraph (b) or (c) please specify the nature of the benefits in kind and the methods of providing them.

/

Article 43

Please state, for each scheme concerned, the nature and the duration of the qualifying period, if any, for title to the benefits provided in accordance with the provision of this Article. Please summarise the rules for the computation of the qualifying period.

The child benefit is a cash benefit aiming to provide parents or the child supplementary income. The right to child benefit is granted for the period of one year.

For a person to obtain the child benefit no qualifying period as such is required under the condition that meets the criteria pursuant to the PCFBA (see the answer given to the question set forth under the Article 40). 

Article 44

A. Please furnish, under this Article, information in the form set out in Title I under Article 66 below.

Article 66 / paragraph 4 / (a)

Wage of the ordinary male adult labourer

·         time basis = the year 2020

·         annual average of the amount of wage of the ordinary adult labourer selected (gross) in 2020 = 1772,37 EUR[39]

A = 1772,37 EUR

B. Please also furnish the following information:

1. Total amount of cash benefits granted in respect of children of the persons protected, as shown under Article 41 above;

B.1 = 301.459.345 EUR[40]  

2. Total value of benefits in kind granted in respect of children of the persons protected[41], as shown under Article 41 above;

B.2 = /

3. Total value of benefits in cash and in kind granted in respect of children of the persons protected (B.1 + B.2).

B.3 = B.1 + B.2 = 301.459.345 EUR

C. Please furnish:

i.  the total number of children of all residents;

C.i = 535.508[42]

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

(A x  C.i) x 1.5% = 949.118.313,96  x 0.015 = 14.236.774,70 EUR

14.236.774 EUR < 301.459.345 EUR

Article 45

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

The right to child benefit is terminated on the first day of the following month after the conditions for its granting are no longer fulfilled pursuant to the PCFBA-1 (for the conditions see above).


PART VIII

MATERNITY BENEFIT

The Constitution of the Republic of Slovenia (CRS) defines Slovenia as a law-governed and social state. The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, retirement, disability and other social insurance, and to ensure the operation thereof. War veterans and victims of war violence are ensured special protection in accordance with a special law. The Constitution also stipulates that the state protects the family, motherhood, fatherhood, children and young people, and creates the necessary conditions for such protection (Article 53 of CRS).

Primary legislation:

·         Parental Care and Family Benefits Act (Official Gazette RS, no. 26/1490/1575/17 – ZUPJS-G, 14/1881/19158/20 and 92/21);

·         Health Care and Health Insurance Act (Official Gazette RS, no. 9/92, 13/93, 9/96, 29/98, 77/98 Odl US, 6/99, 56/99-ZVZD, 99/01, 42/02-ZDR, 60/02, 11/03 Skl. US, 126/03, 20/04-UPB1, 62/05 Odl US, 76/05, 100/05-UPB2, 100/05 Odl. US, 21/06 Odl. US, 38/06, 72/06-UPB3, 114/06-ZUTPG, 91/07, 71/08, 76/08, 118/08 Skl. US, 62/10-ZUPJS, 87/11, 40/12-ZUJF, 21/13-ZUTD-A, 91/13, 99/13- ZUPJS-C, 99/13-ZSVarPre-C, 111/13-ZMEPIZ-1, 95/14-ZUJF-C, 47/15-ZZSDT);

·         Social Security Contributions Act (Official Gazette RS, no. 5/9618/96 – ZDavP, 34/9687/97 – ZDavP-A, 3/987/98 – odl. US, 106/99 – ZPIZ-1, 81/00 – ZPSV-C, 97/01 – ZSDP, 97/0162/10 – odl. US, 40/12 – ZUJF, 96/12 – ZPIZ-2, 91/13 – ZZVZZ-M, 99/13 – ZSVarPre-C and 26/14 – ZSDP-1).

Secondary legislation:

·         Rules on the Execution of Childcare Leave (Official Gazette RS, no. 89/2014);

·         Rules on Compulsory Health Insurance (Official Gazette RS, no. 73/95, 39/96, 70/96, 47/97, 3/98, 3/98, 51/98 Odl. US, 90/98, 6/99 corr., 109/99 Odl. US, 61/00, 64/00 corr., 59/02, 11/03 Skl. US, 18/03, 30/03, 35/03 corr., 78/03, 84/04, 44/05, 86/06, 90/06 corr., 64/07, 33/08, 71/08, 118/08 Skl. US, 7/09, 88/09, 30/11, 49/12, 106/12, 99/13-ZSVarPre-C, 25/14 Odl. US, 25/14, 85/14).

Basic features of legal arrangements

Parental Care and Family Benefits Act (PCFBA-1) regulates parental care insurance and the rights arising from this insurance, family benefits, conditions and the procedure of exercising individual rights as well as other issues concerning the enactment of the law (Article 1 of the PCFBA).

Under the principles of mutuality and solidarity this insurance grants the insured persons with rights in connection with parental responsibilities. If not enough funding has been accrued with the payments of contributions for parental care to pay for the rights arising from the insurance, then additional funding is provided from the budget.

Contributions for parental care are paid by the insured persons as well as by employers. The contribution amount is determined by law (Social Security Contributions Act). The contributions are paid into the budget of the Republic of Slovenia.

The rights granted under this law are as follows (Article 2 of the PCFBA):

·         rights arising from the insurance for parental care,

·         rights to family benefits.

The rights arising from the parental care insurance are (Article 14 of the PCFBA-1):

1)      types of leave (Article 15 of the PCFBA):

·         maternity leave (105 days);

·         paternity leave (30 days);

·         parental leave (260 days or longer);

2)      types of benefits (Article 40 of the PCFBA):

·         maternity benefit;

·         paternity benefit;

·         parental benefit;

3)      right to work part-time and to payment of social security contributions due to parenthood.

4)      right to payment of social contributions due to 4 or more children.

5)      right to benefit during the nursing break.

Article 48

A.Please state to which of the sub-paragraphs of this Article recourse is had.

In the case of Slovenia, the persons protected shall comprise all women in prescribed classes of employees, constituting not less than 50 per cent of all employees, and, for maternity medical benefit, also the wives of men in these classes (Article 48 / sub-paragraph (a)).

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


      

Protection of maternity is legally regulated as follows:

(1)         Pregnancy and confinement: The Health Care and Health Insurance Act and the Parental Care and Family Benefits Act.

The rights arising from compulsory health insurance are (Article 13 of the HCHIA):

-                the right to payment of health services, and

-                the right to sickness benefit in lieu of pay during temporary absence from work.

The right arising from compulsory parental care insurance is the right to maternity benefit (cash benefit). The length of right to maternity benefit depends upon the use of maternity leave, which according to the law must be undertaken 28 days prior to the confinement.

According to the Health Care and Health Insurance Act (HCHIA), persons covered by the compulsory health insurance (insured persons) are:

x.                                                                                    those insured (insurees) and

xi.                                                                                  their family members (Article 14 of the HCHIA).

Those insured are:

1.          Persons who are employed in the Republic of Slovenia;

2.          Persons employed by an employer with their principal office in the Republic of Slovenia and sent to work or for professional training abroad, if they are not compulsorily insured in the country to which they have been sent;

3.          Persons employed by foreign and international organizations and institutions, foreign consular and diplomatic representations based in Slovenia, unless otherwise provided by treaty;

4.          Persons with permanent residence in the Republic of Slovenia employed by a foreign employer and not insured with a foreign health insurance provider;

5.          Persons who independently perform commercial or professional activities in the territory of the Republic of Slovenia as their only or main occupation;

6.          Persons who are owners of private companies in the Republic of Slovenia if they are not insured elsewhere;

7.          Farmers, members of their establishments and other persons performing farming activities in the Republic of Slovenia as their only or main occupation;

8.          Top sportsmen and chess players – members of physical training and chess organisations in the Republic of Slovenia who are not insured elsewhere;

9.          Unemployed persons who receive unemployment benefit or unemployment assistance from the employment institute;

10.      Persons with permanent residence in the Republic of Slovenia who receive pensions in compliance with the regulations of the Republic of Slovenia or maintenance in compliance with the regulations on maintenance for farmers;

11.      Persons with permanent residence in the Republic of Slovenia who receive pensions from a foreign provider of pension insurance unless otherwise provided by treaty;

12.      Persons with permanent residence in the Republic of Slovenia insured with a foreign health insurance provider who during their stay in the Republic of Slovenia cannot exercise their rights under that insurance;

13.      Family members of a person insured with a foreign health insurance provider and having permanent residence in the Republic of Slovenia but not being insured as family members with the foreign health insurance provider;

14.      Foreigners pursuing studies or training in the Republic of Slovenia who are not insured elsewhere;

15.      Persons with permanent residence in the Republic of Slovenia who are recipients of disability benefit according to the regulations on disabled military personnel and disabled civilian victims of war, who have rights according to the regulations on protection of war veterans, victims of wartime aggression and participants of other wars and recipients of national benefits for their services, if they are not insured elsewhere;

16.      Persons with permanent residence in the Republic of Slovenia who receive benefits in compliance with the act governing social protection for mentally and physically challenged adults, if they are not insured elsewhere;

17.      Persons with permanent residence in the Republic of Slovenia who receive permanent monetary benefit as their only source of maintenance according to the social security regulations;

18.      Persons with permanent residence in the Republic of Slovenia who are recipients of benefits for their services according to the regulations on protection of participants of war, if they are not insured elsewhere;

19.      Those liable for military service with permanent residence in the Republic of Slovenia and who are performing civilian service in place of military service;

20.      Persons with other incomes and with permanent residence in the Republic of Slovenia if they are not insured elsewhere;

21.      Citizens of the Republic of Slovenia with permanent residence in the Republic of Slovenia who are not insured elsewhere.

Under the conditions determined by the HCHIA (Article 20), the following are insured as family members of the insured person:

a)  the close family members:

1.   spouse,

2.   children (both from and out of wedlock and those adopted);

b)  the wider family members:

1.   stepchildren whom the insured person maintains,

2.  grandchildren, brothers, sisters and other children without parents, whom the insured person has taken in and maintains, under the conditions determined by this act for children,

3.   parents (father and mother, stepfather and stepmother and adoptive parent) who live with the insured person in a common household and whom the insured person maintains, and who do not possess sufficient means of their own for maintenance and who are permanently and completely incapable of working.

(2)         After confinement: The Parental Care and Family Benefits Act.

The right arising from compulsory parental care insurance is the right to parental benefits (cash benefits), parental leave and rights arising from the entitlement to work shorter hours and to payment of social security contributions due to parenthood.

Persons insured for parental care are (Article 8 of the PCFBA-1):

1.        persons who are employed in the Republic of Slovenia;

2.        persons who are employed by an employer established in the Republic of Slovenia and sent to work abroad, if they are not covered by compulsory insurance in the country to which they have been sent, and persons who are employed by a foreign employer for which the laws of the Republic of Slovenia apply in compliance with Union regulations;

3.        persons who are employed by international organisations and institutions, foreign consular and diplomatic missions established in the Republic of Slovenia, unless otherwise provided by an international agreement;

4.        persons who are independently engaged in a gainful or other permitted activity in the Republic of Slovenia;

5.        persons who perform a religious service in the Republic of Slovenia as religious workers in accordance with the regulations governing religious freedom;

6.        persons who provide foster care as a profession in accordance with regulations governing foster care;

7.        company members of companies established in accordance with the regulations in force in the Republic of Slovenia or founders of institutes who are the managers, if not insured on any other basis;

8.        persons who are insured under compulsory pension and disability insurance on the basis of performing an agricultural activity;

9.        unemployed persons who receive a cash benefit from the Employment Service of Slovenia pursuant to the regulations governing the labour market;

10.    persons who upon termination of employment receive financial compensation during temporary absence from work from the Health Insurance Institute of Slovenia pursuant to the regulations governing health insurance;

11.    persons who receive parental benefit pursuant to this Act and are not insured on any other basis;

12.    persons who are entitled to have their social security contributions paid due to part-time work owing to parenthood pursuant to this Act;

13.    persons who are entitled to have their social security contributions paid in the case of four or more children pursuant to this Act;

14.    persons who are entitled to partial payment for loss of income pursuant to this Act or the regulations governing social assistance;

15.    spouses, cohabiting partners and registered same-sex civil partners of employees of the ministry responsible for foreign affairs or the ministry responsible for defence who were posted to work abroad;

16.    persons entitled to occupational rehabilitation benefit pursuant to the Act governing pension and disability insurance and are not covered by compulsory insurance on any other basis.

C. Please furnish statistical information under this Article as follows: Title I under Article 74

Please see Part II – Medical Care / Article 9 / question C.

D. Please confirm that the dependant wives of men in the classes of persons protected are entitled to the medical benefits stipulated in Article 49, in accordance with the provision of this Article.

As mentioned above, according to the Article 14 of the HCHIA, persons covered by the compulsory health insurance (insured persons) are those insured (insurees) and their family members.

Family members are insured if they have permanent residence in the Republic of Slovenia, unless otherwise provided by international treaty for close family members (Article 20 of the HCHIA).

Among persons insured as family members are also spouses. The HCHIA sets forth that spouses are insured as family members if they are not themselves insured. On this condition insurance cover is also provided for a divorced spouse for whom a court order has decreed maintenance. Insurance for spouses also covers persons who live with an insured person in a relationship, which according to the Marital and Family Relations Act, is legally equated with marriage (Article 21 of the HCHIA).

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.

/

Article 49

A. Please indicate in detail the nature of the benefits provided under each scheme concerned, with reference to paragraph 2 of this Article, specifying more particularly the services provided in case of hospitalisation.

Pre-natal, confinement and post-natal care:

The HCHIA lays down that women are provided with:

·         regular and other preventive check-ups in connection with pregnancy;

·         women’s health care in connection with family planning, pregnancy and childbirth.

According to the Article 27 of the Rules on Compulsory Health Insurance (Rules), preventive check-ups for women are:

-              check-ups and counselling with regard to family planning, pregnancy, sexually transmitted diseases and their consequences;

-              contraception;

-              up to 10 systematic check-ups during pregnancy and 2 check-ups with ultrasound;

-              discovering carriers of HBs antigen, infected with toxoplasmos and syphilis;

-              one home visit to a pregnant woman in the second half of pregnancy;

-              medical check-ups six weeks after confinement, spontaneous or artificial miscarriage;

-              disensibilisation of Rh negative women with gamaglobulyns after the confinement or after the termination of pregnancy;

-              indirect Coomb’s test for every pregnant women and Rh disensibilisation in 28th weeks of pregnancy;

-              early discovering of breast and uterus cancer once per year with women over the age of 20;

-              genetic counselling;

-              amniocentesis and cariotypesation with positive transplantation test for women under the age of 35;

-              transplantation test for women aged between 35 – 37, and in case of the test being positive also amniocentesis and cariotypesation;

-              amniocentesis and cariotypesation or transplantation test with pregnant women aged over 37.

Hospitalisation (medical care and health services in connection with confinement):

According to the Article 38 of the Rules, insured persons (pregnant female) have the right to the hospital treatment (hospitalisation) which includes:

-            providing professional, technological and organisational services (services that cannot be performed on a primary care level or in specialist-ambulant practices);

-            medical care during the hospitalisation;

-            maintenance during the hospitalisation;

-            providing medications and material for dressing wounds;

-            Accessories required for medical treatment;

-            health services and health care related to confinement.

B. Please confirm that, in accordance with the provisions of this Article, the beneficiary or her breadwinner is not require to share in the cost of the medical benefits provided. If the scheme provides for the reimbursement of the expenses which the beneficiary or the breadwinner was obliged to incur in order to obtain the benefits stipulated in paragraphs 2, please furnish all available information to show that the beneficiary of breadwinner does not share the cost of such benefits.

Article 23 of the HCHIA explicitly defines the rights to health services deriving from compulsory insurance for which insured persons are provided payment in their entirety. Among those health services are:

·         regular and other preventive check-ups for women in connection with pregnancy;

·         women’s health care in connection with family planning, pregnancy and childbirth.

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

Article 50

A. Please state whether recourse is had to Article 65 or to Article 66 for the calculation of the benefit.

In the case of Slovenia, the recourse is had to Article 65.

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

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

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

Article 65 / paragraph 6 / (c): a person whose earnings are equal to 125 per cent of the average earnings of all persons protected:

·                     average wage (gross) in 2020 = 1.856,20  EUR

·                    ASSESMENT BASIS FOR THE CALCULATION OF BENEFITS: 125 per cent of average wage (gross) in 2020 = 2.320,25 EUR

·                     average wage (gross) Jan-Mar 2021 = 1977,59 EUR

·                     STANDARD WAGE: 125 per cent of average wage (gross) Jan-Mar 2021 = 2.471,99 EUR

(1) TITLE I

A:  Standard beneficiary: a person whose earnings are equal to 125 per cent of the average earnings of all persons protected (Article 65 / paragraph 6 / (c))

B:  125 per cent of average wage (gross)

C:  Standard wage (gross) in Jan-Mar 2021 = 2.471,99 EUR

(2) TITLE II

TIME BASIS: March 2021

D:  Amount of benefit granted during the time basis

·                     woman

·                     assessment period: 105 days (15 weeks)

·                     assessment basis = 2.320,25 EUR [43]

100%[44] of the assessment basis = 100% of 2.320,25 EUR = 2.320,25  EUR

E: Child benefit: 0 EUR

F: Child benefit: 0 EUR

G: (D + F) / (C + E)

 (2.320,25 EUR + 0 EUR) / (2.471,99 EUR + 0 EUR) = 0.9386  - 93,9%

Article 51

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

In accordance with the HCHIA, a person is entitled to the right to health services (medical care) from the first day of compulsory health insurance onwards.

The right to maternity benefit have persons who are (Article 41 of the PCFBA-1):

-          entitled to maternity leave, and

-          had been insured pursuant to the PCFBA-1 before the day of commencement of maternity leave.

The persons who are not entitled to maternity leave shall also have the right to maternity benefit if they had been insured pursuant to the PCFBA-1 for at least twelve months during the past three years prior to the commencement of individual type of parental leave (Article 41 of the PCFBA).

Article 52

1. Please state whether, in accordance with the provision of this Article, the medical benefits stipulated in Article 49 are granted through the contingency. Please specify also:

 

(a) the duration of the benefit during which the periodical payments stipulated in Article 50 are granted; and

(b) the duration of any period of abstention from work which may be required or authorised by national laws or regulations.

The medical benefits stipulated in Article 49 (health services) are granted through the contingency, including the pre-confinement (pregnancy, childbirth) and, if necessary, the post-confinement period (medical check-ups, hospitalisation).

The right to maternity benefit have persons who are entitled to maternity leave and had been insured pursuant to the PCFBA before the day of commencement of individual type of parental leave (Article 41). If these conditions are met, then the insured person is entitled to the right to maternity benefit during maternity leave for 105 days.

Pursuant to Article 29 of the PCBA-1, Each parent has the right to 130 days of parental leave (together 260 days). Mother can transfer to a father 100 days of parental leave and a father can transfer to a mother 130 days of parental leave. Parental leave follows immediately after maternity leave and is intended for the further care and protection of the child. Parental leave shall be used in a continuous series in the form of full or partial absence from work.

In exceptional cases, parental leave may also last longer:

Part of the parental leave of children lasting a maximum of 75 days may be transferred and used up until the child finishes the first grade of elementary school.

Adoptive parents have the right to parental leave, under same conditions as biological parents.

Father has the right to 30 days of paternity leave, which are nontransferable. It is extended by 10 days for the birth of twins and 20 days for triplets.

The father must use the paternity leave as follows:

*        at least 15 days in the form of full or partial leave to be used within one month after the end of the parental leave.

*        maximum 15 days (plus the additional days for the birth of twins or triplets)  in the form of full or partial leave until the child finishes the first grade of elementary school.

RIGHTS ARISING FROM THE ENTITLEMENT TO WORK SHORTER HOURS

The right to part-time work is held by one of the parents who is caring for and protecting a child up to three years of age.

One of the parents, who cares for and protects two or more children, may exercise the right to part-time work until the youngest child has completed the first grade of elementary school. One year is non-transferable for each parent.

One of the parents who cares for and protects a child with a moderate or severe motor handicap or moderate to severe mentally handicapped child, may extend the right until the child is 18 years of age. This right may be extended on the basis of the opinion of a medical commission.

Part time work must involve at least half of working obligations (20 hours a week). The right and the method of use are agreed between the employer and employee by a contract.

The right to payment of social security contributions is the right of a person exercising the right to part-time work. The employer pays the contributions according to actual working duties, and the Republic of Slovenia guarantees payment of social security contributions up until full working time.

PAYMENT OF CONTRIBUTIONS IN CASE OF CARING FOR FOUR OR MORE CHILDREN

One of the parents who leaves the labour market because of protection and care of four or more children has the right to payment of social security contributions based on the minimum wage, until the youngest child has completed the first grade of elementary school.

COMPENSATION DURING BREAKS FOR NURSING MOTHERS

The mother has the right to compensation during breaks for nursing (for one hour a day) until child reaches 18 months.

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

The PCFBA-1 lays down the provision on termination of the right to maternity/paternity/parental benefits (Article 48).

The right to maternity/paternity/parental benefit is terminated if:

-          the competent labour inspectorate establishes that the person in question carries out work during the period of use of maternity leave;

-          the person referred to in the second paragraph of Article 39 (the persons who are not entitled to maternity leave also have the right to maternity benefit if they had been insured pursuant to the PCFBA for at least twelve months during the past three years prior to the commencement of maternity leave) begins to work or to carry out an independent activity.

If any of the reasons referred to above arise, the person receiving maternity benefit must return the unjustifiably received amount of maternity benefit together with due interest.


PART X

SURVIVORS’ BENEFIT

The Constitution of the Republic of Slovenia defines Slovenia as a law-governed and social state (Article 2 of CRS). The chapter on human rights and fundamental freedoms specifically guarantees the right to social security (Article 50 of CRS), which stipulates that, under the conditions laid down by law, citizens of RS have the right to social security. It is the duty of the state to arrange compulsory health, pension, disability and other social insurance, and to ensure the operation thereof.

Primary legislation:

·         Pension and Disability Insurance Act (Official Gazette of the RS, no. 96/12, 39/13, 99/13 – ZSVarPre – C, 101/13 – ZIPRS1415, 85/14 – ZUJF-B, 95/14 – ZUJF-C, 95/14 – ZIUPTD, 96/15 – ZIPRS1617, 102/15, 23/17, 40/17, 65/17, 28/19, 75/19, 139/20, 189/20 – ZFRO and 51/21; hereinafter referred to as the PDIA-2);

·         Official Records of Insured Persons and Beneficiaries of Pension and Disability Insurance Act (Official Gazette of the RS, no. 111/13, 97/14);

·         Social Security Contributions Act (Official Gazette of the RS, no. 5/96, 34/96, 3/98, 81/00, 97/01, 62/10 - Odl. US, 96/12 – ZPIZ-2).

Secondary legislation:

·         Statute of the Pension and Disability Insurance Institute of Slovenia (Official Gazette of the RS, 52/14).

Basic features of legal arrangements

The system of pension and disability insurance is governed by the Pension and Disability Insurance Act (PDIA-2).

The system of pension and disability insurance in the Republic of Slovenia comprises (Article 1 of PDIA-2):

·         compulsory pension and disability insurance;

·         compulsory supplementary pension insurance;

·         voluntary supplementary pension insurance.

The state ensures the operation of compulsory insurance by determining the rate of contributions, imposing the compulsory payment of contributions of Employers and Insured Persons, setting out rules governing the compulsory admission to the insurance, the mode of assessment, payment and recovery of contributions, and the conditions for the recognition, assessment and enjoyment of rights, by arranging the system of personal data records and supervision over securing individual rights. (Article 5 of PDIA-2).

Also, in the event that the expenditure of the Pension and Disability Insurance Institute of Slovenia exceeds revenues from contributions from compulsory insurance, the state must guarantee the payment of pensions and other benefits from compulsory insurance to eligible persons. In this case, the deficit is covered from the state budget or from other sources (Article 5 of PDIA-2).

Articles 62 (Co-financing from the state budget) and 163 (Ensuring the liquidity of the Institute) of the act also stipulate that the state must cover the difference between the revenues and expenditure of the Institute from the state budget.

Compulsory insurance includes natural persons who meet the conditions laid down by the PDIA-2 or a treaty (first paragraph of Article 6).

Rights arising from the compulsory pension and disability insurance are rights to a pension, rights, arising from disability, the right to a yearly bonus and the right to an assistance and attendance allowance (Article 3 of PDIA-2).

Widow(er)’s and survivor’s pension – brief overview

The Pension and Disability Insurance Act (PDIA-2) lays down the provisions concerning the rights arising from cases of the death of the insured person. In such cases certain conditions have to be met, on the part of both, the insured person and the beneficiary, for the acquisition of these rights.

The rights arising from cases of the death of the insured person are:

-          widow(er)’s pension,

-          survivor’s pension,

A widow, a widower or other family members of a deceased Insured Person or a beneficiary of rights determined herein shall acquire the right to a widow/widower pension or survivor’s pension provided that the latter:

-     fulfilled the terms for the entitlement to an early retirement benefit, an old-age pension or a disability pension hereunder, whereby the death is construed in the same way as if a disability of category I had been established for the Insured Person, or

-     was the recipient of an early retirement benefit, an old-age pension or a disability pension arising from the Compulsory Insurance, or the beneficiary of rights arising from the Compulsory Insurance based on a disability.

If an Insured Person or a beneficiary of rights died due to an occupational injury or an occupational disease, the beneficiaries shall acquire the right to a widow/widower’s pension from the deceased insured person or a survivor’s pension irrespective of the years of pensionable service completed by such person (Article 52 of PDIA-2).

(1) Widow(er)'s pension

Widow(er)'s pension can be claimed by a widows or widowers of a deceased insured persons or beneficiary of rights:

1.      if by the time of the death they have completed 58 years of age;

2.      if by the time of the death they were completely incapable of work, or if they became so within a year after the death, or

3.      if by the time of the death, they were left with a child or more children who are entitled to a survivorˊs pension, whom they have the obligation to take care of (Article 53 of the PDIA-2).

A widow/widower who, becomes completely incapable of work for the duration of their right to a widow/widower’s pension (under the conditions set out in point 3 of the previous paragraph) shall maintain the right to the widow/widower’s pension for as long as such incapacity exists.

A widow/widower who by the time of death of the insured person or beneficiary of rights, has not completed 58 years of age but has completed 53 years of age, shall acquire the right to a widow/widower’s pension when they complete 58 years of age.

A widows /widower who, in the course of the right to a widow/widower’s pension obtained due to incapability of work or due to a child, complete 58 years of age, shall maintain the right to a widow/widower’s pension permanently. If this right expires before they reach 58 years of age, but after they have completed 53 years of age, they may re-enforce the right upon completing 58 years of age (Article 53 of PDIA-2).

The transitional period of increasing the age limit for widows, which began in 2013, ends in 2021, when the following conditions apply:

Year

Age limit

Paragraphs 1, 3 and 4

(transition to 58 years of age)

Paragraphs 3 and 4

(transition to 53 years of age)

2021

57years and 6months

52years and 6months

From 1 January 2022 the age condition of 58 years applies (for the onset of the “waiting period” 53 years).

The right to a widow/widower’s pension shall also be acquired by a widow who gives birth to a child of the Insured Person or beneficiary of the rights determined herein within 300days after their death at the latest, whereby she shall be entitled to this right from the time of the death onwards.</