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Repetition The Committee notes that the Government has reviewed and updated the consolidated report (CR) on the application of Conventions Nos 12, 17, 42, 102, 128 and 130 and the European Code of Social Security (ECSS) for the period 2006–16, and provided the clarifications requested.Old-age benefit (Part V of the CR). Article 18(2) of Convention No. 128. Payment of a reduced pension. The Czech Republic has introduced an amendment to the Pension Insurance Act with effect from 1 January 2015, which stipulates the entitlement to an old-age benefit to the insured individual, who has had at least 15 years of insurance, by reaching the age of five years higher than the statutory retirement age. The Committee points out that this amendment does not give effect to Article 18(2) of the Convention, which requires that all persons protected who have completed 15 years of contributions or employment shall be entitled to a reduced pension at reaching the same statutory pension age. The Committee requests the Government to indicate the measures taken or envisaged to give full effect to this Article of the Convention.Suspension of benefit (Part XIII of the CR). Article 69 of Convention No. 102. Articles 32–33 of Convention No. 128. Article 28 of Convention No. 130.Suspension of sickness and unemployment benefits for violation of employees’ obligations under section 301(a) of the Labour Code. The Committee notes that in reply to its previous comments on this subject with respect to the application of the ECSS, the Government refers to the judgment of the Constitutional Court of the Czech Republic of 23 May 2017, where the Court found that the provisions of the national legislation contested by the group of 54 deputies of the Chamber of Deputies of the Parliament do not contradict the constitutional order of the Czech Republic. Taking into account the complexity of the matter, which directly involves the application of Article 68 of the ECSS and Article 69 of Convention No. 102, the Committee requests the Government to provide further information on the application of section 301(a) of the Labour Code.Sickness benefit. The report states that the regime of sanctions in sickness insurance from the 15th day of sickness provides for a 50 per cent reduction of the sickness benefit if the insured individual has brought about his/her temporary incapacity to work as a result of his/her participation in a fight, as a direct consequence of his/her inebriation or abuse of narcotic or psychotropic substances, or while committing an intentional offence or an intentional misdemeanour. An insured individual who has deliberately brought about his/her temporary incapacity to work has no entitlement to sickness benefits. The Committee points out that the above grounds for the reduction or refusal of sickness benefit may be authorized by Convention No. 102, Article 69(e) and (f), and Convention No. 130, Article 28(1)(d) and (e), to the extent that the contingency has been caused by a criminal offence or by the wilful misconduct of the person concerned. The Committee therefore requests the Government to explain how decisions to reduce the sickness benefit in the abovementioned cases are taken and provide examples of such decisions in the recent years.Medical care. (a) The Committee requests the Government to indicate whether the abovementioned grounds for the reduction of sickness benefit, particularly in cases where the temporary incapacity to work was caused by participation in a fight, inebriation or abuse of narcotic or psychotropic substances, or by an attempted suicide, may also be used to limit the provision of medical care, for example, to emergency care only or to reduce the reimbursement of the care provided in such situations.(b) As regards legislation regulating provision of medical care, the Government refers to Act No. 280/1992 Coll., regulating the Departmental, Professional, Company and other Health Insurance Companies, as amended, which establishes that all health insurance companies are responsible for providing health services to the persons insured. According to the Government, the rule is that responsibility for health care rests primarily on the respective authorized insurance company with which the person is registered for health insurance which, in case of problems, is obliged to seek a solution to the problem of the insured person. The Committee wishes to recall in this respect that, according to Article 72(2) of Convention No. 102 and Article 30(2) of Convention No. 130, the general responsibility for the proper administration of the social security institutions and services lies on the Government and cannot be entirely outsourced to health insurance companies. Under these provisions the Government has to ensure that the regime of sanctions in the form of suspension of benefits applied by health insurance companies complies with the limitations laid down in these instruments. The Committee notes that according to the Government, public health insurance in the Czech Republic is conducted by seven health insurance companies, which are institutions with a public mandate, and that the management of the health sector is governed by the Ministry of Health. The Committee requests the Government to provide information on the regime of sanctions established by the internal rules and practices of these health insurance companies, including the list of cases where they may “seek a solution to the problem of the insured person” by suspending or limiting the payment for the health services prescribed, for example, when insurance contributions were not paid in full or medical care was provided in another country.Old-age benefit. The Committee requests the Government to indicate situations in which payment of an old-age pension may be suspended or stopped.Article 69(b) of Convention No. 102. Family benefit. The report states that, in accordance with section 54(4) of Act No. 117/1995 Coll., the entitlement to benefits ceases to exist if the beneficiary is in custody or imprisoned. The Committee requests the Government to indicate whether the dependants of the beneficiary who is in prison or in custody are entitled to receive any portion of the family benefit, in accordance with Article 69(b) of Convention No. 102.Article 69(c) of Convention No. 102 and Article 28(1)(h) of Convention No. 130. Coordination of sickness benefit with disability and old-age pensions. According to the report, if an insured person who is temporarily unable to work applies for a disability pension in accordance with the Pension Insurance Act, as amended, and is acknowledged as having a disability by the social security body, the temporary incapacity to work ends at the latest on the 30th day after the insured individual was acknowledged as having a disability. The disability pension will be granted from the day following the date of termination of the temporary incapacity to work. The Committee also notes that similar and more elaborate provisions regulate cases of termination and replacement of sickness benefit when old-age benefit becomes payable. The Committee points out that under Article 69(c) of Convention No. 102 and Article 28(1)(h) of Convention No. 130, sickness benefit, which in principle should be paid throughout the contingency, can be replaced by another social security cash benefit, such as a disability benefit, subject to the part of the sickness benefit which is suspended not exceeding the disability benefit. The Committee notes in this respect that, according to the calculations made in the report for the standard beneficiary, the sickness benefit provides a replacement rate of 64 per cent, which is substantially higher than the replacement rate of the disability benefit for total incapacity (45.4 per cent). The Committee requests the Government to examine the national provisions requiring termination of sickness benefit before expiration of the maximum duration of 380 days and its replacement by disability benefit or by old-age benefit with a view to preventing the reduction in the level of protection in such cases.Part XI (Standards to be complied with by periodical payments). Application of Convention No. 102 on the force of minimum benefits. The Committee recalls that the Convention can be applied on the force of social insurance schemes providing earnings-related benefits (Article 65), or flat-rate benefits (Article 66), or social assistance schemes providing means-tested benefits (Article 67), or any combination thereof. Another option consists in applying the Convention on the basis of basic income security guarantees where a social insurance scheme provides a minimum benefit, or a fixed basic amount as part of an earnings-related benefit, or where there is a guaranteed minimum income scheme or a universal social pension. The Committee systemically looks at this option every time when the regular benefit provided by the scheme in question does not attain the level prescribed by the Convention. It observes that the importance of the minimum benefits for the application of the Convention has been growing steadily, inasmuch as in many countries the replacement level of standard benefits showed a marked downwards trend, falling below the percentage prescribed by the Convention and, for low wage earners, even below the poverty line.According to the Convention, the amount of a guaranteed minimum cash benefit, in whichever form it takes, shall be not less than the corresponding benefit calculated in accordance with the requirements of Article 66. For the family of a standard beneficiary, this amount shall be such as to attain, in respect of the contingency in question, at least the percentage of the reference wage of the ordinary adult male labourer indicated in the Schedule to Part XI of the Convention. For other beneficiaries with different family responsibilities, the guaranteed minimum benefit shall bear a reasonable relation to the benefit of the standard beneficiary (Article 66(3)). In all cases, the resulting amount shall be sufficient to maintain the family of the beneficiary “in health and decency” (Article 67(c)) under the conditions of entitlement prescribed by the corresponding Part of the Convention with respect to the qualifying period, age and duration of payment. With respect to maintaining the family of the beneficiary in conditions of health, payment of the minimum cash benefit in respect of other contingencies shall not unduly limit the concurrent entitlement of the beneficiary and his or her family to the types of medical care guaranteed under the conditions stipulated in Part II of the Convention. Persons on minimum benefit in need of health care should not face an increased risk of poverty due to the financial consequences of accessing the types of health care specified in Article 10(1). In particular, the minimum benefit shall be sufficient to cover the required cost sharing by the beneficiary in medical care guaranteed to his or her family under Part II of the Convention in such a manner as to avoid hardship and not to prejudice the effectiveness of medical and social protection (Article 10(2)).With regard to maintaining the family of the beneficiary in conditions of decency, the minimum benefit, together with other statutory social protections, shall allow life in dignity and provide income above the national poverty line or similar income threshold, preventing vulnerability and social exclusion. The entitlement to the minimum benefit shall not be subjected to any additional conditions of a discriminatory nature applied to any member of the family of the beneficiary, and shall not deprive the beneficiary of their acquired social and insurance status, including rights acquired or in the course of acquisition under statutory social security schemes. When the legislation makes the provision of social security benefits conditional upon occupational activity, periods during which minimum benefits are paid should normally be taken into consideration for acquisition of the right to other social security benefits. The rate of social insurance contributions or taxation or both applied to minimum benefits shall be determined in a manner which avoids hardship to persons of small means with due regard to social justice and equity (Article 70(1)). The current rates of the minimum benefits in respect of longterm contingencies shall be adjusted to the cost of living (Article 66(8)). In the light of these explanations, the Committee requests the Government to assess in its next report whether and to what extent the existing minimum social security guarantees comply with the abovementioned requirements of the Convention as to their level and conditions of entitlement, and could be used to give effect to its provisions under each accepted Part of the Convention. For the relevant statistical indicators concerning income, poverty and wages the Government may wish to refer to the ILO technical note transmitted to the Government.
The Committee notes the Government’s report. It notes, however, that it contains no information on the implementation of Part II concerning medical care. The Committee has nonetheless examined all the legislation to implement the Convention, particularly Act No. 54 of 1956 on employees’ sickness benefit, as amended, and Act No. 48 of 1997 on public health insurance.
So that it may assess fully how effect is given to the Convention, the Committee would be grateful if the Government would provide detailed information on the following points.
Part II (Medical care), Article 10, and Part III (Sickness benefit), Article 19 of the Convention (Scope). Please provide the information and statistics required by the report form under these Articles of the Convention. With regard in particular to Article 19, the Committee would be grateful if, in establishing statistics on the persons protected, the Government would separate those who must be covered by Act No. 48 of 1997 from those who are covered thereby on a voluntary basis.
Part II (Medical care), Article 17 (in conjunction with Article 13) (sharing in the cost of medical care). Please describe in detail the manner in which pharmaceuticals are supplied to insured persons on the basis of the type of medicine (full reimbursement, partial reimbursement, non-reimbursement). Please also indicate the rules on participation by insured persons in the cost of prosthetic and orthopaedic appliances (including their maintenance and replacement) and dental care.
Part III (Sickness benefit), Article 21 (in conjunction with Article 22) (rate of benefit). The Committee notes from the information in the Government’s report that sickness benefits amounted to 74 per cent of the previous wage in 1999 and 75 per cent in 2000, due account being taken of family allowances paid during employment and after the contingency, whereas the rate prescribed by the Convention is 60 per cent. The Committee observes in this connection that both the wage of the skilled manual male employee and the benefits and family allowances were calculated on a monthly basis. However, since according to sections 17 and 18 of the Act of 1956 on employees’ sickness insurance - read in conjunction with section 5 of Act No. 589 of 1992 on social security and unemployment contributions - the amount of the sickness benefit is calculated according to the maximum gross pay of the worker in question established on a daily basis, the Committee would be grateful to receive in the Government’s next report statistics on the rates of benefits specifying how the monthly rate of the sickness benefit was calculated.
The Committee further notes that the skilled manual male employee chosen by the Government is the one defined in paragraph 6(d) of Article 22 of the Convention. It would point out to the Government that the gross average wage referred to by the Government is not necessarily the same as the average earnings of all persons protected referred to in paragraph 6(d).
Article 26 (Duration of sickness benefit). The Committee requests the Government to provide detailed information on the practical effect given to section 15(5) of the Act of 1956 on employees’ sickness insurance, showing that the duration of sickness benefit is still consistent with the provisions of Article 26, paragraph 1, of the Convention, which requires the grant of the benefit to be not less than 52 weeks in each case of incapacity even in the event of an onset of a new incapacity within the time limit prescribed by section 15(4).
Article 27 (Funeral costs). The Committee notes the government statement in its report to the effect that an allowance for funeral costs is paid to the person who has borne the expense of the funeral of a deceased person who was in receipt of or entitled to sickness benefit. The Committee requests the Government to indicate the provisions of the law that apply in this case, specifying the amount of the allowance.
Part IV (Common provisions), Article 28, paragraph 1(h) (suspension of benefit in the event of receipt of more than one benefit). Since the Government has indicated that it avails itself of this provision of the Convention, which allows sickness benefit to be suspended as long as the person concerned is in receipt of another social security cash benefit, the Committee requests the Government to indicate the provisions of the law that apply in this case.
Article 29 (Right of appeal). The Committee requests the Government to provide detailed information on the practical effect given to this provision as regards both medical care and sickness benefit specifying the legislative, regulatory or administrative provisions that apply.
Article 31 (Participation in the administration). Please indicate how effect is given to this provision of the Convention which provides for participation by representatives of the persons protected and representatives of the employers in the management of the system with regard to sickness benefit (for the various sickness insurance funds) and medical care.
The Committee notes that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which reads as follows:
The Committee notes the information provided by the Government in its reports, according to which the national legislation on health care and sickness insurance has undergone considerable modification in recent years and has been the subject of numerous amendments. The Committee notes however that the text of the new legislative provisions in force has not been supplied by the Government. In view of the importance of the changes made, the Committee would be grateful if in its next report the Government would indicate, under each Article of the Convention, as required by the report form adopted by the Governing Body, the effective provisions of the national legislation currently in force and explain their content. It also hopes that the report will contain all the necessary statistical information required by the report form and, where possible, the translation of the national legislation into one of the working languages of the Committee.
[The Government is asked to report in detail in 2000.]
Article 33 of the Convention (in conjunction with Article 26). In answer to the Committee's previous comments, the Government states that, as part of the reform of the sickness insurance scheme which is now being prepared, legislation is planned which will be in line with the provisions of the Convention and that, consequently, there will be no further need to make use of the temporary derogation from the provisions of Article 26; and that as soon as the new provisions on sickness insurance are approved, the Government will not fail to inform the Committee of them. The Committee notes this statement with interest. It hopes that the sickness insurance reform will be completed shortly and asks the Government to provide information on progress in this respect. Please provide a copy of the new legislation once it has been adopted.
Article 33 in relation with Article 26 of the Convention. The Committee would be grateful if the Government would continue to provide information, as requested in paragraph 2 of Article 33, on the position of its law and practice as regards the temporary derogation from the provisions of Article 26 as well as on any progress made towards complete application of this Article of the Convention. In particular, the Committee requests the Government to indicate whether section 15 of Act No. 54 of 1956 concerning employees' sickness insurance and section 8 of Act No. 103 of 1964 concerning the social security of members of agricultural co-operatives are still in force. Under these provisions, the duration of payment of sickness benefits can be reduced to less than one year, account being taken of the duration of payment of such benefits on a previous occasion.