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which are supplemental pensions arising from collective agreements made by the unions
and employers‟ federations.
Social insurances
All workers (employed and unemployed) are covered by the public sickness and
disability insurance schemes. Most workers are also covered by an unemployment
insurance scheme. Unemployed individuals (either covered or not covered by the
unemployment insurance scheme) have access to the sickness insurance scheme. Until
July 2008, there was no formal time restriction on the length of sick leave under the
sickness insurance scheme. Such formal time restrictions do exist in the unemployment
insurance scheme, however. Overall, the benefit requirements are the least generous in
the unemployment insurance scheme and the most generous in the sickness insurance
scheme.
During the first seven days of sick leave, it is up to the individual to decide whether
or not (s)he is ill and the extent to which this warrants absence from work. The
individual merely has to inform the employer that he or she is ill. As of the eighth day, a
medical certificate is required. For sick leave continuing longer than two weeks, the
employer notifies the Sickness Insurance Agency (SIA) about continuation. The SIA
sends a letter to the insured person with a form and a request for a medical certificate. In
the certificate, the doctor indicates the length and extent of sick leave that (s)he believes
is necessary. Based on the medical certificate, the SIA determines the right to sick
leave, a process that normally takes at least one to two weeks after the end of the sick-
leave period paid for by the employer. When this first sick-leave period with benefits
from the SIA has expired, a renewal certificate is issued if required. The renewal
certificate is also sent to the SIA and a new assessment of the right to sickness benefits
is made. When the renewal certificate expires and if the insured person is still sick, the
process is repeated.
Health care
The local county councils are the major financiers and providers of Swedish health care.
There are 25 county councils and each council is obliged to provide its residents with
equal access to health services and medical care. Health care is mostly financed through
local taxes. Each county council sets its own patient fees, but a national ceiling limits
the total amount that a patient pays during a 12-month period (out-of-pocket). Thus,
