Information in English – Staff 46303

Docto’r fee:

• doctor’s fee is reimbursed at 70 percent of the original cost (includes Kela reimbursement)
• the administrative fee is not reimbursed

How to claim:

• when visiting a clinic with an invoicing contract, present your Kela-card with the EBF number and you only pay the deductible 30%.
• if you visit a private clinic with which EBF does not have an invoicing contract, you have to pay the cost yourself. The Kela reimbursement can be deducted from the price. If the Kela reimbursement is not deducted, you need to fill in the claim form SV 127e and send it to EBF along with the invoice and the Kela form SV 120 filled out by the clinic.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through OmaKela (www.kela.fi) if the Kela reimbursement is not deducted from the invoice
  • through Iris e-service

Treatment fee:

• treatment fee is reimbursed by up to EUR 50 per visit
• if you are considering being a private patient in a hospital or a private clinic for surgery or treatment, ask for a cost estimate for each treatment, after which you can ask the fund whether they are reimbursed

How to claim:

• send the invoice to EBF.
• file your claim within 6 months of the original expense.
• send the invoice to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

Discretionary contribution

• medical testing and examinations are reimbursed at 70 per cent of the original cost (includes Kela reimbursement)

How to claim:

• when visiting a clinic with an invoicing contract, present your Kela-card with the EBF number and you only pay the deductible 30%.
• MRI: When you have a referral from a specialist, make an appointment with one of EBF’s contracting partners and let EBF know the clinic and date of MRI. EBF will send a payment commitment directly to the clinic. You will pay 30 % deductible at the clinic and they will charge 70 % from EBF.
• if you visit a private clinic with which EBF does not have an invoicing contract, you have to pay the cost yourself. The Kela reimbursement can be deducted from the price. If the Kela reimbursement is not deducted, you need to fill in the claim form SV 127e and send it to EBF along with the invoice and the Kela form SV 3 filled out by the clinic.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through OmaKela (www.kela.fi) if the Kela reimbursement is not deducted from the invoice
  • through Iris e-service

• max 30 treatment sessions per year
• the referral is valid for one year from the doctor’s order

Physiotherapy:

• prescribed by a physician is reimbursed at 70 per cent of the original cost (includes Kela reimbursement)

How to claim:

• when visiting a clinic with an invoicing contract, present your Kela-card with the EBF number and you only pay the deductible 30%.
• if you visit a private clinic with which EBF does not have an invoicing contract, you have to pay the cost yourself. The Kela reimbursement can be deducted from the price. If the Kela reimbursement is not deducted, you need to fill in the claim form SV 127e and send it to EBF along with the invoice and the Kela forms SV 3FM and SV 3FS filled out by the clinic.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through OmaKela (www.kela.fi) if the Kela reimbursement is not deducted from the invoice
  • through Iris e-service

Massage:

• provided by an authorized massage therapist prescribed by a physician, occupational nurse or occupational physiotherapist is reimbursed at 50 per cent of the fee
• the authorized massage therapist should be found in https://julkiterhikki.valvira.fi/

How to claim:

• send the referral and the invoice/receipt with the massage therapist’s name to EBF. The dates of the visits should be written on the referral.
• reimbursement can only be claimed after the treatment, not in advance (e.g. serial cards).
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

Chiropractice, osteopathy and naprapathy:

• prescribed by a physician is reimbursed at 50 per cent

How to claim:

• send the referral and the invoice/receipt to EBF. The dates of the visits should be written on the referral.
• reimbursement can only be claimed after the treatment, not in advance (e.g. serial cards).
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• Psychotherapy prescribed by occupational health care is reimbursed max 5 visits per year

How to claim:

• send the referral and the invoice/receipt to EBF.
• file your claim within 6 months of the original expense.
• end the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• medication prescribed by a physician and intended for the treatment of an illness is reimbursed at 100 per cent of the reference price, after the 50 € initial deductible per year. The medication has to be eligible for compensation under the Health Insurance Act, i.e. reimbursed by KELA
• clinical nutrients and corresponding products, and emollients are reimbursed in cases where they are eligible for compensation under the Health Insurance Act
• disinfectants and bandages prescribed by a physician are also reimbursed

How to claim:

• you can usually get the reimbursement directly at the pharmacy when you present your Kela-card with the EBF number.
• If you didn’t get a direct reimbursement, you need to fill in the claim form SV 178e and send it to EBF along with the invoice/receipt and the invoice itemization.
• If you got the Kela-reimbursement but had to pay the deductible, send the invoice/receipt to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through OmaKela (www.kela.fi) if the Kela reimbursement is not deducted from the invoice
  • through Iris e-service

• for dental care, the fund reimburses EUR 200 a year, in addition to the KELA reimbursement
• includes dentist’s fees and dental hygienist’s fees (no aesthetic treatment, e.g. teeth whitening)
• X-ray is reimbursed as examination, i.e., the reimbursement is 70 %
• the dates of the visits determine the year under which the costs are recorded

There are big differences in the prices of dental care. The most inexpensive prices for EBF members:

• Renideo (only in Hyvinkää clinic, Torikatu)
• Hammas Mehiläinen (reduced prices also for family members)  https://hammasmehilainen.fi/toimipisteet/

When making an appointment let them know that you are EBF member.

How to claim:

• if you visit a private dental clinic, the Kela reimbursement can be deducted from the price. If the Kela reimbursement is not deducted, you need to fill in the claim form SV 127e and send it to EBF along with the invoice and the Kela form SV 126 / 3SHM / 3SHS filled out by the clinic.
• if the Kela reimbursement is deducted, send the invoice to EBF.
• if you visit the municipal dental clinic, send the invoice to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through OmaKela (www.kela.fi) if the Kela reimbursement is not deducted from the invoice
  • through Iris e-service

• EUR 200 is reimbursed for (prescription) eyeglasses every second calendar year, the reimbursement can also be used for corrective eye laser surgery.
• eyesight examination performed by an optician is reimbursed at 100 per cent.

How to claim:

• send a receipt of the purchase with your name and a copy of the eyesight examination record to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• fees for serial treatment and a municipal day surgery fee are reimbursed at 100 per cent
• the fund reimburses daily hospital fees for 150 days for one illness according to the lowest payment class in municipal central hospital care

How to claim:

• after paying the invoice send it to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• outpatient clinic fees and health center visits are reimbursed at 100 per cent

How to claim:

• after paying the invoice send it to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• travel costs to visit a doctor or to undergo an examination or treatment in a medical examination institution or hospital are reimbursed at 100 per cent in cases where they are eligible for compensation under the Health Insurance Act, i.e. reimbursed by KELA
• the fund reimburses the 25 € copayment
• you’ll find further information on travel costs in https://www.kela.fi/web/en/travel-costs

How to claim:

• send the receipt of the 25 € to EBF.
• the fund reimburses daily hospital fees for 150 days for one illness according to the lowest payment class in municipal central hospital care
• travel costs to visit a doctor or to undergo an examination or treatment in a medical examination institution or hospital are reimbursed at 100 per cent in cases where they are eligible for compensation under the Health Insurance Act, i.e. reimbursed by KELA
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

• medical devices (pediatric supports, occlusal splint, etc.): one (pair) per year is reimbursed (max. 500 €) in cases where reimbursement cannot be received anywhere else, e.g. from the municipal health center
• the device has to be prescribed by a doctor
• the fund reimburses 50 % for the rent of a CPAP machine or for the price of a temporary sleeping mask used in the treatment of sleep apnea, until the device is available from the public sector. The purchase of a CPAP machine is not reimbursed.
• in uncertain situations please contact EBF

How to claim:

• send the doctor’s referral and the receipt to EBF.
• file your claim within 6 months of the original expense.
• send the documents to the EBF
  • by mail: Koneen toimihenkilöiden vakuutuskassa, PL 6, 05801 Hyvinkää
  • through Iris e-service

Sickness allowance

• If your sick leave exceeds the period for which employer pays sick leave salary, you can claim sickness allowance.

How to claim

• Sickness allowance can be claimed online in www.kela.fi (only in Finnish) by logging on to the eServices using the online banking codes. Allowance can also be claimed by completing the sickness allowance claim (SV 8e) and sending it to EBF
• File your claim within 2 months of the beginning of the sick leave.
• Please, check also your employer’s policy about reporting absences

Amount

• Sickness allowance is determined on the basis of an annual income. The annual income is calculated for a reference period of 12 calendar months prior to the calendar month that precedes the start of your work disability.
• The annual income includes salary, salary for insurance purposes, YEL and MYEL income, certain benefits and certain compensations for loss of income.

Payment

• Sick leave salary is paid by the employer and Kela will pay the sickness allowance to the employer for the paid leave.
• After the paid leave Kela will pay the allowance to you according to their payment periods and payment days, which you will see on Kela’s online service.

Other considerations

• Usually, tax is withheld from the allowance at the same rate as from your salary. If the withholding rate on your salary is lower than 25%, tax is withheld at 25%, minimum, unless you apply for a revised tax card from the Tax Administration.

Further information: www.kela.fi
Employee benefit fund: www.vakuutuskassa.com

• Partial sickness allowance makes it possible for an employee to return to work from a long sick leave on a part-time basis.
• The waiting period of partial sickness allowance is the first day of illness and the following 9 working days. The employee must be absent from work throughout the waiting period.
• The minimum period of partial sickness allowance is 12 days.
• The maximum period of partial sickness allowance is 120 working days.

How to claim

• Partial sickness allowance can be claimed online in www.kela.fi (only in Finnish) by logging on to the eServices using the online banking codes. Allowance can also be claimed by completing the sickness allowance claim (SV 8e) and sending it to EBF.
• Enclose with your claim a certificate B from an occupational health doctor and an agreement on part-time employment signed by you and your employer.
• File your claim within 2 months of the beginning of the part-time work.

Amount

• The amount of the partial sickness allowance is half of the preceding sickness allowance.

Payment

• If the employer pays full sick leave salary for the part-time work, Kela will pay the partial sickness allowance to the employer. Otherwise the allowance will be paid to the employee.
• The allowance will be paid according to Kela’s payment periods and payment days, which you will see on Kela’s online service.

Further information: www.kela.fi

Employee benefit fund:  www.vakuutuskassa.com

Maternity and parental allowance

• Maternity allowance application will be handled by Vakuutuskassa / Employee Benefit Fund (EBF)

How to claim

• Maternity allowance must be claimed at least 2 months before the estimated date of delivery
• Maternity allowance can be claimed online in www.kela.fi (only in Finnish) by logging on to the eServices using the online banking codes.  Allowance can also be claimed by completing the Application – Parental benefits for mothers (SV9e) and sending it to EBF
• You can send the pregnancy certificate to Kela or EBF (PL 6, 05801 Hyvinkää)
• Please, check also your employer’s policy about reporting absences

Amount

• Maternity allowance is determined on the basis of an annual income. The annual income is calculated for a reference period of 12 calendar months prior to the calendar month that precedes the start of your maternity leave.
• The annual income includes salary, salary for insurance purposes, YEL and MYEL income, certain benefits and certain compensations for loss of income.

Maternity leave compensation

• Maternity leave salary is paid by the employer. Maternity leave is fully paid for the first 3 months when the conditions of the collective agreement are met. Kela will pay the maternity allowance to the employer for the paid leave.

Other considerations

• Certificate on postnatal examination has to be sent to EBF/Kela to ensure the continuation of the payment of parental allowance.
• Usually, tax is withheld from the allowance at the same rate as from your salary. If the withholding rate on your salary is lower than 25%, tax is withheld at 25%, minimum, unless you apply for a revised tax card from the Tax Administration.
• Members who are on maternity or parental leave are entitled to EBF benefits
• Members who are on child home care leave are entitled only to Kela reimbursements

Further information:  www.kela.fi

Employee benefit fund:  www.vakuutuskassa.com

Paternity allowance

• Your paternity allowance application will be handled by Vakuutuskassa / Employee Benefit Fund (EBF)

The length of paternity leave

• Paternity leave is 54 working days altogether. The father can take 1-18 working days at the same time as the mother receives maternity or parental allowance for the same child.

How to claim

• Paternity allowance must be claimed after the child is born or when starting paternity leave
• Paternity allowance can be claimed online in www.kela.fi (only in Finnish) by logging on to the eServices using the online banking codes. Allowance can also be claimed by completing the Application – Parental benefits for fathers (SV29e) and sending it to EBF
• Please, check also your employer’s policy about reporting absences

Amount

• Paternity allowance is determined on the basis of an annual income. The annual income is calculated for a reference period of 12 calendar months prior to the calendar month that precedes the start of your paternity leave.
• The annual income includes salary, salary for insurance purposes, YEL and MYEL income, certain benefits and certain compensations for loss of income.

Paternity leave compensation

• Paternity leave salary is paid by the employer. Paternity leave is fully paid for the first 6 days when the conditions of the collective agreement are met. Kela will pay the paternity allowance to the employer for the paid leave.

Other considerations

• Usually, tax is withheld from the allowance at the same rate as from your salary. If the withholding rate on your salary is lower than 25%, tax is withheld at 25%, minimum, unless you apply for a revised tax card from the Tax Administration.
• Members who are on paternity leave are entitled to EBF benefits.
• Members who are on child home care leave are entitled only to Kela reimbursements.

Further information:  www.kela.fi

Employee benefit fund:  www.vakuutuskassa.com