Am I eligible to become a sickness fund member?
Tradeka’s sickness fund membership is exclusively for the employers specified in these rules and for their employees.
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If you are under an open-ended employment contract, you can become a fund member after a trial period.
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If you have a part-time employment contract, your average working time, stated in your contract, must be at least 10 hours/week or 30 hours/three weeks.
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If your employment is for a fixed term of over 6 months, you can become a member after a trial period. There is, however, an additional prerequisite: the occupation must be your primary source of income.
Your fund membership ends as you resign from the service of a fund-eligible employer, you retire, or a fund-eligible employer is no longer your primary source of income. Membership fees are not returned.
What is a sickness fund?
Tradeka’s sickness fund is your employment benefit. The sickness fund operates as an employer’s fund regulated by the Health Insurance Act. Among other things, this means that the fund processes applications reimbursed by Kela as set out in the Health Insurance Act. In other words, all your health insurance matters are handled by the fund. It also provides advise for applying benefits.
In addition, the sickness fund provides additional benefits, such as reimbursements for e.g. spectacle purchases and dental care. Please see the Reimbursements page for all benefits.
Is the membership fee charged automatically?
Yes, the fund membership fee is automatically deducted from your salary. The membership fee is 0,75 % of your gross income, or up to 420 euros per calendar year. For instance, if your gross income is 2,000 euros per month, your membership fee is 15 euros a month, i.e. 180 euros a year.
Besides membership fees, the additional benefits offered by the fund and some of the administrative costs are funded also by employers’ support payments. In addition, as part of the Tradeka group’s corporate responsibility strategy, Tradeka-Yhtiöt Oy also funds the operations by paying a share of all members’ membership fees. According to fund rules, the board of directors may raise or lower the membership fee for a limited term.
How do I prove I am a fund member?
Your membership is verified with your Kela card.
Kela will send you a new card once you become a member of Tradeka’s sickness fund. The new card includes a fund ID indicating your fund membership.
If your membership ends, Kela will send you a new card again.
When are costs reimbursed?
Reimbursements are paid only for costs accumulated during fund membership. The member is not entitled to fund reimbursements during unpaid leaves, such as job alternation leave, study leave, or childcare leave.
Costs are assumed to be accumulated at the time of treatment or examination. When reviewing annual reimbursement totals, the grounds for compensation are determined by the time of treatment. The time of payment is not relevant.
A reimbursement by the sickness fund requires that you have a medical certificate from a specialist in psychiatry, a specialist in oral and maxillofacial surgery, and a dentist before seeking treatment or examination. Examination and treatment referrals are valid for one year and a dentist’s referral to a dental hygienist is valid for two years. Otherwise, treatment and examinations do not require a doctor’s referral.
Are there limitations to reimbursements?
No reimbursements are made if a fund member becomes ill during stoppage of work (strike), or unpaid leave
How do I apply for a reimbursement?
Usually reimbursements require a Kela-approved form filled out by the place of care. However, if the Kela reimbursement has already been deducted, you only need to provide the invoice to the fund.
An invoice from public health care services is also sufficient. Pay the invoice first and then provide it to the sickness fund.
If you submit the form filled out by the place of care, attach a copy of the payment receipt and a statement from the provider detailing the treatment given. You can also send these directly to Kela via Kela’s online service as a message. If you are applying for several reimbursements at once, one application is enough.
Keep the original receipts so you can provide them to the fund if necessary.
Apply for a reimbursement within 6 months of receiving treatment or having an examination done.
You may submit your application
Iris Electronic Service
You can log in to the service through this link: Omasairauskassa or https://tradeka.omasairauskassa.fi/.
If you are a new user of the eService Iris, you must first accept the electronic processing of your personal data by going to https://tradeka.omasairauskassa.fi/ and logging into the service with Suomi.fi credentials. Activating the eService takes 1-3 business days, after which you can start making applications. You will receive an email notification about joining the service.
You can use the Iris service with all common browsers. We recommend using the latest versions of supported browsers. Avoid using the service with Internet Explorer (IE).
If you cannot log in with your bank credentials, the error may not be due to the Iris program. Clear your browser’s cache and try logging in again. You can also try logging in with another browser. If you still cannot log in or the program gives an error message, contact the health insurance fund.
Through Iris, you can:
- Apply for reimbursement of additional benefits from the sickness fund
- Track the progress of your application
- Check your reimbursement information
Note! If the Kela reimbursement has not been deducted in advance, submit the documents to the OmaKela service. We will process the Kela application.
Tips for making an electronic application
- Scan or photograph the receipts related to your application (receipt, invoice, referral) Go to https://tradeka.omasairauskassa.fi/ and log into the program
- Select the “Make a new reimbursement application” button from the Reimbursements tab
- Follow the instructions on the screen
- Add the necessary attachments (receipt, invoice, referral)
- Submit the application
If you photograph the document with a mobile phone/camera:
- Photograph all pages of the document, e.g., invoice
- Take the photo so that all information on the receipt/invoice is readable
- If the Kela reimbursement has not been deducted in advance, submit the application directly to Kela through the OmaKela service
How to use Iris
- Authenticate yourself in the Suomi.fi service at www.tradeka.omasairauskassa.fi
- CONTINUE TO THE SERVICE
- Select NEW APPLICATION from the top menu
- Fill in the reimbursement lines, select ADD LINE from the bottom
- Select the type of reimbursement from the drop-down menu, e.g., massage
- Fill in the cost field; the amount paid in euros
- In the visit date field, enter the date in the format month-day-year
- Add an attachment from the SELECT ATTACHMENT section
- Once the attachment is added, select SAVE from the bottom right
- You can then add MORE LINES to your application, e.g., outpatient visit
- Or you can select NEXT from the bottom if no more reimbursement lines are to be added
- Check BANK DETAILS
- Select NEXT once the account number is verified
- In the ADDITIONAL INFORMATION section, you can give a title to the application, send additional information, and add supplementary attachments related to the application
- Select NEXT from the bottom
- Review the application and select SUBMIT
What should I do if I am not happy with a reimbursement decision?
If you are not satisfied with a decision, you may appeal it. The fund will assist you on appeals and other change requests.
For any reimbursements regulated by the Health Insurance Act, the appeal is first made to the Social Security Appeal Board and then to the Insurance Court, if necessary.
For any additional benefits paid by the fund, please request the Finnish Financial Ombudsman Bureau to provide a recommendation for resolution.