TABLE OF CORRESPONDENCES OF FORMS - BY TYPES OF BENEFITS
|Social security field||Document (form)||Form type according to Regulations No. 883/04 and No. 987/09||E-Form according to Regulations No. 1408/71 and No. 574/72|
|Applicable legislation||Certificate of applicable social security legislation||A1||E101
|Sickness and maternity in kind||Registration with a health insurance institution in another Member State of residence||S1 (portable)
Part A of
E120 or E121
Part B of
E120 or E121
|Sickness and maternity in kind||Planned treatment abroad (EU)||S2 (portable)
|Sickness and maternity in kind||Treatment in the previous country of employment - retired border workers||S3 (portable)||-|
|Sickness in kind||Sickness benefits (in kind) for occupational accidents or diseases||DA1 (portable)
|Summing up periods for continuity of rights||Summing up periods||S040
|E107, E001 or
E104 (part A)
E104 (part B)
|The information request, modification or cancellation of registration||Requests for information, termination of registration||S016, S017
|Request a certificate for the presence of rights||
|Certification of temporary incapacity for work||Hospital sheet||-||E116|
|Unemployment benefits||Certificate of preservation of the right to unemployment benefits (including benefits in kind)||U2||E303|
(FOR THE PURPOSES OF AGGREGATING PERIODS OF INSURANCE,
PERIODS OF EMPLOYMENT OR PERIODS OF RESIDENCE)
FORM E 104 - PURPOSE AND CHANGES IN THE ORDER FOR ITS ISSUANCE BY THE NATIONAL HEALTH INSURANCE FUND
In the framework of health insurance, Form E 104 is issued for the summation of health insurance periods, which enables a person who starts insurance in another EU Member State, EEA or Switzerland to acquire health insurance rights as a result of recognition of his / her previous insurance service.
Upon returning to Bulgaria, a person who has been insured in another Member State submits a Form E 104 to the NRA Territorial Directorate (TD) and acquires health insurance rights after processing the form.
In this way, the procedure prescribed in Article 40a of the Health Insurance Act does not have to be followed: insurance for 6 consecutive months, or a lump sum payment of 12 health insurance contributions.
As of January 1, 2010, Form E 104 will be issued by the Head of the NHIF only for its main purpose needs:
- To aggregate health insurance periods acquired in one Member State to health insurance periods in another Member State, for the purpose of entering another Member State's health insurance system and to guarantee continuity of rights;
- To prove the applicable health insurance legislation for pensioners entitled to a pension in more than one Member State;
- At the request of a social security institution of another Member State, according to the official procedure established in the EU (with forms E 107 or E 001) - in order to certify completed health insurance periods in Bulgaria.
Applications for the issuance of E 104 may be submitted in person, by a parent or proxy, or required ex officio by the relevant health fund in the Member State (using forms E 001 or E 107) - in the records of the NHIF or the RHIF, by post, fax, or by e-mail.
Application for Issue / Request Form S041 (E 104) by a Member State.
Prior to submitting E 104 applications to the NHIF office, applicants will be consulted by an European integration and international cooperation (EIIC) Directorate officer at the NHIF and, if possible, by the relevant staff at the NHIF processing the European application forms.
For further clarification, please contact the EIIC Directorate at the Headquarters of the NHIF (tel. 02/965 9116) and the international departments of the relevant competent insurance institutions in the country of stay.
Тип: pdf Issuance of the EHIC