Details of the employer

*Mandatory fields

Details of the employee

Title
Is the insured fully capable of working or gainful employment? A person is considered to be unable to work if he or she is no longer able to work in his or her current occupation due to ill health. The degree of incapacity for work is determined by the physician. A person is considered to be unable to earn if, due to ill health, he or she is no longer able to engage in gainful employment in any section of the labour market to which consideration could be given. The degree of disability is determined exclusively on the basis of the degree of incapacity for gainful employment. This is determined by the DI office.

Please note: Insurance cover can only continue beyond statutory retirement age if the employee is fully capable of working or gainful employment.

*Mandatory fields

Registration for insurance cover to continue beyond retirement age

Annual salary and degree of employment before statutory retirement age

Annual salary and degree of employmentafter statutory retirement age

Please note: As the employee will be reducing his/her degree of employment when he/she starts to benefit from insurance cover continuing beyond retirement age, he/she has the option of taking the difference as a retirement benefit.

Would the employee like to take the reduction in the number of hours worked as a retirement benefit (semi-retirement)?

Conditions for insurance cover to continue beyond retirement age

Insurance cover can continue beyond retirement age if the insured person

  • has reached statutory retirement age (64 for women and 65 for men: and
  • is continuing to work for his/her current employer and is receiving a higher annual salary than the entry threshold defined in the regulations and
  • is fully capable of working or gainful employment at the time of registration
  • submits this form at least one month before reaching statutory retirement age.

Confirmation

This registration was entered by

Note: Please give your employee the «Information sheet on continuing insurance after retirement age».

Note: Please give your employee the "Information sheet on continuing insurance after retirement age".

*Mandatory fields

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