Mandatory Health Insurance Rules
Step 6 - The Compliance File
Following the documentation of key elements for mandatory social security regimes, it is now crucial to incorporate all relevant mandatory health insurance rules into the Social Security Compliance File.
This Compliance File requires continuous maintenance; ensure it is regularly updated to reflect any changes in circumstances that may impact the applicable social security and health insurance regimes.
In addition to the information you already stored in the social security compliance file, you must identify/ verify and document the following key factors (if relevant for the specific case):
1. The Country of Insurance
This is the country where the employee is subject to mandatory social security including health insurance coverage.
2. The Depending Family member(s)
It is essential to continuously monitor and update family member statuses. Key life events to track include children reaching adult age and a spouse obtaining their own source of income, as these changes can significantly impact compliance requirements.
The definition of depending family member is determined by the legislation of the country of Residence.
3. The Country of Residence
This is the country where the employee and any dependent family members habitually live, their home country, where their centre of interest is.
4. The Country of Temporary Stay
A temporary stay is a period during which the employee is staying in a place other than the one where they usually live and they do not move their "centre of interest" there.
5. Assessment Medical Expense Settlement & the employee
Save assessment and copy of forms and documents in the compliance file.
6. Assessment Medical Expense Settlement & dependent family members
Save assessment and copy of forms and documents in the compliance file.
7. Assessment Medical Expense Settlement & Temporary Stay
Save assessment and copy of forms and documents in the compliance file.
8. Assessment need for supplementary international (travel) insurance
Save assessment and copy of forms and documents in the compliance file.
Caution
Compliance File Confidentiality
The Compliance file contains sensitive documentation regarding legal requirements, regulatory adherence, and internal control measures. This strict separation from employee files helps maintain clear boundaries between personnel records and compliance documentation. Access to this file is restricted to authorized compliance officers, legal department personnel, and senior management on a need-to-know basis. Even during external audits or investigations, the confidentiality of these documents must be maintained to protect the organization's legal strategy and sensitive compliance matters.