v. 19/12/2018 Provisions in proposal related to: Long-term care benefits - Plain text: text of the original Regulations (EC) No. 883/2004 and No. 987/2009; - Bold: proposals of the Commission (2016/0397 (COD)) compared to the original Regulations; - Bold underlined italic: amendments proposed by the European Parliament (PE612058v03-00EN); - Bold underlined: amendments proposed by the Council (ST 10295/18); - Some rows where none of the institutions have made amendments have been inserted for information purposes only. Rows              Commission proposal                 EP Amendments                         Council Position         Comments 1.                                                                   Regulation 883/2004 2.                                                                         Recital 20 3.       (20) In the field of sickness,     (20) In the field of sickness,      (20) In the field of sickness, maternity and equivalent           long-term care, maternity and maternity and equivalent paternity benefits, insured        equivalent paternity benefits,      paternity benefits, insured persons, as well as the members    insured persons, as well as the persons, as well as the members of their families, living or       members of their families,          of their families, living or staying in a Member State other    living or staying in a Member       staying in a Member State other than the competent Member          State other than the competent than the competent Member State, should be afforded          Member State, should be             State, should be afforded protection.                        afforded protection.                protection. AM 45 4.                                                                         Recital 24 5.       (24) Long-term care benefits       (24) In accordance with the         (24) In line with the case law of for insured persons and            case-law of the Court of            the Court of Justice long-term members of their families need     Justice of the European             care benefits for insured to be coordinated according to     Union, long-term care               persons and members of their specific rules which, in           benefits for insured persons        families need should, in principle, follow the rules        and members of their                principle, continue to be applicable to sickness benefits,   families should, in principle,      coordinated according to in line with the case law of the   continue to be coordinated          specific rules which, in Court of Justice. It is also       following the rules applicable principle, follow following the 1

v. 19/12/2018 Rows      Commission proposal              EP Amendments                    Council Position         Comments necessary to provide for       to sickness benefits. However, rules applicable to sickness specific provisions in case of those rules should take into   benefits, in line with the case overlapping of long-term care  account the specific nature of law of the Court of Justice. benefits in kind and in cash.  long-term care benefits. It is However, these rules should also necessary to provide for  take into account the specific specific provisions in case of nature of long term care overlapping of long-term       benefits. It is also necessary to care benefits in kind and in   provide for specific provisions cash.                          in case of overlapping of long- term care benefits in kind and AM 46                          in cash. 6.                                                               Recital 24a (new) 7.                                                               (24a) Long-term care benefits refer only to those benefits which have the primary purpose of addressing the care need of a person, who on account of impairment due to, for example, old age, disability or illness, requires considerable assistance from others to carry out essential activities of daily living for an extended period of time. Moreover, long-term care benefits refer only to those benefits which can be considered as social security benefits within the meaning of the Regulation. In line with the case law of the Court of Justice in, for example, Case C- 2

v. 19/12/2018 Rows  Commission proposal        EP Amendments                     Council Position        Comments 433/13, Commission v Slovak Republic, social security benefits are those benefits granted without any individual and discretionary assessment of personal needs to beneficiaries on the basis of a legally defined position and long-term care benefits should be interpreted accordingly. In particular, long-term care benefits do not include social or medical assistance. Benefits granted on a discretionary basis, after an individual assessment of the claimant's personal needs, are not long- term care benefits covered by this Regulation. 8.                      Recital 48d (new) 9.                      (48d) Nothing in this Regulation limits the independent rights and obligations recognised in the Council of Europe Convention on Social and Medical Assistance in the Member States concerned. AM 54 10.                                                 Article 1 Definitions 3

v. 19/12/2018 Rows        Commission proposal                     EP Amendments                      Council Position            Comments 11. (c) 'insured person', in relation to (c) 'insured person', in relation  (c) 'insured person', in relation to the social security branches         to the social security branches    the social security branches covered by Title III, Chapters 1,    covered by Title III, Chapters     covered by Title III, Chapters 1, 1a and 3, means any person           1, […] and 3, means any            1a and 3, means any person satisfying the conditions            person satisfying the              satisfying the conditions required under the legislation of    conditions required under the      required under the legislation of the Member State competent           legislation of the Member State    the Member State competent under Title II to have the right to  competent under Title II to        under Title II to have the right to benefits, taking into account the    have the right to benefits, for    benefits, taking into account the provisions of this Regulation;       at least one of the risks          provisions of this Regulation; covered by the Chapter which is to be applied, taking into account the provisions of this Regulation; AM 56 and 57 12. (i)(1)(ii) with regard to benefits   (i)(1)(ii) with regard to benefits (i)(1)(ii) with regard to benefits in kind pursuant to Title III,       in kind pursuant to Title III,     in kind pursuant to Title III, Chapter 1 on sickness, maternity     Chapter 1 on sickness, long-       Chapter 1 on sickness, maternity and equivalent paternity benefits    term care, maternity and           and equivalent paternity benefits and Chapter 1a on long-term          equivalent paternity benefits      and Chapter 1a on long-term care benefits, any person            […], any person defined or         care benefits, any person defined or recognised as a           recognised as a member of the      defined or recognised as a member of the family or              family or designated as a          member of the family or designated as a member of the        member of the household by         designated as a member of the household by the legislation of      the legislation of the Member      household by the legislation of the Member State in which            State in which he/she resides;     the Member State in which he/she resides;                                                         he/she resides; AM 58 and 59 13. (va) 'Benefits in kind' means:       (va) 'Benefits in kind' means:     (va) 'Benefits in kind' means: (i) for the purposes of Title III,   (i) for the purposes of Title III, (i) for the purposes of Title III, Chapter 1 (sickness, maternity       Chapter 1 (sickness, maternity     Chapter 1with regard to 4

v. 19/12/2018 Rows       Commission proposal                 EP Amendments                      Council Position        Comments and equivalent paternity         and equivalent paternity          sickness, maternity and benefits) and Chapter 1a (long-  benefits) […] benefits in kind    equivalent paternity benefits, term care benefits), benefits in provided for under the            and Chapter 1a (long-term kind provided for under the      legislation of a Member State     care benefits), benefits in kind legislation of a Member State    which are intended to supply,     provided for under the which are intended to supply,    make available, pay directly or   legislation of a Member State make available, pay directly or  reimburse the cost of medical     which are intended to supply, reimburse the cost of medical    care and products and services    make available, pay directly or care and products and services   ancillary to that care. This also reimburse the cost of medical ancillary to that care […];      includes long-term care           care and products and services benefits in kind provided for     ancillary to that care. under the legislation of a Member State which are            (-ii) for the purposes of Title intended to supply, make          III, Chapter 1 with regard to available, pay directly or        long-term care benefits, reimburse the cost of long-       benefits in kind provided for term care.                        under the legislation of a Member State which are AM 60 and 61                      intended to supply, make available, pay directly or reimburse the cost of long- term care as referred to in the definition under point (vb). 14. (vb)(new) "long-term care        (vb) “long-term care benefit”     (vb) 'Long-term care benefit' benefit" means any benefit in    means a benefit in kind or in     means a benefit in kind or in kind, cash or a combination of   cash the purpose of which is      cash the purpose of which is to both for persons who, over an    to address the care or support    address the care need of a extended period of time, on      needs of a person who, on         person who, on account of account of old-age, disability,  account of old age, disability,   impairment, requires illness or impairment, require   illness or impairment,            considerable assistance from considerable assistance from     requires assistance from          another person or persons to another person or persons to     another person or persons to      carry out essential […] 5

v. 19/12/2018 Rows       Commission proposal                 EP Amendments                       Council Position          Comments carry out essential daily        carry out their essential           activities of daily living for an activities, including to support activities of daily living for an   extended period of time in their personal autonomy; this    extended period of time in          order to support his/her includes benefits granted to or  order to support their              personal autonomy; this for the person providing such    personal autonomy, including        includes benefits granted for assistance;                      in a workplace; this includes       the same purpose to the person benefits granted for the same       providing such assistance. purpose to the person or persons providing such assistance; AM 62 15.                                  (vba) "continuation of treatment" means the continued investigation, diagnosis and treatment of an illness for its entire duration; AM 63 16.                                  (vbb) "continuation of long- term care" means the continued granting of long- term care benefits in kind due to the need of care which was established before retirement and which continues beyond that date. AM 64 17.                                                                 Article 3 Matters covered 6

v. 19/12/2018 Rows        Commission proposal                  EP Amendments                      Council Position                    Comments 18. 1. This Regulation shall apply to  1. This Regulation shall apply    1. This Regulation shall apply to  No proposals, for information all legislation concerning the     to all legislation concerning the all legislation concerning the     purposes only. following branches of social       following branches of social      following branches of social security:                          security:                         security: 19. (a) sickness benefits;             (a) sickness and long-term        (a) sickness and long-term care    EP and CL - same position care benefits;                    benefits; AM 65 20. 1.(ba) (new) long-term care […]                                      (ba) (new)       long-term    care EP and CL - same position benefits;                                                            benefits; AM 66 21.                                                                 Article 11 General rules 22. 2. For the purposes of this Title, 2. For the purposes of this       2. For the purposes of this Title, persons receiving cash benefits    Title, persons receiving cash     persons receiving cash benefits because or as a consequence of     benefits because or as a          because or as a consequence of their activity as an employed or   consequence of their activity as their activity as an employed or self-employed person shall be      an employed or self-employed self-employed person shall be considered to be pursuing the      person shall be considered to     considered to be pursuing the said activity. This shall not      be pursuing the said activity.    said activity. This shall not apply to invalidity, old-age or    This shall not apply to           apply to invalidity, old-age or survivors' pensions or to          invalidity, old-age or            survivors' pensions or to, to pensions in respect of accidents   survivors’ pensions, to           pensions in respect of accidents at work or occupational diseases pensions in respect of accidents at work or occupational diseases or to long-term care benefits in at work or occupational             or to long-term care benefits in cash.                              diseases, […] to sickness         cash provided to the person in benefits in cash covering         need of care. treatment for an unlimited period, or to long-term care benefits in cash to which a person in need of care is entitled. 7

v. 19/12/2018 Rows        Commission proposal                   EP Amendments                          Council Position                    Comments AM 68 and 69 23.                                                               Title III, Chapter 1 24. Sickness, maternity and             Sickness, long-term care,             Sickness, long-term care,           EP and CL - same position equivalent paternity benefits       maternity and equivalent              maternity and equivalent paternity benefits                    paternity benefits AM 77 25.                                                                    Article 19 Stay outside the competent Member State 26. 1. Unless otherwise provided for 1. Unless otherwise provided             1. Unless otherwise provided for No COM proposal, contains EP by paragraph 2, an insured          for by paragraph 2, an insured        by paragraph 2, an insured          and CL amendments person and the members of           person and the members of his person and the members of his/her family staying in a         or her family staying in a            his/her family staying in a Member State other than the         Member State other than the           Member State other than the competent Member State shall        competent Member State shall competent Member State shall be entitled to the benefits in kind be entitled to the benefits in        be entitled to the benefits in kind which become necessary on           kind which become necessary           which become necessary during medical grounds during their        on either medical grounds or          their stay either on medical stay, taking into account the       due to the need for long-term         grounds or due to the need for nature of the benefits and the      care during their stay, taking        long-term care, taking into expected length of the stay.        into account the nature of the        account the nature of the These benefits shall be provided benefits and the expected                benefits and the expected length on behalf of the competent          length of the stay. These             of the stay. These benefits shall institution by the institution of   benefits shall be provided on         be provided on behalf of the the place of stay, in accordance    behalf of the competent               competent institution by the with the provisions of the          institution by the institution of institution of the place of stay, in legislation it applies, as though   the place of stay, in accordance accordance with the provisions the persons concerned were          with the provisions of the            of the legislation it applies, as insured under the said              legislation it applies, as though though the persons concerned legislation.                        the persons concerned were            were insured under the said legislation. 8

v. 19/12/2018 Rows        Commission proposal                 EP Amendments                    Council Position                    Comments insured under the said legislation. AM 78 27.                                                                   Benefits in kind, including those in conjunction with chronic or existing illnesses, childbirth or long-term care, are not covered by this Article when the objective of the stay in another Member State is to receive these benefits. 28. 2. The Administrative             2. The Administrative           2. The Administrative              No COM proposal, contains EP Commission shall establish a list Commission shall establish a    Commission shall establish a list  and CL amendments of benefits in kind which, in     list of benefits in kind which, of benefits in kind which, in      EP and CL - same position order to be provided during a     in order to be provided during  order to be provided during a stay in another Member State,     a stay in another Member        stay in another Member State, require for practical reasons a   State, require for practical    require for practical reasons a prior agreement between the       reasons a prior agreement       prior agreement between the person concerned and the          between the person concerned    person concerned and the institution providing the care.   and the institution providing   institution providing the benefit. the benefit. AM 78 29.             Article 20                        Article 20                      Article 20             No COM or CL proposal, Travel with the purpose of       Travel with the purpose of       Travel with the purpose of     contains EP amendment receiving benefits in kind -     receiving benefits in kind —     receiving benefits in kind - Authorisation to receive          Authorisation to receive        Authorisation to receive appropriate treatment outside the     appropriate treatment and   appropriate treatment outside the Member State of residence         long-term care outside the      Member State of residence Member State of residence 9

v. 19/12/2018 Rows        Commission proposal                    EP Amendments                      Council Position                      Comments AM 79 30. 1. Unless otherwise provided for     1. Unless otherwise provided      1. Unless otherwise provided for     No COM or EP proposal, by this Regulation, an insured       for by this Regulation, an        by this Regulation, an insured       contains CL amendment person travelling to another         insured person travelling to      person travelling to another Member State with the purpose        another Member State with the     Member State with the purpose of receiving benefits in kind        purpose of receiving benefits in  of receiving, during the stay, during the stay shall seek           kind during the stay shall seek   benefits in kind referred to in authorisation from the               authorisation from the            Article 1(va) (i) of this competent institution.               competent institution.            Regulation, shall seek authorisation from the competent institution. 31. 2. An insured person who is          2. An insured person who is       2. An insured person who is          No COM or CL proposal, authorised by the competent          authorised by the competent       authorised by the competent          contains EP amendment institution to go to another         institution to go to another      institution to go to another Member State with the purpose        Member State with the purpose     Member State with the purpose of receiving the treatment           of receiving the treatment or     of receiving the treatment appropriate to his/her condition     long-term care appropriate to     appropriate to his/her condition shall receive the benefits in kind   his or her condition shall        shall receive the benefits in kind provided, on behalf of the           receive the benefits in kind      provided, on behalf of the competent institution, by the        provided, on behalf of the        competent institution, by the institution of the place of stay, in competent institution, by the     institution of the place of stay, in accordance with the provisions       institution of the place of stay, accordance with the provisions of the legislation it applies, as    in accordance with the            of the legislation it applies, as though he/she were insured           provisions of the legislation it  though he/she were insured under the said legislation. The      applies, as though he or she      under the said legislation. The authorisation shall be accorded      were insured under the said       authorisation shall be accorded where the treatment in question      legislation. The authorisation    where the treatment in question is among the benefits provided       shall be accorded where the       is among the benefits provided for by the legislation in the        treatment or long-term care in    for by the legislation in the Member State where the person        question is among the benefits    Member State where the person concerned resides and where          provided for by the legislation   concerned resides and where he/she cannot be given such          in the Member State where the     he/she cannot be given such 10