EsSalud: continuidad de las prestaciones de salud a los trabajadores en suspensión perfecta de labores
Author | Cristina Oviedo/Brian Ávalos/Martín Ruggiero |
Position | Consejera/Asociado/Asociado |
El día 9 de mayo de 2020 se publicó la Resolución de Gerencia General 576-GG-ESSALUD-2020, que aprobó la Directiva de Gerencia General 10-GCSPE-ESSALUD-2020, Disposiciones complementarias para la implementación de la continuidad de las prestaciones de salud a los trabajadores en suspensión perfecta de labores. En ese sentido, se ha establecido lo siguiente:
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Alcance. Trabajadores comprendidos en una suspensión perfecta de labores que no cuenten con los aportes mínimos establecidos en el artículo 11 de la Ley 26790 y a quienes por aplicación de dicho artículo hubieran accedido sólo a la prestación por el periodo de 2 meses. Dicha cobertura especial incluye a sus derechohabientes.
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Condiciones para el otorgamiento de la continuidad de las prestaciones de salud. El trabajador deberá cumplir con las siguientes condiciones:
- El trabajador de encontrarse en periodo de carencia.
- No alcanzar los 5 meses de aportación que les permita obtener el beneficio de 2 meses de cobertura por latencia, superado el periodo de carencia.
- Contar con 5 y menos de 10 meses de aportación, con lo cual les corresponde 2 meses de cobertura por latencia.
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Cobertura por continuidad de las prestaciones de salud
Aspecto Detalle Trabajadores en periodo de carencia y sus derechohabientes Desde la fecha de inicio hasta la finalización de la suspensión perfecta de labores presentada por el empleador Trabajadores que han superado el periodo de carenciay cuentan con menos de 5 meses de aportación Desde la fecha en que pierden su cobertura, hasta la finalización de la suspensión perfecta de labores Trabajadores que cuentan con 5 y menos de 10 meses de aportación y sus derechohabientes Trabajadores que cuentan con 5 y menos de 10 meses de aportación y sus derechohabientes La cobertura de continuidad de las prestaciones de salud comprende el plan específico de EsSalud (PEAS y exceso al PEAS).
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Solicitudes de suspensiones perfectas denegadas. En el caso que la Autoridad Competente deje sin efecto la suspensión perfecta y se hubieran otorgado prestaciones de salud a los trabajadores involucrados y sus derechohabientes, EsSalud exigirá a la entidad empleadora, el reembolso del monto de las prestaciones brindadas.
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