State Governments are instrumental in delivering healthcare services under the ESI Act. An enabling provision was inserted in the Act to establish a body at the State level to address certain operational issues.

A committee, entitled Medical Services and Medical Education (MSME), was constituted to explore various options to improve operational efficiency.

In Guinea, the population has suffered from difficulties in accessing health care for a long time. The country has lacked sufficient health infrastructures and facilities.

The Social Security Corporation (SSC) has started to assess the work place according to the occupational health and safety standards since January, 2014. This initiative is based on the legislative reform that took place in the Social Security Law number (1) for the year 2014. This assessment also stems from the increase in the numbers of work place accidents and occupational diseases that have occurred. Therefore, the main objective of this initiative is to enhance the culture of occupational health and safety standards in the work place.

Since its establishment, the Public Institution for Social Security (PIFSS) has endeavoured to provide a better service to all its subscribers and clients, relying on an automated system to transfer legal data, to implement its procedures, and to face the increasing number of subscribers. To this end, PIFSS has developed a complete set of smart solutions using the latest technologies aimed at converting manual transactions to electronic transactions through its  Automation of Procedures and Correspondence System, a paperless solution that also helps save the environment.

The Social Insurance Bank (Banco de Previsión Social ‒ BPS) has developed measures to discourage the non-compliance of those paying social security contributions and to promptly recover debts by applying controls that discourage the adoption of irregular behaviour.

The Contributor Profiling System (Calificación Tributaria) is a model that describes each contributor as a function of the possible risks in their dealings with BPS from the time of their admission to the scheme, as derived from coefficients of trustworthiness based on their past behaviour.

During the second half of 2013 and the first of half 2014, a comprehensive analysis including all delegations and national administrative units identified the need to develop a tool to provide information and advice to beneficiaries in relation to their personal loans, thus avoiding unnecessary visits to the offices of the State Employees' Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE)).

Web application that allows salaried workers to obtain an official certificate of their incomes, validated by the Federal Administration of Public Revenue (Administración Federal de Ingresos Públicos (AFIP)). Workers can use this certificate, issued by the national Government, as a proof of income, presenting it as a backup on loans, rent or warranty. Moreover, the receiving entity (business, bank, etc.) can check the certificate online at the AFIP website and confirm its veracity.

The project “Classes with ZUS” is addressed to secondary schools. It aims to raise awareness of young Poles on the role of social security in their lives.

The project presents: social solidarity principles, practical knowledge on the functioning of the system, obligations of employers towards ZUS, employer-friendly solutions - e-ZUS.

The project includes 4 lessons with the materials for teachers and for students (multimedia presentations, videos, exercises and texts to deepen the knowledge): 

The Social Security Law of Iran was enacted in 1977 but its circulars are very extensive and complicated. To solve this problem, the Iranian Social Security Organization (SSO) planned a project to consolidate the existing circulars. For this purpose, we have created a main consolidating council and 40 workgroups. To date, we have summarized and consolidated approximately 500 circulars into 10 summarized and consolidated circulars.

Improving data accuracy and simplifying the process of registration for employers and insured persons are always taken into consideration by the Public Authority for Social Insurance (PASI). Previously, PASI was completely dependent on the information submitted by employers for new registrations or for updating employee-related information related, with no assurance of the accuracy of the information.

The paperless benefit documents project consists of eliminating paper (prescriptions, medical treatment forms, etc.), and replacing it with Web application screens starting with doctors and then other healthcare providers (laboratories, pharmacies).

The three main advantages for patients are:

The Polish Social Insurance Institution (ZUS) is by law obliged to prepare forecasts of the spending and revenues of the Social Insurance Fund (FUS) (i.e. the pension fund, the disability fund, the sickness fund and the work injury fund). A cohort model built to fulfil this requirement was sufficient to forecast aggregate spending and revenues, but, being based on average cohort values, it does not provide information on the benefits’ structure.

From 1 January 2014 the Croatian Pension Insurance Institute (CPII) introduced the electronic service Lana mirovinsko, as a web application for registration in its central database (e-applications).

Based on the changes made on the “Regulation on Medical-Social Expert Commissions”, the applied system ensures that the disability assessment process is carried out objectively and transparently through the electronic infrastructure without official-citizen contacts.

The Malagasy population's unfamiliarity with the social security concept partly explains the low rate of social security coverage (10%). Despite efforts to publicize and raise awareness, the situation remains somewhat static. To remedy this, an education program on the right to social services was implemented in February 2014 through the introduction of Junior Clubs which bring children together. They will act as information vectors through fun and festive activities and will instill a social service culture in their families and society in general.

The Croatian Pension Insurance Institute (CPII) receives the death data for Croatian pension beneficiaries residing abroad on the principle of delivered Life Certificates and letters received from the competent foreign pension institutions. That way, CPII receives the beneficiaries' death data after a certain delay thereby causing possible undue payments of pension amounts.

The electronically assisted company audit makes the procedure much simpler and at the same time more efficient for employers and tax consultants and for the Audit Office of the German Pension Insurance (Deutsche Rentenversicherung – DRV). The employer’s electronic payroll accounting data is transferred to the Audit Office in a defined form via a secure connection. Audit preparation for the employer is in many cases just a mouse click; paper documents only have to be provided occasionally.

In 2013, various actions allowed to eliminate the need for pensioners to validate their rights on-site. This practice required pensioners to go personally twice a year to the State Employees' Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE)) to prove they were alive and that they continued to collect their pensions. In these periods, nearly a million pensioners, most of them aged 65 and over, attended one of the 365 national offices.

Financial institutions in Africa have successfully plugged into the mobile ecosystem and deployed services that have revolutionized service delivery, transforming customer engagement touch points and feedback mechanisms as well as enhancing responsiveness of the financial institutions. In addition to this mobile tech has enabled financial penetration. Currently Kenya has 68 per cent financial penetration through mobile tech and is at 80 per cent in use. While many Social Security services providers use mobile technology, they are still to fully leverage on its capabilities.

The National Social Security and insurance Trust (NASSIT) was established through Parliamentary Act No. 5 of 2001 and charged with the responsibility of administering the Sierra Leone Pension Scheme. The scheme started operations in January 2002 as a mandatory contributory defined benefit Pension Plan. As at December 2010, NASSIT had 161,000 active Members (Contributors) and operates a payroll of over 12,000 Pensioners. By end of December 2014, membership of the Scheme grew to 165,000 and the number of Pensioners grew to 14,500.

As part of the social security reform processes in Indonesia as mandated by the 2004 Law concerning the National Social Security System, BPJS Ketenagakerjaan must cover all workers in Indonesia, in both formal and informal sectors, totalling 120 million workers distributed in 17,000 islands.

Extending social security coverage to people who do not have it is a priority. This concerns people falling outside the social security systems in many countries. In France, the problem also involves people not claiming the benefits to which they are entitled. This is what is known as the non-take-up of benefits.

Unclaimed social benefits undermines the effectiveness of public policy, equal access to rights for everyone and the fight against poverty.

Since 2014, a cash benefit allowance is paid to millions of recipients in the month of March of every year to the most needy people and families. This benefit is called the “March Permanent Family Benefit” (Aporte Familiar Permanente Marzo – AFPM) which consolidates through the use of better technology the payment of various extraordinary allowances dating back to 2009 by standardizing the process, setting the selection criteria for beneficiaries, and issuing beneficiaries’ lists.

The objectives of the National Health Insurance Fund (Caisse nationale d'assurance sociale (CNAM)) are expenditure control and improving the quality of care. Electronic transmission requirements and medical control prerogatives have made it necessary for the CNAM to invest in the automated processing of medical claim forms.

The main objective is the establishment of a decision-support system with a medical knowledge base which would take into account the specificities of each medical claim form.

The Employees  Provident Fund Organisation (EPFO), under the Ministry of Labour & Employment, Government of India provides social security benefits to its members in terms of provident fund and old age pensions under the Employees' Provident Funds & Miscellaneous Provisions Act, 1952 (referred to as the Act hereafter), enacted by the Parliament of India, which extends to the whole of India except the state of Jammu and Kashmir.

The Wage Protection System (WPS) is a joint programme between the Ministry of Labour (MOL) and the General Organization for Social Insurance (GOSI), and it has been built to be the wage repository for all workers to assure wages are affectively deposited to workers bank accounts and are also reported correctly to GOSI. The system requires all employers to generate a wage file which is compliant with the WPS specification.

It has been recognized that a major challenge in developing countries is how to ensure that the poor are included in health financing arrangements and they can access benefit from health insurance coverage as the non-poor.

The social security administrator, as mandated in the Law, must provide a single identity number to its members. As part of the social security reform processes in Indonesia, BPJS Ketenagakerjaan initiated a project to integrate its whole administration system with the National ID administered by the Home Affairs Ministry (which was recently reformed in the agenda of national public administration).

In 2010, the government of Mali introduced a compulsory health insurance scheme with third-party payment for civil servants and workers to guarantee affordable health care.

In 2011, the National Sickness Insurance Fund (Caisse nationale d'assurance maladie (CNAM)) concluded agreements with all public agencies, in particular with hospitals, referral health centres and community health centres.

Since 2014, the National Family Allowance Fund (Caisse nationale des allocations familiales – CNAF) has been engaged in a major participative innovation approach to design services that are better adapted to users’ expectations and ensure better accessibility.

Since April 2014 the Social Insurance Institute - State Employees' General Retirement Fund (Institut de prévoyance sociale - Caisse générale de retraite des agents de l'Etat (IPS-CGRAE)) has been the object of a major reform which aims notably at ensuring ongoing improvements in the quality of services provided to insured persons by accelerating payment of the first pensions after retirement.

The system for managing public pensions in Côte d’Ivoire underwent a major reform in 2012.

The National Social Insurance Fund (Caisse nationale de prévoyance sociale – CNaPS) is continuing its efforts to extend social security coverage in Madagascar. An initiative to expand awareness raising activities has become a laudable strategy in terms of its achievements. In 2014 it launched a programme for Catholic school leaders that promotes and raises awareness on the provisions of social security and of their responsibilities regarding such rights.

The Family Branch is at the heart of solidarity policies and provides support for the most vulnerable individuals. Its organisation and service delivery prioritize access to entitlements – now a key public policy issue.

In 2014 the Family branch implemented a new service with a renewed focus on identifying and accessing available entitlements and services called the “entitlement meeting”.

The Social Security (Minimum Standards) Convention No.102 adopted by the International Labour Conference of the ILO on 28 June 1952 establishes worldwide-agreed minimum standards for all nine branches of social security to encourage the widest development of social security schemes. These branches are; medical care, sickness benefit, unemployment benefit, old-age benefit, employment injury benefit, family benefit, maternity benefit, invalidity benefit; and survivors benefits.

In 2014, the Government of Malta enacted a host of active labour market policies termed “Making work pay”, with the aim of boosting the potential of the Maltese economy, reducing welfare dependency by incentivising inactive or unemployed persons to work and, in the process, enabling Maltese citizens at large to enjoy a higher standard of living.

Ensuring that people are supported to achieve their employment potential and ambitions is one of the most significant labour market and social policy challenges for policymakers today.

The National Employment Office (ONEM) has been using an integrated management model for a number of years.

This model is upgraded constantly and includes the vision, mission, values, strategic plan, operational plans, dashboards, the cost price calculation of and the of productivity measurement.

This management model has been materialized in the form of a management cockpit.

The National Social Security Institute (Instituto Nacional de la Seguridad Social – INSS) is a social security management body responsible for managing and administering certain financial benefits in the Spanish social security system, including medical checks related to temporary incapacity (TI) benefit.

From 2012 to 2018 there was a considerable increase in all TI indicators (incidence, prevalence and average duration).

In the framework of the policies for technological innovation of management, the resource My Mobile ANSES was created with the purpose of achieving fluid and direct communication via the mobile phone. This application seeks to facilitate and expedite the paperwork and queries that citizens carry out daily. In only one year of implementation, this application reached more than 190,000 total downloads in Android systems, with a rating of 3.72 stars out of 5, assigned by users.

An application was launched to facilitate access to the information and services of the National Social Security Administration (Administración Nacional de la Seguridad Social – ANSES) through mobile phones, which are widespread among the population.

As part of its role of managing the contribution history of its insured members, the Social Insurance Institute – National Social Insurance Fund (Institution de prévoyance sociale – Caisse nationale de prévoyance sociale – IPS-CNPS) has developed a computer-based tool, termed “e-DISA”, to encourage employers to communicate workers’ individual data (length of service and remuneration). Introduced in 2013, e-DISA enables employers to produce workers’ Individual Declarations of annual earnings (DISA) electronically and securely.

The National Social Insurance Fund (Caisse nationale de prévoyance sociale – CNaPS) of Madagascar has created a think tank devoted to social security. This innovative initiative aims at remedying the inadequacy of academic research on the subject and its inability to influence public policy. The goal is to provide high-quality services to a large number of beneficiaries.

The Family Allowances Fund offers a complete package to separated parents which combines:

According to Law No. 5510 (Social insurance and Universal Health Insurance Law) some short- and long-term ınsurance benefits and similar payments, called 'Personal payments’ are paid through the beneficiaries' ID number on the 8th-14th days of a month. If someone who has payments sent to the bank misses these pre-determined days, the benefits are sent back to the SSI’s accounts. This process is repeated every month until the individual receives the payment.

Overcrowding caused by the number of pensioners attending to collect payment of their entitlements has led the National Social Security Fund (Caisse nationale de sécurité sociale – CNSS) of the Central African Republic to switch to paying insured persons through the banking system, using prepaid cards.

This practice has made it possible to reduce waiting times and eliminate congestion at the institution’s service counters. It also enables the organization to pay the benefits to the real beneficiaries and fight fraud.

The National Social Insurance Fund (Caisse nationale de prévoyance sociale – CNaPS) is the public institution managing the various branches (family benefits, work injuries, and occupational disease, pensions) of social protection for employees in Madagascar. It also manages the collection of contributions, and hence needs nationwide geographical presence. The priority accorded to maintaining the level of coverage and adjusting it to the needs of its members is a daily challenge for the CNaPS.

Over the past several years the National Sickness and Invalidity Insurance Institution (Institut national d’assurance maladie-invalidité (INAMI)) has been developing an active policy of occupational reintegration for persons receiving benefits under the invalidity insurance scheme.

This good practice presents the training programmes implemented by the Uruguayan social security institute, which have been deemed a substantial qualitative step forward. The strategic plan for 2011–2015 included in its lines of action “the development of modern human resource management policies, honing staff members’ skills and improving the working environment and occupational health in the organization”.

In July 2014, Spain´s National Social Security Institute launched the online service platform TU SEGURIDAD SOCIAL (YOUR SOCIAL SECURITY).

Following a labour court ruling, determining whether a work relationship truly existed based on certain contractual circumstances, it is necessary to record the data collected from such rulings in order to formalize the collection of the social security debt and record the social security history of the employment relationship for the benefit of the worker.

Since April 2014 the Social Insurance Institute - State Employees' General Retirement Fund (Institut de prévoyance sociale - Caisse générale de retraite des agents de l'Etat (IPS - CGRAE)) has been the object of a major reform which aims notably to ensure continued improvements in the quality of services provided to insured persons by setting up an efficient reception structure.

The implementation of improved services by local authorities of the Pension Fund of the Russian Federation (PFRF) is aimed at providing the absolute majority of citizens with the opportunity to receive pensions without having to be physically present at a local PFRF office. Now, the granting of pensions is only based only on an extract of the insured person’s individual account which contains the required full information to award the pension such as length of service, wages and insurance contributions.

The issue of inadequate savings faced by the members of the Employees Provident Fund (EPF) coupled with a low level of financial literacy demonstrate the urgent need to enhance the knowledge and skills in financial and retirement planning among Malaysians.

In order to achieve good corporate governance, the Risk Management Department developed an excel model for Risk Rating and Grading of the PASI investment portfolio for more effective risk management:
 

1. Design Risk Measurement Models:

Data is collected from PASI investments on a monthly basis to calculate the Yearly Volatility and Return.
 

2. Capital Asset Pricing Model (CAPM)

Calculation of Beta, Expected Return and Drift Rate.
 

The project SA.SI.A is based on the integration of technology into the current security procedures in the corporate sector industry. It starts from the experience of Si.S.Ca. "Active safety on construction sites.", validated as a good practice by the Ministry of Labour in 2013 and awarded a recognition in the ISSA Good Practice Award competition for Europe in 2013. The platform SA.SI.A allows real-time monitoring over all working areas with special attention to the following risks:
 

Since 2014, the Family branch of the social security authority has been organizing a structured approach to management and cooperation in order to develop services suited to the needs of families and to combat disparities between different geographical areas:

There was a year in Mexico when identity theft increased by 141 per cent. According to statistics from the Bank of Mexico, the country has the eighth highest rate of identity theft in the world (Gazette No. 2667, Chamber of Deputies: 2016).

As regards the State Employees' Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado – ISSSTE), weaknesses were found in the personal loan approval process that facilitated the falsification of ID documents and loan application forms.

The Public Service Pensions Fund (PSPF) was established in 1999 to serve public servants employed in the central government and executive agencies. The PSPF operates two schemes, the mandatory scheme and the supplementary scheme. To date the Fund serves 340,098 contributing members in the mandatory scheme, 91,137 members in the supplementary scheme and has 77,508 pensioners.

As reflected in the Service Transformation Initiative 2014-2016, Social Security Board's (SSB's) Organizational Vision on customer-centered service guides the institution in transforming service delivery for the benefit of customers, employees and SSB. This aligns with our belief that to achieve our Vision "To be a model Social Security institution, the pride of Belize" we must dramatically improve the way our beneficiaries and other stakeholders access SSB information and services available to them during critical times of their lives.

The "Trabajo Registrado en Línea" (TRL) (Online Work Registration) system is an auditing tool which enables the information that the employer submits in his monthly social security sworn statements to be consulted online, as well as other information from the auditing body's databases, which can then be immediately compared with the economic reality observed during on-site inspections.

China is progressively implementing a national social insurance coverage registration programme to speed up full social insurance coverage, and to put in place a more equitable and sustainable social security system.

The registration programme is a dedicated initiative to promote full and sustained coverage of working people and of urban and rural residents.

Using new information and communication technologies (ICT) to implement a project of great social intensity: reimbursing health services by SMS and 3G in the pharmacy network under the supervision of a leading bank. Social benefit reimbursement is fundamental to the State because it relies on respecting the national commitments made to the population. It is not a theoretical question but a practical reality. When a person on a low income is entitled to a reimbursement of health services, the reality of having to manage a household budget on a daily basis becomes apparent.

This submission outlines the delivery of a Claim, Payment and Entitlement Web Service to Student Universal Support Ireland (SUSI) from the Department of Social Protection (DSP).

The Social Security Corporation (SSC) in its efforts to enhance and improve the quality of services has started to link electronically with the main stakeholders' databases. Actually, the systemic electronic exchange of data between SSC and the partners, stakeholders, and counterparts stems from its strategic orientation to deliver high quality services. To achieve this, SSC has signed bilateral agreements and memoranda of understanding with both private and public sector organizations.

The integration of student certificates to the Health Benefits Rights Programme (SPAS) involves the electronic flow of data between the Turkish Social Security Institution (SSI) and both the Higher Education Institution (YÖK) and the National Education Ministry (MEB) on up-to-date student certificates.

The groundwork to develop the software started at the beginning of 2013, and finished at the end of 2013, but the entire project was completed in February 2014 and the flow of data on student certificates began electronically.

In order to achieve service excellence, BPJS Ketenagakerjaan developed a new service blue print putting prime concern on three aspects: People, Process, Physical Evidence.

In 2014, the Canadian Retirement Income Calculator (CRIC) was redesigned to align with the recent reforms to the public pension programmes while taking advantage of the latest web tools. The CRIC was transformed into a dynamic, mobile-accessible application which received much acclaim. In line with the Government of Canada's National Strategy for Financial Literacy, the modernized CRIC helps individuals plan for their retirement; and it promotes both financial literacy and awareness of Canada's public pensions.

The Standard for Pension Projections aims to help the Swedish pension insurance industry serve its clients better.

The Standard provides a tool for consistent projections across the industry. Two guiding principles have driven the Standard:

With the goal of building a social security system that covers the urban and rural residents in a comprehensive way, the Chinese government has implemented a universal social security enrolment programme that focuses on old-age insurance and medical insurance. By the end of 2017, the registration of all targeted groups across China had been basically completed through the measures of policy optimization, publicity, strict law enforcement, service improvement and registration at every doorstep.

The general public in Sweden has little interest in the social security system and many times incorrect expectations of how much they will receive in benefits. But at the same time most people are positive about having a general social welfare system. The Swedish Social Insurance Agency’s communication strategy was created to remind the general public of just that and to connect the Agency with those positive feelings by showing how the agency embodies that idea of social security in a modern way.

The institutional reform in 2014 had transformed BPJS Ketenagakerjaan into a new non-profit public entity which is directly responsible to the President of Republic of Indonesia. The creation of this new entity has had an enormous impact on its supervisory system, both external and internal, to ensure its transparency and accountability.

As a result of the new governance landscape, BPJS Ketenagakerjaan has been reconstructing its value and governance system toward the vision of good citizenship governance in 2018.

In 2012 social security agencies in Germany decided to use the United Nations Convention on the Rights of Persons with Disabilities as a model in their own organization. Social security institutions were to be model employers. Anyone insuring the social risks of people must also take human rights into account. All those working in social security have to live up to these on a daily basis whether they work in prevention, rehabilitation or claims.

The inefficiency and complexity of various processes involving a multitude of forms and returns and the resulting difficulty in delivery of online services to over 60 million contributory subscribers and over 200 million accounts, was a big challenge for the Employees’ Provident Fund Organisation (EPFO) of India since some time back. The sheer size of stakeholders heightened the need of digitization.

Co-operation and networking across institutions is an essential factor in successful occupational reinsertion. The customer (always an accident victim in the context of what follows) should be able to benefit from as comprehensive a service as possible from social insurance institutions.

“Vision Zero: Zero accidents – Healthy work!” is the innovative prevention strategy of the German Social Accident Insurance Institution for the raw materials and chemical industry (BG Rohstoffe und chemische Industrie – BG RCI). This strategy sets out concrete objectives for reducing the risk of accidents and occupational diseases.