A frontier worker is a person who works or acts as a self-employed person in one member state and lives in another member state to which he/she regularly returns every day or at least once a week.
In order to receive a standard form E106 in Estonia, the frontier worker must submit an application to the Estonian Health Insurance Fund. When processing the application, the Estonian Health Insurance Fund may request a copy of the worker’s employment contract, tickets, etc. for clarification and for verifying that the worker crosses the border every week.
For example, if the person works in Estonia but travels to his/her family in Finland at least once a week, then Estonia shall be that person’s insuring country, as the employer of the worker is located in Estonia and the social tax on the worker’s salary is paid to Estonia.
A form E106 issued by the Estonian Health Insurance Fund grants the person the right to register as a member of the health insurance system of his/her state of residence. This means that a frontier worker has the right to receive medical care on equal terms with persons insured in that state on the basis of local legislation, but the medical treatment expenses are later reimbursed to state of residence by Estonia (the extent of health care is broader than necessary health care received on the basis of the European Health Insurance Card).
Holders of the form E106 can apply for the European Health Insurance Card from the Estonian Health Insurance Fund. By presenting the card, the person will get any necessary health care in the country whereto he/she was not assigned with the form E106 but where he/she for example spends his/her holidays or is on short-term assignment.
If dependent family members live with the frontier worker but have no health insurance in their state of residence, then their names are added to the form E106 by a competent authority of the state of residence. After the registration of the form, other family members also gain the right to health care while residing in another member state on equal terms with local insured persons.
Who pays the benefit for incapacity for work to frontier workers?
A frontier worker working in Estonia but living in another member state is part of the Estonian social security system and his/her insuring country is Estonia; as a result, the Estonian Health Insurance Fund pays sickness and maternity benefits to the frontier worker on the basis of the Health Insurance Act.