The coronavirus pandemic, which has affected the entire world and Turkey in particular, has also had a major impact on the economy and the business world. As a result, many employers continue to suspend workplace operations under pandemic precautions and place employees on unpaid leave. However, unpaid leave affects general health insurance for a certain period of time.
Be Aware of Unpaid Leave Exceeding 30 Days
Due to the suspension of operations, many employers prefer unpaid leave to avoid terminating employment contracts while reducing tax, social security or personnel costs. In an environment where unpaid leave is becoming more common, employees should pay attention to their basic rights. If unpaid leave exceeds 30 days, employees may lose access to health services covered by the Social Security Institution (SGK) under General Health Insurance—such as examinations, treatment and medication. This important point affecting those placed on unpaid leave is not sufficiently well known.
When employees are placed on unpaid leave or take it voluntarily, employers do not pay wages. Because the employment contract is suspended, employer notifications to SGK report zero contribution days and zero earnings subject to contributions, and the absence is recorded with the code 21–Other Unpaid Leave. With this reporting, the employer has no social security premium liability for that period. Under the Social Insurances and General Health Insurance Law No. 5510 and its Article 67, for insured persons covered by 4A, general health insurance continues for unpaid leave periods up to one month within a year when documented by the employer. During these documented unpaid leave periods not exceeding one month in a year, health insurance remains in force and the insured person’s dependents can continue to use health services.
General Health Insurance if the Period Exceeds 30 Days
However, if unpaid leave exceeds 30 days in a calendar year, the last paid contribution becomes the basis, and for those insured under 4A the general health insurance coverage ends under Law No. 5510. From the termination date, the person would be required to pay the applicable premiums themself according to the law. If unpaid leave surpasses 30 days in a calendar year and the insured has a dependent who can include them under their insurance, it is possible to access SGK-provided health services by activating coverage through that dependent.
If the person cannot be covered as a dependent by someone else, they must apply to the social assistance and solidarity foundation in their residence area to have an income test for General Health Insurance (GSS). If the income test shows that per capita household income is below 981 TL (as of 2020), GSS premiums are paid by the state. If per capita income exceeds one third of the minimum wage, the individual must pay GSS premiums equal to 3% of the minimum wage.
The Period Should Be Extended to 90 Days
In this respect, employees placed on unpaid leave may also suffer losses in accessing health services. Because they lose both wage income and health service rights, the unpaid leave threshold for general health insurance should be raised from 30 days to 90 days to prevent hardship. Extending this limit would reduce the number of people facing such difficulties.