D
ApprovED
ApprovED
International Process Guidelines
UB_BUC_04 – Reimbursement of Unemployment Benefits
Date: 24/08/2018
Version of guidelines document: v4.1.0
Based on: UB_BUC_04 version 4.1.0
Common Data Model version 4.1.0
TABLE OF CONTENTS
UB_BUC_04 – Reimbursement of Unemployment Benefits 4
How to start this BUC? 7
What is my role in the social security exchange of information I have to complete? 7
CO.1 Who do I need to exchange information with? 7
CO.2 How do I identify the correct Liaison Body? 7
CO.3 How do I initiate and process the reimbursement request? 7
CO.4 What should I do if I have received SED U023 from the Counterparty? 8
CO.5 What should I do if I have received SED U024 from the Counterparty? 10
CO.6 What should I do if I want to Charge interest, SED U026? 10
CO.7 What should I do if I have received SED U027 from the Counterparty? 11
CO.8 What do I do if the business use case ends 11
CP.1 How should I respond if I received a Reimbursement Request, SED U020, from the Case Owner? 12
CP.2 What do I do if I want to make a Reimbursement Contestation, SED U023? 13
CP.3 How should I respond to SED U029 - Amended reimbursement request reacting to contestation? 13
CP.4 What do I do if I want to make a Payment Notification, SED U024? 14
CP.5 How should I respond to SED U026 - Charging Interest? 15
CP. 6 What do I do after the Case Owner closed the case? 16
BPMN diagram for UB_BUC_04 17
Structured Electronic Documents (SEDs) used in the process 17
Administrative sub-processes 17
Horizontal sub-processes 17
Document history:
Revision
Date
Created by
Short Description of Changes
V0.1
20/07/2017
Secretariat
First draft of the document submitted for review to the Unemployment Benefits Ad Hoc group
V0.2
31/08/2017
AHG / BA / Secretariat
Implement changes and updates following the AHG comments.
Version submitted for AC approval
V0.99
04/10/2017
Secretariat
Implemented changes and updates following the AC review. Version submitted for AC approval.
V1.0
27/10/2017
Secretariat
AC approved version.
V4.1.0
24/08/2018
Secretariat
Performed patch changes to reference the new CDM version 4.1.0.
UB_BUC_04 – Reimbursement of Unemployment Benefits
Description: The role of the UB_BUC_04 is to support the procedure of the reimbursement of unemployment benefits provided to crossborder workers. The state of residence (the creditor) can request a reimbursement of unemployment benefits paid to a crossborder worker. The State of former activity (the debtor) has to reimburse these unemployment benefits under certain conditions, with a certain ceiling amount, and also within a certain time frame.
The obligation of reimbursement is laid down in Article 65 (6) and (7) of Regulation No 883/2004. Article 70 of Regulation No 987/2009 provides procedural aspects of reimbursements of unemployment benefits and refers also to certain general reimbursement rules stipulated in Articles 66 (1), 67 (5) to (7) and 68 (2) of Regulation No 987/2009 which apply mutatis mutandis also to reimbursements of unemployment benefits.
Decision no. U4 of the Administrative Commission provides more details on the interpretation of the reimbursement provisions of the Regulations.
Furthermore, the expert group on Unemployment benefits agreed on some additional rules to be followed and recommends that these are respected by all Member States and their Liaison Bodies:
Article 70 of Regulation No 987/2009 provides that “the request shall be made within six months of the end of the calendar half-year during
which the last payment of Unemployment Benefits, for which reimbursement is requested, was made”.
This could cause difficulties in case of 5 months refundable periods where the receipt of benefits is suspended. In such a case, the creditor State has to wait until the end of refundable period to be sure whether the receipt of benefits will or will not be resumed. In case the receipt of benefits is not resumed and the decisive date for the deadline is the early payment of benefit, it can considerably shorten the time for the creditor state to submit the claim with respect to the case in question.
In order to address this issue, the decisive date for determining the half- year from which the deadline for submission of the claim is counted should be either the date of the last payment (as follows from Article 70) OR the date on which the refundable period ended – depending on which date takes place later.
Example – Refundable period is 5 months. Person starts to receive UB in June 2017 (when also the first payment is made) and then the receipt of UB is suspended. The creditor has to wait until the refundable period is over (until October 2017) to be sure whether the receipt will be resumed and a payment will follow. If indeed there is another payment say in October 2017, the claim has to be made by June 2018 and there is no problem. However, if no payment follows then the June 2017 payment is the decisive date, it falls within the first half-half-year of
2017 which means that the claim has to be submitted by the end of
2017. This leaves only two months for the Creditor to arrange the
submission of the claim.
Where the receipt of unemployment benefits is interrupted by a short- term employment which is not taken into account for the following continuation of receipt within the same entitlement, the short-term employment should not have any influence on the reimbursement obligation under Article 65(6) and (7) and the following receipt of benefits can still be claimed for refund.
Example – a former frontier worker was employed in Germany and now receives UB in Poland for 1 month, then takes up a job for 1 month and subsequently continues to receive UB for another 1 month (work in Germany as frontier worker -> 1 month receipt UB from Poland -> 1
month job -> 1 month receipt UB from Poland).
Provided that the 1 month job is not taken into account for the following receipt of unemployment benefit, Poland can claim the reimbursement for both 2 months even if the 1 month job took place in Poland or any other MS.
In the same sense, where a person was granted Unemployment Benefits based on periods worked in his home State and then takes up as a crossborder worker a short-term work abroad, which is not taken into account for the continuation in the original entitlement to benefits (based
on the home insurance periods), the home State cannot claim reimbursements for the following receipt of Unemployment Benefits because the foreign periods of employment were not taken into account in fact.
Article 65(8) of Regulation No 883/2004 allows Member States or their competent authorities to provide for other methods of reimbursement or waive all reimbursement between the institutions falling under their jurisdiction. If that is the case, reimbursement between two particular Member States may follow different (simplified) rules or may not take place at all.
The claims are introduced and paid via the Liaison Bodies of the Member States. Therefore, the Liaison Body for unemployment benefits should in each Member State represent a single point of contact for the matters related to reimbursements.
UB_BUC_04 starts with the Reimbursement Request, SED U020. It normally contains a bulk of multiple individual claims.
The debtor verifies the reimbursement request and has three possibilities to answer the request.
a) It accepts all individual claims included in the reimbursement request with SED U021.
b) It rejects the entire request due to the reason that the request (i.e. all individual claims included in the reimbursement request) was submitted
after the time limit laid down in Article 70 of Regulation No 987/2009, using the SED X011 Reject SED.
c) It contests individual claims with SED U023.
A) If all individual claims included in the reimbursement request are accepted by the debtor, this is confirmed by SED U021 which is sent back to the creditor. The debtor should without delay proceed with the payment of reimbursement and confirm the transfer of money with SED U024. The creditor acknowledges the receipt of the payment with SED U025 and the BUC should be closed.
B) If the entire reimbursement request (i.e. all individual claims included in it) is submitted after the deadline laid down in Article 70 of Regulation No 987/2009, the debtor may reject such request with SED X011. This is an exceptional option to reject the whole reimbursement request due to the late submission of the request (this reason for rejection applies to all individual claims contained in the request), if there are other reasons for rejection of individual claims, SED U023 should be used (see below).
C) The debtor can contest some or all individual claims included in the reimbursement request with SED U023. Individual claims which are not contested become defacto accepted (they should not be contested anymore) and must be reimbursed by the debtor without further delay. The creditor has to assess the contestations made by the debtor in SED U023 and reply to it via SED U029 – Amended reimbursement request reacting to contestation, including all individual claims of the initial reimbursement request (i.e. initial SED U020), with the latest status from the point of view of the creditor.
The debtor either agrees with the amended reimbursement request or contests the remaining individual claims to which the debtor cannot agree (via new SED U023). This pattern may constitute a sort of recurrent dialogue, where the creditor– following SED U023 received from the debtor –updates the reimbursement request and sends SED U029 (i.e. amended reimbursement request) to the debtor. The debtor checks the new SED U029 and if the debtor still cannot agree with this updated request for reimbursement, the debtor contests the problematic individual claims again with a new SED U023. This may happen a
number of times until the creditor and the debtor come to an agreement.
Once the agreement between the debtor and creditor is reached, SED U021 should follow so that the state of EESSI reflects the agreement on claims between the States concerned.
Each time the debtor accepts at least a few individual claims from the reimbursement request (be it the initial SED U020 or the amended reimbursement request SED U029) the debtor has to reimburse (pay) the accepted individual claims and inform the creditor accordingly. Each notification of payment needs to be done by using SED U024. The creditor confirms the receipt of the reimbursed
amount each time a reimbursement amount is transferred, using SED U025. When all reimbursement amounts are transferred and the reimbursement request is fully paid, the creditor indicates that the reimbursement request is considered closed.
It is possible for the creditor to charge interests in the case that claims are not refunded or contested within the deadline laid down in Article 67(5) of Regulation No 987/2009. The charging of interest is handled via the request/reply pair of SEDs U026/U027. The notification of payment of the interest should also be via the Reimbursement Payment Notification SED U024. This is mostly handled together with the payment of the related individual claim(s).
Legal base: The legal basis of the UB_BUC_04 lies in article 70 of Regulation No 987/2009. The following table specifies SEDs used in this BUC and documents the articles that provide the legal basis for each SED:
Basic Regulation No 883/2004
Implementing Regulation No 987/2009
SED
Art. 65(6)
Art. 65(7)
Art. 70
Art. 68(2)
U020 – Reimbursement Request
U021 – Reimbursement Full Acceptance
U023 – Reimbursement Contestation
U024 – Reimbursement Payment Notification
U025 – Reimbursement Receipt / Closing Notification
U026 – Charging Interest
U027 – Reply on Interest
U029 – Amended reimbursement request reacting to contestation
Glossary of relevant terms used in UB_BUC_04:
Term used
Description
Case Owner
This is the Liaison Body which initiates a case.
Liaison Body of a Member State (the State of Residence / creditor) which paid Unemployment Benefits (UB) to a Crossborder Worker and requests reimbursement from the Member State of last activity.
Counterparty
Liaison Body of a Member State (State of Last Activity / debtor) which will receive a request from the Case Owner.
Crossborder worker
A crossborder worker is a person who during his or her last activity resided in one country and worked in another country. Article 65 of Regulation No 883/2004 applies to crossborder workers and allows them to claim unemployment benefits in the Member State of their residence rather than the Member State of their last activity. Frontier workers (see Article 1(f) of Regulation No 883/2004) always claim unemployment benefits in the State of their residence, other crossborder workers can apply for unemployment benefits either in the Member State of their last activity or in the Member State of their residence (Article 65(2) of Regulation No 883/2004).
Request-reply SEDs:
REQUEST SEDs
REPLY SEDs
U020 – Reimbursement Request
U021 – Reimbursement Full Acceptance
Or U023 – Reimbursement Contestation
U023 – Reimbursement Contestation
U029 – Amended reimbursement request reaching to contestation
U024 – Reimbursement Payment Notification
U025 – Reimbursement Receipt / Closing Notification
U026 – Charging Interest
U027 – Reply on Interest
U029 – Amended reimbursement request reaching to contestation
U021 – Reimbursement Full Acceptance
Or U023 – Reimbursement Contestation
How to start this BUC?
In order to help you understand the UB_BUC_04 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 are the Liaison Body of a Member State that paid unemployment benefits as Member State of residence to a crossborder worker and you considered insurance periods from the Member State of last activity for the entitlement to Unemployment Benefits and you want to request the reimbursement of unemployment benefits from the Member State of former activity, your role will be defined as the Case Owner.
I am the Case Owner. (step CO.1)
If you are the Liaison Body that receives a request for reimbursement of Unemployment Benefits paid by the other Member State to crossborder workers, your role will be defined as the Counterparty.
I am the Counterparty. (step CP.1)
CO.1 Who do I need to exchange information with?
As the Case Owner, your first step in any new reimbursement request will be to identify the Member State that should refund the unemployment benefits which your Member State has paid to crossborder workers. The second step is to identify the Liaison Body for unemployment benefits in the Member State concerned. This activity will define the Counterparty you will be working with in the reimbursement procedure.
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 Liaison Body?
In order to determine the relevant Liaison Body 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.
The reimbursement claims are introduced and paid via the Liaison Bodies of the Member States. You should choose the Liaison Body for the unemployment sector.
To access the IR please use the following link.
I have now identified the Liaison Body from the Member State I need to contact. (step CO.3)
CO.3 How do I initiate and process the reimbursement request?
The reimbursement procedure involves basically three fields of exchanges – exchange on the content of the
reimbursement request (U020, U029 – U023, U021), exchange on payments (U024 – U025) and exchange on charging interest (U026 – U027). These exchanges can take place to some extent independent of each other. For the clerks various steps are available in different stages of the process depending on the progress of the individual exchange.
The first step in the exchange on the content of the reimbursement request for you is to fill in SED U020 – Reimbursement Request, making sure you enter all the required information. Afterwards you send the SED U020 (including any attachments if necessary) to the Counterparty.
Once you have sent your SED U020, there are three possible outcomes:
a) The Counterparty can accept the reimbursement claim fully, by sending you SED U021 Reimbursement Full Acceptance.
Then the Counterparty will make a payment for all the accepted individual claims. After payment, you expect to receive SED U024 – Reimbursement Payment Notification.
I have received SED U024. (step CO.5)
b) If the whole reimbursement request (i.e. all individual claims included in that request) was submitted after the time limit laid down in Article 70 of Regulation No 987/2009, the Counterparty is not obliged to consider the claims submitted late. If the Counterparty decides not to consider the late claims, you will receive SED X011 - Reject SED, including the reason for the rejection of the entire reimbursement request.
In case you agree with the rejection, you close the case.
I have to close the business use case. (step CO.8)
In case you do not agree with the rejection, you can object to it by using the horizontal SED H001 -Notification/Request for Information to decide how to move forward with the Business Use Case. Depending on your decision, the Business Use Case can be continued, e.g. you update SED U020, or the Counterparty replies to the initial SED U020 via SED U023 or SED U021 (= the case continues as described in this step outcome a or c), or it is decided to close the case (= as described in this step outcome b).
c) The Counterparty can contest all or some individual claims. If the Counterparty wants to contest all or some individual claims, it will send you SED U023 – Reimbursement Contestation. You expect for the non- contested individual claims to be reimbursed without further delay and
to receive confirmation of payment via SED U024 – Reimbursement Payment Notification confirming the payment.
I have received SED U023. (step CO.4)
I have received SED U024. (step CO.5)
Where the Counterparty does not react in due time, you may choose to issue SED U026 - charging interest on outstanding and undisputed claims. This initiates the exchange on charging interest.
I want to send SED U026. (step CO.6)
Sub-process steps available to the Case Owner at this stage:
I want to remind the Counterparty of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U020 (AD_BUC_06), before I receive SED U021 or SED U023. Once SED U020 is invalidated, the business use case ends and the Case Owner has to close the case. (Step CO.8)
I want to update the information contained in the sent SED U020 (AD_BUC_10), before I receive SED U021 or SED U023.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SEDs (H_BUC_01).
CO.4 What should I do if I have received SED U023 from the Counterparty?
After receiving SED U023 – Reimbursement Contestation, you have to examine it. Only contested individual
claims are included in this SED with an indication of the reason of contestation. Individual claims which are not included, are to be regarded as accepted and must be reimbursed by the Counterparty without further delay. You expect for these non-contested individual claims to receive confirmation of payment via SED U024 – Reimbursement Payment Notification.
I have received SED U024. (step CO.5)
Based on your examination of SED U023 – Reimbursement Contestation, you fill in SED U029 – Amended reimbursement request reacting to contestation, indicating the status of every individual claim for all individual claims included in the initial SED U020. SED U029 contains all individual claims included in the initial reimbursement request in SED U020 together with the special section indicating the status of that individual case in the current phase of the reimbursement procedure.
You should indicate the present state (status) of the individual claim as follows:
01- Accepted: If the Counterparty accepted the individual claim (i.e. when the individual claim was not included in SED U023) and where the claim is not yet notified as paid in SED U024.
02 - Notified as paid in SED U024: For those claims which the
Counterparty had already notified as being paid with SED U024. These individual claims should not be changed anymore.
03 - Amount adapted to national ceiling: For claims where the
Counterparty applied its national ceiling to reduce the amount (previous SED U023) and you aligned the amount as indicated. You also expect to receive an agreement with this particular individual claim in the next (new) SED U023 or SED U021 from the Counterparty and further Reimbursement Payment Notification (SED U024).
04 - Individual claim changed: For other contested claims (previous SED
U023) where you accepted the contestation and changed the individual claim accordingly (e.g. if only 3 months refundable period should have been claimed instead of 5 months).
05 - Individual claim removed from the reimbursement request: For
individual claims for which you accept their refusal in the previous SED U023. These individual claim(s) should not be changed anymore in the further process of the case. The requested amount for reimbursement does not need to be changed to zero, however, in such a case the amount must not be included in the updated total amount requested in the general information section of SED U029.
06 - Under dispute: If you do not agree with non-acceptance or partial-
acceptance as indicated from the Counterparty in the previous SED U023.
Next step is to send SED U029 to the Counterparty. Depending on the result of the Counterparty’s assessment of the content of SED U029, three outcomes are possible:
a) When the Counterparty can fully accept SED U029, you can expect to receive SED U021 Reimbursement Full Acceptance.
Next, the Counterparty will make payment(s) for all the accepted (remaining) individual claims. After which you expect to receive SED U024 – Reimbursement Payment Notification.
I have received SED U024. (step CO.5)
b) The Counterparty can contest the individual claims which are not yet accepted and notified as paid and will send you a next (new) SED U023 – Reimbursement Contestation. You expect for the accepted individual claims that the Counterparty will reimburse them without further delay and notify the payment with SED U024.
I have received SED U024. (step CO.5)
c) Where the Counterparty does not react in due time, you may choose to issue SED U026 charging interest on outstanding and undisputed claims (if you have not already done this). This initiates the exchange on charging interest.
I want to send SED U026. (step CO.6)
Note that there will only be 1 pair of SED U020 – U023 as a first phase
of the exchange on the content of
reimbursement request. After this, you will reply with SED U029, as from here on the exchange between creditor and debtor on the content of reimbursement request takes place via the pair of SEDs U029 – U023. A new SED U029 is created as a reaction to each new SED U023 received.
For individual claims which remain 'under dispute', you and the Counterparty should reach a solution. You can use SEDs H001 'Notification/Request for Information' and H002 'Reply to Request for Information' to exchange further information in order to reach an agreement.
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC, the case can be closed.
I have to close the business use case. (step CO.8)
Sub-process steps available to the Case Owner at this stage:
I want to resolve uncertainties about information in a reply SED I received from the Counterparty (AD_BUC_08).
I want to remind the Counterparty of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U029 (AD_BUC_06), before I receive a SED U021 or next SED U023.
I want to update the information contained in the sent U029 SED (AD_BUC_10), before I receive a SED U021 or next SED U023.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SEDs (H_BUC_01).
CO.5 What should I do if I have received SED U024 from the Counterparty?
Upon receiving SED U024 – Reimbursement Payment Notification, you confirm the receipt of the payment with SED U025 – Reimbursement Receipt / Closing Notification and state whether the reimbursement request is closed or not. You have to check whether all individual claims submitted for reimbursement have been fully refunded by the debtor, including – where appropriate – an interest charged in respect of delayed individual claims.
If you indicate that the reimbursement request can be closed, you close the case.
I have to close the business use case. (step CO.8)
If you indicate that the reimbursement request cannot yet be closed, you indicate the reason, and the business use case continues.
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC, the case can be closed.
I have to close the business use case. (step CO.8)
Sub-process steps available to the Case Owner at this stage:
I want to resolve uncertainties about information in a reply SED I received from the Counterparty (AD_BUC_08).
I want to remind the Counterparty of a SED or information that it needs to send to me (AD_BUC_07).
I want to update the information contained in the sent SED U025 (AD_BUC_10).
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case-
specific SEDs (H_BUC_01).
CO.6 What should I do if I want to Charge interest, SED U026?
In case of delay with payment of reimbursement, you fill out SED U026 – Charging Interest, indicating the individual claims to which the interest applies, outstanding amount for which the interest is charged, the interest rate and due date. The interest rate is established by you in accordance with Article 68 (2) of Regulation No 987/2009. Then you send SED U026 to the Counterparty.
You expect a reply with SED U027 – Reply on Interest from the Counterparty to indicate its (dis-)agreement with the request for charging interest.
I have received SED U027. (step CO.7)
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC, the case can be closed.
I have to close the business use case. (step CO.8)
Sub-process steps available to the Case Owner at this stage:
I want to resolve uncertainties about information in a reply SED I received from the Counterparty (AD_BUC_08).
I want to remind the Counterparty of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U026 (AD_BUC_06).
I want to update the information contained in the sent SED U026 (AD_BUC_10).
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SEDs (H_BUC_01).
CO.7 What should I do if I have received SED U027 from the Counterparty?
Upon receiving SED U027 – Reply on Interest from the Counterparty, you are informed on whether the Counterparty agrees or disagrees with the range of individual claims for which the interest is charged, the outstanding amount due and the interest rate you requested for indicated individual claim(s).
In case of disagreements, further discussion can take place using the horizontal SEDs H001 'Notification/Request for Information' and H002 'Reply to Request for Information'.
When it is agreed to charge interest, SED U026 can be updated following the agreement. In such case, you expect to receive updated SED U027.
When it is agreed to not charge interest, SED U026 should be invalidated and the reimbursement process continues without the interest being charged.
In case of an agreement, the business use case continues. For next payment(s) of individual claim(s), you expect that the amount of interest will be added to the amount of the individual claims. When not added, you expect to receive a separate payment notification for the interest amount for the relevant individual claim(s). After payment, the Counterparty will notify you by sending per payment SED U024 – Reimbursement Payment Notification.
I have received SED U024. (step CO.5)
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC, the case can be closed.
I have to close the business use case. (step CO.8)
Sub-process steps available to the Case Owner at this stage:
I want to resolve uncertainties about information in a reply SED I received from the Counterparty (AD_BUC_08).
I want to remind the Counterparty of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U026 (AD_BUC_06).
I want to update the information contained in the sent SED U026 (AD_BUC_10).
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SEDs (H_BUC_01).
CO.8 What do I do if the business use case ends
When during the execution of the Business Use Case (after the first SED has already been exchanged)
unexpected circumstances occur which make it pointless to carry on with the BUC or
the case has reached a conclusion (e.g. the reimbursement request was fully paid or rejected),
you have to close the case using the sub-process 'Close Case' AD_BUC_01.
If a need arises to open it again and resume with the data exchange, both you and the Counterparty can initiate reopening of the case using the sub-process 'Reopen Case' AD_BUC_02.
When the reopening is accepted by both parties, the business use case returns to the point before the close of the BUC.
CP.1 How should I respond if I received a Reimbursement Request, SED U020, from the Case Owner?
The reimbursement procedure involves basically three fields of exchanges – exchange on the content of the reimbursement request (U020, U029 – U023, U021), exchange on payments (U024 – U025) and exchange on charging interest (U026 – U027). These exchanges can take place to some extent independent of each other. For the clerks various steps are available in different stages of the process depending on the progress of the individual exchange.
When you receive SED U020 – Reimbursement Request, you have to verify the request, i.e. check and assess every individual claim contained in the request. There are three possible answers to the request:
a) You can accept the reimbursement claim fully, by sending SED U021 Reimbursement Full Acceptance. (I.e. each individual claim included in the reimbursement request is accepted for the refund).
Next, you will reimburse all individual claims and transfer the money without further delay. You notify the Case Owner via SED U024 – Reimbursement Payment Notification.
I want to send a payment notification, SED U024. (step CP.4)
b) When the reimbursement request was submitted to you after the time limit laid down in Article 70 of Regulation No 987/2009 (i.e. each individual claim fails to meet that time limit), you are not obliged to consider the claims submitted late (Art. 70 stipulates that „There is no requirement to consider requests introduced after the time-limit.“). You can fill out SED X011 – Reject SED, including the reason for the rejection of the entire reimbursement request. You expect the Case Owner to close the case and it ends here. In case the Case Owner does not agree with the rejection, the Case Owner can object to it by using a horizontal SED H001 'Notification/Request for Information' to be able to decide on how to move forward with the Case.
c) When you do not agree with all or some individual claims contained in the request, you can make a contestation via SED U023 – Reimbursement Contestation.
I want to make a reimbursement contestation, SED U023. (step CP.2)
For the non-contested individual claims, you should reimburse them without further delay, and notify the Case Owner with SED U024.
I want to send a payment notification, SED U024. (step CP.4)
Where the individual claims were submitted on time, but you fail to reimburse or contest them within the time limit laid down in Article 67 (5) of Regulation No 987/2009 (18 months from the introduction of claims), you might receive SED U026 – Charging Interest from the Case Owner by which an interest on outstanding and undisputed claims is charged.
I have received SED U026. (step CP.5)
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC; the case can be closed by the Case Owner.
I have received a close of the business use case. (step CP.6)
Sub-process steps available to the Counterparty at this stage:
I want to Reject the received SED U020 (AD_BUC_09), before I send SED
U021, U027 or U023.
I want to resolve uncertainties about information in a SED that I received (AD_BUC_08).
I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U021 (AD_BUC_06), before my next SED U024 is sent.
I want to update the sent SED U023 (AD_BUC_10), before my next SED U024 is sent und before I receive U029 SED.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SED (H_BUC_01).
CP.2 What do I do if I want to make a Reimbursement Contestation, SED U023?
When you do not agree with all or some individual claims, you fill out SED U023 – Reimbursement Contestation. You have to include all the individual claims which you want to contest. Individual claims which you do not contest become defacto accepted and should not be contested later.
For each contested individual claim you have to indicate whether you do not accept the individual claim or whether you partially accept it. You specify the reason and when needed provide additional information.
Next you send SED U023 to the Case Owner.
The Case Owner will examine your contestation and you expect to receive SED U029 – Amended reimbursement request reacting to
contestation, with an indication whether the Case Owner accepts the contestation or not.
I have received SED U029. (step CP.3)
For the non-contested individual claims, you should reimburse them without further delay, and notify the Case Owner of the Reimbursement Payment, via SED U024 – Reimbursement Payment Notification.
I want to send a payment notification, SED U024. (step CP.4)
Note that there will only be 1 pair of SED U020 – U023 as a first phase of the exchange on the content of reimbursement request. After this, the Case Owner will reply with SED U029, as from here on the pair of SED is U029 – U023. A new SED U029 is created as a reaction to each new SED U023 received.
For individual claims which remain 'under dispute', you and the Case Owner should reach a solution. You can use SEDs H001 'Notification/ Request for Information' and H002 'Reply to Request for Information' to reach an agreement.
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC; the case can be closed by the Case Owner.
I have received a close of the business use case. (step CP.6)
Sub-process steps available to the Counterparty at this stage:
I want to resolve uncertainties about information in a SED that I received (AD_BUC_08).
I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED (AD_BUC_06), before I received a U029 SED or before my next U024 is sent.
I want to update the information contained in the sent SED U023 (AD_BUC_10), before I received SED U029 or before my next SED U024 is sent.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SED (H_BUC_01).
CP.3 How should I respond to SED U029 - Amended reimbursement request reacting to contestation?
If you have received SED U029 – Amended reimbursement request reacting to contestation from the Case Owner, you can view the position of the creditor for each individual claim. In principle, you only need to
examine the individual claims that were contested by you in the last SED U023.
a) In case the Case Owner agreed with all your contestations of the last SED U023, you confirm and fill out SED U021 Reimbursement Full Acceptance so that the state in EESSI reflects the agreement on claims between the States concerned. No individual claims included in SED U029 have the status 'Under dispute' anymore. This also applies in case the creditor provided a valid justification for the contested individual claims (with the status 'Under dispute') and based on this justification, you no longer have any objection against the reimbursement request as presented in SED U029 and you find this reimbursement request legitimate as a whole.
Next you reimburse all individual claims which have not yet received the status 'Notified as paid in U024' or 'Removed from the reimbursement request', and you transfer the money, without further delay. You notify the Case Owner via SED U024 – Reimbursement Payment Notification.
I want to send a payment notification, SED U024. (step CP.4)
b) When you still do not agree with some individual claims, you can
make a new contestation via new SED U023 – Reimbursement Contestation for the individual claims you consider unjustified.
I want to make a reimbursement contestation, SED U023. (step CP.2)
For the individual claims which are not included in this SED U023, they are all regarded as 'accepted' by you, except for the individual claims which received the status 'Individual claim removed from the reimbursement request' in the previous SED U029, or were already reimbursed (status = ''Notified as paid in U024'). You should reimburse the accepted individual claims without further delay, and notify the Case Owner when the payment is transferred with new SED U024.
I want to send a payment notification, SED U024. (step CP.4)
In case you failed to reimburse or contest some individual claims within the deadline laid down in Article 67 (5) of Regulation No 987/2009, you might receive SED U026 – Charging Interest from the Case Owner on outstanding and undisputed claims.
I have received SED U026. (step CP.5)
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC; the case can be closed by the Case Owner.
I have received a close of the business use case. (step CP.6)
Sub-process steps available to the Counterparty at this stage:
I want to resolve uncertainties about information in a SED that I received (AD_BUC_08).
I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U021 (AD_BUC_06), before my next SED U024 is sent.
I want to update the information contained in the sent SED U023 (AD_BUC_10), before I received SED U029 and before my next SED
U024 is sent.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SEDs (H_BUC_01).
CP.4 What do I do if I want to make a Payment Notification, SED U024?
After receiving SED U020 or SED U029, and accepting individual claims, you reimburse the accepted amount and inform the Case Owner about the refund. When you agreed to the interest charged for some individual claims (SED U027), you add the interest amount to the amount in SED U024 (the interest amount has to be calculated based on the interest rate and the period of delay). You fill out SED U024 – Reimbursement Payment Notification, and indicate the individual claims to which the payment relates. Next you send SED U024 to the Case Owner.
Please note that once individual claims are notified for payment via SED U024, it will no longer be possible to contest these individual claims.
The Case Owner will confirm the receipt of the reimbursed amount each time a reimbursement amount is transferred with SED U025 – Reimbursement Receipt / Closing Notification and states whether the reimbursement request is to be closed or not.
If the reimbursement request is closed, the business use case ends here.
I have received a close of the business use case. (step CP.6)
If the reimbursement request cannot yet be closed, the Case Owner will specify the reason, and the business use case can continue.
Sub-process steps available to the Counterparty at this stage:
I want to resolve uncertainties about information in a SED that I received (AD_BUC_08).
I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).
I want to update the information contained in the sent SED U024 (AD_BUC_10), before I receive a SED U025.
I want to forward the case to a new Liaison Body in my Member State (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SED (H_BUC_01).
CP.5 How should I respond to SED U026 - Charging Interest?
When you have received SED U026 – Charging Interest which specifies the late individual claims, total outstanding amount for which the interest is charged, the interest rate and due date, there are three possibilities:
a) You fully accept the charging interest request.
b) You do not accept the charging interest request and you specify the reason for non-acceptance, e.g. incorrect due date.
c) You accept the charging interest request partially. This means that you agree to the charging interest, but cannot agree for some individual claims. All individual claims for which charging of interest is not accepted have to be listed in SED U027 and the reason has to be indicated.
You fill out SED U027 – Reply on Interest and send it to the Case Owner.
For any disagreements, further discussion can take place using the horizontal SEDs H001 'Notification/Request for Information' and H002 'Reply to Request for Information'.
For next payment(s) of individual claim(s) for which interest is charged and agreed upon, you have to add the amount of interest to the amount of the individual claim. Or for cases where the interest amount is not added, you can pay it separately. For each payment transfer, you notify the Case Owner by sending per payment SED U024 – Reimbursement Payment Notification.
I want to send a payment notification, SED U024. (step CP.4)
When during the course of this step, unexpected circumstances occur which make it pointless to carry on with the BUC; the case can be closed by the Case Owner.
I have received a close of the business use case. (step CP.6)
Sub-process steps available to the Counterparty at this stage:
I want to resolve uncertainties about information in a SED that I received (AD_BUC_08).
I want to remind the Case Owner of a SED or information that it needs to send to me (AD_BUC_07).
I want to invalidate the sent SED U027 (AD_BUC_06).
I want to update the information contained in the sent SED U027 (AD_BUC_10).
I want to forward the case to a new Liaison Body in my Member State because I am not or no longer competent to handle it (AD_BUC_05).
I want to exchange additional information not foreseen in the case- specific SED (H_BUC_01).
CP. 6 What do I do after the Case Owner
closed the case?
The Case Owner has closed the case by using the sub-process 'Close Case' AD_BUC_01.
If a need arises to open it again and resume with the data exchange, both you and the Case Owner can initiate reopening of the case using the sub-process 'Reopen Case' AD_BUC_02.
When the reopening is accepted by both parties, the business use case returns to the point before the close of the BUC.
BPMN diagram for UB_BUC_04
Click here to open the BPMN diagram(s) for UB_BUC_04 main process.
2 sub processes for the Case Owner:
Click here to open the BPMN diagram for UB_BUC_04 Receive Payment and Close Notification sub process.
Click here to open the BPMN diagram for UB_BUC_04 Receive Contestation sub process.
2 sub processes for the Counterparty:
Click here to open the BPMN diagram for UB_BUC_04 Payment and Close Notification sub process.
Click here to open the BPMN diagram for UB_BUC_04 Contestation sub process.
Structured Electronic Documents
(SEDs) used in the process
The following SEDs are used in UB_BUC_04:
SED U020 – Reimbursement Request
SED U021 – Reimbursement Full Acceptance
SED U023 – Reimbursement Contestation
SED U024 – Reimbursement Payment Notification
SED U025 – Reimbursement Receipt / Closing Notification
SED U026 – Charging Interest
SED U027 – Reply on Interest
SED U029 – Amended reimbursement request reacting to contestation
Administrative sub-processes
The following administrative sub-processes are used in UB_BUC_04:
AD_BUC_01_Subprocess – Close Case
AD_BUC_02_Subprocess – Reopen Case
AD_BUC_05_Subprocess – Forward Case
AD_BUC_06_Subprocess – Invalidate SED
AD_BUC_07_Subprocess – Reminder
AD_BUC_08_Subprocess – Clarify Content
AD_BUC_09_Subprocess – Reject SED
AD_BUC_10_Subprocess – Update SED
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 UB_BUC_04:
H_BUC_01_Subprocess Ad hoc exchange of information