REPORT

38^th General Annual Country Report including the developments and changes in the legislation of the Social Security Institution (SSI) between 01 July 2018 and 30 June 2019 regarding the implementation of the obligations laid down in the accepted parts of the European Code of Social Security is submitted below.

I.  OVERVIEW

With the entering into force of Social Security Act No. 5502, published in the Official Gazette on 20 May 2006, several social security institutions that were in charge of implementation of the provisions of several Acts to serve different workers’ categories have been incorporated into a single organizational structure as a result of which a Social Security Institution has been established.

The Social Security and Universal Health Insurance Act No. 5510, drafted within the framework of sustainability to ensure uniformity regarding norms and standards for the insurance branches and in their implementation by the former social security schemes incorporated under the Social Security Reform which eventually passed in the Grand National Assembly of Turkey in 2006, came into force on 01 October 2008.

Thereby, the social security reform, which thoroughly re-regulates the social security system in Turkey, started to be implemented in 2008.

With the Social Security and Universal Health Insurance Act No. 5510 which came into force in October 2008, the differences of the rights and obligations of the insured subject to social security institutions incorporated instead of different provisions applied for different working groups in Turkey have been removed and a new social security system has been established which they are equal with regard to rights and obligations. Taking into account both the problems of the current system in Turkey and the expected change in the population structure it has been intended to reach a fair, easily accessible, a more effective protection against poverty and a financially sustainable social security system in the mid and long term. In addition, a uniformity of norm in the health and pension systems has been ensured.

In accordance with the Act, the statuses of the insured persons who have started to work for the first time as from October 2008 have been redefined as follows in Article 4 of the Act No. 5510:

§  Persons employed by one or more employers on the basis of a service contract (4/a),

§  Persons who work independently on their own account and are not bound by a service contract (4/b),

§  Persons employed in the public administrations (4/c).

Accordingly, the insured persons who had been subject to Acts No. 506 and 2925, the insured persons who had been subject to Acts No. 1479 and 2926 and those who had been subject to Acts No. 5434 before the beginning of October 2008 are deemed to be covered under Article 4/a, 4/b and 4/c of the Act No. 5510 respectively.

The social security of those working on the basis of contributions covers the benefits provided in the insurance branches of sickness, maternity, occupational accidents and diseases (short term insurance branches), invalidity, old-age and survivor’s (long term insurance branches) as well as benefits provided from the universal health insurance. Social benefits and services offered for the groups who are out of the system with contributions and subject to indigence criteria are guaranteed by the State.

A. ADMINISTRATION / ORGANISATION

Having had the financial and administrative autonomy and public legal entity, the Social Security Institution, which is established by the Act No. 5502 and also subject to private law provisions in cases where there is no provision in the said Act, is the relevant organization of the Ministry of Family, Labour and Social Services to implement the provisions of the said Act and other Acts that assign functions and competencies of the Institution. The Social Security Institution is subject to the audit of the Court of Accounts.

With the onset of the Presidential Government System in Turkey on 9 July 2018, the aims and duties of the Social Security Institution are stated in the Presidential Decree No.4 dated 15 July 2018. The main purpose of the Institution is to maintain an effective, equitable, easily accessible, actuarially and financially sustainable social security system based on the principles of social insurance.

1.      Administrative Structure/Practices

Administrative bodies of the Social Security Institution comprises of the General Assembly, the Board of Directors and the Presidency. The General Assembly is the decision making body that bears the highest decision, competency and responsibility of the Institution.

The Institution consists of Central and Provincial Organizations. The President has the highest superiority in rank and is responsible to the Board of Directors for the Institution’s actions as well as activities and performances of his subordinate officials.

Organizational structure

The Presidency of Social Security Institution consists of the central organization and provincial branches.

a. Central organization

Central organization consists of the following units:

1. General Directorate of Pension Services
2. General Directorate of Insurance Premiums
3. General Directorate of Universal Health Insurance
4. General Directorate of Service Provision
5. Board of Guidance and Inspection
6. Department of Actuaries and Fund Management
7. Presidency of Strategy Development
8. Department of Human Resources
9. Department of Support Services
10. Department of Construction and Real Estate
11. Presidency of Training, Research and Development
12. Department of Legal Consultancy
13. Consultancy of Media and Public Relations

Within each general directorate, a maximum of 11 departments can be established by a resolution of the Board of Directors.

b. Provincial organization

The Board of Directors decided upon the foundation of a total number of 608 Social Security Centers in total, 457 out of which are Social Security Centers, 32 Guidance Social Security Centers, 37 Health Social Security Centers and 82 Financial Services Social Security Centers. 556 Social Security Centers are now in service, 412 of which are Social Security Centers, 26 Guidance Social Security Centers, 36 Health Social Security Centers and 82 Financial Services Social Security Centers.

Status of the personnel

The following categories of employees are working in the social security institutions, in line with Article 4 of the Act no. 657 on Civil Servants:

§  Public Servants (4/a)

§  Contractual employees (4/b) (Contractual Pharmacist, Contractual IT Specialist, Contractual Office Staff etc.)

§  Workers (4/d)

2.      Changes and developments

a.      Changes made in the reference period:

The amendments regulated with the Law No. 7143 on the Restructuring of Tax and Certain Receivables and Amending Certain Laws, which came into force as of 18/05/2018, are as follows:

§  Payment of premiums has been facilitated for the insured persons working on their behalf and account within the scope of Article 4/b of the Social Security and General Health Insurance Law no. 5510. Two arrangements have been made to facilitate access to health services for these insured persons.

The first of these arrangements is to give the insured persons who have premium debts, the right to restructure their debts and for those who restructured their debts and pay the first installment in time, to benefit from health services.

The second of these arrangements is to give the insured persons who have premium debt before 31/05/2018, the right to pay or restructure these debts, the unpaid insurance periods of the insured who did not make payment or restructuring have been stopped and the debts related to these periods have been abandoned to allow them to benefit from health services.

§  With the same Law, the Treasury is to cover the premiums for one year of those who are between 18-29 years old and insured for the first time as of 01/06/2018 under the first paragraph of subparagraph (1) of Article 4 of the Act No. 5510.

Provisional Article 2 is added to Act No 7143 by the Article 11 of the “Law No 7159 on the Amendment of the Highways Traffic Law and Some Laws”. With this arrangement, those who do not pay the due amounts even though they have applied for debt restructuring in accordance with the Law No. 7143 can continue their payments with the same conditions if they have made the payment before the end of February 2019.

Other amendments in the related legislation are as follows:

The Circular No. 2018/26 which amended the Circular No. 2016/21 on short-term insurance branches was published on 10/07/2018.

According to the Article 11 of the Act No. 7146 (dated 26/07/2018) Concerning Amendments in the Military Service and Other Laws and in the Statutory Decree No. 663, the sequence number (20) has been added to the table existed in the second paragraph of Article 40 of the Act No. 5510. With this change, those that are accepted as medical employees under the Act No. 1219 dated 11/04/1928 on the Method of Execution of the Medicine and Medical Sciences, Nursing Act No. 6283 dated 25/02/1954 and the Act No. 6197 dated 18/12/1953 on Pharmacists and Pharmacies and that are employed in protective, diagnostic, treatment and rehabilitative services for human health will benefit from the pay rise in terms of actual service duration.

Within the scope of the Article 4 of the same Law and the additional Article 84 added to Act 5434 on the Retirement Fund of the Republic of Turkey, the “additional payment” was introduced in addition to the old-age pension for doctors and dentists who have been granted old-age, disability, service-disability pension and have not been entitled to payment of special position allowance. This additional payment has been started as of January 2019.

With the Act No. 7159, the last payment date for the general health insurance premium debts for April 2018 and previous months, which were under the scope of the sub-paragraph (g) of the first paragraph of Article 60, was extended from 31.12.2018 to 28.02.2019

As of 01/01/2019, male orphan payments have been made online without correspondence with related institutions and organizations. Information on male orphans is obtained online from relevant institutions and organizations within the framework of data sharing protocols.

With Act No. 7161 on the Amendments to Tax Laws and Certain Laws and Decree Laws, an additional Article 19 added to the Act No. 5510 and a threshold was set for old age, disability and death pensions. In the scope of the provisions of this Act, monthly pays and the total amount of monthly payments made under disability and old-age insurance cannot be less than 1,000.00-TL (app. $185) including the additional payments to be made pursuant to Article 1 of the Act No. 5454, dated 08/02/2006; whereas the total amount of payments made under death insurance cannot be less than the amount to be determined based on the ratio of the shares of the beneficiaries of such amount.

Provisional Article 78 is added to Act No. 5510 by the Article 10 of the “Law No. 7162 on the Amendment of the Income Tax Law and Certain Other Laws” which was published on the Official Gazette dated 30.01.2019 and numbered 30671. With this arrangement, minimum wage support was provided to private sector employers for January-December 2019 and government contributions were made to the cost increases resulting from minimum wage increase. The Circular on Minimum Wage Support 2019/8 regulating the transactions to be carried out in this regard was published on 22/03/2019.

The process of producing the “Clearance Certificate” and the “Release of Guarantee Certificate” in electronic form with barcodes has been completed.

With the Presidential Decree No. 31 “Amending the Presidential Decree on the General Staff and Procedure” published in the Official Gazette dated 06/02/2019 and numbered 30678, it is decided for bailiffs to be included in the general administrative services class and for those who have been granted old-age, disability, service-disability, widow or orphan pension before the date of entry into force of the Decree, have been provided with the additional indicator applied to civil servants in the general administrative services class as of 01/03/2019 following the date of entry into force of the Decree.

The Circular No. 2019/6 which determines the procedures and principles regarding the employer and insurance transactions of the apartment management establishments was published on 05/03/2019 and IT infrastructure has been completed and put into service. These establishments have been incorporated into the insurance coverage with the amendment in the Additional Article 9 of the Social Security and Universal Health Insurance Act No. 5510.

b.      Completed or initiated research (Evaluations included):

The activities of the “Supporting Registered Employment Project (KİDEP)”, initiated on 19/04/2017 to prevent unregistered employment, were completed on 13/11/2018. Within the scope of KİDEP, the following activities were carried out:

§  Information activities were organized for elementary school students in 15 different provinces in May and June 2018, and 50.000 story books, bags and piggy bank were distributed to students.

§  Social security information activities were conducted in 15 different provinces for small businesses and artisans. Informative guides were distributed on social security rights and obligations.

§  Social security information activities were conducted in 15 different provinces for the mufti, imams and preachers who are among the opinion leaders of the society and informative material was distributed.

§  A short film contest was organized on 12/02/2018 - 15/04/2018 for the communication faculty students of all universities and five awards were presented to the winners at the awards ceremony held on 26/10/2018.

§  A prize story contest, titled ‘Take Your Pencil and the Social Security Adventure is Beginning”, was organized to benefit from the experiences of the SSI employees, interesting events and stories they have experienced throughout their working lives in order to create a subject for the script for theatre activities to be prepared for secondary school students. Five persons ranking the highest the degrees received their rewards in a ceremony organized on 26/10/2018. 

Sending SMS for information has begun since January 2018 for insured persons whose basic earnings level has fallen by 20% or more. 835.480 persons have been notified with SMS as of 22/04/2019 in this context.       

Within the framework of the Yearly Programme of the Presidency, the Action Plan on Coping With Unregistered Economy (2019-2021) was stipulated to be prepared and put into effect. In this context, various actions have been mentioned in the draft action plan regarding the inspections and legal infrastructure that need to be changed. In the context of studies on a protocol on data sharing aiming at preventing informal employment, a protocol was signed with the Ministry of Culture and Tourism on 08/02/2019. Technical studies are being carried out both in making a protocol with the other institutions and organisations and in sharing electronic data. Analysis have been carried out by using the data of the SSI and other institutions and so sectors have been determined as risky in terms of unregistered employment and underreporting of wages.

Software testing studies designed for monitoring inspections in electronic environment carried out by Social Security Inspectors have been completed and a pilot study was initiated in Ankara, İstanbul, İzmir, Trabzon, Eskişehir, Konya and Diyarbakır. After solving the problems faced at this stage, the application is planned to be implemented in the entire country.

Visits to 50 workplaces chosen by sampling method among the workplaces employing the largest number of workers in Ankara province were made in February 2019. In choosing the workplaces employing the largest number of workers, the high possibility of employing foreigners who are under temporary protection has been taken into account. In the context of the above mentioned visits, information on rights and obligations regarding social security is given and also information is passed to employees about work permits. Moreover, an informative conference in Hatay province was held for foreigners under temporary protection on 29/04/2019.

The meetings on social security problems and ways of solving them with the aim of encouraging registered employment and consequently changing attitudes towards this direction were organized and opinions were received from social partners at the interviews hold on 22/11/2018 and 13/03/2019. After preparing a report by gathering the results, it will be sent to all the relevant partners.

3.      Payment methods

a. Changes made in the reference period:

Beneficiaries used to give a written petition for revenues and salaries that had been sent back to the Institution because of absence of banking transactions for a period of one year. By linking up a new screen on banks’ MOSIP menus, the bank personnel will be able to view the amount of the inactive or returned account of the beneficiary. In this way, sending of inactive and/or returned salaries in a very short time has been ensured by the method of e-petition.

While the first pensions of those who are entitled to the old-age pension in the scope of 4/a of the Law No. 5510 used to be paid on certain days of each month (between the 17th and the 26th days of each month), the pensions are now paid on the same day after the finalization of the transaction process. Information started to be given by sending SMS to the beneficiaries that their first pensions have been paid.

b. Changes agreed, planned or proposed for the next term:

Those insured under the scope of 4/a of the Law No. 5510 and entitled to the first old-age pensions are paid at certain days (between the 17th and the 26th days) of each month. With the new arrangements, pensions will begin to be paid after the 2^nd workday of the finalization of the transaction process. Moreover, while these payments were paid via a certain branch of the bank that the insured person demanded, pensions can be withdrawn from any branches of the relevant bank from now on.

4.      Use of information technologies

a.      Changes made in the reference period:

Studies in the field of Pensions:

With the additional Article 18 added to the Law No. 5510 by Law No. 7143, payment of 1.000 TL (app. $185) bonus in the Feast of Ramadan (Eid al-Fitr) and the Feast of Sacrifice (Eid al-Adha), to those receiving pensions from the SSI is regulated. In this context, procedures and principles entered into force with the decision of the Board of Directors dated 24 May 2018. Feast bonus payment operations were realized after making necessary revisions on Emektar 4A and Emektar 4B programmes.

In order to prevent the incorrect payment of monthly income/salaries of the insured and the right owners under the coverage of 4/a of the Law No. 5510, COVERAGE 4A Project on removal of registration data of the ones under the scope of 4/a, 4/b and 4/c from the system and repeal/deduction and listing of benefits/allowances became available for utilization in terms of registration processes as of 05/06/2017 and studies are continuing.

Integration of Emektar 4A Programme regarding Article 100 Programme has been completed. In this context, income/salaries are continuing to be paid to sons older than 18-year-old for the ones whose active education status going on after the end of employment period by querying at Article 100 Programme (Ministry of National Education and Council of Higher Education systems); to persons until the age of 25 in case they attend higher education and their health provisions can be opened automatically. Payment of income/salaries and health provisions of beneficiaries who have been determined that they don’t attend school and are not active students are stopped simultaneously.

“Coverage 4/c application” has been made available in order to prevent the incorrect payment under the situations which requires cutting of salaries such as marriage, beginning to work and graduation for the insured and beneficiaries under 4/c of the Law No. 5510 and also Additional Article 81 and Additional Article 84 of the Act No. 5434.

Moreover, software works for borrowing applications over e-government platform with regard to missing durations of part time work, the durations of lawyer internship, the durations of doctorate (PhD) studies and unpaid education for medical expertise of the physicians in accordance with the Law No. 4857 have been launched.

Software studies for granting additional period at the rate of ¼ for borrowing application over e-government platform with regard to durations of (birth, lawyership, doctorate, etc.) for a woman insured having severely disabled child provided that she had insurance after 01/10/2008 have come to the final stage.

For the ones who had been granted pensions before entry into force of the Temporary Article 35 of the Social Insurance Operations Regulation and had not met the conditions for payments of premiums because of the reasons other than their misconduct, software work for completing of lacking service periods have come to the final stage. The project on 4/b non-working declaration with regard to notices for non-working of the insured under Article (4/b), automatic payment of breast feeding payment to the ones receiving income/salaries, process of obtaining the residence permits of foreign nationals from the General Directorate of Migration Administration in electronic environment have been completed. It is ensured that the activation procedures are performed automatically and the process of taking rest reports is facilitated by removing chief physician approval mechanism.

The application of the Higher Board of Health, which aims to finalize, record and follow up the transactions of Social Insurance Higher Board of Health in a short time, to combine statistical information about the results and archive information in electronic environment into a single database and to develop data and evidence-based policies, has been put into operation as of 01/01/2019.  

The payment of the amounts entitled by the retired persons to their heirs after they decease is made possible by the entry of the power of attorney and allocation of the amount.

With the launch of applications on the e-government platform, efforts were made to make it easier for retirees to access the services offered by SSI through e-government.

Software works for borrowing applications of the insured under the coverage of (4/a) and (4/b) of the Law No. 5510 over e-government platform with regard to the durations of military service and pregnancy have been concluded and is now available.

The pensions paid to the entitled insured and beneficiaries within the scope of 4/b are transferred to the MOSIP system daily without waiting for the payment period.

In January 2019, manual health report entry procedures from Disability and Ageing modules included in the Emektar 4/B program were started to be received automatically from the e-disability program.

Within the scope of 4/c, software works for retirement of pensioners through Service Tracking Program (HİTAP) have been completed.

The studies on notification of occupational accidents and diseases in electronic environment for the insured persons in the scope of 4/c, the project on the rest reports received abroad which will enable such reports to be transferred to electronic platform, and designing of e-detection project providing monitoring the process of work accidents and occupational diseases have been completed.

Work is under way for integrating the disability detection procedures of the insured and right owners within the scope of 4/c of Law No. 5510 into the e-invalidity program. Software work is conducted for the health boards of the Institution for the designation of acquisition loss rate in occupation in result of occupational diseases and accidents.

Within the scope “Interest Implementation in Billed Receivables”, follow-up and collection transactions of the so-called billed receivables according to the Law No. 5434 on State Retirement Fund, namely retirement bonuses, death payments for the rights owners of retirement/ordinary invalidity/duty invalidity pension receivers, rank/representation/duty payments paid to orphans, and other related payments are carried out by SSI. Interest payments have been initiated for the collections that are not paid in due time and interest application is included in the Financial Automation System Project (MOSIP) system.

Daily payments of 4/a pensions, payments made as a result of court decision and 4/b pensions resulting from court decision were provided.

Studies in the Field of Insurance:

Works regarding the issuance of the monthly premium and service certificate in electronic environment after the last day of the legal period to be given to the Institution were completed and put into service.

It is provided to display the historical address information of the insured in the program by expanding the integration of the General Health Insurance Registration program with the Identity Sharing System.

In the General Health Insurance Registration program, software arrangements were made to define the archive number for the files of the insured.

The application, which enables to report work accidents and occupational diseases of the civil servants has been completed.

The delivery of the Service Documents issued by the diplomatic representatives to the Institution in electronic environment and the development of a program enabling online viewing of these documents by the relevant units have been completed.

The works regarding the installment of the debts of compatible premium debtors to our Institution have been completed in accordance with Article 48/A added to the Law No. 6183.

The works for the electronically notification of the writings which were notified according to the Law No. 7201 and 6183, are in the testing phase.

Works are going on for electronic confiscation (e-title deed confiscation) on the immovable property of the debtors who have been commenced execution proceedings in accordance with the Law No. 6183 due to their debts to the Institution.

In the "e-Deposit confiscation" application, instead of establishing a separate connection with each bank, the application was opened to production environment in order to establish a single point of connection. Banks that have completed the test have been transferred to this system.

In the “Potential Incentive Inquiry” screens prepared for employers to analyze whether the persons are within the scope of incentives before hiring the persons to be employed, in addition to the current incentives, in the temporary articles 15 and 50 of the Law No. 4447, works have been completed to make inquiries regarding incentives mentioned in Article 30 of the Law No. 4857.

Regarding the execution of transactions on incentive Laws No. 3294, 2828 and 4447/Additional-Article No 4. in electronic environment, works for the incentives within the scope of the Law No. 2828 have been completed. Works on the incentive Laws No. 3294 and 4447/Additional Article No. 4 is ongoing.

By making the entry of the premium basis to be paid for the insured in benefiting from insurance premium incentives, support and discounts, “Incentive Calculation Menu” designed to analyze the amount of the incentive discount to be calculated over this amount within the scope of the current incentives is enabled to be included in the Employer System.

Works regarding all transactions for the e-declaration password retrieval following the completion of the program for ratification of the e-Declaration agreement from the e-Government, have been completed to make it through e-Government without any document being sent or given to the Institution.

Program works are going on for the only electronic submission of workplace declaration in all cases where the workplace declaration should be submitted.

As for the insured persons working in domestic services, as well as the insured persons working in workplaces of janitor, it is possible to make the notifications made to the Institution automatically every month.

Within the scope of sub-paragraph (k) of the first paragraph of Article 81 of the Law no 5510, the program work has been completed for covering the premiums for a period of 1 year by the Treasury of individuals who have completed the age of 18 and who have not completed the age of 29 and insured within the scope of 4/b, on the basis of the sub-limit of premium determined in accordance with Article 82 of the same Law.

Program works for returning of incorrectly paid premiums by the public institutions within the scope of 4/c are in the pilot phase.

The works for viewing the records transferred to the HİTAP (Program on Follow up Services) application by the Public Institutions via the e-Government have been completed.

Works for having borrowing requests from the insured under the scope of 4/c and sending the accruals to the institutions via HİTAP and informing the insured about the result of transaction via SMS, have been completed.

By applying statutory interest to the receivables of incentives to be used retrospectively within the scope of Additional Article 17 which came into force on 01.04.2018, works on deducting or repaying of the existing debts have been completed.

It is ensured that the clearance certificates requested by the municipalities from the owners of special construction workplaces are sent electronically.

Revenue Administration and the Social Security Institution systems are integrated with each other and debt inquiry services are prepared and implemented.

KİGEP Project:Job Creation and Entrepreneurship Opportunities for Syrians Under Temporary Protection and Host Communities in Turkey Project - sub-components of the Employment Promotion Program Registered Employment Transition Program (KİGEP) is carried out by the Social Security Institution and ILO Turkey Office. In order to make payments to employers employing Syrian workers within the framework of the program, the pre-application screen has been made in the MOSİP system and applications for the Project have started to be received from the system.

Studies in the Field of Health:

As of 01.10.2018, all primary health care providers outside the scope of e-prescription have been obliged to write e-prescriptions in MEDULA PharmacyProvision Application.

As of 04.04.2019, the application of a secure electronic signature is required in the reports for medicine usage issued as e-reports with the institutional physician password.

As of 31.12.2018, the process of rewriting and updating all screens of MEDULA Personal Payments application in accordance with the requirements in the MEDULA application in which accrual transactions such as travel expenses, daily and companion expenses of the right holders in the field of health are made has been completed. The application is opened to implementation in the test stage and it will be opened all through Turkey in a short time.

With Automatic Distribution of Documents to the Analyzers in MEDULA Hospital Application, the process of automatically distributing the hospital invoice and its annexed documents to the analyzers, which were examined by the Health Social Security Centers, was completed. In this way, standard and monitorability in document distribution has been ensured. The application was opened to the public all over Turkey as of 01.11.2018.

The prescriptions issued by workplace physicians have been compulsory to be issued with an electronic signature.

The application of e-report that will enable the registration of reports for medicine usage processed with institutional physician password as electronically signed to the MEDULA Pharmacy Application, has been opened to implementation as of 03.04.2019 all through Turkey.

The pilot works of the Hip Arthroplasty Application, which is one of the registration systems established for monitoring the data related to the health services to be determined by the Social Security Institution and to gather information and constitute the basis for the determined health and reimbursement policies, have been initiated in 08.01.2019. The registration form of the hip arthroplasty following the pilot works is decided to be implemented compulsorily as of 01.05.2019 (according to the date of the transaction of hip arthroplasty) all through Turkey.

Works have been initiated for the MEDULA Pharmacy regarding the application of the project for the receipt of documents attached to the invoice to the electronic environment which was initiated in MEDULA Hospital application. At present, work on the project is going on in four provinces.

Software works for family physician and hospital practice has been completed in the context of the application enabling the monitoring of procedures such as the penalties, undue payments etc. over the transactions and the registration of the audit reports related to the facilities by the Provincial Directorates and the complaints from the official channels (Presidency's Communication Center- CIMER, Family, Labour and Social Services Call Centre- Alo 170 etc.). The software will be put into operation in practice following the reassessment of the legislation unit.

The payment of the physiotherapy, treatment and rehabilitation (FTR) bills transferred by MEDULA to MOSIP online was ensured.

Regarding to the health insurance holders abroad, a MOSİP module has been prepared for invoicing of expenses related to health care services that have been received from Turkey and the deduction of items falling within the scope of insurance operations from the country where the insured is bound

Studies in the Field of Accounting:

The premium debts which have been detected on MOSİP system during and aftermath of pension entitlement procedure have been identified to users.

Those who applied for restructuring within the scope of Law No. 7143 and whose restructurings have been disrupted because of the fact that they haven’t made their payments were allowed to make payment according to the Law No.7159 published in the Official Gazette dated 28/12/2018 and numbered 30639. Necessary revisions have been set up in the relevant programs in the MOSİP system.

In accordance with Additional Article No.17 of the Law No. 5510, essential actions which have been taken with regard to retroactive incentive practices in the MOSİP system have been accomplished.

All financial transactions carried out by the Social Security Institution having monetary consequences are executed in accordance with certain power delegated to staff performing these transactions. A new module software work is underway with a view to establishing a systematic control mechanism in the MOSİP System in respect of delegating and abolishing powers accordingly which is generating financial responsibility in compliance with the Law No. 5018 and related subsidiary legislation.

Works under the Law No. 6183, Article 48/A regarding postponement, down payment and installments to be made by banks within MOSİP system are underway.

b.      Changes agreed, planned or proposed for the next term:

Activities Planned in the Field of Retirement:

Activities regarding finding out the incorrect income/pension payments which have been made in 4/a payment system is underway by making comparison with 4/a, 4/b and 4/c pension registrations.

Due to the difficulties experienced in making necessary revisions, conversion from Oracle 4/1-c pensioner and payment programs to 4/c Java has been initiated.

It is required that the information letter informing of inability for work which is handed over manually, should be entered over e-state platform by the employers with a view to enabling provisional invalidity benefit to be paid to the insurance holder within the context of additional Article No.9 (domestic workers) of the Law based on the medical resting report. Thereby, it will be explicitly shown on the payment screens and in the report details of e-payment applications.

During the operations in the SPAS programme, documents as such court decision, petition, health aid request form and reports of the disabled children, which are still requested on paper, are to be scanned, transferred and kept on the SPAS program, and thereby the documents will not be requested again on paper.

The software of the e-Detection Project, which will monitor the process of occupational accidents and diseases, will be completed and put into practice.

Health report information entered manually into the Emektar 4/A program will be automatically retrieved from the e-disability programme.

Activities Planned in the Field of Insurance:

It is planned that following the connection to be established between the General Health Insurance Registration Programme and the document management system, the notifications be prepared by the system automatically and sent to the insurance holders the notice about their general health insurance.

Levy and release of attachments of mining licenses and guarantees under the authority of Directorate General of Mining and Petrol (MAPEG) will be made electronically.

Administrative fines would not be implied as debt if the written notice (in case of date of notification is empty) hasn’t been delivered yet.

Execution and attachment proceedings will be followed up electronically under Occupational Health and Safety Registration, Follow-up and Monitoring Program (ISG-KATIP) project regarding receivables of SSI in accordance with the Law no. 6183 on Collection of Public Receivables.

Activities Planned in the Field of Health:

It is planned to transfer of the contract processes of hospital, pharmacy, optical, medical market and medical pharmacy users with SSI to the electronic environment. In this way, the duration of the contract will be shortened, the workforce in the central directorates will be reduced, and the archive (warehouse) problem will be eliminated by keeping the contractual documents in electronic environment. The implementation is planned to be realized by the end of 2019.

It is planned to provide the online collection and follow-up of application fees and dues after the agreement of the users of hospitals, pharmacy, optics, medical market / medical pharmacy and medical companies with our institution. In this way, it will be ensured that the applications and dues are paid on time and the receivables of the corporation will be taken under control more quickly. The application is planned to be realized by the end of 2019.

In order to prevent unnecessary examinations and tests and to accelerate the treatment processes, studies have been initiated to ensure that the results of the examinations and tests are stored on MEDULA and it is planned to be put into operation by the end of 2019.

Activities Planned in the field of Accounting

As a result of the study to be carried out together with the Ministry of Justice, the process for automatic reimbursement of the execution costs to the relevant execution file via online bank transaction is still continuing.

EFT transactions are realized by integrating with 3 banks and the efforts for working with the other banks is continuing.

After merging three institutions in the field of social security by Law, The Social Security Integration Project (SGEP) was initiated in 2010 as an investment Project in order to unite the information technologies, services and infrastructures of these three institutions and was gradually structured under the name of Social Security Information Management System (BİYÖS). The software phase has started in the said Insured Registration system.  Requirements and design studies in the demand management system which consists of the “Pension and Payments” components, have been completed. It is planned to receive consultancy and supervisory services for the main work of the Social Security Integration Project (BİYÖS Phase-1). In this context, technical specifications and contract studies have been completed.

c.       Completed or initiated research (Evaluations included):

Through the ERDS (Electronic Risk Audit System) project, which started with the Qliksense business intelligence tool in order to prevent abuses in the health field and monitor non-standard trends, it was ensured to monitor invoices coming from more than 2,500 Health Service Providers (SHS) on the same screen. These invoices are approximately amounted 40 billion TL annually.  It has been made possible to evaluate and compare health service providers according to the facility class, the invoice amount per doctor/ patient/ patient- follow-up and the health branch - treatment type. Identifying risk bearing amounts/ facilities/ branches and different behaviors according to average behaviors in Turkey became easier.

Within the scope of Information Systems Maintenance Project, license updates and hardware infrastructure updates were made in order to use the technological innovations of the Authority and to increase security.

Database Monitoring software, Data Leak Monitoring Software (DLP), Network Access Control Software (NAC), Cyber Operations Monitoring Software (ATAR), Vulnerability Scan System (Tenable) Software, Data Center internal firewall were provided and micro segmentation was done. Leakage tests and penetration tests were performed by two different companies. Data Warehouse Business Intelligence and big data were provided in order to use corporate data more effectively.

5.      Training of Social Security Personnel

a.      Changes made in the reference period:

	Trainings Between 01.07.2018 – 31. 12.2018
No.	Name of the Training	Number of Participants
1	General Health Insurance (GSS) Operations Training (Field Organizations)	756
2	Short Term Insurance Legislation and Application Training (Training on-site at desk)	89
3	Guidance and Public Relations Communication Training (Central and Field Organizations)	182
4	1.    Training on legislation related with “Allowance Law No. 6245” 2.    Legislative training on pre-fiscal control works and financial transactions. 3.    Within the Scope of The Law on Public Fiscal Administration and Control (Law no. 5018), training on the implementation of the Internal Audit and Internal Audit Standards Communique and the Internal Audit Standards Action Plan within the Institution.	150
5	Consultation Meeting of Provincial Directors and Unit Supervisors	90
6	Training on STATA	22
7	Training on Android Mobile App and İOS Mobile App	16
8	Training on the Program of Emektar and Legislation of 4/b General Entitlement (Field Organisation)	73
9	Training on Apps of 4/a and 4/b Registration and Services	254
10	Basic training on SPSS and Data Mining	8
11	Training on Employers’ Procedures and Legislation	754
12	Training on legislation of primary and secondary proceedings of decision-making when granting 4/a Survivors’ pension	145
13	Training on Risk Management	10
14	Training on DYS (Document Management System) and KEP (Registered E-Mail)	97
15	Training on Entitlement and Registration of Universal Health Insurance	453
16	Training on the Practices of Checks Concerning Constructions of the Social Security Institution  (Central and Field Organisation)	164
17	Training on Infrastructure and Technical Proceeding of Data Center	13
18	Training on Awareness of Data Safety	480
19	Training on CCNA	10
20	Training on Duties and Proceedings of Social Security Inspectors and Authorised Social Security Inspector Assistants (Field Organisation)	1271
21	Training on the Qlik Sense or QlikView Program (Central Organisation)	19
22	Training on Skim Reading	28
23	Training on News Photography and Social Media and News Editing Techniques	107
24	Training on the Legislation- Laws No 5510-5434-5335	98
25	Training on Regulation on Archival Services  (Central Organisation)	19
26	Training on Rules for Formal Correspondence (Central Organisation)	13
27	Training on Maven, Spring Core, Spring MVC, Spring Security, Hibernate and JPA	56
28	Training on Inquiry Screens for Paperworks (Central Organisation)	14
29	Training on the General and Updated Legislation in relation to Active Duty And War-Related Invalidity under Articles 56 and 64 of the Law No 5434, Active Duty-Related Invalidity Pension Granted from the Non-Contributory System as per Article 4, Law No 2330, Pensions and Benefits paid under the Additional Articles 16 and 17 of the Law No 442, Pensions Granted under the Law No 5233 on Compensation of Damages Resulted from Terrorism and Fight against Terrorism, Honorary Pensions Granted under the Laws No 1005, 3292 and 5269, Honorary Athlete Pensions Granted under the Laws No  2913 and 5774	96
30	Video conference training with basic and preparative briefing about Social Security Inspector Assistants’ career entry.	583
31	Training of Supervisors	10
32	Training on Postgresql	38
33	Video conference training for staff in provincial directorates	553
34	Training on Personal Development and Legislative Practices along with Proceedings and Processes for Filed Cases and Case Renderings to which the Social Security Institution is a party.	415
35	Training on Practices of MOSİP System (Training for trainers)  (Central and Field Organisation)	225
	TOTAL	7.311

	Trainings Between 01.01.2019-01.07.2019
No.	Name of the Training	Number of Participants
1	Training on Practices concerning Leaves and Medical Reports of Human Resources	19
2	Excel Training at Beginners' Level	43
3	Training on Java 4/a	86
4	Basic Training on Rational Team Concert (RTC)	38
5	General Training on the Legislation of Entitlement (Field Organisation)	340
6	Training on Techniques of Drafting Legislation (Central Organisation)	26
7	Training the Trainers  (Central Organisation)	89
8	Training on the Practices of 4/a - 4/b Registration and Programs	156
9	General Training on the Legislation	10
10	Training on the Medical Charts of the Institution’s Data Stock (Central Organisation)	24
11	General Training on the Legislation concerning registration and entitlement of the insured under 4-1/ (c) of the Law No  5510	200
12	Training on the Legislation for the Department Staff of Invalidity and Medical Committees	47
13	General Training on the Legislation of 4/a entitlement and Java Program (Field Organisation)	189
14	Training on the Legislation and Practices of Minimum Standards of Work (Field Organisation)	272
15	Assessment of Nessus Security Gap	10
16	Training on the Law No 4734 on Public Tender and Law No 4735 on Public Tender Contracts	15
17	(Applied)  Excel Training at Beginners' Level	46
18	Training on Legislation and Practices of Short-Term Insurances (Desk-Based Training on the Spot)	128
19	Training on Proceedings of 4/1-(a) Permanent Incapacity Income and Survivors’ Income and Java Program (Field Organisation)	33
20	Training on Finance Mathematics and Actuary	7
21	Introductory Training on Algorithm and Programming (Central Organisation)	21
22	Training on Information Inquiry -  Duties and Proceedings of CIMER (Communication Center of the Presidency)	333
23	Training on the Institutions’s Real Estate Transactions (Center and Field Organisation)	180
24	Communication Training on Counseling and Public Relations (Central and Field Organisation)	219
25	Training on Social Media Expertise, Press and Media Relations, New Photography and Practices, Use of News Materials, News Editing Techniques and Practices	178
26	Bootstrap Training	27
27	Deduction Information Systems Training and IPC Applications Training	70
28	Spring Training	54
29	CISSP Training	10
30	Basic and preparative training-1 on Social Security Inspector Assistants’ career entry. (Field Organisation 9th group admitted to public office )	344
31	Training On Tracking And Collecting The Receivables Of The SSI	819
32	Training On Personnel Dealings Of Holders Of Permanent Worker Status	218
33	Training On Amendments in the Personnel Legislation Through Presidential Government System And Presidential Decrees	50
34	Training on Purchasing Legislation, Documents and Disposal, Movable Property Dealings. (Central and Field Organisation)	411
35	Training “Executive Assistants” (Central Organisation)	115
36	Training on NET Core	22
37	Training on Ombudsman Institution Practices (Central Organisation)	66
38	Training on Personal Development and Legislation.	312
39	Training on Pharmacoeconomics (Central Organisation)	11
40	Training on Duty-Related Invalidity	108
41	Training on the Program of Emektar and Legislation of 4/b General Entitlement (Field Organisation)	15
42	Merger of Revenue / Pension Training for 4/a and 4/b  Allocation Staff  (Field Organisation)	200
43	4/a Integrated Registration Program Training	313
44	General Information Training on Amendments made within the Scope of Public Financial Management and Control Law No. 5018	150
45	Ombudsman Institution Practices Training (Field Organisation)	150
46	Health Boards Physician and Administrative Staff Legislation Information First Half Year Meeting	190
	TOTAL	5.867

Within the scope of e-learning, all SSI personnel have access to e-courses. 31 trainings on pertinent legislation developed within the scope of the project have been made accessible to the personnel of the Social Security Institution since 2015. Within the scope of e-learning, all SSI personnel have access to e-courses from within the institution, online, through tablets and mobile phones. In addition to the above-mentioned trainings, 1013 personnel were provided with distance learning via video conferencing.

b.      Changes agreed, planned or proposed for the next term:

	Trainings Planned for  13.07.2019-31.12.2019
No.	Name of the Training	Number of Participants
1	Training on Project Preparation and Implementation of EU and National / International Grant Programs  (Central Organisation)	15
2	Training on Institutional Coordination  (Central Organisation)	70
3	Training on JSF 2.3	24
4	Training on NET Package (MCSD: Web Applications + ASP.NET Web API + WPF Application Development + WCF Service Development)	14
5	Document Management System Training	131
6	Understanding Speed ​​Reading Training	43
7	Health Economics Training (Central Organization)	20
8	MOSİP Training	150
9	Training on the Law of Contracts (Central Organization)	20
10	Supervision Applications Training for Institution Constructions (Central and Field Organization)	150
11	Advanced Excel (Applied) Training	48
12	Referral, Control Inspection and Reimbursement Procedures Training for  4/a and 4/b Allocation Personnel  (Field Organisation)	200
13	Training for Registration and Service Transactions of the Insured within the Scope of 4 / b	200
14	Health Boards 4th Training and Consultation Meeting	200
15	Secure Software Development Training	24
16	Supervisor Training (Central and Field Organization)	240
17	Personal Development and Legislation Training	1007
18	Training on Corporate Innovation And Decision-Making  in Public Administration (Central Organization)	20
19	Branch Managers Information, Coordination and Personal Development Training  (Central and Field Organization)	300
20	Health Boards Physician and Administrative Staff Legislation Information 2nd Half Year Meeting	190
21	5510 4/a and 4/b General Legislation Training on Registration and Allocation of Insured Persons	100
22	Training on Medium-Level Excel (Central Organization)	20
23	Training on News Photography and Social Media and News Editing Techniques	100
24	Advanced Software and Architecture Development Training	24
25	Training on Medium-Level Excel (Central Organization)	20
26	Training on the Qlik Sense (Central Organization)	20
27	Process Management and Analysis Training	25
28	CICS-Certified Internal Control Specialists Certification Preparation Training	30
29	Training of the employees of the health committees and administrative staff of the provinces	740
30	Training on the Short Term Insurances and E-Allowance Second Version Program Training	500
31	Institution’s  Legislation and Personal Development Training for Social Security Central Organization Assistant Directors	314
32	Institution’s  Legislation and Personal Development Training for Social Security Central Organization Directors	500
	TOTAL	5.459

6. Information Provided to the Right Holders and Other Services

Family, Labour and Social Services Call Centre “Alo 170”:

The objectives of ALO 170 Communication Center:

• Providing timely and easy access to accurate information with uninterrupted 24/7 service,
• Providing feedback by considering all kinds of questions, problems, criticisms, suggestions, notice and requests of the citizens,
• Bringing service to the citizens’ doorstep and preventing queues in institutions,
• Providing employment for the disabled, women, relatives of martyrs and veterans, mining sector employees, citizens who have had a mining accident and their families,
• Providing sound, safe, and high-quality service to our citizens by solving problems effectively and quickly,
• Functioning as the single contact point of the citizens regarding the legislation of the four aforementioned institutions dealing with social security and working life.

The Prime Ministry Circular No. 2011/2 entered into force by being published in the Official Gazette dated 19.03.2011, No. 27879 within the scope of preventing Mobbing in Workplaces. ALO 170 is the first and only call center providing support about mobbing in Turkey.

“Alo 170 Family, Labour and Social Services Communication Center” was first established as the Unregistered Employment Hotline to provide service during working hours with the work team consisting of the employees of the Institution in Ankara in 2008. The Center was transformed into a common communication center, with the Ministry of Family, Labour and Social Services, Turkish Employment Agency (İŞKUR) and the Social Security Institution (SSI) providing service on a 7-day and 24-hour basis.

ALO 170 Family, Labor and Social Services Communication Center provides call services at ten locations: Karaman, Şanlıurfa, Sivas, Kütahya, Ankara, Trabzon, Bayburt, Zonguldak, Muş and Elazığ with 1567 employees.

Within the scope of more than fifty thousand pages of legislation relevant to the Ministry of Family, Labour and Social Services, Turkish Employment Agency (İŞKUR), Social Security Institution (SSI) and Vocational Qualifications Authority (MYK) ALO 170 provide service on a 7-day and 24-hour basis to our citizens living in Turkey and abroad. ALO 170, which can be dialed from Turkey and any other place in the world, responds to the calls of citizens in about 3 seconds, and receives an average of 48.500 calls per day, is the largest and the most far-reaching communication center. 89 million 630 thousand calls have been received by ALO 170 line, beginning from the day of opening until 15.04.2019.

ALO 170 Family, Labor and Social Services Communication Center, 30% of whose workforce comprises the disabled, over 50% women, and 15% veterans and the relatives of martyrs and veterans, as well as other disadvantaged groups, is considered one of the largest Public Social Responsibility projects in Turkey. According to the research of an independent survey company, the Ministry of Family, Labour and Social Services, Turkish Employment Agency (İŞKUR), and Social Security Institution (SSI), which have conducted this major social project, have achieved a citizen satisfaction rate of 94.8% due to their effective, transparent, fast and citizen-focused work

78.791 applications about mobbing were received between 19.03.2011 and 31.03.2019. In 2018, calls about mobbing increased by 7% compared to the previous year with 18,700 applications. 4.411 applications have been made until 31 March 2019.

The sectoral distribution of the applications was as follows: The maximum number of applications about mobbing in the public sector was received from employees who prefer not to declare their institution (56,14), followed by Ministry of Health (11,83%) and Ministry of National Education (7,74%). Of the applicants working in public administration, 52% of the applicants were male and 48% were female In the private sector, the highest rate of calls has been taken from industrial enterprises (6,74%). 59% of the applicants from the private sector are male and 41% are female.

Around 3 million citizens having impaired hearing are served via the number “0850 222 7 170”. 11.673 calls were made by our disabled citizens until 31 March 2019.

The web chat service is provided on the channel “http://www.alo170.gov.tr/”. Citizens have access to ALO ​​170 by using this service channel 24 hours a day, 7 days a week. The Social Media (Facebook, Twitter etc.) is regularly scanned for content relating to MoFLSS, SSI and İŞKUR by 40 Social Media Experts employed by ALO 170. A total of 4.172.508 comments in the social media were examined between 01.10.2013-31.05.2018.

Around 10 million Turkish citizens living abroad are served through ALO 170. Our citizens abroad can reach the call centre by calling +90 216 170 11 22. By the end of March 2019, there were 14.233 calls from abroad. Most calls were taken from Germany, France and the Netherlands.

ALO 170 Communication Center for Family, Labor and Social Services has been awarded the gold medal in "The Best Outsourced Business Partnership Category" in the “Contact Center World.com” competition, a medal recognized as one of the most prestigious awards of the world in this field. ALO 170, the winner of the Europe, Middle East and Africa region in the competition held in London, won the first place in "The Best Outsourced Business Partnership Category" held in Las Vegas. ALO 170 was shown as an exemplary public project in terms of its 87% first call resolution rate and high customer satisfaction, in a competition in which world giants rival each other.

a.      Changes made in the reference period:

Apart from AÇSHİM ALO 170, the following changes have been made in the information activities for the beneficiaries:

The managers and members of the Martyrs and Veteran Associations located in Muğla, Eskişehir, Bursa, Erzurum, Trabzon, Konya, Van and Kars as well as in the surrounding provinces were given a seminar on the rights of the martyrs and veterans.

Three public service announcements (PSA) have been prepared to enlighten the public about the occupations and transactions of our institution, to inform the insured and right holders, to ensure that they have access to the correct information and to reduce the number of applications made to our institution. Studies for the publication of Public Service Announcements are proceeding with the Office of Press and Public Relations.

A brochure was prepared for the rights provided by maternity insurance and made ready for publication.

Posters were prepared related to work accidents and occupational diseases; maternity insurance and health activation processes.

SMS Information System interface program has been altered and MEYES integration has been ensured through authority groups in compliance with the current content and legislation. Trainings have been given to the central and provincial organizations of our institution. In order to raise the mobile phone number registered in the SMS Information System, promotional announcements were implemented in e-government SSI applications. In addition, 74.500.000 SMS were sent to the citizens between 01.01.2018-31.12.2018. Likewise, between 01.01.2018-31.1212018, 580.000 citizens were registered to SMS Information System.

b.      Changes agreed, planned or proposed for the next term:

It is planned to organize seminars for the five provinces (Diyarbakır, Iğdır, Siirt, Şanlıurfa, Hakkari) and the governorship and governorate personnel and the Provincial Directorates of Social Security in the neighboring provinces about the social security rights and obligations of Security Guards.

It is planned to organize a seminar on martyr and veteran rights for the executives and members of the Martyrs and Veterans Association in Ankara, Samsun, Izmir and Mersin provinces as well as in neighboring provinces.

In order to inform rights holders;

§  Public spots that have been prepared in the previous period will be published.

§  The brochure prepared for the rights granted by the maternity insurance will be completed and hanged in places that can be seen by the citizens, especially maternity hospitals.

§  Printing of posters prepared for occupational accidents and diseases, maternity insurance and health activation procedures will be completed.

SMS Information System regulation studies have been initiated and it is considered to integrate the concept of entitlement to the existing system in order to make the existing SMS Information System more comprehensive.

c.       Completed or initiated research (Evaluations included):

Within the scope of the information system, necessary analysis and research studies are carried out in order to convey the issue the right ownership to the citizens appropriately.

B. BENEFITS

1. Personal and Material Scope

Population Groups Under Social Security Scope as of December 2018 and Ratio to General Population:

December 2018			Active Insured	Pension/ Income Beneficiaries (Passive Insured)	Dependents	Total	General Population Ratio % (**)
Those Employed Under Employment Contract (4/a)	1- Mandatory		14.229.170	7.736.004	18.507.169	40.472.343
	2-Apprentice		341.659			341.659
	3-Abroad Community Insurance		22.899			22.899
	4- Agriculture (4/a)		45.384			45.384
	5- Other Insured (*)		254.525			254.525
	6-Interns and Trainees		1.161.122			1.161.122
	Total		16.054.759	7.736.004	18.507.169	42.297.932	%51,58
Self-Employed (4/b)	1- Mandatory		2.114.071	2.652.722	9.872.300	14.639.093
	2- Agriculture (4/b) (Mandatory )		696.175			696.175
	3- Voluntary		151.481			151.481
	4-Neighborhood Governor		23.053			23.053
	Total		2.984.780	2.652.722	9.872.300	15.509.802	%18,91
Public Employees (4/c)	1- Mandatory		3.031.311	2.224.425	6.717.061	11.972.797
	2- Voluntary (Article 12)		323			323
	3- Other (Annex 71, 76, Prov. 192)		1.667			1.667
	Total		3.033.301	2.224.425	6.717.061	11.974.787	%14,60
TOTAL			22.072.840	12.613.151	35.096.530	69.782.521
Private Funds			142.391	92.906	178.686	413.983
Total (Contributory System)			22.215.231	12.706.057	35.275.216	70.196.504	%85,60

* According to the Law No. 5510 (Annex-5, Annex-6, Annex-9) Insured persons working for less than 10 days, Prisoners and convicts employed by the Prisons and Detention Houses, and those who are suspended in public administrations.

** According to Address Based Population Registry System results, Turkish population is 82.003.882 in 2087.

2. Update in the Amounts of Aid

a.      Changes made in the reference period:

The lower limit of the daily earning kept to constitute a basis for the account of allowance to be given and premiums to be received pursuant to Law No. 5510, is one thirtieth of the minimum wage, and the upper limit is 7.5 times the daily earning lower limit.  For public workers who are considered to be insured under the scope of 4/c, the upper limit in question related to the amount of earning on which the premium is based, is not applied.

The lower limit of the daily earning between 01/01/2018-31/12/2018 has been set as 67,65 TL, and the upper limit has been set as 507,38 TL (67,65x7,5). The lower limit of the daily earning between 01/01/2019-31/12/2019 has been set as 85,28 TL, and the upper limit has been set as 639,60 TL (85,28x7,5).

The monthly earning amounts which constitute the basis for the calculation of premiums to be collected and allowances to be given in the period examined:

Period*	Lower Limit Amount of Monthly Earning TL		Upper Limit Amount of Monthly Earning TL
	Daily	Monthly	Monthly
July – December / 2018	67,65	2.029,50	507,38 x 30 = 15.221,40
January – June / 2019	85,28	2.558,40	639,60 x 30 = 19.188

* After 01/01/2016, the minimum wage has been started to be implemented so as to be increased once a year.

The pensions and incomes allocated to the 4/a and 4/b insured persons of the Law and their beneficiaries have been paid by an increase of 9,17 % in 2018/July and 10,19 % in 2019/January period pursuant to the second clause of Article 55 of Law No. 5510.

Similarly, the pensions and revenues which were allocated to 4/c insured people and their beneficiaries are increased by the coefficients determined pursuant to the provisions under Articles 5 and 8 of the 4th Term Collective Agreement that covers years 2018 and 2019 on Financial and Social Rights Towards Public Workers in General and By Service Branches. 

Salary and basic salary coefficients applied for 4/c insurance holders according to certain periods:

At the end of 4th collective agreement negotiations held for years covering 2018 and 2019, ratios of salary coefficient and official duty basic coefficient to be applied for converting the figures shown in monthly indicator table as well as the figures in the additional indicator and seniority indicator tables into monthly salary amounts were decided to increase by 4% in the first six month period and 3,5% in the second six month period for 2018 and 4% in the first six monthly period and 5 % in the second six monthly period for 2019 in compliance with the Article no:154 of  Public Officials Act No.657.

On the other hand, it was also decided to increase the aforementioned coefficients consistent with the Consumer Prices Index (TUFE) announced by Turkish Statistics Institution under Article 8 “payment of inflation difference” of the Collective Agreement.

In this context, 8,65% increase in the second six months period of 2018 and 10,73% in the first six month period of 2019 would be applied for the retired public officers’ pensions who are the insurance holders of the 4/c of the Law No. 5510.

The minimum and maximum public official (4/c) salaries defined according to coefficients applied in the period.

(*) These salaries are calculated basing on the highest public official with a 25 year of service (former Prime Ministry Undersecretary, current Presidential Head of Administrative Affairs by the new regulation) Salaries include the additional payment and 1/12 of Feast (Eid) Bonus (religious day bonus) which is 2.000TL.

II. HEALTH BENEFITS

a.      Changes made in the reference period:

Population Groups		Number
Premium system		2018 December
Those Employed Under Employment Contract (4/a)	Insured persons	16.054.759
	Pension and Income Receivers	7.736.004
	Family members	18.507.169
	Total	42.297.932
Self-Employed (4/b)	Insured Persons	2.984.780
	Pension and Income Receivers	2.652.722
	Family Members	9.872.300
	Total	15.509.802
Public Officials (4/c)	Insured Persons	3.033.301
	Pension and Income Receivers	2.224.425
	Family Members	6.717.061
	Total	11.974.787
Private Funds (*)	Insured Persons	142.391
	Pension and Income Receivers	92.906
	Family Members	178.686
	Total	413.983
Registered within the scope of General Health Insurance	Total	10.585.086
TOTAL		80.781.590

Number of groups within the context of health benefits covered by Health Insurance as of December 2018:

(*) Health benefits of these are covered by the foundation pensioned funds to which they are affiliated, rather than the Social Security Organization.

According to TUIK, Turkey’s population reached 82.003.883 in 2018 according to the Address Based Population Registry System. The number of people under health insurance scheme in the same year is recorded as 80.781.590 which constitutes %98,5 of whole country population. Health benefits required for those who falls behind the coverage are provided by various public Institutions.

Under restructuring activities in accordance with the Law no.7143, article 60 and clause (g), applications received from totally 130.621 applicants who have undergone first time means-test process between the dates of 18.05.2018 and 31.11.2018 have been updated under clause (c) subparagraph 1 of the same Law.

SSI provides its health services through contracts signed with health service providers. For this purpose, the following contracts, “Contract for Visual Supportive Medical Material”, “Contract for Procurement of Tailor-Made Prosthetics and Orthotics between Social Security Institution and Official Health Institutions”, “Contract for Ready to Use Medical Material for Outpatient Treatment”, were signed on 19/01/2018 and entered into force at the same date.

The following arrangements were made in the Social Security Institution Health Implementation Communiqué published in the Official Gazette no 28597 dated 24/03/2013:

§  By the Law Amending Certain Laws and Decree Laws regarding health issues numbered 7151 published in the Official Gazette No. 30616 dated 05/12/2018, with the exception of couples who have healthy children, the issues with regard to married couples who have a hereditary disease determined by the Institution or who are known to be carriers of such a disease were arranged.

§  Studies on harmonizing the radiology and laboratory operation codes with LOINC codes have been completed.

§  Modification enabling second step service providers which have licence as Bone Marrow / Organ Transplantation Center and Therapeutic Apheresis Center was made by granting authorization in order to issue medical board report for only Graft Versus Host Disease and solid organ transplantation to prevent tissue rejection (heart, lung, kidney transplantation). Thereby, it was made that extracorporeal photopheresis treatment not delayed and the patient not to be referred to the tertiary hospital.

The following regulations have been enacted with Social Security Institution Health Implementation Circular published in the Official Gazette dated 28/12/2018 No. 28597:

§  Regulation was made in relation to drugs used in the treatment of Hepatitis C and access was provided to 1 new generation combination treatment.

§  3 new generation agents were included in the reimbursement list in order to be used in multiple myeloma treatment.

§  1 drug to be used in the treatment of gut and hyperuricemia diseases and 1 drug to be used in the treatment of viral infections, have been included in the reimbursement scope.

§  3 new generation agents were included in the reimbursement list in order to be used in leukemia treatment.

§  Treatment with subcutaneous form of tocilizumab was regulated in adult patients with Giant Cell Arteritis (DHA) 

§  Pediatric dose adalimumab use was regulated in Crohn disease and uveitis disease indications.

§  1 new generation drug is included under the scope of reimbursement in order to be used in Hepatitis B.

§  The subcutaneous form of the drug named rituximab used in the chronicle lymphocyte leukemia indication, was included in the reimbursement. 

§  Statin use in children was regulated.

§  Treatment process has been cascaded for the drugs used in the treatment of macula degeneration affiliated with age, diabetic macular edema, retina vein clogging and sight disability arising from choroidal neovascularization affiliated with pathologic myopia.

In compliance with term “except otherwise implied in the contracts, unless one of the parties notifies the termination until the end of the working hours on the date of December 15 of each calendar year, the contract shall be deemed extended for 1 (one) year under the same conditions and a re-contract fee shall be collected.”, the contracts were extended for the next year and the extension was announced on 09/01/2019.

The following regulations have been enacted with Social Security Institution Health Implementation Circular published in the Official Gazette dated 01/02/2019 No. 30673:

In patients with Spinal Muscular Atrophy (SMA), Type II and III patients are provided access to medication.

In addition to above contracts, ”Protocol on Procurement of Customized 3D Design and Manufacturing Devices between SSI and University of Health Sciences” was signed and entered into force on 12/04/2017. The Protocol which is also prevailing for 2019, enables the supply of personalized materials to be utilized in traffic accidents, firearm injuries and bone loss in bone cancer.

On the other hand, “the Protocol for Procurement of Medical Materials for Outpatient Treatment of Veterans” signed on 04/10/2017 between SSI and University of Health Sciences is still valid. (This is the agreement in which the terms regarding the provision of materials other than the SUT lists of our veterans are included. The quality and reliability of the services to be provided to our veterans are guaranteed.)

“Agreement for Providing Health Care Service and Its Procedural Principles” signed between SSI and the Ministry of Health basing on lump sum price also continues in 2019 as well. Furthermore, agreement on “Providing Health Care Service Based on Lump Sum Price” with 43 State Universities in 2019 was also acted. Contracts with 14 Foundation Universities, Private Health Care Service Providers of which have cooperation protocol with 8 Foundation Universities, Contracts with 13 Municipalities, Contract with Second Step Health Care Service Providers, Contract with Near East University located in Turkish Republic of Northern Cyprus, Contract with Kolan British Hospital and with Girne Military Hospital still continue. “Contract for Health Care Service Purchasing from Private Health Care Providers” is also valid for 2019. 

Procurement of medicine from 25.700 and medical stuff from 19.000 contracted pharmacies is in force under the “Protocol of Procurement of Medicine from Contracted Pharmacies which are the Member of Turkish Pharmacists’ Association”. Financial matters were updated taking the annual inflation rates that turned into force on 01/04/2018. Extension study for 2019 is underway.

Three separate process codes have been created in Dental Treatments Point List under the names cleft lip, cleft palate and cleft palate orthodontic treatment codes (Formation After Birth, Complicated Dentition Period, Permanent Dentition Period).  It was rearranged so as to cover all orthodontic treatments, namely early orthodontic treatment, orthodontic treatment in cleft lip palate – cleft palate patients, fixed orthodontic treatment, and orthodontic treatment in orthognathic surgery

In the relevant annex of Health Implementation Communique, a new process code was added under the name “eculizumab” in the “Process Per Service Point List” 

In the relevant annex of Health Implementation Communique “Lists of Processes with No Additional Fee”, 27 process codes were added and it was updated.

A regulation was made in order not to charge any additional fee to our citizens for the health services provided under the scope of cancer surgery which is financed by the health service providers that have contract/ protocol with our institution and 394 health services were defined in the list under this scope.

A regulation was made for not issuing any separate invoice for the hemodiafiltration process as in the case of hemofiltration in the ICU treatment.

The blood components and the identified drugs that are used during health service provided to patients that are in need of palliative care treatment, are also covered by the Institution. 

b.      Changes agreed, planned or proposed for the next term:

SUT codes for scanning and verification laboratory analysis within the scope of fight against addiction will be determined.

Radiologic imaging and interventional process codes will be determined under the scope of Logical Observation Identifiers Names and Codes (LOINC) study. 

Examination and imaging process codes provided with service procurement method by health service providers that have contract/ protocol with our institution will be followed up.

III. SICKNESS BENEFITS

a.      Changes made in the reference period:

The number of those protected in terms of temporary incapacity allowance between the dates of 01/07/2018 and 30/06/2019and those receiving temporary incapacity allowance within this period:

Insured Status	Number of insured persons	Number of Sickness Cases Causing Temporary Incapacity Within the Year
Those Employed Under Service Contract (4/a)	* 14.893.637	2.175.150
Self-Employed (4/b)	** 2.984.780	3.944

(*) It covers the obligatory insured, apprentices and those insured under 5(g).

(**) Self-employed insured have been included under the scope of work accident, occupational disease and maternity insurance as the first time with this Law. These were provided with the opportunity to receive temporary disability pay during the period of eight weeks before and after births, as well as maternity insurance, and during the inpatient treatment due to work accident and occupational diseases, as the first time with this Law. On the other hand, Public workers are not covered by disease payments since they continue to receive their salaries during disease.

The number of cases of illnesses causing temporary incapacity according to their insurance status in the period of 01/01 / 2019- 31/05/2019 is shown in the table below.

Insured Status	Number of Sickness Case Causing Temporary Incapacity Within the Year
Those Employed Under Service Contract (4/a)	1.945.460
Self-Employed (4/b)	3.926

Temporary incapacity allowance daily upper and lower limits for 2019 have been changed as follows:

Type of treatment	Minimum Amount	Maximum Amount
For outpatient treatment	56,853 TL	426,39 TL
For inpatient treatment	42,64 TL	319,80 TL

The amounts of temporary incapacity allowance granted to the insured persons subject to temporary incapacity from the sickness insurance in 2018 and 2019:

 IV. UNEMPLOYMENT BENEFITS

-

V. OLD-AGE BENEFITS

a. Changes made in the reference period:

The old-age pensions paid within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 9.17% under Article 55 of the Law being valid from the payment period of 2018/July.

The old-age pensions of the insured within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 10.19% under Article 55 of the Law being valid from the payment period of 2019/January.

The pensions of the insured within the scope of 4/c of the Law No. 5510 under Article 55 of the Law have been increased at the rate of 8.65% being valid in the last six months of 2018 and 10.73% being valid in the first six months of 2019.

Total number of those protected in terms of old-age benefits as of the end of 2018 and those put on pension within the year and those receiving pension are shown in the table below:

Insured Status	Number of insured persons	Those put on pension within the year	Total number of those receiving old-age pension
Those Employed Under Service Contract (4/a)*	14.893.637	301.601	5.332.246
Self-Employed (4/b)	2.984.780	83.007	1.639.870
Public servants/Contributors (4/c)	3.033.301	49.374	1.404.252

(*) Covers Compulsory, Voluntary, Agriculture and Community Insurances.

b. Amounts of payment within the reference period:

There has been no amendment in the legislation within the reference period.

VI. OCCUPATIONAL ACCIDENTS AND DISEASES BENEFITS

a. Changes made in the reference period:

There has been no amendment in the legislation during the reference period. Changes concerning those who are already within the scope are as follows:

The number of those protected in terms of occupational accidents and diseases as of the end of 2018 and those receiving temporary incapacity allowances due to occupational accidents and diseases occurred within the year and the amounts are shown in the table below:

Insured Status	Number of insured persons	Number of persons receiving temporary incapacity allowance	Total (TL
Those Employed Under Service Contract (4/a)	14.893.637*	410.300	292.526.513
Self-Employed (4/b)	2.984.780	144	245.125

(*) Covers Compulsory insured, apprentices 5(g) and those insured within the scope

Total number of those protected in terms of occupational accidents and diseases as of the end of 2018, those put on permanent incapacity income due to occupational accidents and diseases occurred within the year and their beneficiaries (their widows and orphans):

Insured Status	Number of insured persons	Number of persons in the scope of permanent incapacity	Those Getting Permanent Incapacity Income	Beneficiaries Put on Salary Within the Year	Total Number of Beneficiaries Put on Salary
Those Employed Under Service Contract (4/a)*	15.777.335	3.995	75.406	5.588	92.215
Self-Employed (4/b)	2.833.299	36	248	147	1.038

(*) Covers compulsory and agricultural insured persons, apprentices and trainees

Total number of those (for the insured in the category of 4/c) protected in terms of duty disability on grounds of occupational accidents and diseases as of the end of 2018, those put on duty disability income due to occupational accidents and diseases occurred within the year are shown in the table below:

	Those insured who have become disabled within the year	Total number of those getting duty disability income
Disabled on Duty (Those put on income during year)	319	13.504

b. Amounts of payment within the reference period:

The upper-limit of occupational accidents and diseases income for the insured persons in accordance with the Law No 5510 is as below:

The lower limit of the period of occupational accident and occupational illness income for the insured persons in need of continuous care of another person according to Law No 5510 is shown in the table below.

Period	Permanent Incapacity Income
	Lower-limit (TL)
01/07/2018-31/12/2018	67,65 x 30 x %85 = 1.725,08
01/01/2019-30/06/2019	85,28 x 30 x %85 = 2.174,64

VI. FAMILY BENEFITS

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VIII. MATERNITY BENEFITS

a.      Changes in the Reference Period:

Temporary incapacity allowance daily upper and lower limits for 2019 have been changed as follows:

Type of treatment	Minimum	Maximum
Outpatient treatment	56,853 TL	426,39 TL
Inpatient treatment	42,64 TL	319,80 TL

Nursing benefit was increased to 180 TL in 2019 from 149 TL in 2018.

Number of persons covered and the number of persons receiving temporary incapacity benefit for the period 01/07/2018- 31/05/2019 are shown in the table below:

Insured Status	Number of insured persons	Number of persons getting temporary incapacity allowance	Amount (TL)
Those Employed Under Service Contract (4/a)*	14.893.637	217.752	602.931.073
Self-Employed (4/b)**	2.961.727	3871	9.599.669

* Temporary incapacity allowance regarding maternity is not paid to those within the scope of Articles 5-1(b), 5-1 (c), 5-1(e), Annex-5, Annex-6 and paragraph 2 of Annex-9 of the Law No. 5510 and for the intern students.  

** The insured women within the scope of Article 4-1 (b)/3 of the Law No. 5510 are not paid temporary incapacity allowance in the scope of maternity.

The number and amount of persons receiving temporary incapacity benefit according to their insured status in the period 01/01/2019-31/05/2019 are shown in the table below;

Insured Status	Number of persons getting temporary incapacity allowance	Amount (TL)
Those Employed Under Service Contract (4/a)	178.991	514.538.200
Self-Employed (4/b)	3847	9.638.327

IX- INVALIDITY BENEFITS

a. Changes in the reference period:

Old age pensions that are paid within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 9.17% under Article 55 of the Law being valid from the payment period of 2018/July.

Old age pensions of the insured within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 10.19% under Article 55 of the Law being valid from the payment period of 2019/January.

Total number of those protected as of the end of 2018 in terms of invalidity insurance, those put on invalidity pension and receiving invalidity pension within the year are as below:

Insured Status	Number of insured persons	Those put on invalidity pension within the year	Total number of those receiving invalidity pension
Those Employed Under Service Contract (4/a)*	14.551.978	7.138	76.554
Self-Employed (4/b)	2.984.780	2.475	22.166
Public servants (4/c)	3.033.301	951	26.216

(*) Covers Compulsory, Voluntary, Agricultural and Community Insured.

b. Amounts of payment during the reference period:

There has been no change in the legislation during the reference period.

X- SURVIVORS’ BENEFIT

a. Changes in the reference period:

Benefits / pensions that are paid within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 9.17% under Article 55 of the Law being valid from the payment period of 2018/July.

Benefits / pensions of the insured within the scope of 4/a and 4/b of the Law No. 5510 have been increased at the rate of 10.19% under Article 55 of the Law being valid from the payment period of 2019/January.

The widow and orphan pensions paid within the scope of 4/c of the Law No.5510 have been increased at the rate of 8.65% being valid in the second six months of 2018 and 10.73% being valid in the first six months of 2019.

Total number of those covered as of the end of 2018, those put on survivors’ pension and receiving survivors’ pension within the year are shown in the table below: 

Insured Status	Number of insured persons	Those put on survivors’ pension within the year	Total number of those receiving right holder’s pension
Those Employed Under Service Contract (4/a)*	14.551.978	124.229	1.939.548
Self-Employed (4/b)	2.984.780	70.795	950.605
Public servants (4/c)	3.033.301	30.796	685.893

(*) Covers Compulsory, Voluntary, Agricultural and Community Insured.

b. Changes agreed, planned or proposed for the next term:

Approximately 2.200.000 files of survivor’s pension are planned to be transferred to the Provincial Directorates of Social Insurance in order to enable the procedures of putting to pension more rapidly, effective and relevant.

In 2018, 130.000 files were updated and the transfer of the files that were programmatically updated started in 2018/November and as of March 2019, approximately 600 thousand files were transferred.

c. Amounts of payment during the reference period:

There has been no change in the rates of distribution of the salary of the dead insured that shall be calculated according to the provisions of this Law during the reference period. Developments concerning the amounts of salary during this period are given below:

Amounts of minimum salaries during the reference period for the beneficiaries (covered by the Law No. 506, Article 4/a) are as below:

Period	Rate of Increase	Single Person 80% TL	One Spouse 60% TL	One Child 30% TL
July-December 2018	9,17%	1431,66	1048,38	524,21
January-June 2019	10,19%	1.577,56	1.155,21	577,63

Amounts of minimum salaries for the beneficiaries (for 4/a insured) from survivors insurance in case they had service before 2000 during the reference period are as below:

Period	Rate of Increase	Single Person 80% TL	One Spouse 60% TL	One Child 30% TL
July-December 2018	9,17%	1.429,56	1.047,66	523,87
January-June 2019	10,19%	1575,24	1.154,42	577,25

              

Amounts of minimum salaries for the beneficiaries from survivors’ insurance in case they had service only after 2000 during the reference period:

Period	Rate of Increase	Single Person 80% TL	One Spouse 60% TL	One Child 30% TL
July-December 2018	9,17%	845,11	633,81	316,94
January-June 2019	10,19%	931,23	698,39	349,23

Amounts of lower limit salaries applied for widows and orphans during the reference period (4/c insured) are as below:

Period	For three and more people (TL)	For two people (TL)	For one person (TL)
July-December 2018	2.169,40	1.940,10	1.719
January-June 2019	2.402,20	2.148,20	1.093,40

On the other hand, according to the Laws No. 1479, 506, 2925, 2926, 5434 and 5510; the orphans who are receiving survivor's pension due to being invalid because of the deceased insured, can benefit from Article 2 of the Law No. 2022 in case they lose their working capacity

-          at a rate of 70% or more (disabled not being unable to continue his/her life without the help of another person),

-          between 40% and 69% (disabled).

In case the total amount of income and pension received by the children with disability over 70% and more, is below the amounts mentioned below, they get additional benefit equal to the difference.

-          for the period of 01/07/2018 - 31/12/2018 5253 x 0,117940 = 619,53 TL

-          for the period 01/01/2019-30/06/2019 5253 x 0,130597 =686,02 TL

In case the total amount of income and pension received by the children with disability between 40% and 69%, is below the amounts mentioned below, they get additional benefit equal to the difference.

-          for the period 01/07/2018-31/12/2018 3502 x 0,117940 = 413,02 TL

-          for the period 01/01/2019-30/06/2019 3502 x 0,130597 = 457,35 TL

The amount of funeral allowance:

The amount of funeral allowance paid during the reference period (for 4/a and 4/b insured) are shown in the table below:

Period	The amount of funeral allowance determined by the Governing Body of the Institution (TL)
July-December/2018	595
January-June/2019	716

Minimum funeral allowance amount applied during the period (4/c insured):

Period	Amount of funeral allowance determined by current coefficient and additional indicators (TL)
July-December/2018	2.240,86
January-June/2019	2.481,34

XI- FINANCING

a. Changes in the reference period:

Changes in the Field of Insurance

According to the Law No. 5510, contribution is taken over the rates determined on the basis of the total earnings subject to contribution for the insurance branches below and the General Health Insurance.

Contribution rates paid for the insured on a service contract under sub-paragraph (4/a):

Insurance Branches	Worker’s Share (%)	Employer’s Share (%)	Total
Contribution for Short-term Insurance	-	2	2
Contribution for Invalidity, Old-age and Survivors Insurance	9	11	20
Contribution for General Health Insurance	5	7,5	12,5
Contribution Rate of Unemployment Insurance	1	2	3
Total	15	22,5	37,5

The employers in the private sector employing the insured under 4/a of the Law No. 5510 were enabled to benefit from the premium incentives, support and deduction for reducing social security expenses provided that they ensure additional employment, pay their premium regularly and not to employ unregistered insured, etc.

In this context, 18 different work and proceedings on the premium incentives, support and deduction in total are carried out by the Institution; seven in the Law No. 5510, three in the Unemployment Insurance Law No. 4447, one in the Labour Law No. 4857, one in the Law on Supporting Research and Development Activities No. 5746, one in the Law on Encouraging Cultural Investments and Initiatives No. 5225, one in the Social Services Law No. 2828, one in the Law on Encouraging Social Assistance and Solidarity No. 3294 and one in Occupational Health and Safety Law No. 6331.

Within the scope of the application of additional six points deduction, with the Decree of the Council of Ministers dated 25/12/2018 and No. 503 which was published in the Official Gazette dated 26/12/2018 and No. 30637, the period of enjoyment in the provinces taking place in the lists of (I), (II) and (III) where an additional six points deduction is applied was extended until 31/12/2019.

In accordance with the additional Article 4 of the Unemployment Insurance Law No. 4447, with regard to the employer share incentive of unemployment insurance premium to be provided to establishments with more than ten employees which does not result in a fatal or permanent disability for three years taking place in very dangerous class, a “Communiqué on Procedures and Principles Regarding the Benefit of Unemployment Insurance Premium Employer's Share Incentives in Workplaces with Very Dangerous Classes and More Than Ten Employees” has been published in the Official Gazette dated 31/12/2018, No. 4.

As a result of the amendment made with the Article 41 of the Law on Amendment of the Tax Laws of 7161 and some Laws and Decree Laws published in the Official Gazette dated 18/1/2019, No. 30659, the possibility of benefiting from the discount of five points within the scope of paragraph (ı) of Article 81 of the Law No. 5510 which is applied for the staff within the scope of provisional Article 20 of the Law No. 506 has been abolished.

With Article 8 of the Social Services Law and the Law Amending Some Laws No. 7166 which was published in the Official Gazette dated 22/2/2019, No. 30694 and with the additional paragraph added to the provisional article 19 of the Unemployment Insurance Law No. 4447, the “Remuneration Support” has entered into force and the Circular dated 21/3/2019 and No. 2019/7 regarding the said support has been published.

Changes in the Field of Health

Average prices of hemodialysis, home hemodialysis and emergency hemodialysis procedures in the SUT supplement lists have been increased by 19% on average.

In order to provide the materials used in cochlear implant surgeries more easily, the price of the material was determined and an arrangement was made for the payment separately by our Institution.

A total of 3550 health care services, including normal delivery, cardiovascular surgery, cancer surgery, cancer radiotherapy (radiation therapy), bone marrow transplantation, organ-tissue transplantation, neonatal surgery, special surgery and hyperaric oxygen therapy, the price of the above mentioned services covered by the Institution have been increased.

The prices of intensive care, neonatal intensive care, dental treatments, physical and rehabilitation procedures, cataract surgery procedures, normal delivery procedures, assisted reproductive methods and palliative care treatments offered in university and educational research hospitals were increased by 20% and 55%.