Medical Insurance

E

Expat13

Silver
Jun 7, 2008
3,255
50
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Apparently after having an employee for 3 months, the employer must provide insurance.

Can someone tell me what is the minimum(by law) or standard medical insurance that companies must provide for their employees in the DR?

What's the cost and what does it cover? Do you also have to provide an insurance plan that also covers dental?

Thx.
 
A

amp

Bronze
Oct 5, 2010
730
8
18
Your employee picks the plan they want. You pay part of it and so do they from their pay check which is automatically withheld.

That's what I know from my understanding.
 
B

Black Dog

Bronze
May 29, 2009
1,761
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I agree with RAAAY, it's the TSS contributions so just let your accountant earn his/her money!
 
W

william webster

Platinum
Jan 16, 2009
30,247
4,330
113
some will tell you this isn't important... it is.
I've been called on to the carpet for not doing.

However, I think its the right thing to do for the right employee and you can get a group of 3 together...including yourself.... and POOF! you're insured too.

it is the law
 
D

Deyvi

*** I love DR1 ***
Dec 23, 2009
579
2
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Sounds pretty much like the way it used to be in the US. Better hope the DR is not quick to copy cat.
 
C

Criss Colon

Platinum
Jan 2, 2002
21,843
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38
yahoomail.com
A "Maid", a "Gardener", & a Cook, are EMPLOYEES, just like an "IT tech", but get different benefits under the law.
Just asking.
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F

Floridaborn

New member
Sep 25, 2010
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jefe de la finca said:
Guzm?n Ariza | An Overview of Dominican Labor Law

Scroll down to item 7 re. social security payments
Click to expand...



The information regarding employee portion and employER is not correct on this information. When inscribing your employees in TSS (Social Security system) the employee pays 5.91% of their monthly salary to TSS, which gives them some health insurance, pension, life insurance, disability, ect. ..... ---- the EMPLOYER has to pay 14.19% of their monthly salary to TSS (the employees account).
 
E

Expat13

Silver
Jun 7, 2008
3,255
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Floridaborn said:
The information regarding employee portion and employER is not correct on this information. When inscribing your employees in TSS (Social Security system) the employee pays 5.91% of their monthly salary to TSS, which gives them some health insurance, pension, life insurance, disability, ect. ..... ---- the EMPLOYER has to pay 14.19% of their monthly salary to TSS (the employees account).
Click to expand...

Is there a standard on the medical insurance side? I realize this may depend on the wage of the employee but suspect the minimum required medical that is lumped in with TSS would not be very good coverage?
 
M

MJSantoDomingo

Bronze
Apr 13, 2011
680
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I look at the difference like this... a maid, gardener, cook are people doing work that would be considered "self-employed" or "contracted services" in most other countries - they collect a payment from individuals/households for services done. The individuals/households that hire a maid, gardener, cook are not set up as a business.
Businesses hire full-time employees for things like "IT tech". Part of the gross profit of a business pays for the employees salaries and benefits.
 
W

william webster

Platinum
Jan 16, 2009
30,247
4,330
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correct.... but if you own/hold your property in a company - as many do - you are can be on the hook for the tax/medical
 
R

rubio_higuey

Gold
Feb 7, 2007
8,005
625
113
Expat13 said:
Is there a standard on the medical insurance side? I realize this may depend on the wage of the employee but suspect the minimum required medical that is lumped in with TSS would not be very good coverage?
Click to expand...

Standard medical & dental is what most people insure din the DR have. It covers 80% of expenses with out of pocket (copay) topped at 2 minimum salaries. It covers also your spouse and underage children automatically. Insurance coverage by all insurance companies under plan basico is the same. You can pay a selective plan with your insurance, on top of your plan basico, to get additional coverage. I pay 400 pesos per month at Constitucion and I have 100% coverage for everything, with the exception of doctor's visits, where you have to pay a copay even with a platinum diamond plan.
 
cobraboy

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
40,964
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We have formed a small group. Alida and I have "basic" coverage through a business, but one of our members has none.

A significantly upgraded policy is US$29 for us, and US$43 for the non-insured.

It's worth it to form a small group if you are concerned about your potential health issues.
 
R

rubio_higuey

Gold
Feb 7, 2007
8,005
625
113
CB - you actually do not need a group for an insurance via TSS. You can have one single employee, and have him/her insured via TSS. For the supplemental plan (plan complementario), as far as I know, there are no minimum number of persons, but it may vary by insurance company. My supplemental plan costs me just $10 per person per month, at ARS Constitucion, and I have a 100% coverage for everything, and my hospital room is up to 7,500 pesos per day which should cover basically any clinic in the DR including the best of Santo Domingo. Also one (not widely mentioned) benefit of insurance via TSS is coverage of preexisting conditions, and coverage of catastrophic illness (which the private insurance plans do not do, or cap at the regular per-year expense limit). Also readers should understand that the same health insurance company (ARS) has both private plans, plan "basico" (through social security, TSS), and supplementary plans (on top of plan basico). For those not used to DR insuarnce system this may be a bit confusing.
 
J

jpblan2001

New member
Jun 23, 2014
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From An Overview of Dominican Labor Law
===
3.4.Profit Sharing

Employers must share 10% of their net profits with their employees. The Labor Code, however, allows employers to cap the amount distributed as follows: an employee with less than three years on the job will receive a maximum of 45 days? salary; an employee with three years or more, will receive a maximum of 60 days? salary (Art. 223).
===
This was news to me, most likely not followed by most.
 
M

MJSantoDomingo

Bronze
Apr 13, 2011
680
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jpblan2001 said:
From An Overview of Dominican Labor Law
===
3.4.Profit Sharing

Employers must share 10% of their net profits with their employees. The Labor Code, however, allows employers to cap the amount distributed as follows: an employee with less than three years on the job will receive a maximum of 45 days’ salary; an employee with three years or more, will receive a maximum of 60 days’ salary (Art. 223).
===
This was news to me, most likely not followed by most.
Click to expand...

I am sure most small businesses work things out so their Net Profit is as close to zero as possible, mostly to avoid paying taxes on that profit.... (the gross profit may be much higher...)
 
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