The Employers' Mutual Insurance (Mutualité des employeurs) provides a full reimbursement (100% instead of 80%) for periods of incapacity for work due to quarantine or isolation imposed by a competent authority. This measure is applied by calculating contributions made since March 2021, and is backdated from 1st July 2020.
For technical reasons, the additional reimbursement amount could not be included in the monthly 'Information on the Employers' Mutual Insurance reimbursement breakdown' letter for March 2021 to September 2021. For COVID-19-related absences, this led to discrepancies between the aforementioned letter and the monthly account statement.
Since the new computer system for calculating contributions was introduced in October 2021, additional COVID-19 reimbursements can now be included in the 'Information on the Employers' Mutual Insurance reimbursement breakdown' letter, as follows:
- October: the amounts missing on the March 2021 to September 2021 letters will be added to the October letter. In other words: the reimbursement breakdown total for October, in the case of COVID-19-related absences, will be higher than the October account statement amount. Please note that the account statement amount reflects the actual situation.
- November: from November 2021, the reimbursement breakdown will be back in line with the monthly account statement.
Example 1: Reversal + recalculation (standard case)
In February 2021, the 2020/12 reference period (month-2) was calculated for the first time for insured individual Max Mustermann. A MAL (illness) incapacity for work (ITT) declaration was submitted for 40 hrs, for which the employer received an 80% reimbursement of EUR 1,118.27. This amount was shown on the 'Employers' Mutual Insurance reimbursement breakdown' letter for the 2020/12 period dated 06.02.2021.
However, according to the incapacity for work (ITT) data provided by the National Health Fund (Caisse nationale de santé - CNS), the 40 hrs of illness declared is broken down as follows:
- 'Normal' illness hours: 24
- COVID hours: 16
Consequently, an additional 20% reimbursement of EUR 111.83 was calculated at a later date (in March 2021) for the 16 COVID hours. While this additional reimbursement was credited to the account statement for March 2021, for technical reasons it did not appear on the corresponding reimbursement breakdown. Instead, a separate letter (dated 11.03.2021) was sent to the employer to provide information on additional COVID reimbursements calculated in March.
Following the introduction of the new computer system in October 2021, the missing amounts on the letters from March 2021 to September 2021 are included on the 2021/08 period reimbursement breakdown dated 08.10.2021. In this example, this covers the additional EUR 111.83 reimbursement calculated in March.
In most cases, this is applied by way of a reversal (extourne) of the initial 80% reimbursement amount (line showing value 'E' in the 'E/R' column) and by a recalculation of the total amount that the employer should have received for this declaration (line showing value 'R' in the 'E/R' column). There is therefore a reversal of EUR 1,118.27, and a recalculation of EUR 1,118.27 + EUR 111.83 = EUR 1,230.10.
At first glance, this reimbursement breakdown may give the impression that the employer received a recalculation in its favour in October, which is not the case. The recalculation is not shown on the October monthly account statement, as the additional reimbursement of EUR 111.83 had already been credited in March 2021.
Example 2: Reversal + recalculation with rounding difference
In September 2021, the 2021/07 reference period (month-2) was calculated for the first time for insured individual Pierette Untel. A MAL (illness) incapacity for work (ITT) declaration was submitted for 16 hrs, for which the employer received an 80% reimbursement of EUR 224.92. This amount was shown on the 'Employers' Mutual Insurance reimbursement breakdown' letter for the 2021/07 period, dated 11.09.2021.
However, according to the incapacity for work (ITT) data provided by the CNS, the 16 hrs of illness declared is broken down as follows:
- 'Normal' illness hours: 0
- COVID hours: 16
Consequently, an additional 20% reimbursement of EUR 56.23 was calculated in September 2021 for the 16 COVID hours. While this additional reimbursement was credited to the account statement for September 2021, for technical reasons it did not appear on the corresponding reimbursement breakdown. Instead, a separate letter (dated 15.09.2021) was sent to the employer to provide information on additional COVID reimbursements calculated in September.
Following the introduction of the new computer system in October 2021, the missing amounts on the letters from March 2021 to September 2021 are included on the 2021/08 period reimbursement breakdown dated 08.10.2021. In this example, this covers the additional EUR 56.23 reimbursement calculated in September.
In most cases, this is applied by way of a reversal (extourne) of the initial 80% reimbursement amount (line showing value 'E' in the 'E/R' column) and by a recalculation of the total amount that the employer should have received for this declaration (line showing value 'R' in the 'E/R' column).
The logical outcome would therefore be a reversal of EUR 224.92, and a recalculation of 224.92 + 56.23 = EUR 281.15. While the October reimbursement breakdown indeed shows a reversal of EUR 224.92 for the insured individual Pierette Untel, the corresponding recalculation differs from the expected amount by one euro cent (EUR 281.16 instead of EUR 281.15). This is caused by the fact that the rounding accuracy of the calculation algorithm has been improved.
At first glance, this reimbursement breakdown gives the impression that the employer has received an adjustment in its favour of EUR 281.16 – 224.92 = 56.24 EUR. This is not the case. Indeed, the actual adjustment amount is only EUR 0.01, given that the additional reimbursement of EUR 56.23 had already been credited in September 2021.
There is therefore a discrepancy of EUR 56.23 (rather than EUR 56.24) between the reimbursement breakdown and the October account statement.
Example 3: Recalculation without reversal
In July 2021, the 2021/05 reference period (month-2) was calculated for the first time for insured individual John Doe. At this time, there was no ITT declaration for the relevant salary declaration, and therefore the employer did not receive a reimbursement for the absence of this insured individual.
As a result, the insured individual also did not appear on the 'Employers' Mutual Insurance reimbursement breakdown' letter for the 2021/05 period, dated 10.07.2021.
The missing 33 hours of illness ITT was declared later on, between the calculation of the September and October contributions. The 2021/05 reference period for insured individual John Doe was recalculated in October's calculation but, contrary to examples 1 and 2 above, this recalculation was triggered by the ITT declaration rather than the fact that all COVID reimbursements were automatically recalculated in October.
According to the ITT data provided by the CNS, the 33 hrs of illness declared can be broken down as follows:
- 'Normal' illness hours: 0
- COVID hours: 33
Following the October recalculation, the employer therefore received a 100% reimbursement of EUR 534.96 for the relevant declaration. The insured individual is therefore included in the 2021/08 period reimbursement breakdown, dated 08.10.2021.
As this is a recalculation, the row in question shows the value 'R' in the 'E/R' column. However, there is no corresponding 'Reversal (Extourne)' row, as there was no illness reimbursement in the first declaration calculation.
The reimbursement of EUR 534.96 is also visible on the October monthly account statement, as it had not previously been credited.
Example 4: No reversal or recalculation
In October 2021, the 2021/08 reference period (month-2) was calculated for the first time for insured individual Juan Pérez. As this is the first calculation, it is entirely normal that on the October reimbursement breakdown, this declaration is not marked with an 'R' or 'E' in the 'E/R' column.
According to the ITT data provided by the CNS, the 16 hrs of illness declared are made up as follows:
- 'Normal' illness hours: 16
- COVID hours: 0
Therefore, the employee receives an 80% reimbursement, of EUR 277.96, for this insured individual.
The reimbursement of EUR 277.96 is also listed on the October monthly account statement, as it had not been previously credited.