The new benefits regime that will come into effect from 2026 brings significant changes to the provisions of insurance funds. The changes include increases in pregnancy benefits for self-employed mothers and parallel reduction of funeral expenses across all funds, as reported by Antonis Vasilopoulos for “Kyriakатiki Apogevmatini”.
Unification of benefits under common terms
The Ministry of Labor is preparing a bill to be submitted in the autumn aimed at eliminating inequalities in benefits. The new regulation covers all funds that have been integrated into EFKA and aims to create unified criteria for sickness, maternity, work accident and disability benefits.
Today there are huge differences in benefits between funds. A characteristic example is funeral expenses which range from 700 euros in NAT to 3,000 euros in the former DEI fund. Other funds pay intermediate amounts such as 1,100 euros for the Legal Fund, 1,200 euros for OAEE and 2,723 euros for TSAV for doctors.
The 5 key changes
1. Sickness benefit for employees. Its provision will start from the 4th day of illness and from the 11th for voluntarily insured. The daily amount of sickness benefit for employees for the first 15 days will equal 25% of the deemed daily wage of the insurance class to which the insured belongs and from the 16th day of illness onwards reaches 50%. The amounts are increased by 10% for each indirectly insured family member of the beneficiary with a maximum limit of four indirect members. The final daily sickness benefit with increases cannot exceed 70% of the daily wage of the insurance class based on which the benefit is calculated, nor the deemed daily wage of the 8th insurance class.
2. Sickness for non-employees. Will be paid from the 31st day of illness instead of the 11th that applies today, while the daily amount will reach 25 euros.
3. Funeral expenses. Will be limited to the amount given today by former IKA (860 euros) increased to 900 or 1,000 euros.
4. Pregnancy and childbirth benefits. The benefit doubles for non-employees, professionals insured with ETAA and farmers. The pregnancy and childbirth benefit for employees equals 50% of the deemed daily wage of the insurance class in which the insured is classified and will be increased by 10% for each protected member up to 40%. The benefit will range from 384 euros to 460 euros per month, as in OGA, which today gives 230 euros. For all categories the subsidy amount cannot exceed 70% of the deemed daily wage of the 28th insurance class. Specifically for non-employee insured in OAEE, ETAA the benefit more than doubles and in addition to the above amounts an additional benefit from DYPA will be provided, lasting 2.5 years.
5. Duration of sickness benefit. Today it reaches up to 720 days, for the same condition, provided that 4,500 days of actual insurance have been completed before the day of illness notification, or 1,500 days of actual insurance, of which at least 600 days during the 5 previous years before the illness. In case the insured does not meet any of the above prerequisites, they are entitled to sickness benefit, depending on their age and days of actual insurance.
Exceptions
In practice, the new benefits regulation will abolish all individual amounts paid by the Funds, according to their statutes, for funeral expenses, sickness and accident benefits, recognizing certain special exceptions. There are also benefits, such as the possibility of accommodation in certain institutions for the elderly, which concern insured who pay additional contributions. In this case it appears that the solution of abolishing them is preferred, with elimination of the additional contribution, provided that the need to cover insured who already use the benefit ceases. Finally, a “thorn” in the changes is the Public Sector, which remains outside the changes, as public employees today pay a contribution of around 2% and continue to be paid normally, without reduction, in case of sick leave.
