JSIS special reimbursement (Article 72(3) [1]) calculations will be sent automatically, can you verify? The rules say it can happen, but has it ever happened? Witnesses please! We can find no figures and we need your help! So, any colleagues out there who have (or have had) heavy medical expenses, have you ever received an information note listing non-reimbursed expenditure over the previous 36 months and informing you of your potential eligibility for additional special reimbursement? Please get in touch!
The (incomplete) procedure is contained within Chapter 6 of the General Implementing Provisions for the reimbursement of medical expenses and the codes, which date from 2008 (they’re by no means new) but Generation 2004 had cause to look recently at this rule and we’re wondering how realistic it is.
‘An information note established on the basis of non-reimbursed expenditure incurred during the previous 36 months will be sent automatically or on request to members likely to qualify for special reimbursement. The note takes account of the adjustment of remuneration provided for in Article 65 of the staff regulations.’ (p.93 General Implementing Provisions for the reimbursement of medical expenses and the codes)
As you can see it provides abundant wiggle room and leaves it quite unclear as to who is responsible for taking action where a colleague is drowning in medical costs (bold is not present in the original).
So to use this entitlement you might have to:
- be aware of this right;
- exercise this right;
- comply with the availability window (the rolling deadline).
Does this look familiar? Yes, we’ve recycled it, these are the same issues we had the Central Staff Committee raise in 2021 with regards to those on long term sick leave missing out on exercising their rights to transfer their annual leave to the following year. Why is this a concern? Because if colleagues are not receiving the information note automatically then they are potentially still ill and missing out, is this a genuine oversight?
What?! You didn’t already know?
This phrase is too often heard after the deadline passes or the option is no longer available. In fact, the colleague who sent us this well-used example involving difficulties with reimbursement for category C2 orthopaedic surgery now realises that as an AST3(2) the option of an additional special reimbursement was probably there, but no one said! The €2000 outstanding was, on its own, well over 50% of the average monthly salary and therefore should have entitled that colleague to request additional reimbursement. This is without even looking at all of the other JSIS reimbursement requests made within a 12-month period. Check out how it works via the example given on Staff Matters.
In the end, that colleague did not miss out as they had purchased complementary insurance (phew!). But even the external insurer said nothing about this being something that might be further reimbursed. Odd, eh? On this occasion it made no difference, but if that money is coming out of your pocket, please make some noise!
What’s on offer (potentially)
Unfortunately, while this special additional top-up has the potential to raise the reimbursement to 100% in total for those with children or a declared significant other, for everyone else the most they can hope for is a 90% reimbursement (see Staff Matters). Nevertheless, for the surgery above an additional 5% reimbursement might have been some 600€.
Have any of you ever seen an information note?
Have any of you ever requested an information note? How? We can find no process outlined, no form or button. Can we make the request via staff contact? How is the note received? Within the PMO platform? Via Ares? By email? Via snail mail? Did any of you ever spontaneously receive an information note? We are aware that, in general, it’s best to ignore emails offering money, but what if it’s an additional reimbursement? Did it ever happen? Please let us know!
What makes this a bit more complicated is the rolling deadline (the last 12 months). What’s your experience of this rolling-deadline reimbursement? Are any of you calculating not just the total but also the best moment to launch the request? While there’s a calculator available for pensions, for the annual travel payment and even for the rolling-deadline Shengen visa counter for those entering from third countries, we can find nothing for the JSIS. There’s no means to export the account sheets to an excel and do the calculations yourself.
We find this awareness to be a big ask for any colleagues, but particularly for those who have been (or still are) unwell: are colleagues missing out on what they’re entitled to?
For any other questions, do not hesitate to get in touch or leave a comment below.
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[1] Article 72(3) of the staff regulations:
- Where the total expenditure not reimbursed for any period of twelve months exceeds half the official’s basic monthly salary or pension special reimbursement shall be allowed by the appointing authority, account being taken of the family circumstances of the person concerned, in manner provided in the rules referred to in paragraph 1.
