The short answer
Continued salary payments and sickness daily allowance insurance benefits are distinct. Review the employment contract, any applicable collective employment agreement (CCT) or standard employment contract (CTT), alongside the insurance policy. A percentage of salary is not enough to demonstrate an equivalent arrangement: the persons covered, waiting period, duration and conditions must also be examined.
1. Compare commitments with insurance
Gather the documents defining the company's obligations and those defining the insured benefits. Identify the wording provided to staff. An old HR information sheet may promise arrangements that no longer match the renewed policy.
Ask the questions on the same basis: for which category of staff, which absence and which period? The State Secretariat for Economic Affairs (SECO) FAQ on inability to work provides the framework for distinguishing salary obligations; assessing equivalence involves more than the most prominent figure in a quotation.
2. Check insured persons and salary
Compare your actual workforce with the groups described: joiners, leavers, special employment statuses and any categories. Have the inclusion conditions clarified without assuming that an employee on the payroll has identical cover to everyone else.
Review the definition of salary: components, variations and items to declare. Compare it with payroll practices and the declarations submitted. For unusual remuneration, request written confirmation rather than applying an assumed rule. Retain the necessary administrative data with appropriate access controls.
3. Read the waiting period, duration and exclusions together
Identify the waiting period, how benefit entitlement is counted, the exclusions and the notification obligations. Ask who funds the period for which no benefits are paid and how it fits with the company's commitments. Do not treat a commonly used duration or percentage as a contractual guarantee.
The AXA sickness daily allowance insurance general terms and conditions (GTC), 01.2024, are used here as an identified example of clauses to look for, not as a recommendation or a standard. For your policy, note the exact references and the questions requiring clarification, particularly regarding relapses and how days for which benefits have already been paid are counted.
4. Prepare for transitions and claim notification
A change of insurer, departure from the group contract or a new absence after returning to work requires particular scrutiny. Gather the successive policies, their dates and the information to be provided to the employee. Do not assume that a new contract wipes out the previous claims history.
Prepare a simple notification procedure: person responsible, channel, administrative documents and follow-ups. Diagnoses remain between authorised parties. Track dates, certified percentages of incapacity for work, confirmations and benefit statements. A sickness daily allowance benefit does not automatically determine protection against dismissal; these matters must remain separate in HR discussions.
Frequently asked questions
Does a percentage of salary prove equivalence?
No. The arrangement must be examined as a whole against the applicable obligations: in particular, staff groups, waiting period, duration and conditions. Comparing the percentage alone is insufficient.
Does the new policy start from scratch after a relapse?
Not necessarily. Review the contracts and their periods, then ask how the case is handled and how previous days are counted. The relapse guide helps organise these questions.
What should be prepared before the first absence?
A procedure covering the person responsible, notification channel, administrative documents, payroll monitoring and follow-ups. Also check what staff are told, without asking HR for a diagnosis.