Lexipedia

EESSI – CDM 4.3

S-Sickness

S_BUC_03-v4.3.4

Cancellation of entitlement document

BUC Guidelines

EESSI – CDM 4.3

S-Sickness

S_BUC_03-v4.3.4

Cancellation of entitlement document

BUC Guidelines

TABLE OF CONTENTS

S_BUC_03 – Cancellation of entitlement document 5

How to start this BUC? 6

What is my role in the social security exchange of information I have to complete? 6

CO.1 Who do I need to transmit information to? 6

CO.2 How do I identify the correct institution to exchange information with? 6

CO.3 How do I proceed after having identified the Counterparty? 7

CO.4 How do I proceed after having received the ‘Reply to cancellation of entitlement document’ SED S017 from the Counterparty? 7

CO.5 How do I express a dispute concerning the registration date indicated in SED S017 from the Counterparty? 7

CP.1 What should I do if I have received a ‘Cancellation of entitlement document’ SED S016? 8

CP.2 How do I proceed If I have received a ‘Dispute of date’ SED S050? 8

BPMN diagram for S_BUC_03 9

Structured Electronic Documents (SEDs) used in the process 9

Administrative sub-processes 9

Horizontal sub-processes 9

Document Control Information

Document Control

Value

Project Title

Electronic Exchange of Social Security Information (EESSI)

Document Name

S_BUC_03-v4.3.4

Document Category

BUC guidelines

Revision

CDM Package

CDM 4.3.4

Last Update

Project Milestone

30/04/2024

EESSI - 2024

Document Status

Final

Sensitivity (TLP)

Distribution terms

Traffic Light Protocol (TLP) = “GREEN”

The distribution of this document is done strictly in line with the Traffic Light Protocol (TLP) established by the European Commission's note AC 790/15 REV for the EESSI project documentation.

In line with the note AC 790/15 REV, this document is labelled as TLP = “Green”. Therefore, it can be circulated widely within the EESSI community. However, the document or the information herein may not be published or posted on the Internet, nor released outside of the EESSI community.

Connected/Embedded Files

None

Authors

European Commission, DG EMPL A4, EESSI BA

Revised by

European Commission, DG EMPL A4, EESSI BA

Approved by

European Commission, DG EMPL A4, EESSI PMO

Document history

Milestone /

Component version

Publication Date

Changes/Corrections

Description

v0.1

07/04/2017

First draft of the document submitted for review to the Sickness Ad Hoc group

v0.2

09/05/2017

Implement changes and updates following the AHG comments. Version submitted for AC review.

v0.99

15/06/2017

Version submitted for AC approval.

v1.0

13/07/2017

AC approved version

With minor formatting and clarification corrections

v4.1.0

11/09/2018

Performed patch changes to reference the new CDM version 4.1.0

v4.2.0

01/09/2019

Performed patch changes to reference the new CDM version 4.2.0

v4.3.0

31/08/2021

Performed patch changes to reference the new CDM version 4.3.0

v4.3.1

07/12/2021

Links update

v4.3.4

30/04/2024

Implementation of change request EESSI-11722 by updating CO.3 step to cover the scenario when the entitlement is cancelled in full.

S_BUC_03 – Cancellation of entitlement document

Description: As the regulation dictates (Art. 24 of 987/2009 and Art. 17, 22, 24, 25 and 26 of 883/2004) the insured person and/or members of his family shall register with the institution of the place of residence. Their right to benefits in kind in the Member State of Residence shall be certified by a document issued by the Competent Institution upon request of the insured person, upon request of the institution of the place of Residence or upon initiative of the Competent Member state.

The case described hereafter models the process that leads to

cancellation of the entitlement to the benefits in kind of the insured person or/and his/her family members in the Member State of residence.

Legal Base: The Business Use Case document's legal base is described in the following Regulations

Basic Regulation (EC) No 883/2004

Implementing Regulation (EC) No 987/2009

The following matrix specifies the SEDs that are used in this Business Use Case and documents the articles that provide the legal basis for each SED.

Basic Regulation No 883/2004

Implementing Regulation No 987/2009

SED

17

22

24

25

26

24

S016 Cancellation of entitlement document

S017 Reply to Cancellation of Entitlement Document

S050 Dispute of Date

Request – Reply SEDs

The following table specifies the SEDs that have a logical pairing to one another, usually this is known as a request-reply pair.

REQUEST SED

REPLY SED(s)

S016 Cancellation of entitlement document

S017 Reply to Cancellation of Entitlement Document

S050 Dispute of Date

S017 Reply to Cancellation of Entitlement Document

Glossary of relevant terms used in S_BUC_03:

Term used

Description

Case Owner

In this BUC the Case Owner is the Institution of the Member State where the person is insured. This Institution informs the institution of the place of residence about the cancellation of the entitlement

document concerning the insured person (and/or his/her family).

Counterparty

In this BUC the Counterparty is the Institution of the place of residence of where the insured person is registered.

How to start this BUC?

In order to help you understand S_BUC_03 we have created a set of questions that will guide you through the main scenario of the process as well as possible sub-scenarios or options available at each step along the way. Ask yourself each question and click on one of the hyperlinks that will guide you to the answer. You will notice that in some of the steps, where it is allowed to use the additional horizontal and administrative sub-processes, they will be listed under the step description.

What is my role in the social security exchange of information I have to complete?

If you want to inform a Member State regarding the cancellation of an entitlement document of a person and/or its family members who currently reside(s) in that Member State and if you are the institution that previously issued the entitlement document, your role will be defined as the Case Owner.

I am the Case Owner. (step CO.1)

If you are the Competent Institution of a Member State where the person(s) in question currently reside(s) and if you are contacted by an

institution from another Member State (Case Owner) which initially issued an entitlement document for the person(s) in question, your role will be defined as the Counterparty.

I am the Counterparty. (step CP.1)

CO.1 Who do I need to transmit information to?

As the Case Owner, your first step in any new exchange of information will be to identify the Member State that you need to exchange information with, which is the Member State where the person in question resides and was registered on the basis of an entitlement document issued by you. The second step is to identify the relevant institution in this Member State that is responsible for the information you need to exchange. This activity will define the Counterparty you will be working with. There can be only one Counterparty.

I need to identify the Counterparty. (step CO.2)

I have identified the Counterparty I need to contact.(step CO.3)

CO.2 How do I identify the correct institution to exchange information with?

In order to determine the relevant Competent Institution from another Member State you will need to consult the Institution Repository (IR). The IR provides an electronic record of all current and previous Competent Institutions and Liaison Bodies that have been responsible for the cross border coordination of social security information for each of the relevant Member States.

Please note that in this BUC you should select from the IR the institution that sent you the information of registration (S073) upon receiving the entitlement document issued by you and concerned by the cancellation. If an old E-form is to be cancelled, the institution which should be selected from the IR is the institution which registered in part B the E-form E106, E109, E120, E121.

Please note that the Liaison Body should be chosen only if it is impossible to identify the correct Competent Institution in the respective Member State or if the case is handled by the Liaison Body.

To access the IR please use the following link.

I have now identified the Competent Institution from the Member State I need to contact. (step CO.3)

CO.3 How do I proceed after having identified the Counterparty?

Fill out the ‘Cancellation of entitlement document’ SED S016 by entering the original entitlement date, the date of cancellation and the reasons for non-entitlement. If the entitlement is cancelled in full, you should fill in the ‘End date of Entitlement’ in section 5 of the S016 the same date as is in the Start date of the entitlement in section 4. In addition, you should use ‘Other reason’ in section 5 and indicate the full cancellation in the free text field together with the reason of cancellation from section 5.2 (e.g. "The entitlement is cancelled in full. Not insured in our Member State since…"). If the cancellation concerns a family member, you have to fill in the data of a main insured person in section 4 of the S016. After filling it out, you can send it to the Counterparty.

The Counterparty shall subsequently fill out and send the ‘Reply to cancellation of entitlement document’ SED S017 to inform you that the cancellation has been registered and that the cancellation as indicated is effective.

I have received SED S017 from the Counterparty.(step CO.4)

Sub-process steps available to the Case Owner at this stage:

I want to request ad-hoc information from the Counterparty (H_BUC_01)

I have sent a S016 and want to remind the Counterparty of the reply that I expected, but did not yet receive (AD_BUC_07).

CO.4 How do I proceed after having received the ‘Reply to cancellation of entitlement document’ SED S017 from the Counterparty?

If you have received the SED S017, you can review it. The Business Use Case ends here, unless you want to express a dispute concerning this cancellation date.

I want to express a dispute concerning the cancellation date indicated in the SED S017 I have received from the Counterparty.(step CO.5)

Sub-process steps available to the Case Owner at this stage:

I want to request additional information not foreseen in the case- specific SED (H_BUC_01).

I want to remind the Counterparty of information that it needs to send to me (AD_BUC_07).

CO.5 How do I express a dispute concerning the registration date indicated in SED S017

from the Counterparty?

In order to express a dispute concerning the date of cancellation of the entitlement indicated in the SED S017 after having received it from the Counterparty, you need to fill out a ‘Dispute of Date’ SED S050 and send it to the Counterparty.

The Case Owner may reply with another SED S017, therefore you might need to repeat this step several times in case of ongoing disagreement. After you and the Counterparty have agreed on S017, you may close the case.

Sub-process steps available to the Case Owner at this stage:

I want to request additional information not foreseen in the case- specific SED (H_BUC_01).

I want to remind the Counterparty of information that it needs to send to me (AD_BUC_07).

CP.1 What should I do if I have received a ‘Cancellation of entitlement document’ SED S016?

If you have received a ‘Cancellation of entitlement document’ SED S016 from the Case Owner, verify according to your national procedures that you are competent to treat this particular case and review it. Subsequently, you need to send a reply to the Case Owner.

If you are competent to treat the case, you need to fill out a SED S017

and subsequently send the SED S017 to the Case Owner. If the Case Owner does not dispute your indicated period of registration, your Business Use Case ends here.

I have received a ‘Dispute of Date’ SED S050 from the Case Owner after I have sent SED S017 to the Case Owner.(step CP.2)

Sub-process steps available to the Counterparty at this stage:

I want to request additional information not foreseen in the case- specific SED (H_BUC_01).

I want to remind the Case Owner of previously requested ad-hoc information that I expected, but did not yet receive (AD_BUC_07).

I want to forward the case to another Competent Institution in my Member State (AD_BUC_05).

CP.2 How do I proceed If I have received a ‘Dispute of date’ SED S050?

After you have received SED S050, in which the Case Owner expresses a dispute concerning the date of cancellation of the entitlement indicated in SED S017, you need to fill out another the SED S017 entering the new data of cancellation of the entitlement or the original data of cancellation of the entitlement and send it to the Case Owner.

The Case Owner can reply with another SED S050, so you may need to repeat this process several times in case of ongoing disagreement. After you and the Case Owner have agreed on S017, you may close the case.

Sub-process steps available to the Counterparty at this stage:

I want to request additional information not foreseen in the case- specific SED (H_BUC_01).

I want to remind the Case Owner of previously requested ad-hoc information that I expected, but did not yet receive (AD_BUC_07).

BPMN diagram for S_BUC_03

Click here to open the BPMN diagram(s) for S_BUC_03.

Structured Electronic Documents (SEDs) used in the process

The following SEDs are used in S_BUC_03:

SED S016 – Cancellation of entitlement document

SED S017 – Reply to cancellation of entitlement document

SED S050 – Dispute of date

Administrative sub-processes

The following administrative sub-processes are used in S_BUC_03:

AD_BUC_05_Subprocess – Forward Case

AD_BUC_07_Subprocess – Reminder

The following sub-processes are used for the handling of exceptional business scenarios that arise due to the exchange of social security information in an electronic environment and can be used at any point in the process:

AD_BUC_11_Subprocess – Business Exception

AD_BUC_12_Subprocess – Change of Participant

Horizontal sub-processes

The following horizontal sub-process is used in S_BUC_03:

H_BUC_01_Subprocess – Ad-hoc Exchange of Info