The State Council Regulation On The Implementation Of The Health Insurance Law

Original Language Title: Valtioneuvoston asetus sairausvakuutuslain täytäntöönpanosta

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In accordance with the decision of the Council of State, which was the presentation of the Ministry of Social Affairs and health, provides for amending the financial regulation of 21 December 2004, the Health Insurance Act (12/2004): Chapter 1 Day cash benefits in the workplace and working conditions article 1 of the condition of the insured person's work or working conditions associated with the erityisäitiysrahan of a chemical substance can be judged to be a hazard for health insurance (12/2004), Chapter 9, section 4: within the meaning of subparagraph (1) of the insured person or of the foetus, if a chemical substance is: 1) anesthesia gas;
2) lead or lead compound;
3) Mercury or a mercury compound;
4) chemotherapy;
5) carbon monoxide or carbon monoxide;
dangerous to the health of the insured person or of the foetus 6) estimated pesticide;
dangerous to the health of the insured person or of the foetus 7) estimated the organic solvent;
8) toxic, carcinogenic or mutagenic classified as substance, the Pack into the occupational safety and health (738/2002) or chemicals (599/2013) according to the provisions adopted under the label phrase H340, H350, H350i, H341, H351, H360, H360Fd, H360Df, H360FD, H360D, H361 indicate, H361d or H361df;
9) cancer risks factors in the decision of the Ministry of labour adopted (838/1993) or the amending Regulation, the Ministry of Social Affairs and health (12/2000) the cancer-causing substance;
10) environmental tobacco smoke.
(21.5.2015/619)
What provides, in addition to chemical substances, of: 1), including the radio-nuclides emitting ionizing radiation;
2) toksoplasmoosia, listerioosia, herpestä, rubella, chickenpox, hepatitis b and C, parvorokkoa, sytomegalotulehdusta and HIV infection, as well as other comparable to contagious diseases.
(21.5.2015/619)
The rest of the work of the insured person or working conditions associated with the corresponding element, can be used to assess the threat to the health of the insured person or of the fetus, if it is underground on the premises of the mining work, paineistetuissa work or underwater diving.


section 2 of the hazardous elements in the evaluation of the Health Insurance Act, section 4 of Chapter 9 as referred to in sub-section 1, the insured or a fetal health hazard assessments must be carried out in the context of the design of the working environment and working conditions for health-care professionals engaged in health or other responsible person.
A job in the context of the report are identified by the insured or the presence at the workplace of hazardous factors on the health of the fetus, as well as those in the workplace, where the risk occurs. If necessary, the measurements shall be used to occupational hygiene, health care, the biological exposure measurements, or otherwise commonly used identification methods.
Health-care professionals engaged in health care or the person responsible for the processing of the rest of the assessment of the risk by taking into account the existing medical knowledge of the danger and the intensity of the cyclicality of the hazardous effect of intellectual property, and the time. Environmental tobacco smoke environmental tobacco smoke, however, respects the what and the risk of cancer associated with the work of the Council of State decision on the fight against (1153/1999) 2.
Health-care professionals engaged in health care will be informed of the risk factors in the work of the employer as well as the substances used in the work, working methods and the risk posed by employees, as well as to make proposals to eliminate the risk of, or for the purpose of hedging.


section 3 (2.12.2010/1090) Will check the health insurance Chapter 9, section 8: the second inspection referred to in paragraph 3, shall carry out the necessary research to determine the State of health of the mother and the prospective childbirth. The inspection shall also seek to ensure that the mother shall be addressed to the appropriate treatment, if the inspection reveals a disease condition or birth injury.


section 4 (21.5.2015/619) Severe illness or injury, Chapter 2, section 10 of the law on health insurance of the workers ' Statute the meaning of difficult illnesses or injuries are leukemia and other malignancies, severe heart failure, severe injuries and burns, diabetes treatment in the start up phase and difficult to balance the sugar disease, severe mental disorders, severe mental retardation, severe bronchial asthma and severe rheumatoid arthritis and other diseases of the severity that should be compared to any of the above diseases, injuries, and illness.


section 5 of the Weighty medical reason for erityishoitorahan to be issued subject to the health insurance section in Chapter 10, 3 (3) on the basis of the medical reasons for weighing referred to in erityishoitorahaa shall be paid to the more than 150 business days, are: 1) the life-threatening condition that requires continuous monitoring of the child such as the immunosupressio and the risk of infection;
2) of severe accidents and burns;
3) a dying child care;
4) dialysis require child care, when it requires the presence of the child's continuous surveillance, and the parent's; as well as 5) other heavy medical reason.
Chapter 2 section 1 of the application and the payment of benefits to daily cash benefits in the report when applying for the health of the insured person must be presented when applying for the necessary money and reliable explanation of the illness and the date on which the incapacity for work. If disability continues for longer than the health insurance law, Chapter 8, section 7 (1) and (2) the insured person must submit his incapacity for the excess time, referred to in the medical certificate.
The insured person must be presented when applying for the necessary Erityishoitorahaa and reliable settlement for loss of earnings and medical certificate of their child's illness or injury arising from a sick child medical care or rehabilitation.
The application of the insured shall be accompanied by a special maternity allowance a physician, nurse, midwife, or a certificate issued by the public health nurse, pregnancy, as well as workplace health to take medical or other working conditions of the insured person to have knowledge of the medical opinion of the insured or the fetal health deriving from health insurance Chapter 9, the risk referred to in article 4, as well as the employer's evidence that the employee is away from work and that the employees have been transferred to other tasks of the employment contracts Act (55/2001), edellytetyin. His own work is required in a statement of tekevältä shall apply mutatis mutandis.
Maternal allowance cannot be received when applying to the insured shall be a physician, nurse, midwife, or nurse's testimony to the fact that the pregnancy has lasted at least health insurance Chapter 9, section 2, for the period of time. Parental benefit to getting a parental allowance period is to be distributed shall be notified, how parents. Partial parental allowance for both parents to be with their employers on part-time work contract, indicating the agreed working time arrangement, as well as part-time work to pay wages. An entrepreneur with a parent must provide a reliable statement in your company on the order of 40-60% of the decrease in the past. (November 2, 2006/980)
Paternity of money when applying for the times, which the father care for the child and is not in gainful employment or other outside work. The father shall be notified immediately to the social insurance institution of Finland, if he is no longer participating in the child's care. (21.5.2015/619)
The adoptive parent to seek parental allowance or partial parental allowance he must take the social welfare institution for the treatment of the child or the adoption of the law (22/12) referred to in subsection (1) of section 22 of the adoption certificate issued by the Office. The application of the adoptive parent must be clarified, that he take care of the child and is not in gainful employment or otherwise, in your own work, with the exception of my own work in the economy. (21.5.2015/619)
The communicable disease Act (583/1986) referred to in subparagraph (1) of section 27 of the day money getting must be presented;
the fight against communicable diseases in the equivalent of 1), the absence of a decision of the body work or isolation, or 2) the Ministry of Social Affairs and health, the fight against communicable diseases in the provincial government or the institution responsible for the decision to quarantine, as well as 3) reliable for loss of earnings and the amount of it.
If the amount of loss of earnings provided a reliable report, on the basis of the preferential tariff provides for its earned income, which is fixed per diem.
(8th/997)
Osasairaus day money when applying for a job to be familiar with the occupational health of the insured person must submit his medical or other working conditions of the insured person to have knowledge of the medical opinion of the insured incapacity for work, as well as the fact that this is pending will be able to complete a part of their duties without endangering the health or recover. In addition, the insured person shall submit to the employer, with the agreement on part-time work, indicating the agreed working time arrangement, as well as part-time work to pay wages. The entrepreneur must provide a reliable statement in your company on the order of 40-60% of the decrease in the past. (November 2, 2006/980) of article 2 of the conditions of payment of the daily allowance daily cash benefit, the payment of the benefit is subject to the condition that the insured person presents for each pay period, on request, the social insurance institution of Finland in a report on the work of their absence.
Payment of sickness allowance is subject to the condition that the insured person presents a report on the request for the continuation of the incapacity for work is necessary and reliable.

You and a partial payment of all the tier system is subject to the condition that the insured person is provided by the social insurance institution of Finland medical insurance Chapter 9, section 8 of the certificate referred to in paragraph 3 of the control.
Osasairaus shall be paid equal to the daily subsistence allowance for the period is less than 12 working days, that the insured person presents a report on the necessary and reliable, in which he shows that he is in poor health is therefore incapable of also work part time, or equivalent, is the necessary and reliable report on the osasairaus end of the entitlement to the daily subsistence allowance for a reason. (November 2, 2006/980) section 3 (21.5.2015/619) a day per diem Sickness cash benefits payment periods, osasairaus and erityishoitoraha shall be paid in arrears, with the first pay period is 6 working days and each of the next pay period of 25 working days. If the incapacity does not stand up to the full payment, sickness allowance and per diem per diem shall be paid to the right to osasairaus. If the osasairaus the daily allowance period is the health insurance section 11 of Chapter 8 of the ground referred to in paragraph 6, shorter than the payment period, osasairaus the end of the entitlement to the daily subsistence allowance shall be paid.
If the payment of the employee's medical condition will be interrupted because of the occupational health-care opinion have been submitted to the health insurance law, Chapter 8, section 5 (a) within the time limit laid down, the day the money paid to the 90 working day. If an employee shall submit to the opinion of the health care, sick days later the money is paid to the end of the payment period of the stalled. After the illness, in accordance with paragraph 1, the per diem will be paid.
Erityisäitiysraha, maternity, paternity and parental allowance, as well as partial parental allowance shall be paid to the money in arrears up to 25 business days maksukausissa. However, the money, the first pay period of maternity leave of 30 working days.
As a result of the disease if the mother of the child has become incapable of performing their child health insurance Chapter 9, article 13, as intended, or he has died, parents ' allowance shall be paid to the father afterwards 25 working days of the date of illness of the mother and the maksukausissa working day following the day of death of the mother, or the following weekday. If the child's father is not responsible for the child's custody, is the equivalent of the sum secured less, where applicable, in effect on the exercise of parental responsibility, what is the child's father.
The job of Treasury cash a two-thirds majority of the meeting may take a decision under paragraph 1, the payment of sick pay period pursuant to palkanmaksukausittain.


section 4 of the report when applying for compensation from the Sairaanhoitokorvauksia while getting medical treatment, the costs of pregnancy or birth of the insured person shall: 1) a necessary and reliable explanation of the illness, pregnancy or birth;
2) necessary and reliable report on the basis of paragraph 1, study or treatment given;
3) payment receipt or other reliable statement of the costs incurred; as well as 4) other similar necessary to be regarded as a statement.
The insured person shall demonstrate in Chapter 5, section 5 of the drug need to be replaced, as well as limited as referred to in articles 6 and 7 of the health insurance system referred to as well as the need for food products and the clinical trials of the medicinal products qualifying for higher specialized medical unit studies, based on the long term, the insured or a specialist or doctor statement or in any other manner determined by the social insurance institution, more specifically erillisselvityksellä. (brought on 29 December 2005/1267) section 5 dental treatment at the same time, to be determined by the replacement of the front veterans notwithstanding the provisions of Chapter 3, section 5 of the law on sickness insurance: provides a front organisation of the front of the Veterans ' shall be replaced by the dental care for veterans and to the law on (678/1992) oral and dental research and the treatment of the same provision of the dental implants, based on floating throughout the manufacturing and maintenance operations, if they have been carried out within two years of dental treatment by prescription.
Chapter 3 section 1 of the strengthening of the Cash Advances Job cash at the start of the operation of the law in accepting the Insurance Fund (1164/1992), in line with the insurance fund in the Health Insurance Act, the social insurance institution will determine the job kassaksi the time, the date on which the action starts till the health insurance in accordance with the law. This date must not be later than three months from the adoption of the decision approving the order. You can, however, not earlier than the Treasury action starts from the moment when it is entered in the register of insurance cash.
The cash register is before the start of the operation in accordance with the health insurance law, handed over to the social insurance institution of Finland, section 2 of this chapter: (1) in order to determine the amount of the withholding tax referred to in the relevant information. Upon receipt of this information in the social insurance institution of Finland shall, without delay, in writing of the amount of the advance to be paid to the decision of the checkout.
The withholding tax is applicable, mutatis mutandis, article 2 of this chapter is provided.


section 2 of the social insurance institution is running a checkout of advances before the end of November to give a written decision on the job the following year, the advance to be paid to the cashier. The amount of the cash advance in establishing health insurance mukaisien benefits needed to complete in order to safeguard the liquidity of the Fund shall be increased by one-tenth of the estimated amount of the benefits. In order to determine the amount of the advance shall be handed to the cashier the necessary information for the social insurance institution of Finland by the end of October.
The social insurance institution of Finland has during the month of January of each calendar year, to pay for a job at the checkout in order to secure the liquidity of the Fund as referred to in sub-section 1, the estimated number of. In addition, the social insurance institution of Finland is on the first working day of each month, to be carried out at the checkout in a quantity that it, along with the previously paid with enough is enough to the benefits during the same month. If you do not have sufficient cash advances received by the health insurance benefits under the law, the social insurance institution will give at checkout, without delay, the necessary number of.
If the withholding tax in accordance with the vuotuismäärä turns out to be too small or large, is the amount of the advance to be revised accordingly. In addition, the social insurance institution of Finland will be the first working day of each month, complete the checkout process for Treasury management costs one-twelfth of the amount laid down.
The cashier shall comply with the performance and a review of the advance of the information necessary for the social insurance institution of Finland. In addition, the Fund is to provide for the social insurance institution of Finland medical insurance statistics for the necessary information.


Article 3 of the procedure for the settlement of the settlement for the Treasury Job has to be done for the calendar year under section 2 of Chapter 16 of the laws of the sickness insurance of the benefit referred to in subparagraph (1) and the administrative expense of the expenditure by the end of January of the following year.
If your workplace safe has received too much money, too much use of the amount paid to be restored by the end of February. If the funds provided are not sufficient to fund health insurance benefits under the law, the social insurance institution run by the end of February, the missing component.
The amount of administrative costs will be reviewed the Ministry of Social Affairs and health, in accordance with the criteria laid down by the relevant calendar year.
Chapter 4 (brought on 29 December 2005/1267) financial section 1 (brought on 29 December 2005/1267) to run a State financial contribution to the expenses of the income from the Ministry of Social Affairs and health insurance to pay for the social insurance institution of Finland, based on the State's financial contribution to the establishment of an advance on the monthly estimate of one twelfth part of a corresponding amount of the health insurance law, chapter 18, section 13 of the costs referred to in paragraph 1. (30 December 2008/1132)
The Ministry of Social Affairs and health will need to run the State referred to in subparagraph (1) of the health insurance fund each month, the share of the advances on the first working day.
The social insurance institution of Finland shall inform the Ministry of Social Affairs and health each month paid health insurance, chapter 18, section 13 (1) the costs referred to in the latest on the 15th day of the second month following the month of payment. The difference between these costs and advances will be taken into account in anticipation of the third month following the month of payment. (30 December 2008/1132), section 2 (brought on 29 December 2005/1267) the State financial contributions to the costs of the social insurance institution of Finland sairaanhoitovakuutuksen the Ministry of Social Affairs and health information provided by the Health Insurance Act, chapter 18, on the basis of the calculations pursuant to section 28 of the Ministry of Social Affairs and health to run for the social insurance institution of Finland medical insurance fund health insurance in chapter 18, section 10 of the State shares in the amount of the annual contribution shall be paid in such a way that at least one-sixth of the month of January and then on a monthly basis in equal amounts over the remaining amount of the monthly instalments. In order to safeguard the financing of or changes in the State share of the supply of an essentially by way of derogation from the above may be monthly accrued on the. (30 December 2008/1132)
The Ministry of Social Affairs and health will be the health insurance of the quotas referred to in paragraph 1 the Fund on the first working day of each month.
Health insurance (2) and section 10 of chapter 18 of the State's shares in the amount of which is fixed under the social insurance institution in the context of the financial statements.


section 3 (registry on 29 December 2005/1267) to perform abroad for medical care of the financial contribution of the State expenses of the Ministry of Social Affairs and health to run for the social insurance institution of Finland medical insurance fund for health insurance, according to chapter 18, section 10 of the 18 century the share of State funds to be financed under article 8 of the medical care costs referred to in paragraph 5.

The social insurance institution of Finland should be delivered to the Ministry of Social Affairs and health statement of the costs referred to in paragraph 1, no later than ten working days before the running of the State contribution.
Chapter 5, section 1 of the health insurance Affairs Advisory Boards Advisory Board health insurance Affairs of the Advisory Board shall be to: 1) to foster and develop cooperation between the involved in the implementation of health insurance;
2 institution of Government) to make the shows and give it the opinions of health insurance in order to carry out the studies and research; as well as 3 of the social insurance institution of the Government) to make presentations and give it advice on health insurance and health insurance for the development of things.
The Secretary of the Conference shall be entitled to, and consultation of experts. The social insurance institution, the Governing Board shall adopt a proposal from the Secretary of the Advisory Board and the experts.
The costs arising from the operation of the Advisory Board of the health insurance fund are carried out.


section 2 of the Sosiaalilääketieteellinen Advisory Board Sosiaalilääketieteellisen the Board's task is to deal with health insurance-related medical issues.
Sosiaalilääketieteellinen Advisory Board can be separated into divisions.
The Secretary of the Conference shall be entitled to take over and hear from the experts. The social insurance institution, the Governing Board shall determine, by the President of the Advisory Board, the Secretary and the members of the experts, the amount of the premium.
Chapter 6 section 1 of the entry into force of the date of entry into force of This Regulation shall enter into force on 1 January 2005.
Before the entry into force of this Regulation may be to take the measures needed to implement it.

The change of the date of entry into force and the application of the acts: brought on 29 December 2005/1267: This Regulation shall enter into force on 1 January 2006.
Before the entry into force of this Regulation may be to take the measures needed to implement it.




on 2 November 2006/980: This Regulation shall enter into force on 1 January 2007.
Before the entry into force of the regulation may be to take the measures needed to implement the regulation.




8 November 2007/1012: This Regulation shall enter into force on 15 November 2007.
Health insurance chapter 18 under section 13, as referred to in paragraph 3, the proportion of the State from January to October 2007, as well as in Chapter 4 of this regulation under article 1 of the State share of the advance referred to in paragraph 3 of the year 2007 during the months of November and December are carried out of the health insurance fund on the first working day of December of the year in 2007.




30 December 2008/1132: This Regulation shall enter into force on 1 January 2009.
Before the entry into force of this Regulation may be to take the measures needed to implement the regulation.




on 17 December 2009/1083: This Regulation shall enter into force on 1 January 2010.
Before the entry into force of this Regulation may be to take the measures needed to implement the regulation.




2.12.2010/1090: This Regulation shall enter into force on 1 January 2011.




21.5.2015/619: This Regulation shall enter into force on 1 June 2015.

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