Other insurance. Health insurance

All individuals employed under employment contracts are subject to insurance contributions to the remaining funds of the state social insurance (SSI) – General Sickness and Maternity and Unemployment. Additionally, contributions to the Occupational Accidents and Diseases Fund and the Guarantee Fund for Employees’ Claims, if applicable, are made solely at the expense of the employer. Self-employed persons may voluntarily choose to contribute to the General Sickness and Maternity Fund.
General Sickness and Maternity Fund
The General Sickness and Maternity Fund pays benefits for sick leave (temporary incapacity for work), maternity (pregnancy and childbirth), raising a small child, adoption. Self-insured persons can choose whether to make contributions for this risk. If they do not, they are not entitled to benefits. The total amount of insurance contributions due to the fund is 3.5% of the insurable income, with 2.1% borne by the employer and 1.4% – by the employee.
The sick leave benefit is 80% of the average daily gross salary for the last 18 months. A minimum of 6 months of insured length of service for general sickness is required. The first two days are at the expense of the employer and represent 70% of the gross salary.
The maternity benefit is 90% of the average daily gross salary for the last 24 months. It lasts for 410 days, of which 45 days are before the due date, and the rest – after the birth. The father can also use this benefit after the child turns 6 months. The amount of the childcare allowance for raising a child up to the age of 2 is determined by the State Social Insurance Budget Act for the respective year. It is granted from the end of the 410-day maternity leave until the child reaches 2 years of age. The benefit for adopting a child up to 5 years old is provided under similar rules and amounts as the maternity benefit and may be extended up to 2 years if the child is being raised by the adoptive parent.
Unemployment Fund
The Unemployment Fund pays benefits to persons temporarily unemployed if they meet certain conditions. The most important of these are that the unemployed person must be registered with a labour office, must have been insured for at least 12 months out of the last 18, and in order not to receive minimum benefit - the initiative for the termination of the legal employment relationship must have been the employer's and the employee must not have agreed. The total amount of insurance contributions due to the fund is 1% of the insurable income, with 0.6% borne by the employer and 0.4% – by the employee. Self-insured persons do not owe contributions to this fund and are not entitled to benefits from it.
The benefit is in the amount of 60% of the average daily gross remuneration for the last 24 months. The duration of receiving the benefit depends on the length of service, as follows:
• up to 3 years – 4 months
• from 3 years and 1 day to 7 years – 6 months
• from 7 years and 1 day to 11 years – 8 months
• from 11 years and 1 day to 15 years – 10 months
• over 15 years – 12 months
The amount of the minimum daily allowance is determined by the State Social Insurance Budget Act for the respective year and is granted for a period of up to 4 months.
Workplace Accident and Occupational Disease Fund and Workers’ and Employees’ Guaranteed Claims Fund
Contributions to these funds are made only at the expense of the employer. In the Workplace Accident and Occupational Disease Fund, the contribution depends on the economic activity of the employer. It can be between 0.4% and 1.1%. This fund pays benefits for temporary incapacity for work due to an accident at work and for permanent incapacity for work. Disability pensions are also paid in the event of an occupational disease or accident, as well as to heirs if the worker dies as a result of an accident at work.
The Workers’ and Employees’ Guaranteed Claims Fund provides a one-time payment that replaces the wages and benefits due when the employer is insolvent. Contributions are not made regularly but are determined annually - only when the fund needs to be replenished.
Health Insurance
Health insurance is defined as compulsory by law. The Health Insurance Act (HIA) regulates the relations concerning mandatory and voluntary health insurance. The body that conducts and manages mandatory health insurance is the National Health Insurance Fund (NHIF). The NHIF organizes the collection, management, and distribution of funds for mandatory health insurance.
The Health Insurance Act identifies two types of obligated persons:
· “Insurer” is a natural or legal person who is obligated to pay health insurance contributions for a third party.
· “Self-employed” is a natural person who pays health insurance contributions for themselves.
The health insurance contribution is the amount that a natural or legal person pays for mandatory health insurance, calculated as a percentage of the insurable income defined in the HIA.
The amount of the health insurance contribution is determined as a percentage of the income on which the contributions are due. It is set annually by the NHIF Budget Act.
For example, in 2025, the distribution of health insurance contributions between the insurer and the insured is in a 60:40 ratio, as follows:
· 3.2 percent at the expense of the insured person
· 4.8 percent at the expense of the insurer.
The health insurance contribution of self-insured persons is entirely at their own expense.
The health insurance contributions of unemployed persons are covered by the state budget for the period during which they receive unemployment benefits from the labour bureau. After the benefit period expires, and in cases where no benefits are received, unemployed persons must pay their health insurance contributions themselves.
Before individuals begin to pay their due health insurance contributions themselves, they must submit Declaration Form 7 by the 25th day of the month following the month in which their obligation for insurance arises, if they are not insured on another basis under the Health Insurance Act (HIA) and are paying health insurance contributions at their own expense.
Unemployed persons owe monthly health insurance contributions based on an insurable income not less than half of the minimum insurable income for self-insured individuals.
If, during the previous year, they have received taxable income (e.g. from rent, copyright royalties, etc.), they must perform an annual reconciliation of their insurable income in Table 2 of the Reference for the Final Amount of Insurable Income attached to their annual tax return for personal income taxation under Article 50 of the Personal Income Tax Act (PITA). If they have not received such income, they are not required to perform an annual reconciliation.
A specific group of individuals is insured at the expense of the state budget, if they are not insured on another basis. These include, for example: citizens up to 18 years of age, and after reaching that age, if enrolled in regular education – until completion of secondary education, but no later than reaching 22 years of age; students in full-time higher education programmes up to 26 years of age, and PhD candidates in full-time state-funded programmes; individuals receiving unemployment benefits; citizens who meet the criteria for receiving monthly social assistance and targeted heating aid under the Social Assistance Act, and others.
Health insurance rights of individuals who are insured at their own expense are suspended if more than three monthly health insurance contributions are unpaid within a 36-month period. When health insurance rights are suspended, i.e. more than three contributions are missing over the last 36 months, rights can be restored only after all health insurance obligations for the past 60 months have been paid.
If necessary, check the current rates of the various types of deductions in the relevant regulatory documents.
Useful links:
National Health Insurance Fund
This article has been prepared with the support of the OECD, as part of the project "Strengthening the Capacity for Implementation of the National Financial Literacy Strategy", funded by the EU through the Technical Support Instrument. This material is for informational and educational purpose only. It does not constitute investment advice, a recommendation or offer to buy or sell financial instruments, or the provision of any other type of investment services. More information can be found here.