Administratives
19.04.2001
INTERINSTITUTION, BRUXELLES, LUXEMBOURG, + écoles européennes Bruxelles et Luxembourg + L'école de Mol
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| Informations Administratives 19.04.2001 | N° 37-2001 INTERINSTITUTION, BRUXELLES, LUXEMBOURG, + écoles européennes Bruxelles et Luxembourg + L'école de Mol |
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 This notice only concerns those whose spouse is a member of the Belgian social security system and whose children are fully covered by the Joint Sickness Insurance Scheme (JSIS). Under Article 72§4 of the Staff Regulations, members of the JSIS are required: ".... to declare the amount of any reimbursements paid or which they can claim under any other sickness insurance scheme provided for by law or regulation for themselves or for persons covered by their insurance." Up to now, the Belgian mutuelles applied Article 125 of the Royal Decree of 3 July 1996 which stipulates that children have primary cover with the older parent. This meant that in cases where our member was older than his/her spouse, the mutuelles refused to cover the children at all. Last year the JSIS wrote to INAMI stating that, in our opinion, the above rule should only apply when both parents were in the Belgian system and explaining that we are essentially a complementary system. On 13 March 2001 the JSIS received a letter from INAMI confirming our interpretation. This means that in the case where one of the parents is a European official and the other covered by the Belgian system, the latter is obliged to offer primary cover to the children who will then automatically be entitled to complementary cover with the JSIS. This has the following implications: If your spouse is covered by the Belgian national social security system, the JSIS will only be offering complementary cover to your children from now on. We will be contacting each person concerned individually in the near future to provide you with the following documents:
From the date of our letter, we would please ask you to complete the change-over formalities within three months. The date will be mentioned in the end-of-cover certificates. Any outstanding estimates and prior authorisations granted here for children will be respected. If your spouse is self employed in Belgium In order to avoid paying extra contributions to the mutuelle, your children will remain fully covered by the JSIS. However, if your spouse has "gros risques" cover only, we would ask that your dependent children be registered with his/her mutuelle, also for "gros risques" only. They will continue to receive primary cover with us for "petits risques", but should use your spouse's mutuelle if they ever have any hospital treatment. If you are not sure whether you are concerned by this or not, please do not hesitate to contact your Settlements Office (see below). In any case, we will be contacting each of you over the coming months to sort out your situation individually. If you are in possession of a Sickness Insurance Carnet for your children, it is sufficient to destroy it. You do not need to return it to us. If you experience problems with your spouse's mutuelle, please contact your Settlements Office.
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Direction B : Droits et obligations ; politique et action sociale Editeur : Personnel et Administration Direction C : Ateliers de reproduction | |||||||||||||||||