Safety-net claimants · flexible contracts · after-effect
Sickness Benefits Act own-risk insurance through De Goudse
This cover concerns sick former employees: people whose temporary contract ended while they were ill. Your sickness absence insurance does not cover that group, because there is no employment relationship and therefore no continued payment of wages.
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Deze pagina in het Nederlands: Ziektewet-eigenrisicoverzekering via De Goudse.
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A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
Employees without an employer fall under the safety net of the Dutch Sickness Benefits Act. Those are mainly people with a temporary contract that ends during illness, and people who fall ill within four weeks of the end of their employment: the so-called after-effect of Article 46 of the Sickness Benefits Act. Even without an employment relationship, those benefits count towards your premium, and that continues to feed through into WGA inflow years later.
If opting out of the Sickness Benefits Act as a self-insurer you pay that benefit yourself and carry out the absence management for people who no longer work for you. That is the heart of the trade-off: you buy control over files you would otherwise have no sight of, in exchange for administrative work and a payment obligation of up to two years per case. Insurance takes over the benefit and usually provides the administration, including a company doctor and return-to-work support.
This choice is separate from opting out for the WGA, but is connected with it: managing the Sickness Benefits Act period well limits inflow into the WIA afterwards. As an independent broker we set the offerings of several insurers side by side; De Goudse is one of the providers offering this cover. You can read about the adjoining risks under WGA own-risk insurance, and for staff in employment the sickness absence insurance the appropriate policy.
This page deals with one situation. The full overview is on WIA insurance through Avéro Achmea — compare & calculate your premium.
What to look for with the Sickness Benefits Act
Four points that distinguish this cover from an ordinary sickness absence policy.
The after-effect once the contract ends
If someone falls ill within four weeks of the end of their employment and has no new employer or benefit, that sickness notification still comes back to you. So record the end dates of contracts carefully and report a notification of sickness from that period straight away; files that only surface months later can rarely still be steered.
You manage the case without any authority relationship
As a self-insurer you decide on the sickness notification, engage a company doctor and assess suitable work, while the person concerned no longer works for you. If someone refuses to cooperate, you can impose a sanction . That calls for a correct procedure recorded in writing, because those decisions are open to objection.
What stays with the UWV
Outside your own risk and outside the insurance remain benefits under the no-risk policy, benefit during pregnancy and childbirth under the Dutch Work and Care Act, and benefits paid to organ donors. These are paid by the UWV. Nor do administrative fines and the consequences of intent, excluded in Article 7:952 of the Dutch Civil Code, ever fall to the insurer.
Returning to the public system
If you end your status as a self-insurer, the current Sickness Benefits Act files do not automatically go back to the UWV; the payment obligation for existing cases continues. So on cancellation, record in writing who deals with those files to the end, and note that the benefit burden still feeds through into your differentiated premium afterwards.
What does your premium depend on?
- Share of temporary and flexible contracts — the group in which this risk lies almost entirely
- Your company's payroll — the basis for the premium and for the public variant
- Inflow into the Sickness Benefits Act in earlier years — the claims history requested on acceptance
- Staff turnover and average contract length — many short contracts increase the chance of the after-effect
- Administration in-house or outsourced — managing former employees costs time or money
- Sector and physical strain — determines the length of the average absence
Insurers weigh these details differently. That is why comparing pays off.
What is covered
| Situation | ZW own-risk insurance | Sickness absence insurance (verzuimverzekering) |
|---|---|---|
| A casual worker is still ill on the day his annual contract ends | Yes | No |
| A permanent employee is out of action for three months after a knee operation | No | Yes |
| An agency worker placed with you through an agency reports sick | No | No |
| A company doctor and an occupational expert help a former employee back to work | Provided that | Provided that |
| A former employee moves on to the WGA after two years under the Sickness Benefits Act | No | No |
| An employee breaks a wrist playing football at the weekend | No | Yes |
The dividing line is the employment relationship: while it runs it is called absence; once it has ended it is the Sickness Benefits Act.
Frequently asked questions
The questions we are asked most often about this.
Who exactly does this insurance apply to?
To employees who leave employment while ill or who fall ill within the after-effect period and therefore fall under the safety net of the Sickness Benefits Act. Think of seasonal workers, casual workers and employees with an annual contract that ends during illness. For staff who are simply in employment, the obligation to continue paying wages applies and therefore sickness absence insurance, not this cover.
How do you become a self-insurer under the Sickness Benefits Act?
Through an application to the Tax Administration, taking effect on 1 January or 1 July. Unlike the WGA, no guarantee statement is required for the Sickness Benefits Act, but insurers do impose requirements on the administration, because you are taking on statutory duties. Allow a few months' preparation before the start date is achievable.
What does being a self-insurer achieve if the benefits stay the same?
The gain lies in control. At the UWV, supporting a former employee is done at a distance and with limited capacity; as a self-insurer you can engage a company doctor sooner and target help towards finding work. Shorter Sickness Benefits Act files mean less inflow into the WIA, and that is the item that weighs most heavily in the longer term.
When do I have to report a sickness notification?
Straight away, and in any event within the period stated in the conditions. Article 7:941 of the Dutch Civil Code requires you to report an event as soon as you are reasonably aware of it. With former employees that is harder than with your own staff, because the notification often comes in through the UWV or through the person concerned. Record who in your organisation monitors that mailbox.