In order to reimburse the costs of benefits for periods from 2017, the company needs to submit two new documents to the FSS: a calculation certificate and a breakdown of expenses. How to compose them and where to submit them - to the tax office or to the fund?

Note. An updated list of documents that are needed to reimburse the costs of benefits, the Ministry of Labor cited in order No. 585n dated October 28, 2016

From January 1, control over contributions for compulsory insurance in case of temporary disability and in connection with motherhood was transferred to the Federal Tax Service. But the FSS is responsible for checking the expenditure side of this type of insurance. Moreover, both for the periods before January 1, 2017, and for insured events that occurred after this date.

Where to apply and what documents to submit

In all cases, you must still apply to the FSS for reimbursement. Which documents to submit depends on the period for which you want to reimburse the cost of benefits.

If benefits were paid before January 1, 2017

If a company applies for reimbursement of expenses that it made before January 1, the old scheme applies.

In order to reimburse the amount of excess expenses for the payment of benefits over assessed contributions, it is necessary to submit papers to the FSS according to the old list (in accordance with the annex to the order of the Ministry of Health and Social Development of December 4, 2009 No. 951n in the old edition).

1. application for reimbursement (there was no official form, each regional branch of the FSS developed its own form);
2. calculation of 4-FSS;
3. copies of documents that confirm the validity and correctness of the costs of mandatory social insurance. Among them are sick leave sheets for sick leave and maternity leave and calculations of the amounts of payments for these benefits; certificates from the antenatal clinic, birth certificates, etc. - for other types of benefits.

The Fund must transfer money to the settlement account of the organization within 10 calendar days from the date of submission of these documents (part 3 of article 4.6 federal law dated December 29, 2006 No. 255-FZ).

Note! The fund will not return the money without verification.

In practice, the FSS does not allocate money without verification (desk or unscheduled documentary). As part of this review, the company must submit additional documents, which will confirm the validity of the appointment and payment of benefits (part 4 of article 4.6 of Law No. 255-FZ).

The decision to allocate funds is made by the fund based on the results of the audit.

Term desk audit cannot exceed three months from the date when the calculation of 4-FSS and the application were submitted (part 2 of article 34 of the Federal Law of July 24, 2009 No. 212-FZ).

Exit - two months from the day when the fund made a decision on her appointment (part 11 of article 35 of Law No. 212-FZ).

The overspending, which was formed on January 1, 2017, must be taken to the FSS. It is impossible to set it off against the payment of contributions in 2017 to the Federal Tax Service (maybe something will change, but so far).

If benefits were paid after January 1, 2017

Note. To reimburse benefits for 2017, submit a statement of calculation and a breakdown of expenses with the application

If a company applies for compensation for insured events that occurred after January 1, it must submit new documents (FSS letter dated December 7, 2016 No. 02-09-11 / 04-03-27029):

• application for the allocation of necessary funds for insurance payments By approved form;
• certificate-calculation (Appendix 1 to the application for the allocation of the necessary funds for the payment of insurance coverage);
• breakdown of expenses for compulsory social insurance and expenses due to intergovernmental transfers from federal budget(Appendix 2 to the application).

Companies submit a settlement statement only when they receive money for periods starting from January 1, 2017. Enter the amount in it:

• the company's debts on contributions at the beginning and end of the reporting (calculation) period;
• contributions accrued for payment, including for the last three months;
• additional assessed contributions;
• expenses not accepted for offset;
• funds received from the territorial bodies of the FSS in compensation for expenses incurred;
• returned (offset) overpaid (recovered) contributions;
• funds spent for the purpose of compulsory social insurance, including for the last three months;
• contributions paid, including for the last three months;
• written-off debt of the insured.

Why was it necessary to introduce new forms

Note! The new calculation of contributions is not suitable for reimbursement from the FSS

All these documents appeared due to the fact that in the new calculation, which organizations will begin to submit to the Federal Tax Service from the first quarter of 2017, there is no information for reimbursement.

In particular, the sums of incoming and closing balance(debt for the insured or fund), which must be taken into account.

There is also no possibility to submit the calculation of insurance premiums to the Federal Tax Service in the middle of the quarter.

In fact, the reference-calculation and breakdown of expenses is a piece of section 1 of old form 4-FSS.

Can expenses be offset against future payments?

In 2017, in regions that are not included in the pilot regions, the possibility of offsetting expenses against future contributions payments will remain. But only after the fund confirms these expenses.

How would this happen?

The company will indicate the assigned benefits in the new calculation of contributions.

The Federal Tax Service will transfer data on benefits to the fund (no later than five days from the date when they received the calculation in in electronic format and no later than 10 days from the date of receipt of it on paper).

Based on this information, the FSS will conduct an audit. Fund specialists will either confirm the expenses or refuse to offset.

In any case, the fund will notify the tax office of its decision within three days of its entry into force.

If the FSS confirms the expenses and their amount exceeds the contributions, the fund will return the difference or the IFTS will set it off against future payments.

This procedure will continue until the transition of all regions to direct payments of benefits from the fund.

What is the procedure for contributions for injuries

Note. The procedure by which the fund reimburses injury costs has not changed since January 1.

There are few checks in connection with compensation for this type of insurance. Basically, all companies use the set-off principle.

It has been applied since the first quarter of 2017. Only .

How to Reimburse Benefits in 2017

1. If you are claiming reimbursement for sickness and maternity benefits for periods prior to January 1, 2017, please use the form recommended in your area. And the calculation of 4-FSS in the form that was valid until 2017. In the same manner, reimburse the costs of contributions for injuries.

2. If you are applying for reimbursement for sick leave and maternity benefits for periods beginning January 1, 2017, please use the approved form. And instead of 4-FSS - a new calculation certificate and a breakdown of expenses. For injury contributions, the procedure remains the same, but instead of the old 4-FSS form, submit its new form.

Based on the results of the quarter, the IP calculated:

1. I determined the amount of expenses incurred at the expense of the FSS: C \u003d 55,000 + (79,000 - 3,000) \u003d 131,000 rubles.
2. I calculated the amount due for reimbursement from the FSS: C2 \u003d 40,310 - 131,000 \u003d (90,690) rubles.

Reimbursement of expenses is made at the request of the employer with the attachment of documents confirming the payments. The list of documents submitted to the FSS Starting from the period of 2017, the list of documents submitted to the FSS has been changed. The changes were made by the Order of the Ministry of Labor and Social Protection of the Russian Federation of October 28, 2016 No. 585n (hereinafter referred to as the Order). The list of documents depends on the period of expenses. Refunds are made within 3 years from the date of the overpayment (See also the article ⇒ Application for reimbursement on sick leave to the FSS).

Documents required for reimbursement of sick leave in the FSS in 2018

According to the established procedure, the enterprise:

• It pays only for the first 3 days of insured events for disability associated with the illness or injury of the employee himself. The amounts paid by the FSS are transferred directly to the insured person.
• Provides documents for regional office fund to accrue and pay insurance amounts.
• Issues documents to the employee for self-submission to the fund to receive payments.

As part of the pilot project, the employer submits a register of certificates of incapacity for work, copies of ballots, a certificate of income received by the employee before the onset of insured event. Within 5 days from the date of occurrence of the insured event, the employer is obliged to submit a complete package of documents to the Fund.
Refusal to pay for the submitted certificates of incapacity for work is carried out in the event of a discrepancy between these documents.

Compensation for sick leave from the FSS in 2018

1. If the employee works for several insurers - a certificate from all employers stating that the appointment and payment of a monthly allowance is not carried out

One-time allowance at the birth of a child:

1. Copy of birth certificate from the registry office Form 24

1. Copy of work book (first and last page)

1. Copy of Consumables cash orders, payment order for the transfer of benefits payments

1. Copy of application for payment lump sum at the birth of a child

1. A copy of the certificate from the place of work of the second parent stating that the allowance was not assigned and paid if the second parent does not work - a certificate from the authority social protection

Burial allowance: - Federal Law 8-FZ dated 12.01.1996.

Documents required for reimbursement of expenses in the FSS

Injuries received at the enterprise are subject to regulation in a certain form. If the employee's salary as a result turned out to be below the minimum, then instead of it, you will need to put down its value everywhere. Compensation of insurance payments An important role for the manager is played by the moments related to the compensation of spent finances.
According to the law, there is a list of documents that are needed to compensate for disability certificates from the FSS. What list of documents must be submitted to the FSS to compensate for a sick leave? How to write an application to the fund for sick leave payments? In order for the manager to compensate for the funds, the following documents are needed:

1. Application with the address of the head and the amount of compensation.
2. Insurance premiums.
3. Photocopies of important papers.

List of documents in the FSS for reimbursement of expenses

The accuracy of the sick leave data issued by the medical institution must be verified responsible person employer. Expenses of employers participating in the pilot project are not subject to reimbursement of employers due to their absence. The amount of benefits is paid by the FSS without the participation of the insured, with the exception of the provision of documents (See also the article ⇒ Reimbursement of benefits from the FSS.

Reimbursement procedure. Example. application form). Question number 1. Can individual receive the amount on the disability certificate directly from the FSS? The Fund pays the amounts for insured events in the event that the organization does not have the funds to pay for disability certificates. Insufficiency of funds arises in connection with the liquidation, bankruptcy proceedings or the lack of data on the location of the enterprise.
At the expense of the FSS, the period of incapacity for work is paid, starting from 4 days.

Rules and terms of payment of sick leave for the Social Insurance Fund

1. Copy of death certificate

Payment for additional days off for the care of children with disabilities:

1. A copy of the work book (first and last sheet with entries)

1. Copy of applications for additional days off

1. Copy of child's disability certificate

1. A copy of the certificate of the social protection authorities indicating that the child is not kept in a specialized children's institution on full state support

1. A copy of the organization's orders to provide additional days off

1. A copy of a certificate from the place of work of the second parent stating that at the time of the application, additional days off in the same calendar month not used or partially used

1. Detailed calculation of holiday pay

Federal Law 255-FZ, article 13, paragraph 5; Art.

Required documents and procedure for reimbursement of benefits from the FSS in 2018

Info

This is due to the fact that since 2017, the 4-FSS report contains information only on contributions for injuries, and disability deductions are made in tax authority and are reflected in the tax calculation. The term for the refund of the overpayment is 3 years from the moment of its occurrence. If the FSS has a debt to the organization, then it must be paid.

Important! In accordance with the law, when considering an application submitted by an organization, the Fund has the right to check the validity and correctness of the calculations. Field checks are carried out, additional documents may also be requested. The decision on payment is made after verification. If an employee works in an organization for a short time, then he is also entitled to paid sick leave, and the employer can count on reimbursement.

The list of documents for the delivery of sick leave in the FSS

Social Security Fund contributions regarding all employees. If there are expenses of the company on payments that are socially oriented, then you can get a refund. In particular, disability benefits paid to employees can be reimbursed.

• How to reimburse disability benefits in 2018 - step-by-step instruction
  • What documents are needed in the FSS?
    • How is a billing statement made?
    • How to make an application?
• Refund deadlines
• Pilot project
• Useful video
• conclusions

How to reimburse disability benefits in 2018 - step-by-step instructions Disability payments based on the sheets provided are initially carried out by the employer, then the amount of expenses is reimbursed by the FSS.

The list of documents for delivery to the FSS sick leave

This is the main document sent to the FSS. It is necessary to use the form approved by the letter of the FSS N 02-09-11 / 04-03-27029 dated 07.12.2016. When filling it out, you must specify the following information:

• the name of the recipient of the application is indicated in the upper right corner (if we are talking about payments for periods from 2017, then it will be a territorial tax office, and compensation for earlier periods is carried out by the relevant division of the FSS);
• in the main part of the document, the general details of the enterprise (TIN, KPP, address) are filled in, as well as the code of subordination and the registration number of the applicant in the FSS;
• then you need to specify the requested amount and Bank details the applicant.

Download an application for the allocation of the necessary funds for the payment of insurance coverage The document must be signed by the head and chief accountant, and also sealed.
Step-by-step instructions for employers on reimbursement of funds from the Social Insurance Fund:

1. Obtaining a certificate of incapacity for work from the employee.
2. Carrying out the calculation of benefits and its payment to the employee on the next payday.
3. Collection of documents for reimbursement from the FSS (preparation of an application and calculation certificate).
4. Submission of documents to the territorial authority where the employer is listed as an insured.
5. In the absence of checks - receipt within ten days insurance compensation, in case of inspections - receiving a request from the FSS for additional documentation.

The refund of the overpayment formed before 2017 is carried out according to the interim calculations taken from Form 4-FSS, since 2017 - on the basis of a calculation certificate.

Documents for delivery to the FSS sick leave

Attention

Pilot project In accordance with this project, part of the hospital allowance is reimbursed directly to the employee from the FSS, while the employer pays only the part of the payment that is made at his own expense - for the first 3 days. In order for the fund to transfer the amount for the hospital insured person, the employer can send the necessary documents to the FSS himself or transfer them to the employee for self-submission. These documents are submitted to the fund within five days from the date the employer receives the disability certificate.

If the organization has such a method of paying for sick leave, then compensation to the insured is not made due to the absence of such a need. Since 2011, not all regions, but only a small part, have been participating in this pilot project.

Documents for the delivery of a sick leave to the FSS in 2018

Often citizens buy fake documents certifying temporary disability. However, the fact of forgery is quite simple to establish. The employer can do this on the FSS website using the sick leave number. If a certificate of incapacity for work is submitted for reimbursement to the Social Insurance Fund, then a fake sick leave will be immediately detected, and the employee who submitted it will be held liable.
The above list of documents in the FSS for sick leave reimbursement is exhaustive. In some regions, regulatory authorities may require additional applications. A common example is the submission by an individual entrepreneur of copies of work books of employees.
This practice is illegal. If the supervisory authority refuses compensation on this basis, the applicant will be able to appeal against his actions and seek compensation in an administrative or judicial manner.

In what cases is a certificate of settlement in the FSS of Russia issued in 2019? Is such a certificate required? Here is a sample certificate for reimbursement with a transcript.

The principle of reimbursement of funds from the FSS in 2019

Insurers under compulsory social insurance in case of temporary disability and in connection with motherhood (organizations and individual entrepreneurs) pay benefits to employees both at their own expense (for the first 3 days of the employee’s illness) and at the expense of the Social Insurance Fund (in other cases). By the amount of benefits paid at the expense of the FSS, insurers reduce insurance premiums in favor of the FSS (clauses 1, 2, article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ, clause 2 of article 431 of the Tax Code of the Russian Federation). However, if the cost of benefits exceeds the accrued contributions, then the insurers can apply to the FSS for reimbursement of the expenses incurred (clause 3, article 4.6 of Federal Law No. 255-FZ of December 29, 2006, clause 9, article 431 of the Tax Code of the Russian Federation).

At the expense of mandatory social insurance contributions in case of temporary disability and in connection with motherhood, the FSS reimburses:

• hospital benefits;
• benefits related to the birth of a child (for example, for pregnancy and childbirth, for caring for a child under 1.5 years old);
• burial allowance.

Benefits related to the birth of a child and funeral benefits are fully financed by the FSS of Russia. Hospital benefits The organization pays employees:

• either partially at its own expense, and partially at the expense of the FSS of Russia;
• or only at the expense of the FSS of Russia.

Set of documents 2019

In order for the FSS to allocate funds for the payment of insurance coverage (benefits), it is necessary, following the results of the quarter or any month of 2019, to submit mandatory documents to the territorial body of the FSS (Order of the Ministry of Health and Social Development dated December 4, 2009 No. 951n):

1. a written application in the form recommended in the letter of the FSS of Russia dated December 7, 2016 No. 02-09-11 / 04-03-27029, with two appendices:
   - reference-calculation (Appendix 1);
   - breakdown of expenses;
2. copies of documents confirming the reasonableness of expenses (for example, sick leave);
3. other documents at the request of the FSS department.

Calculation reference form

The form of the reference-calculation form is given in Appendix 1 to the Application for the allocation of the necessary funds for the payment of insurance coverage (FSS Letter No. 02-09-11/04-03-27029 dated 07.12.2016).

How to fill out a certificate

Reference-calculation of the sample of 2019 combines data for reporting period, namely:

• the amount of the insured's debt (FSS) for insurance premiums at the beginning and end of the reporting (calculation) period;
• the amount of insurance premiums accrued for payment, including for the last three months;
• the amount of additional accrued insurance premiums;
• the amount of expenses not accepted for offset;
• the amount of funds received from the territorial bodies of the FSS in compensation for expenses incurred;
• the amount of returned (offset) overpaid (recovered) insurance premiums;
• the amount of funds spent for the purpose of compulsory social insurance, including for the last three months;
• the amount of paid insurance premiums, including for the last three months;
• the amount of the written-off debt of the insured.

Until 2017, the same data were given in Table 1 of Section I of Form 4-FSS, which has lost since 2017.

You can download a sample of the completed specific example reference-calculation. In 2019, according to this certificate, the organization reimbursed the costs of benefits from the FSS of Russia.

The procedure for reimbursement of funds from the Social Insurance Fund is regulated by the regulations of Article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ, since last year it has undergone a number of changes

As before, in 2018, every employer who pays contributions to off-budget funds will be entitled to a refund of benefits paid from the budget of the Social Insurance Fund. At the same time, the procedure for the actions of the employer wishing to receive compensation has changed. Previously, benefits and other payments from the FSS should have been reflected in the 4-FSS calculation, in Table 2. Social Insurance, on the basis of a desk audit of this calculation, decided whether the insured could receive a refund or not.

Starting in 2018, the algorithm of actions is different.

So, the first point will be the reflection of the costs incurred by the employer for the payment of benefits in the new unified calculation of insurance premiums.

It is the responsibility of the Tax Office, when receiving settlements from insurers, to report the information received to the Social Insurance Fund. The FSS of the Russian Federation retains the right to decide on the approval or disapproval of reimbursement of expenses. If the answer is negative, the tax authorities will send a notification to the insured demanding payment of the missing amounts of contributions. A positive result of the decision will ensure the return to the insured of the difference in the amounts between the contributions paid and the costs incurred, or the inclusion of this difference in the offset of future contributions.

New list of documents

The procedure for reimbursement of funds from the FSS is regulated by the regulations of Article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ “On Compulsory Social Insurance in Case of Temporary Disability and in Connection with Motherhood” (hereinafter - Law No. 255-FZ). As you know, in order to reimburse the costs of benefits, the insured is obliged to submit a package of documents approved by order of the Ministry of Health and Social Development dated 04.01.2009 No. 951n.

Written statement from the insured

In its application, the policyholder must indicate the name and address legal entity or full name and passport information indicating the address of permanent residence, if the insured is an individual. The application also indicates the registration number of the insured and the amount of funds required to pay insurance coverage.

Copies of documents

In order to receive compensation, the policyholder must submit off-budget fund copies of documents that will provide confirmation of the validity and correctness of the expenses incurred for compulsory social insurance:

• if compensation is required for temporary disability benefits, as well as pregnancy and childbirth, you must submit sick leave sheets filled out according to prescribed form and in the manner prescribed by law, where the calculation of the allowance will be indicated;
• to reimburse the cost of a one-time allowance, women registered with medical institutions in the early stages of pregnancy (no later than 12 weeks) need a certificate from the antenatal clinic. It is allowed to submit reference from another medical organization in which the woman is registered for pregnancy;
• in order to reimburse the expenses incurred by the insured for the payment of a lump-sum allowance at the birth of a child, a certificate of the birth of a child in a unified form should be submitted to the FSS. Such a certificate is issued at the registry office, if the child was born outside the Russian Federation, you must submit a legalized certificate in statutory order document confirming the birth of a child (necessarily with a translation into Russian). It is also required to submit a certificate from the place of work of the second parent stating that he did not receive this species allowances;
• to reimburse the costs of monthly allowance for child care, copies of documents are needed, in accordance with the requirements of parts 6 and 7 of article 13 of Law No. 255-FZ;
• to reimburse expenses incurred for the payment of social benefits for burial, the insured submits to Social Insurance a copy of the death certificate issued by the registry office, certified and certified in the manner prescribed by law.

Use the free online accounting service Buchsoft to calculate sick leave and temporary disability benefits, which allows for automatic calculation with a breakdown of periods at the expense of the employer and at the expense of the Social Insurance Fund.

Help-calculation

For periods before January 1 of the last year, the above documents must be accompanied by a calculation in the form 4-FSS.

Attention! In 2018, instead of calculating 4-FSS, a new calculation certificate is submitted.

Help-calculation contains the following indicators:

• the amount of the insured's debt to the FSS of the Russian Federation for insurance premiums at the beginning and end of the billing period;
• the amount of insurance premiums accrued for payment, incl. for the last 3 months;
• the amount of insurance premiums accrued to the insured;
• the amount of expenses that were not accepted for offset;
• the amount of funds received from the TO of the FSS of the Russian Federation in compensation for expenses incurred;
• the amount of insurance premiums that were returned or credited in case of overpaid or collected premiums;
• the amount of funds spent by the insured for the purposes of compulsory social insurance, incl. for the last 3 months;
• the amount of paid insurance premiums, incl. for the last 3 months;
• the amount of the written-off debt of the insured.

The Social Insurance Fund, in a letter dated 07.12.2016 No. 02-09-11 / 04-03-27029, presented forms for reimbursement of sick leave and maternity benefits:

• sample application for reimbursement of benefits in 2018;
• reference-calculation submitted when applying for the allocation of funds for the payment of insurance coverage;
• breakdown of expenses for the purpose of compulsory social insurance.

These samples have been added to accounting software and cloud accounting Buchsoft.

When the costs of compulsory social insurance in case of temporary disability and in connection with motherhood exceed the accrued contributions to VNiM, the resulting difference can either be offset against future payments or reimbursed by returning to the insured's current account (clause 9, article 431 of the Tax Code of the Russian Federation, part 2 article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ).

The FSS is responsible for reimbursement of social insurance expenses in 2017-2018, as before. This is despite the fact that the Federal Tax Service has been administering insurance premiums since 01/01/2017.

To receive money from the FSS, the insured must submit to the territorial body of the FSS, where he is registered, a set of documents (Order of the Ministry of Health and Social Development dated 04.12.2009 No. 951n):

• written statement;
• certificate-calculation;
• breakdown of expenses at the expense of the FSS for each type of benefit;
• copies of documents confirming expenses (disability certificates, birth certificates, etc.).

We talked about how to draw up a calculation certificate in ours and gave a sample of filling it out.

And how can the insured draw up an application for reimbursement of FSS expenses in 2018?

FSS application form

The written application of the insured for reimbursement of FSS expenses must contain (clause 1 of the List, approved by Order of the Ministry of Health and Social Development dated 04.12.2009 No. 951n):

• name and address of the insured-organization or full name, passport data, address of the permanent place of residence of the insured-individual entrepreneur;
• registration number of the policyholder;
• the amount of funds requested for the payment of insurance coverage.

The application form is given in the Letter of the FSS dated December 7, 2016 No. 02-09-11 / 04-03-27029. It is called an application for the allocation of necessary funds for the payment of insurance coverage.

For the application to the FSS for reimbursement of expenses in 2018, we will give a sample of its completion.

Please note that the policyholder can submit an application and a set of related documents for any period. For example, at the end of the month, quarter or year.

IN general case the territorial body of the FSS returns the amount of overspending on social insurance benefits within 10 calendar days from the date the insured submitted all the necessary documents (part 3 of article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ). Although the FSS has the right to conduct a cameral or field check the insured, as well as request additional documents and information. In this case, the funds are reimbursed to the insured based on the results of such an audit (part 4 of article 4.6 of the Federal Law of December 29, 2006 No. 255-FZ).

We also remind you that the employer must accrue the social insurance benefit within 10 calendar days from the date the employee applied with necessary documents and pay on the next day after the award of the benefit, set for payment wages(part 1 of article 15 of the Federal Law of December 29, 2006 No. 255-FZ). The foregoing means that the employer should not wait for the reimbursement of benefits from the FSS.