Registering with the social security system and having healthcare expenses reimbursed as an employee posted to Luxembourg

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Posted (or seconded) workers are employees who, for a limited and fixed period of time, are sent to work in a country other than their country of habitual employment whilst preserving their employment contract with their original employer.

As such, an employee who is sent to Luxembourg temporarily for a job that is part of a service contract entered into between their employer and a company will be considered to be a posted (or seconded) worker.

However, if the employment contract with the original posting company is terminated, the employee would not be considered to have been posted, but rather to be under a new employment contract.

For their posting to be considered legal, employees must have completed certain formalities beforehand.

Who is concerned

All workers posted to Luxembourg as part of a contract to provide occasional and temporary services, regardless of whether they are nationals of a Member State of the European Union (EU) or of a third State.

Prerequisites

To legally reside and work in Luxembourg, employees must ensure that they have completed certain formalities. These formalities depend on the employee's situation and more particularly on whether they are a national of an EU Member State, or of a country treated as an EU Member State, or a national or a third State.

It is essential that, prior to their posting, employees be enrolled with the competent social security bodies in their country of origin. As a result, the employment contract between the employer and the employee must exist prior to the posting.

Similarly, the posted employee must ensure that any co-insured persons (including members of their family) accompanying them during their stay in Luxembourg are regularly enrolled with the relevant social security services. The social security services in the country of origin have competence to determine the co-insured status of members of the posted employee's family.

In addition, in order to be covered against sickness and maternity and accident risks during their stay in Luxembourg, employees must be able to provide proof of social security coverage in their country of origin. In that case, it is appropriate to make a distinction according to the place of establishment of the business that posts the employee.

In addition, it is necessary to ensure that:

  • the posting was declared with the Inspectorate of Labour and Mines (Inspection du Travail et des Mines - ITM), and that the declaration mentioned the natural person holding the required documents;
  • the labour and income tax laws applicable to the posted employee are respected.

How to proceed

Enrolment and coverage of employees posted from EU-based companies

Initial posting

Employees posted to Luxembourg from a business based in an EU Member State remain enrolled with and covered by the social security system in their country of origin for the entire period of their posting. Generally, postings are for a maximum of 24 months.

Accordingly, before the posting, and for each posted worker, the employer must file an application for an A1 certificate with the social security institution in their country of origin. Once it is prepared by the social security institution, the 'A1 certificate' is sent to the employer, who gives a copy to the posted worker.

Form A1 certifies that the posted worker is enrolled with the social security services in the country of origin.

Employees must apply for a European health insurance card, as well as Form S1, from the social security services in their country of origin. Form S1 certifies entitlement to benefits in kind for sickness and maternity and paternity insurance in the country of origin.

With Form S1, employees can enrol with the Luxembourg National Health Fund (Caisse nationale de santé - CNS). To do so, they must submit an application to the CNS, either by post or in person, accompanied by the following documents:

  • a copy of their ID card or passport;
  • a copy of the A1 certificate;
  • a copy of their Form S1, issued in their country of origin.

Following their enrolment with the CNS, they will be issued with:

  • a Luxembourg health insurance card, if they have established their official residence in Luxembourg, or;
  • an enrolment certificate, if they have kept their official address in their country of origin.

Once the posted worker has been issued with their card/certificate, they will be able to receive any benefits in kind (such as medical examinations, medicine, and hospital care) they may require during their posting in Luxembourg, on the same terms as resident employees.

Extension of the posting

Generally, employees may not be posted for a period exceeding 24 months.

However, a new posting may is possible, provided a waiting period of 2 months is observed. This 2-month period must begin at the end of the initial 24-month posting and have fully elapsed before the new posting.

This means that at least 2 months must have elapsed before a new posting can be authorised for the same employee. In exceptional cases, an extension may be granted, upon request, without having to observe the waiting period. The request must be submitted to the competent authority in the country of origin by the employer. The competent authority will then approach the Luxembourg Ministry of Health and Social Security (Ministère de la Santé et de la Sécurité sociale) for approval.

The A1 certificate and Form S1 would then need to be extended by the social security services in the country of origin.

The posted worker would also have to go in to the CNS to have the validity of their social security card or registration certificate extended.

If a request for the extension of a posting is not approved and the employee continues to work in Luxembourg, the employee would then have to enrol with Luxembourg social security if they have established their residence in Luxembourg or in a bordering country.

Enrolment and coverage of employees posted from companies based in a country treated as an EU Member State

Initial posting

Employees posted to Luxembourg from a business based in a country treated as an EU Member State remain enrolled with and covered by the social security system in the country that they are posted from for the entire period of their posting. Generally, posted work is for a maximum duration of 12 months.

The following are treated as EU Member States:

  • Iceland, Liechtenstein and Norway as signatories to the European Economic Area Agreement (EEA);
  • the Swiss Confederation.

Accordingly, before the posting, and for each posted worker, the employer must apply for an E101 certificate from the social security services in the country of origin.

Form E101 attests to the law that applies to employees who are not enrolled with the social security services in the country that they are being sent from.

Once completed by the social security services in the country of origin, the E101 certificate is sent to the employer, who gives a copy to the posted employee.

Employees must request Form E106 from the social security services in their country of origin.

Form E106 certifies entitlement to benefits in kind for sickness and maternity insurance in the posted employee's country of origin.

With that form, employees can enrol with the Luxembourg National Health Fund (Caisse nationale de santé - CNS). To do so, they must submit an application to the CNS, either by post or in person, accompanied by the following documents:

  • a copy of their ID card or passport;
  • a copy of their E101 certificate;
  • a copy of their E106 form, issued in their country of origin.

Following their enrolment with the CNS, they will be issued with:

  • a Luxembourg health insurance card, if they have established their official residence in Luxembourg, or;
  • an enrolment certificate, if they have kept their official address in their country of origin.

Extension of the posting

If a posting is extended beyond the initial 12 months, employees may apply for a 12-month extension to remain covered in their country of origin. To that end, the employer must send 4 duly completed copies of Form E102 to the Joint Social Security Centre (Centre commun de la sécurité sociale - CCSS).

The CCSS completes the request for extension and sends a copy to the competent body in the country of origin and 2 copies to the employer, who will give one to the employee.

If the posting is extended beyond 24 months, the employer must submit an application to the competent authority in the country of origin. The competent authority will then approach the Luxembourg Ministry of Health and Social Security (Ministère de la Santé et de la Sécurité sociale) for approval.

The posted worker must then go in to the CNS to have the validity of their social security card or registration certificate extended.

Enrolment and coverage of employees posted from companies based in a country that has signed an agreement with Luxembourg

Initial posting

Employees posted to Luxembourg from a business in a country that has signed a bilateral agreement with Luxembourg remain enrolled with and covered by the social security system in the country that they are posted from for the entire period of their posting. Generally, posted work is for a maximum duration of 12 months.

Accordingly, before the posting, and for each posted worker, the employer must apply for a certificate from the social security services in their country of origin. Once completed by the social security services in the country of origin, the certificate is sent to the employer, who gives a copy to the posted employee.

Employees must apply for a form from the social security services in their country of origin, certifying their entitlement to benefits in kind during a temporary stay abroad.

For each of the countries below, the specific form that must be applied for is mentioned:

  • Bosnia and Herzegovina: Form LU/BiH-106;
  • Macedonia: Form L/RM-106;
  • Montenegro: Form MNE/L-106;
  • Serbia: Form SRB/LUX-106;
  • Tunisia: Form T/L 15.

Once they have obtained the form in question, the employee can enrol with the Luxembourg National Health Fund (Caisse nationale de santé - CNS). To do so, they must submit an application to the CNS, either by post or in person, accompanied by the following documents:

  • a copy of their ID card or passport;
  • a copy of the certificate;

Following their enrolment with the CNS, they will be issued with:

  • a Luxembourg health insurance card, if they have established their official residence in Luxembourg, or;
  • an enrolment certificate, if they have kept their official address in their country of origin.

Extension of the posting

If a posting is extended beyond the initial 12 months, employees may apply for a 12-month extension to remain covered in their country of origin. To that end, the employer must send 4 duly completed copies of the extension request form to the CCSS.

The CCSS completes the request for extension and sends a copy to the competent body in the country of origin and 2 copies to the employer, who will give one to the employee.

If the posting is extended beyond 24 months, the employer must submit an application to the competent authority in the country of origin. The competent authority will then approach the Luxembourg Ministry of Health and Social Security (Ministère de la Santé et de la Sécurité sociale) for approval.

The posted worker must then go in to the CNS to have the validity of their social security card or registration certificate extended.

Enrolment and coverage of employees posted from companies based in a country that has not signed an agreement with Luxembourg

Employees posted to Luxembourg must be enrolled with the CCSS, through their host company located in Luxembourg, for health and accident insurance coverage.

The enrolment formalities are somewhat different for residents and non-residents of Luxembourg.

Upon request, posted employees are exempted from enrolment for pension insurance in Luxembourg if they can prove that are still enrolled for pension insurance in their country of origin. This annual exemption is granted by the CCSS for the first 2 years. Beyond that limit, it is granted for a further 3 years by the Ministry of Health and Social Security.

Reimbursement of expenses incurred for healthcare received in Luxembourg

Posted employees who are still enrolled in their country of origin are entitled to healthcare benefits in Luxembourg under the same conditions as persons enrolled with the CCSS in Luxembourg.

When employees are posted by a business based outside the EU (and are therefore enrolled with the CCSS), they must follow the reimbursement procedure that applies to resident or non-resident employees, depending on their place of residence.

For posted employees who remain enrolled in their country of origin, a distinction is made between healthcare for which the employee has had to advance costs, and healthcare that is paid for automatically.

Procedure for reimbursement of expenses incurred by posted workers

  1. a posted worker consults with a healthcare professional;
  2. after the visit with the healthcare provider, the posted worker must pay the medical services provider or supplier immediately, or subsequently by bank wire;
  3. the posted worker must then send a letter to the CNS requesting the reimbursement of the expenses they incurred following their visit to the healthcare professional. That letter must mention/contain:
    • the posted employee's identity details and national identification number;
    • where applicable, the details of the bank account into which the reimbursement is to be paid;
    • the original receipted statement of fees, or if the payment took place later, proof of payment in the form of bank statement. The bank statement can be either a copy of the original or printed from an online banking website. However, a transfer order alone is not sufficient.
  4. the application letter is sent to the CNS, without postage;
  5. the expenses incurred by the posted employee will be reimbursed by wire transfer within a few weeks.

Reimbursement will be made at the rates in force in Luxembourg.

Direct payment by the health insurance fund

In some cases, such as hospitalisation costs, medicine or laboratory services, posted employees are not required to advance the full cost of the delivered services. To benefit from this direct payment system—known as the 'third-party payment' system—the posted employee will need to produce a Luxembourg health insurance card, or the corresponding form, or the certificate of applicable legislation.

The posted employee would then be required to pay healthcare providers only the portion of the cost of the services that remains to be borne by them.

Online services and forms

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Demande de document S1 : inscription à l’assurance maladie - Attestation de droit aux prestations en nature de l’assurance maladie, maternité et paternité assimilés dans votre État de résidence

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Who to contact

  • National Health Fund (CNS) Department 'National reimbursements'

    Address:
    4, rue Mercier L-2144 Luxembourg Luxembourg
    L-2980 Luxembourg
    Phone:
    (+352) 27 57 1
    working days from 8.00 to 16.00
    Fax:
    (+352) 27 57 27 58

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