Instructions in English
Office Tradekan sairauskassa
Street address Hämeentie19,00500 HELSINKI
Postal address PL 72, 00501 HELSINKI
INSTRUCTIONS FOR MEMBERS
MEMBERS AND ACTIVITIES
The operating area of the fund consists of the employers listed in the rules and the fund members employed by these. Each employee with a permanent employment becomes a member of the sickness fund after probationary period. For part-time employees, an average weekly working time of at least 21 hours is required in the employment contract. Employees with temporary employment will become fund members after probationary period of employment provided that the employment is intended to last at least six months. Another condition for the membership is that this employment is the main source of livelihood for the person.
The fund membership terminates when a fund member resigns or retires from the employment of an employer belonging to the operating area. Upon resignation, the member is not entitled to receive a refund for the membership fees paid.
The fund operates as an employees’ sickness fund governed by the Sickness Insurance Act and therefore it also pays its members all compensations based on the Sickness Insurance Act. This means that all your sickness insurance matters are processed through the fund.
- they are provided by Terveystalo Oy or public health care
- For physiotherapy and physiotherapist examination, a maximum of €375 is compensated as additional benefit in a calendar year.
- For the treatment by dentists, specialist dental technicians and dental hygienists, the combined maximum compensation as additional benefit is €375 in a calendar year.
A membership of 12 months is required for the compensation.
- For the treatment and examinations by a psychologist, the maximum additional benefit is
€850 in a calendar year.
- The upper limit for the treatment day fee in hospital care is €34/day and the maximum number of compensable treatment days is 60 days in a calendar year.
- For the expenses related to spectacles/contact lenses, a maximum of €250 is compensated within two calendar years. For this period, spectacles/contact lenses bought during the previous and current calendar year are taken into account. A membership of 12 months is required for the compensation.
These upper limits in EUR can be annually reviewed by the representative body.
For medications, clinical nutritional products and basic ointments prescribed by a doctor, the compensation is 80% when compensation has also been received based on the Sickness Insurance Act. The compensation is calculated based on the price (cost or reference price) at which the compensation based on the Sickness Insurance Act has been calculated.
Additional benefit is not paid for fertility treatment and medications intended for impregnation.
The fund compensates only costs accrued during the membership. The costs are considered to arise at the time of providing the treatment. When considering the maximum annual amounts of compensations, the basis of compensation is determined according to the treatment time regardless of when the costs have been paid.
Employer is required to pay the sick pay. After the termination of sick pay the members will be paid the daily allowance based on the Sickness Insurance Act by Kela. The daily allowance based on the Sickness Insurance Act is taxable income from which the Kela deducts taxes. The employment pension contribution and the unemployment insurance contribution are deducted from the supplementary daily allowance.
Additional benefits are not paid during the nursing leave.
In case of death, the sickness fund pays €1,700 to the beneficiaries as a funeral allowance.
Additional benefits and part of the administrative expenses of the fund are financed by the employers’contributions and membership fees which are 1.4% of the pay subject to the Prepayment Act, however, limited to €420 in a calendar year. The board of the fund can increase or decrease the membership fee for a fixed period on the basis of the rights defined in the rules.
APPLYING FOR COMPENSATION
Applications related to sickness allowances are delivered to the fund office via the payroll department. Applications for other benefits can be delivered directly to the fund office or via the payroll department.
Usually compensation is provided for the same medicament for an amount corresponding to the treatment of three months at most.
For hospital fees, the invoice from the hospital is sufficient as an application for compensation. Treatment days and a specification of any other costs should be clearly indicated in the invoice.
Becoming ill and sickness allowances
For sickness absence exceeding 10 days, a sickness allowance application form must be filled in. These forms are available at the work place, in the sickness fund office or Social Insurance Institution offices, and at the websites of the sickness fund or Social Insurance Institution.
The rules of the fund are available at the fund’s website.