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Even with an LOA agreement, health insurance is generated

February 23, 2020
Natalia Gorpinchenko
Accountex Accounting
Everyone is interested in health insurance (RK). However, since health insurance is directly linked to monthly social security contributions, which at least meet the minimum rate (in 2021, this is 192.72 euros), in some cases—for example, if a person's income is less than 584 euros (gross)—the employer's offer of health insurance may be seen as an additional burden. Is that really the case? How does health insurance arise, and what else should be known about it?

Let's start with the fact that some individuals in Estonia have the right to health insurance regardless of whether they receive any compensation or not. Therefore, if you hire or provide services as a provider to, for example, a child under 19 years old, a student, a university student, a pregnant woman, someone on parental leave (who can work during parental leave), a pensioner, a caregiver for a person with disabilities, or a person with partial or reduced work capacity, then you do not need to worry about their health insurance.

For an individual working under an employment contract, RK (health insurance) arises after 14 days from signing the employment contract and registering the employment in the employment register. The employer is obliged to pay monthly social security contributions of 192.72 euros for the employee (if they have submitted a tax-free income declaration, i.e., if this is their main job), even if the employee earns less than 584 euros. In the case of an employment contract, RK remains valid for 2 months after termination of employment.

Members of management boards, service contracts (töövõtu) and mandate contracts (käsunduslepingud) are subject to the VÕS (Võlaõigusseadus - Law of Obligations Act). For these cases, one scheme applies: if under a VÕS contract the individual has received gross earnings exceeding 584 euros, then health insurance will be established on the day following the submission of TSD (tax data) in the next month. RK is valid for one month after failing to declare social security contributions.

It is incorrect to think that simply paying 192.72 euros monthly for a management board member would make their RK valid. For VÕS contracts, social security contributions are calculated based on actual payments made.

However, it is correct that if one and the same person provides services under multiple VÕS contracts to several companies (including as a management board member), all their monthly payments are summed! If their total exceeds 584 euros (gross), then health insurance will also be established on the day following TSD submission.

Each individual can check their health insurance status themselves by visiting the eesti.ee portal.