Registering with the social security system and having healthcare expenses reimbursed as an employee posted abroad

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Be advised: Brexit may have an impact on the posting of workers of a company based in Luxembourg to the United Kingdom. For more information, please consult our FAQ on the subject.

A posted worker is a worker who:

  • carries out work in another country than the one in which they usually work, for a limited and specified period of time;
  • remains under the employment contract with their initial employer (otherwise it is deemed to be a transfer of an employee).

Who is concerned?

Salaried workers who:

Prerequisites

In order to be covered for sickness and accident during their stay abroad, posted employees must be able to provide proof of social security coverage in Luxembourg for any healthcare expenses during their posting by being duly affiliated to the CCSS.

Moreover, workers must ensure that:

  • they are authorised to reside and work in the country to which they are posted;
  • the labour and income tax laws applicable to them are complied with.

How to proceed

Affiliation of an employee posted to a company established in the EU or in a country of the European Economic Area (EEA) (Norway, Iceland, Liechtenstein since 01.06.2012) or Switzerland (since 01.04.2012)

Initial posting

The initial posting is for a maximum duration of 24 months and is renewable under certain conditions.

Employees who are posted to a company based in an EU Member State remain affiliated and covered by the Luxembourg social security system for the duration of their posting.

In order to remain covered by the Luxembourg social security during the posting, the worker must:

  • carry out an activity as a salaried employee in Luxembourg with an employer who normally carries out their substantial activities in the country (other than purely internal administrative activities);
  • be posted by the employer to another Member State in order to carry out work on said employer's behalf;
  • be posted for a foreseeable duration of no more than 24 months;
  • not be replacing another worker;
  • have been affiliated to the Luxembourg social security for at least 1 month prior to the posting.

Before the posting, and for each employee being posted abroad, the employer must submit an application for work abroad to the CCSS. Once the certificate is established by the CCSS, the 'A1 certificate' is sent to the employer, who must give a copy to the posted worker.

The employee must apply to the CNS for the Form S1. With this document the employee can register with the social security system in the host country.

Once the employee is enrolled with the social security system in the host country, they are entitled to receive benefits in kind (medical examinations, medicines, hospital care, etc.) which may be required during their posting, on the same terms as resident employees.

Extension of the posting

A new posting may be authorised for the same employee in the same country after 24 months, provided that a waiting period of 2 months is observed.

If the posting is extended beyond the 24-month period, an application to maintain affiliation with the Luxembourg social security must be submitted to the Ministry of Health and Social Security.

If, because of the specific nature of the employee's job, it is obvious from the outset that the posting will last for a longer period, an application to maintain enrolment with Luxembourg social security for the entire duration of the posting may be submitted directly to the Ministry of Health and Social Security.

In both cases, the Ministry of Health and Social Security will seek the approval of the competent authority in the other Member State on maintaining the employee's enrolment with Luxembourg social security. This approval is forwarded to both the employer and the employee. The CCSS receives a copy and issues an A1 certificate for this period. It will send a copy to the competent body in the host country and 2 copies to the employer, who will give 1 copy to the employee.

The posted employee must go to the social security institution in the host country to have their enrolment extended.

Enrolment and coverage of employees posted to companies based in a country that has signed an agreement with Luxembourg

Initial posting

Employees posted to a company in a country having signed a bilateral agreement with Luxembourg remain enrolled with and covered by the Luxembourg social security system for the entire period of their posting as provided for in the bilateral agreement concerned.

As such, before the posting, and for each employee to be posted abroad, the employer must apply to the CCSS for a certificate of coverage for employees working abroad. Once it is prepared by the CCSS, the certificate of coverage is sent to the employer, who gives a copy to the posted worker.

The employee must apply to the CNS for a 'certificate of entitlement to benefits in kind', which certifies entitlement to benefits in kind during temporary stays abroad.

The certificate is issued using a form that depends on and is specific to the host country. This can be the case for:

  • Bosnia and Herzegovina: Form LU/BiH-106;
  • Macedonia: Form L/RM-106;
  • Montenegro: Form MNE/L-106;
  • Serbia: Form SRB/LUX-106;
  • Tunisia: Form T/L 15.

With their certificate attesting to the applicable legislation, the employee can enrol with the health insurance fund in the host country.

Once enrolled, they they will be able to receive any benefits in kind (medical examinations, medicine, hospital care, etc.) they may require during their posting abroad.

Extension of the posting

If the posting is extended beyond the initial period provided for in the agreement concerned, the approval of the host country must be sought. To this end, the employer submits a request for an extension in accordance with the provisions of the agreement concerned:

  • either to the CCSS;
  • or to the Ministry of Health and Social Security.

These bodies will, where required, seek the approval of the competent authority in the other state on maintaining the employee's enrolment with Luxembourg social security.

In case of approval, the CCSS and/or the Ministry of Health and Social Security receive a copy and the CCSS issues a certificate of coverage during the agreed period of posting.

The posted employee must take this certificate to the social security institution in the host country to have their enrolment extended.

If, because of the specific nature of the employee's job, it is obvious from the outset that the posting will last for a longer period, an application to maintain enrolment with Luxembourg social security for the entire duration of the posting may be submitted directly to the Ministry of Health and Social Security.

Enrolment and coverage of employees posted to companies based in a country that has not signed an agreement with Luxembourg

Initial posting

Employees who are posted to a company based in a third country remain enrolled with and covered by the Luxembourg social security system for the duration of their posting. Generally, postings are for a maximum of 12 months.

As such, before the posting, and for each employee to be posted abroad, the employer must apply to the CCSS for a certificate of coverage for employees working abroad. Once it is prepared by the CCSS, the certificate is sent to the employer, who gives a copy to the posted worker.

Extension of the posting

The application for an extension is made using the application for a certificate of coverage for employees working abroad and must be submitted to the CCSS before the expiry of the initial authorisation. Applications for extensions must be renewed annually. Starting with the 3rd year of posting, applications for the extension of coverage have to be approved by the CCSS Steering Committee. The maximum duration of a posting is 5 years.

Reimbursement of healthcare expenses incurred abroad

Coverage of health expenses

The posted workerr emains affiliated to the CCSS in Luxembourg and is duly registered with the social security body in the country of posting. In this way, the worker benefits from the coverage of health expenses.

Reimbursement of healthcare costs advanced by posted workers

After paying for a consultation with a health professional, the posted worker can send the invoice either:

  • to the CNS; or,
  • to the health insurance fund in the country of posting.

The CNS will only reimburse the medical or healthcare services listed in the Luxembourg classification of medical procedures and rates (nomenclature luxembourgeoise).

If the country the worker is posted to:

  • is an EU Member State, a member of the EEA, or Switzerland: the reimbursement is made according to the local rates and tariffs;
  • is bound by a bilateral agreement with Luxembourg: the rate reimbursed depends on the local rates and tariffs;
  • is a non-EU country and not bound by a convention: reimbursement is made according to Luxembourg rates and tariffs.

In addition, the posted employee can take out supplementary insurance that covers any difference.

Direct payment by the health insurance fund

In some cases, such as hospitalisation costs, medicine or laboratory services, posted employees are not required to advance the full cost of the delivered services. To benefit from this direct payment system—known as the 'third-party payment' system—posted employees will need to produce the certificate of registration issued by the social security institution in their host country.

Posted employees need only pay healthcare providers for the portion of the costs that remains to be borne by them.

Online services and forms

Who to contact

Joint Social Security Centre

CNS Department - National Reimbursements

Related procedures and links

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