NIS Fulfilling Mandate Through Social Insurance Benefits

The National Insurance Scheme (NIS) was established to safeguard contributors and their dependents through the provision of social insurance benefits to those who meet the required eligibility criteria.

Today, this mandate is being actively fulfilled, with approximately 140,000 pensions and other benefits disbursed.

These include retirement, invalidity, widows’ and widowers’ pensions, survivor pensions for children, health insurance, maternity allowance, a comprehensive range of employment injury benefits, and funeral grants.

For a retirement pension, a contributor must reach the retirement age stipulated in the National Insurance Act and satisfy the prescribed contribution requirements.

“So a contributor has to be at least 65 years old. However, four months prior to attaining age 65, persons can apply for the retirement pension, provided the contributor has stopped working.

Having met this qualifying criterion, we then look at your contributions during your employment,” Director of the NIS in the Ministry of Labour and Social Security, Portia Magnus, tells JIS News.

She also outlined the method used to calculate the retirement pension.

“We add up your contributions, and [combine] that with what we call the insurable period. The insurable period, as explained in our legislation, will be the point from which you are able to begin contributing which is 18 all the way up to retirement,” the Director explains.

“So, let’s use 65 as a start, because that’s the age when you can first start receiving your retirement pension… we would be looking at the number of weeks contributions you would have made, and we are going to now compare that with your insurable period… and the result of that will determine the rate of pension you are awarded,” she adds.

An invalidity pension is granted to a contributor who has not yet reached age 65 but suffers from a permanent medical condition that prevents them from working.

“Somebody could have a massive stroke, or cancer, and can’t work anymore. So there are different types of illnesses basically preventing persons from working… but those two would be common ones that persons can understand. So here now it is age, it is illness in the next instance and also you have a medical component,” Ms. Magnus says.

“The information you supply to us coming from your doctor would then go to the doctors employed by the NIS and they would determine and advise us whether or not that medical condition prevents that applicant from working… and then this pension is paid for life as well,” she further states.

Additionally, a maternity allowance is available to domestic workers who meet the qualifying conditions. This benefit is paid as a lump sum, equivalent to eight weeks at the existing National Minimum Wage.

For underage surviving children of NIS contributors, two benefits are available under the scheme: the Special Child Benefit and the Orphan Benefit.

In the case of the Special Child Benefit, this is payable to the guardian of a child or children under 18 whose mother is deceased and whose father’s whereabouts are unknown. Eligibility for this benefit is determined by the mother’s contribution record.

“To access all the benefits provided by the NIS, an application form is needed along with supporting documents, which are stated on the form. So in this case, for a special child, the guardian will complete the application form, we will look at the contributions of the mother to determine whether or not at the point of death, she satisfied the contributions conditions and then that benefit would be paid up to the 18th birthday of that child,” Ms. Magnus explains.

If the requirements for the Special Child Benefit are not met, a one off grant is provided to the guardian of the child.

“In the case of an orphan… where both parents of the child are now deceased… we look at the contributions of the mother and the father, and use either to determine eligibility. So whoever has enough contributions to satisfy the requirement, then we use their contributions… similar to the Special Child Benefit, to determine eligibility; that is paid up to the child’s 18th birthday. It doesn’t matter how many children… a benefit is paid for each child up to the age of 18, and it’s paid to the guardian,” the Director states.

Ms. Magnus tells JIS News that a benefit is also available to the surviving spouse of an NIS contributor.

“If your partner is not yet at the age of 65, then we do the calculation to determine eligibility to be awarded a pension. Once the person passing away satisfies the contribution conditions, then the surviving spouse gets the widows pension or the widower’s pension,” she explains.

The duration of the pension payment is determined by several factors, including the age of the surviving spouse.

“So if the surviving spouse is younger than 55 years and there are no children at all younger than 18 years old, then that may be paid for one year. If the surviving spouse, however, has a medical condition, now it is different. Other factors will come into play to determine how long that pension is to be paid,” the Director informs.

“If you have children, again, younger than 18 and the child becomes 18 before the surviving spouse attains the age of 55, then the pension will stop at that point. However, if the surviving spouse attains the age of 55 before the child becomes 18, then that pension is paid for life. So in terms of the widow/widower’s pension, there are some nuances,” she adds.

Meanwhile, individuals who qualify for an NIS pension automatically become eligible for NI Gold health insurance.

“We make the arrangements here for you… you don’t need to do anything. Once you qualify to receive a pension, you automatically get health insurance as well… and we mail the NI Gold card out to the pensioners. Health insurance from the NIS is only applicable in Jamaica; so this cannot be used in any other country,” Ms. Magnus states.

The Director explains that NI Gold is a comprehensive insurance plan covering dental care, laboratory services, X rays, and prescribed medication.

“When NIS was being created, and looking at the types of benefits to be provided… the qualifying conditions and so on were taken into account in terms of contributions going to support the benefits that are going to be paid,” Ms. Magnus says.

“NI Gold was an additional benefit included… because there was no health insurance for pensioners at the time. So the intention was to ensure that, not only do pensioners have this money coming to support them, but also to provide health insurance, knowing that, as you age [there are] different medical conditions persons can be faced with,” she adds.

The Director further advises that no additional premiums are required for NI Gold Health Insurance.

Meanwhile, Ms. Magnus explains that a funeral grant is awarded upon the death of a contributor, a pensioner, or their spouse.

“So, similar to other benefits, if the person is a contributor when they pass away, we look at the contributions to see if they satisfy the qualifying conditions. Once they do, the persons who pay the funeral expenses are paid the grant,” she says.

It is also possible for an NIS contributor to be approved for a funeral grant on behalf of their spouse, in the event that the spouse – who was not a contributor – passes away.

“Say a spouse dies, and it’s not that individual who contributed to the NIS, we look at whether or not the contribution of the other spouse is adequate. If they have met it, we treat it just as if it is the person who died. So once you are the spouse of the contributor to the NIS and your spouse meets the qualifying condition, then the funeral grant can be made available as well, arising from that death, and paid to the person who has covered the funeral expense,” the Director states.

In terms of a pensioner dying, then the qualifying conditions in terms of contributions would have already been met. Similarly, the funeral grant is always paid to the person who covered the funeral expenses.

“Now what is important, in terms of the funeral grant, is that the application must be submitted within one year of the date of death. Any time outside of that period of time, [the application] is considered late… and it is, therefore, not paid. So even if it’s one day after the one year, it is late. So within one year of the date of death, the application has to come in,” Ms. Magnus emphasises.

For more information about the NIS and its benefits, visit the Ministry of Labour and Social Security’s website at mlss.gov.jm or call 876-922-8000-13.