IKA…
This IKA Information Page is from Completely Crete's Living in Crete Health Section. The following comes from the official IKA website:
IKA is the largest Social Security Organisation in Greece. It covers 5,530,000 workers and employees and provides 830,000 pensioners with retirement pension. IKA covers those in dependent employment in Greece or abroad for an employer who is based in Greece, as well as those who offer full-time or part-time personal labour on commissioned work agreements and are not insured with any other Main Insurance agency. IKA also covers certain groups of people who offer their labour to various employers at various times and whose insurance is realized through their Unions or Insurance Associations, (e.g. porters, news-stand vendors, slaughterhouse workers etc.) or through special provisions (e.g. exclusive nurses). COMPULSORY INSURANCE Compulsory Insurance does not depend on the good will of the employer or the empoyee and starts on the very first day of employment. Every beneficiary should check that their insurance scheme is the right one and should make sure that their employer has paid insurance contributions for every working day and for the whole sum of their pay. Through the right insurance scheme, an employee is entitled to an entire range of benefits from both IKA and other Organisations, such as OAED (the State Employment Services of Greece), Ergatiki Katikia (equivalent to Council Housing Services) and Ergatiki Estia (labourer’s Union). A higher salary and a higher number of employment days, mean more and greater benefits, if your employer refuses to register you with IKA or pays contributions for fewer employment days or lower wages or you discover, after you have been dismissed, that your insurance stamps have not been affixed to your insurance card (DATE), you must notify IKA in writing the soonest possible and no later than six months after the date of your dismissal. If you work at your employer’s home (house help, gardener, etc.) you must notify IKA in writing immediately, so that your insurance scheme can start. You should also notify IKA as soon as you stop working for an employer. OPTIONAL INSURANCE Those insured with IKA, on termination of their employment, are entitled to request continuation of insurance coverage either for a pension scheme or medical care or TEAM or all three, provided that:
In order to complete the days of insurance mentioned above, the time insured with other Funds is also taken into account, provided the last insurance agency was IKA. One is not entitled to optional insurance schemes if they are employed in heavy or health-hazardous occupations, nor can the days of optional insurance be included in the calculation of the necessary 35 years before one is entitled to receive pension benefits. OPTIONAL INSURANCE FOR GREEKS ABROAD Greek citizens or persons of Greek origin who are established in other countries (as of 1 January 85) are entitled to insurance coverage. Criteria for inclusion in the scheme: the only prerequisite condition for an employee is to be a Greek citizen or of Greek origin. The insured must pay both the employer’s and employee’s contributions to the IKA Pensions Branch according to categories designated by Law. During their permanent or temporary residence in Greece they can also be insured for Medical Care that covers pharmaceutical and hospital expenses. EXTENSION OF RECOGNITION A number of regulations make it possible for IKA to recognise the duration of one’s military service and/or the time of civil service employment as pensionable time. SUPPLEMENTARY SCHEMES (IKA - TEAM) Supplementary schemes were created to increase the main pension of those directly insured for the same occupation. Those who started a pension scheme with IKA and do not belong to any other Supplementary Fund are automatically included in the IKA - TEAM scheme as of 1 February 83. Those who already receive a pension from any other Fund, either main or supplementary, are excluded from the supplementary IKA - TEAM scheme. Those of multiple or parallel employment who belong to another compulsory supplementary insurance fund are also excluded from the IKA - TEAM scheme. IKA - TEAM MERGE WITH OTHER SUPPLEMENTARY FUND SCHEMES Certain Supplementary Funds are not in a position to offer their members the minimum insurance coverage offered by IKA - TEAM. There are also Funds with a pensioner to insured ratio of less than 1 : 2 and their financial state makes it impossible for them to continue operating. In these cases, following a relevant Decision by the Minister of Labour and Social Security, these people can be incorporated in the IKA - TEAM scheme. This way, IKA - TEAM secures the rights of all those insured with the merged funds. CONTRIBUTIONS IKA is a Social Security Organization. It receives contributions from both employers and employees, so that it can pay out benefits. The amount of contribution is a percentage of the gross income of the employee. The employer deducts the employee’s contribution when the salary is paid to the employee or worker and the deducted sum is paid to IKA along with the employer’s contribution within the deadline set by law. The contribution rates, as they stand today for the various sectors of employment, are as follows: IKA CONTRIBUTION RATE PERCENTAGES AS OF 1 January 94 (approved by IKA Administration, Act 75 / 95)
IKA also collects contributions for the following branches of insurance, which are then passed on to the Organisations who are entitled to them: PERCENTAGES OF CONTRIBUTIONS RECEIVED FOR VARIOUS ORGANISATIONS AS OF 1 January 94 (approved by IKA Administration, Act 13 / 95)
Special Self - Insurance Account Since this was established on 1 November 1990, it has been meeting pension scheme needs of various groups of uninsured men between 16 and 63 and uninsured women between 16 and 58. BENEFITS The main task of social security is to offer insurance coverage to its members through various benefits. IKA meets the needs of its insured members in medical care and benefit payments. Medical Care Beneficiaries are those directly insured and the members of their families, provided the insured have completed at least 50 working days reflected in their insurance in the last year or within the preceding 15 months - the last three months not counting. Other beneficiaries are old age pensioners or disability pensioners and members of their families as well as those receiving Death Pensions. Those directly insured (employees) are eligible to claim benefit payments, provided they meet the necessary requirements for Benefit Payment Allowances. MEDICAL CARE Covers: 1. Medical Examination by physicians at local IKA surgeries, family doctors and rural region doctors as well as IKA affiliated physicians who examine patients at their private practices. 2. General or specific examinations and treatments at IKA laboratories or others on contract with IKA. 3. Expenses, based on State set rates, for the fee paid to a private practitioner for a visit or medicine administered at an emergency, provided necessary documents are submitted to IKA within the deadline set. MEDICATION Prescribed medicines are administered by IKA physicians for the restoration of health and full recovery of those insured. Instructions given by the doctor must be strictly adhered to, for the treatment to be completed. Prescriptions must be carried out within five working days since their date of issue, otherwise they are rendered invalid. Insured members pay a 25% participation rate to the medicine cost. Exceptions apply for certain cases:
HOSPITAL CARE IKA meets the need for hospitalisation of directly insured customers as well as pensioners and their families:
The case must be reported directly to IKA within three days, so that an assessment and confirmation of the emergency is made, and the imperative need for hospitalization is determined by the IKA auditor-physician. The necessary documents for the reimbursement of hospital charges must be submitted within six months since the date of hospitalization, otherwise the submission of such documents is considered overdue. The Institute has also signed contracts with private Cardio-surgical Centres - besides State Hospitals - for Open Heart Surgery. DENTAL CARE Dental Care covers all sorts of dental treatment: Preventive dentistry, Dental prosthetics (full or partial), Special treatment at the respective special centres of Orthodontics, Pediatrics Dentistry, Stomatology, Periodontology, Jaw-surgery. Dental Care is provided primarily at IKA dental clinics by IKA dentists and, secondarily, where there are no such clinics, by private dentists under contract with IKA. SUPPLEMENTARY CARE IKA covers the means necessary for special health needs, e.g. heart-pacers, inhalers, hearing aids, speech apparatus, wheelchairs, hernia support belts, elastic shin supports, artificial limbs, eyeglasses, contact lences, etc. In order for the above to be provided,an IKA specialist report is required, ratified by the IKA auditor-physician. For certain kinds of supplementary care, a consultation of the Medical Committee of IKA is required. IKA provides treatment fees - board expenses and acts of therapy to children with special needs, following medical judgement (Diagnostic Therapeutical Care). SPA THERAPIES For conditions that can benefit from spa therapy, provided that those insured have not received Sickness Allowance. THERAPEUTIC TOURISM IKA provides Therapeutic Tourism to low income pensioners provided that they do not receive a Spa Therapy Allowance. Therapeutic Tourism Benefits cover overnight stay in a hotel for the insured and their accompanying member. The programme lasts for 15 days. TRANSPORTATION FOR THOSE INSURED If an insured patient has to be transported, IKA covers 4/5 of the fares for the patient and the accompanying person - if there is one - and pays both of them a daily compensation sum, if they cannot return on the same day. Compensation is paid to the travelling patients until they are hospitalised and no more than ten days in total, whereas the accompanying person receives compensation for the travelling days and no more than three days in total. PREVENTIVE MEDICINE IKA, in its effort to offer constant medical care to its insured persons, has developed activities in the field of preventive medicine through the establishment and development of various Centres and Stations regarding: Medicine of Work, Cytology, Family Planning, Prenatal Control, Breast and Uteral Cervix Cancer Prevention, Blood Donation, Protection of Mother - Child - Adolescent. IKA also covers the children of working mothers with Infant/Nursery Care, - IKA also conducts preventive medical examinations on working minors as well as all inoculations in accordance to the National Inoculation Program. - IKA applies Preventive Dentistry programmes for children of school age. - MATERNITY AID This is a sum paid when a woman gives birth to a full term or premature baby or even if the baby is still born following six months of gestation. Beneficiaries are directly insured women, those who are receiving a pension or wives of directly insured husbands or pensioners, as long as they have been recognised as family-members and are entitled to Sickness Benefits from IKA. PREGNANCY - CONFINEMENT ALLOWANCES These are paid for 56 days prior to labour and 63 days following labour, provided the directly insured woman has completed 200 insurable working days in the last two years before the expected or real delivery date and does not work during the pregnancy or post-natal period. SICKNESS - ACCIDENT ALLOWANCE Directly insured working pensioners are entitled to Sickness Allowance, when ill with an ordinary disease and the IKA Health Authorities find them to be temporarily unfit for work. The IKA physician can issue a Work Disability Report for up to 15 days every year. For any period over 15 days, such a report has to be issued by the IKA Health Committee. The insured patient is entitled to Sickness Allowance for up to: 1. 182 days for the same or different complaints, if they have completed 100 insurable working days in the year preceding their illness or the last 15 months minus the most recent three months. Especially for construction workers, if they have completed 80 working days in the previous year or 15 months, provided they have an overall number of 200 working days. All employment within the last two years or the last 30 months must have been in the construction sector, minus the most recent three months. 2. 360 days for the same disease provided they have completed 300 working days in the last two years or in the last 30 months, minus the most recent three years. 3. 720 days days for the same disease, provided they meet the following provisions: a. 1,500 days, 600 of which within the five years immediately preceding the notification of disease or b. 4,050 days increased by 150 days per year on average as of 1.1.1992 and up to 4,500 or c. 300 days up to the 21st year of age, increased by 120 days for every year after the 21st and up to the 54th year of age at which 4,200 days are required. It is imperative that 300 days of work must have been realised within the five years immediately preceding the year of notification of disease.If the work disablement is due to a complaint or injury due to accident that occured while working and because of it, it is enough for someone to be insured for that specific working day to be entitled to Accident Allowance. If a disease or injury is caused by an accident outside working hours, for someone to qualify for the allowance, half of the prerequisite conditions are enough than those demanded for Sickness Allowance. The notification of the accident must occur within five (5) working days from the day of the accident. FUNERAL EXPENSES These are paid in case of death of a directly insured person or of a pensioner due to old age, disability or death. The directly insured must have completed 100 working days in the year preceding their death. PENSIONS The basic prerequisite conditions for entitlement to a pension are as follows: FULL OLD AGE PENSION 1. Ordinary cases:
Note: * 4,050 working days are required for those insured who have completed their 63rd year up to 31 December 1991, when male, or 58th year, when female. The period of insurance with other Funds is taken into account if the insurance has been provided on the basis of dependent remunerative employment. * They do not receive Old Age Pension or Disability Pension from the State or other Insurance Fund (with the exemption of OGA, the Farmers’ Insurance Agency). 2. Those involved in heavy and health-hazardous occupations Prerequisite conditions: Men: at least 60 years of age, Women: 55 years of age. * At least 4,500 working days, of which 3,600 at heavy occupation, of which 1,000 have been completed in the last 10 years before the application submission or before they reached the prerequisite age. * They should not be receiving old age pension or disability pension from the State or other insurance Fund (with the exemption of OGA, the Farmer’s Insurance Agency). 3. Mothers of Minors Prerequisite conditions: Age: 55 years. Insurable days: at least 5,500. * A minor under 18 (natural or adopted whose adoption took place a year before the pension application was submitted), or a disabled child that is unemployable regardless of the age. * They should not be receiving Old Age Pension or Disability Pension from the State or other insurance Fund (with the exemption of OGA, the Farmers’ Insurance Agency. 4. Para/quadriplegic A. allowance [Law 1140/81] - Beneficiaries * pensioners and members of their families provided they are suffering from Paraplegia or Quadriplegia with a medical disability of 67% * insured persons who suffer from Paraplegia or Quadriplegia with a medical disability of 67% and have completed 350 working days in the last 4 years or the year preceding the time they became unable to work, of which 50 should have been completed in the last year or 15 months or 1,000 days at any time. * members of the insured person’s family, if they suffer from Paraplegia or Quadriplegia with medical disability of 67% and the insured person meets the prerequisite conditions mentioned above. B. Old Age Pension - prerequisite conditions * Disability due to paraplegia - quatriplegia . 4,050 insurable days, * regardless of age limit. * They should not be receiving Old Age Pension or Disability Pension from the State or other insurance Fund (with the exemption of OGA, the Farmers’ Insurance Agency). 5. Construction Workers - Prerequisite conditions * Age: men: 58, Women : 53 * Working days: a) at least 4,500, of which 3,600 in the construction or technical sector. Of these 1,000 should have been in the last decade preceding the pension application submission or the completion of the age limit or b) 4,500 working days, all in the construction or technical sector, of which at least 500 in the last decade preceding the pension application submission date or the completion of the age limit date. * They should not be receiving old age pension or disability pension from the State or a Legal Entity of Public Law or other primary insurance Fund (with the exemption of OGA, the Farmers’ Insurance Agency). 6. Full old age pension to those insured in new areas or new occupational classes. Prerequisite conditions: * Age: Men: 65 years. Women: 60. * Working Days: at least 1,000 within the first five years from the day of extension of the insurance into the new field or the new occupational class, which will increase by 175 days a year until 4,500 working days are completed. * They should not be receiving Old Age Pension or Disability Pension from the State or a Legal Entity of Public Law or other primary insurance Fund (with the exemption of OGA, the Farmers’ Insurance Agency). REDUCED OLD AGE PENSION a. Ordinary cases
A common prerequisite condition for both men and women - except in the case of mothers of minor children - is that the last five years they have completed 100 working days per year preceding the date of pension application submission or the date of completing the age limit. * They do not receive an old age pension or disability pension from the State or a Legal Entity of Public Law or other Insurance Fund besides their main one (with the exemption of OGA, the Farmers’ Insurance Fund). * There is a reduction of 1/200 for every month missing until the age limit for receiving a full pension is reached. b. After 35 years of work - Prerequisites (Article 32 - Law 2874/2000) Age: 53 years for both men and women Days of insurance: 10,500 days, 7,500 of which at heavy and health-hazardous occupations, valid as of 29.12.2000 OLD AGE PENSION (AFTER 35 YEARS OF WORK) DISABILITY PENSION
Prerequisite conditions:
* They do not receive an Old Age Pension or Disability Pension from the State or a Legal Entity of Public Law or other insurance Fund besides their main one (with the exemption of OGA, the Farmers’ Insurance Fund). * The Health Committees of IKA consider them as disabled with a pensionable disability (50% or above).
* They have IKA insurance
For Disability Pension due to an ordinary disease:
a) 4,500 working days or 10,000 working days or
b) 300 working days and they should not have completed their 21st year of age. These days are progressively incresing in number to 4,200 with an additional 120 working days per year until they become 21 years old. Of these days, 300 must have been completed within the 5 years preceding the disablement or
c) 1,500 days, at least 600 of which were completed in the 5 years preceding the disablement.
Disability Pension due to Accident At Work or Occupational Disease: Even one IKA insurable working day of the insured is enough.
Disability Pension due to Accident outside Working Hours: 1/2 of the working days of what is required for Disability Pension due to Ordinary Illness.
In case of death of the insured person or pensioner, death pension beneficiaries include:
1.The surviving spouse. 2. Their children, if they are unmarried, do not work, do not receive a pension and have not completed 18 years of age or their 24th year if they are in further education or are children orphaned from both parents or they were supported by the deceased parent. 3. Children who are disabled or unfit for employment and whose disablement started before they became 18 years old. 4. Grandchildren or step grandchildren who are orphaned from their parents and they were supported by the deceased. 5. Parents, if they were supported by the deceased.
In case of death of a pensioner or an insured person after 1.1.1993, only the surviving spouse and children are concidered as beneficiaries.
PENSION PAYMENT
The above mentioned family members of the insured deceased person receive a Death Pension provided the deceased had completed:
1. 4,500 insurable days 2. 300 insurable days and had not completed the 21st year of age. These days are increased by 120 on average for every year following the 21st until the number of 4,500 has been completed. 3. 1,500 insurable days
Note: In cases 2 and 3, there is an additional prerequisite condition: at least 300 working days should have been completed in the preceding five years before death occured.
* If the death of the insured was due to an Accident at Work or Occupational Disease, the family members are entitled to a pension if the insured had completed even one working day of IKA insurance. * If the death of the insured was due to an Accident Outside Working Hours, the members of the family are entitled to Death Pension provided the diceased had completed 1/2 of the required working days of those mentioned above.
TRANSFERENCE OF PENSION
In the case of death of an old-age pensioner or a disability pensioner, the pension is transferred to the members of their family who are entitled to it without recalculation of the working days completed by the deceased.
CONSECUTIVE INSURANCE (applicable Law: 1902/90, article 14 and 15).
PENSIONERS’ SOCIAL SOLIDARITY ALLOWANCE (EKAS)
From 1st January 2001 until 31st December 2001
Prerequisite conditions:
1. the 60th year has been completed for those old age pensioners or beneficiaries of death
pensions ( for disability pensioners there is no age limit requirement) 2. The overall net income from salaries and pensions for the year 1999 does not exceed the sum of 1,962,220 drachmas. 3. The total Personal Taxable Income for the year 1999 must not exceed the sum of 2,297,425 drachmas. 4. The total yearly Family Taxable Income for the year 1999 must not exceed the sum of 3,575,075 drachmas.
Necessary supporting document: Income tax settlement notice of the year 2000, which refers to the income aquired in 1999.
TRANSNATIONAL SOCIAL SECURITY
a. European Union Regulations 1408/71 and 574/72
The implementation of the Social Insurance Regulations of the European Union by IKA secures equal insurance rights and the entitlement to medical care for its pensioners who temporarily or permanently reside in the territory of another Member-State of the European Union or the European Economic Space. IKA also provides them with the opportunity of taking into account the years of insurance for the establishment of the right of optional continuation of insurance, medical benefits and pensions.
b. Bilateral Agreements of Social Security
Greece has signed bilateral agreements of social security with Switzerland, the USA, Canada, Quebec, New Zealand, Cyprus, Brazil, Argentina, Venezuela, Uruguay, Egypt, Libya, and Poland. In general, agreements foresee equal insurance treatment for the citizens of the contracting state when they reside in the territory of the other state and the inclusion of insurable and pensionable years when calculating pension rights. There are exceptions such as the agreements with Egypt and Lybia, which foresee the transference of insurance contributions for pension purposes from the country of employment to the country of origin, and the agreement with Poland, which regulates matters relating to subjection to insurance and which is applicable only to subjects of Greece and Poland.
LOCAL IKA BRANCH OFFICES
IKA Open Line: 5200555-64 (10 lines) and 184
Puplic Information Bureau:
Athens 5234.211-5230.709, Thessaloniki 031-232005-232186
Administration: Sickness Benefits Directorate: 5236061 ext. 151, Pensions: ext. 146
IKA - DEPARTMENT OF PUBLICATIONS Tel. 5226.071, Fax. 5225.185
http://www.ika.gr
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