Welfare in Ventora

The welfare scheme in Ventora is the general system of social protection in the country. It covers Ventora's provision of health care, social insurance, and social assistance. It is the mechanism by which the country provides its citizens with universal health care, a variety of pensions, and welfare assistance for those in need. While such programs are often publicly funded, much of the program is privately funded in Ventora through a variety of social welfare trusts, of which there are hundreds, under the concept of capitalist benevolence.

Overview

Many of the various elements are predominantly privately funded and administered by health care trusts, social insurance trusts, or omnibus trusts which cover both health care and pension schemes. Various laws and regulations detail the requirements basic plans must meet. These include funding assessments, minimum coverages, and base benefits. Enhanced plans, which have higher assessments, may offer additional benefits, longer benefit periods, lower co-pays, and out-of-pocket caps. Employers must offer their employees a choice from among several trust plans except employers chose the unemployment and occupational wellbeing trusts. The Commonweal Commission oversees the various programs to ensure compliance with applicable laws.

Assessments paid to the trusts typically consist of the employer's contribution and the employee's subscription, both of which are a percentage of wages. Base programs have a primary rate assessed on wages up to the primary wage limit. Health care and old-age pensions are subject to assessments for wages above the primary wage limit as well. Employers do not have to contribute higher rates if an employee chooses an enhanced plan. Employers may, however, contribute more than the minimum in order to provide enhanced plans or reduced basic plan employee subscription costs, considering such as an additional perquisite.

Base trust assessment rates

Trust type	Primary annual wage limit		Primary assessment %		Excess assessment %
	Ɇ	Approx Ꝟ (2022)	Employer	Employee	Employer	Employee
Health care	296,400	54,980	11.00	5.40	0.85	0.45
Old-age pension	345,675	64,120	15.10	7.55	1.10	0.55
Sickness pension	229,450	42,560	2.45	0.95	—	—
Care leave pension	229,450	42,560	1.75	0.55	—	—
Unemployment pension	229,450	42,560	2.10	0.10	—	—
Occupational welfare	—	—	0.43 - 5.37	0.04 - 0.54	—	—

Pension trusts make the assessment payments for health care and other pensions, with the trust funding the "employer" contribution and deducting the employee subscription amount from the stipend. Individuals may suspend higher cost old-age pension schemes or make their own payments to cover the difference in cost between the base old-age pension and the higher cost plan's charges while receiving temporary pensions, such as sickness or care leave pensions. Old-age pensions need only provide for health care assessments since their pensioners do not participate in other pension schemes.

Non-occupational disability pensions and programs for disadvantaged persons to assist with housing, food, subsistence, and dependant care generally derive their funding from taxes.

Many people choose to supplement their pension programs with private-paid schemes. Such programs provide additional payments at eligibility and serve primarily to ensure a higher standard of lifestyle. Trusts exist for old-age, sickness, and disability pensions. The private purchase of survivor pension schemes is somewhat popular to ensure a person's spouse or surviving children receive a stipend in the event of the purchaser's death. There is no legal requirement for participating in private supplementation welfare programs. The majority of voluntary participants are well-to-do. Similarly, private health insurance can be purchased with benefits for medical services and devices not covered by health care trusts or to reimburse co-pay amounts, although this is not common outside of the nobility and upper class.

Main features

Social insurance

Although technically including health care, social insurance commonly refers to various pension schemes to most Ventorans. Thus, the trusts providing pensions are called social insurance trusts and trusts providing health care are called health care trusts. In each case, employers must offer at least two trusts, having different characteristics, for employees to chose from. Social insurance programs derive funding through assessments by the trusts which include employer contributions and employee subscriptions. The main difference between plans offered by trusts is whether they offer enhanced benefits, with such trusts typically being higher cost.

Health care

Main article: Health care in Ventora

Clínica Montpellier, a typical polyclinic

Ventorans enjoy universal health care, as guaranteed by the 9th stipulation of the Canon of Obligations, part of Ventora's body of constitutional law known collectively as the Fundamental Law of Ventora. Health care is paid for by a combination of employer subsidies, compulsory worker subscriptions, certain taxes, and a tiered service co-pay scheme designed to encourage personal care and responsibility for individual health conditions. Certain excise taxes, such as on alcoholic beverages, fimivrea and fimivrea products, and other unhealthful products also fund health care services.

With an emphasis on preventive care, periodic wellness examinations and vaccinations have no out-of-pocket charges. Co-pays for addressing chronic, preventable conditions, such as type 2 diabetes, certain cancers, and coronary heart disease, are still low and vary based on health care trust plan or insurance. Persons who do not sufficiently manage risky behaviors, such as smokers, are subject to higher co-pays for medical treatment attributed to such behaviors.

Access to care typically begins with a person visiting the primary care medical provider at their local polyclinic. General practice and medical specialists provide care at the polyclinic, which also houses a pharmacy, laboratories, and diagnostic testing appropriate to outpatient services. Polyclinics are also suitable for minor emergent injury or medical care while more serious emergent or definitive care occurs at hospitals or specialty medical centers.

Health care benefits include the provision of home health visits by physicians, nurses, medical assistants, and appropriate therapists or the services of suitable caregivers. These services reduce health care costs by limiting inpatient hospitalization time while ensuring suitable health care services by qualified professionals. When appropriate, health care trusts may also see to the provision of domestic assistance, such as cleaning or meal services, on a short-term basis. Dependent health care costs are factored into the assessment rates.

Most health care facilities are privately owned and operated, with about 10% operated by duchies or municipalities. All receive reimbursement for services from the various health care trusts and supplemental insurance plans. All health care trusts must cover preventive and essential medical services and equipment as listed in schedules I and II of the Catalog of Medical Care. The key differences between plans are the amounts of co-pays and out-of-pocket cap, which is income-based in basic plans.

Health care trusts also have responsibility for health care costs for non-employed Ventoran nationals. For pensioners, the health care trust receives its assessments from the pension trust. For unemployed non-pensioners, the case is assigned to a random health care trust on a rotating basis. This method ensures the universal availability of health care for all resident nationals. Although some non-residents subscribe to a health care trust, most visitors to Ventora are obliged to purchase health insurance which underwrites the costs of medical care during their stay in the country. In any case, a medical emergency will receive proper stabilizing care without consideration of the means for cost recoupment.

Old-age pension

A person becomes eligible for old-age pension at age 65 after 40 years of contributions. A reduced stipend may be drawn earlier than age 65 or with fewer years of contributions. The stipend percentage varies based on the number of contribution years. Old-age pension stipends are subject to health care contributions by the paying trust and the recipient. There is no limit on other income for old-age pension recipients except a person may not receive another pension in addition to old-age pension.

Employers must offer at least two defined benefit schemes and at least one defined contribution scheme. Employees must choose a defined benefit plan and may also participate in a defined contribution plan, if desired. Some trusts offer combined defined benefit-defined contribution plans. Upon eligibility for old-age pension, the defined benefit plan pays a monthly stipend as a percentage of the average monthly salary paid during the highest five consecutive years of employment. The base percentage is 75% but may be higher if a higher-benefit trust plan was chosen.

Employers must match at least 1%, and may match up to 10%, of defined contribution plan employee contributions. An employee who participated in a defined contribution plan may begin withdrawals from the plan as early as age 60 or may choose to defer benefits indefinitely. Defined contribution benefits are not subject to health care trust payments.

Sickness pension

The base sickness pension pays full wages for up to two weeks annually to attend medical care for illness, injury, or wellcare not related to employment and may be drawn in hourly increments. Beyond that, a weekly stipend equal to 70% of the previous employment year's weekly wages may be drawn if the person is unable to work due to non-occupational illness, injury, or medical condition not deemed permanent. The stipend may be drawn for up to 50 weeks beyond the initial two weeks per condition or until the person becomes eligible for old-age pension. Stipends are subject to old-age pension and health care assessments.

Care leave pension

A person may draw a care leave stipend to take time away from employment to for the birth or adoption of a child or to care for a dependent child (up to age 20), spouse, or elder parent (over age 75) who is sick, injured, or disabled. The base plan stipend is flexible with the maximum amount being 70% of the average of the previous employment year's wage, drawable for up to 24 weeks. A person may elect to receive a lower stipend which can then extend the length of draw beyond the full draw period. Stipends are subject to assessments to both payer and beneficiary for old-age pension and health care.

Occupational wellbeing

After the first year of employment, employees at a concern are entitled to a period of paid annual leave equivalent to double their average weekly scheduled hours. Thus, a person who normally works 20 hours per week may take 40 hours of leave and receive their regular wages, subject to their trust subscriptions. Employers have a right to schedule leave in the best interests of operational needs, but must ensure their employees have the ability to take advantage of their leave benefit.

Employers must reinstate employees upon return from compulsory service to fulfill their national service obligation or in event of a declared emergency. They must also reserve the employee's position during annual reserve duty fulfillment, including making up any underage between their duty pay and the wages typically paid by the employer. In this manner, military and other national service obligors may fulfill their duty to the state without repercussions to their civilian employment, wages, and benefits.

In addition to the eight national holidays, the duchies have a varying number of additional public holidays. For a majority of employees, holidays are non-working days for which they receive the same pay as if they had worked. Employees who must work on a holiday receive premium pay; some employers also offer a compensatory day off in lieu of the holiday.

Unemployment pension

Worker support specialists at a People's Services Agency office

Unemployment benefits may be available to workers who become under- or unemployed. The objective of the scheme is to return workers to full, gainful employment. Exclusions to eligibility include involuntary separation from employment for any the following reasons:

• Willful disobedience to lawful employer policies, standards, or instructions
• Gross and habitual neglect of duties, gross inefficiency, or abandonment
• Fraud, willful breach of trust/loss of confidence, disloyalty, dishonesty, or conflict of interest
• Commission of a crime or offense

A person who otherwise becomes unemployed may draw a stipend in an amount up to 75% of their average weekly employment wage during the previous employment year provided they are either seeking new employment or are engaged in a retraining program in coordination with the People's Services Agency. The underemployed stipend is an amount equal to the unemployed stiped reduced by the partial employment wages. The maximum benefit period is 100 weeks. The benefit period is reduced by 1/12th for each month under a full year of employment. Stipend payments are subject to old-age and health care trust assessments by the payer and recipient. The unemployment pension is withdrawn if the recipient becomes eligible for any other pension.

In addition to the stipend, un- and underemployed persons may participate in retraining with the cost borne by the unemployment pension trust up to the same 100 week stipend duration. The training must be in a skill with jobs on offer in proximity to the beneficiary's residence. In similar fashion, the unemployment pension trust will reimburse stipend recipients for travel to attend employment interviews for positions for which they qualify. The unemployment trust will also provide a relocation stipend for persons who move to accept a permanent position. The amount of the relocation stipend depends on distance and family size, not to exceed 50,000 Ɇ (Template:Cur-vad9,700 in 2020).

Accident pension

Some occupations have higher injury risks than others

Dating from the beginning of the 20th century, costs for work-related injuries and illnesses fell entirely upon employers. Initially costs only included medical expenses with provisions for lost wages and then retraining as later additions. In 1980, the law was changed to provide an incentive for laborers to work safely. In this regard, employees contribute 10% of the plan assessment. Officially known as occupational welfare programs, they are more commonly referred to as accident pensions. Assessments for occupational welfare trusts vary based on an employer's injury rates during the previous five years and the workplace's occupational hazards. Industries and employers with increased risk have higher assessments to offset their higher claims experiences.

Occupational welfare trusts see to the costs of work-related injury or illness medical costs, rehabilitation and retraining, and stipends to compensate for lost wages. There is no limit on the duration of benefits except stipends for lost wages cease when the recipient becomes eligible for their old-age pension. The lost wage stipend equals 100% of the worker's previous year's average wage. If a worker is able to return to partial employment, the lost wage stipend is reduced by the amount of wages earned in the partial employment. The occupational welfare trust makes contributions and deducts subscription amounts from lost wage stipends for old-age pension and health care trusts.

As with under- and unemployment programs, occupational welfare has the objective of returning the worker to gainful employment. Rehabilitation, retraining, and support for relocation may all be components in the plan to achieve the full employment objective. Accident pension benefits cease when the worker returns to full employment.

To assist in providing a safe workplace, employers may consult with the Workplace Support Service (Ventoran: Servicio de Soporte de Lugar de Trabajo, SSLT) at no charge. The Safety Inquiry Board (Junta de Consulta de Fideicomiso, JCF), an independent government agency, investigates workplace accidents and occupational illness cases. The JCF has the authority to assess punitive damages against employers found to be negligent or otherwise culpable for worker injuries, illness, or fatalities.

Social assistance

Funded by taxes and considered non-contributory programs, social welfare programs provide basic support for disadvantaged persons not eligible for social insurance benefits or whose social insurance benefits are insufficient. Duchies administer the programs and determine benefit eligibility, which is typically based on a percentage of the individual's basic needs amount (cantidad de necesidades básicas, CNB). To facilitate access, social assistance may be applied for at People's Services Agency locations with the appropriate duchy(ies) providing needed manpower to facilitate applications.

Disability pension

If a person is permanently disabled by a non-occupational injury, illness, or permanent medical, physical, or mental condition, they may be eligible for disability pension stipends once any sickness pension benefits have been exhausted. The disability pension stipend is 100% of the CNB for persons with no other income and is reduced if the individual has other income. A person with income double the CNB is not eligible for a disability pension. The pension also covers assessments for a standard health care trust to provide for access to health care and any necessary home health care and caregiver visits as may be deemed necessary based on the nature of the disability. The individual may eligible for additional assistance in obtaining specialized transport, vehicle modifications, and other accommodations such as residential alterations to enhance independent living. The stipend is suspended or withdrawn for persons who are resident in a medical care facility since their basic needs are met by the facility. For disabilities resulting from a work-related condition, the accident pension applies rather than the disability pension.

Housing assistance

The 10th stipulation to the Canon of Obligations defines housing as a basic human right in Ventora. On this basis, if a person is unable to afford basic housing in an area, the housing assistance scheme will see to subsidizing the individual's housing payments. Housing assistance payments are made directly to the landlord. Housing costs in the locality as well as the individual's income from all sources compared to the region's CNB determine amount of the housing assistance stipend. Generally, eligibility is limited to persons with incomes not exceeding 110% of the CNB. While the housing stipend usually applies to subsidizing rental payments, it may also be applied to mortgage payments for a primary residence in which the beneficiary resides.

Food assistance

Food assistance stored value card, c. 1990s

Like housing, the 10th stipulation also includes access to adequate food as a basic human right. Food assistance may, therefore, be available to persons with incomes below the CNB. Families with children where the household income is at or below 110% of the CNB, as well as pregnant women in households with incomes below 125% of the CNB, may also receive nutrition assistance. The value of assistance, which may be used at grocers, food markets, and food stalls at community markets for vegetables, fruits, meats, and dairy products, varies by region. Foodstuffs considered unhealthy, such as snack foods, processed meats, and sweetened beverages, are excluded. The cost of food in comparison to all basic needs determines the maximum stipend available for a locality. The maximum stipend is modified by factoring in the individual's income from all sources and varies based on household size.

Food assistance benefits may be attached to any Ventoran financial institution account. In this manner, the food assistance program applies applicable funds to authorized foodstuffs while other purchases are charged to the customer's payment medium. This option requires participants to connect their banking account to the subsidy system and was developed to reduce social stigma for beneficiaries. It was introduced in 2001 with the deployment of the Universal Services Card (Tarjeta de Servicios Universalis, TSU) smart card and the elimination of the previous stored-value card which had been in use since the late 1960s. Alternatively, beneficiaries may use their TSU to access benefits and then pay for non-covered items in their preferred method, such as cash or a bank card. In either case, the benefit value is automatically adjusted at the start of each benefit period, typically a calendar month. Unused benefits from the previous month carry over to the current month but do not extend to the succeeding month.

Caregiver assistance

A person whose income from all sources is below the CNB for the family size may be eligible for caregiver assistance if they have dependents who are not able to care for themselves. The stipend amounts to the difference between the family income and the CNB attributable to dependents below the age of 20 or over the age of 70 to assist with care of children or elderly parents. For households in which a disabled person resides and for which income is less than 110% of the CNB, the caregiver assistance program provides a stipend paid to caregivers, thereby reducing the cost to the disabled person's family. The stipend may also be used to reduce costs of domestic helpers needed to assist disabled persons with household chores, especially if such services avoid higher costs, such as hospitalization or enrollment in disability pension.

Applications for caregiver assistance are more likely to be approved in cases where the individual will be relatively self-sufficient with the stipend, thereby avoiding more costly care settings. The program seeks to ensure disabled persons have adequate access to society while also encouraging their ability to take advantage of social programs and systems in their communities.

Dependent assistance

A person whose income from all sources is below the CNB for the family size may be eligible for dependent assistance. The stipend amounts to the difference between the family income and the CNB attributable to dependents below the age of 20 or over the age of 70 to assist with care of children or elderly parents. Dependent assistance is different from caregiver assistance in that it does not necessitate specialized care for the covered dependent. The intent is allow dependents to be supported by their families while ensuring they have adequate resources to live satisfying lifestyles.

Welfare fraud

File:Vigilantes fiscales auto.jpg

Fiscal Watchmen Corps car in Benifato, xxx

Social insurances (pension programs) enjoy low rates of fraud, likely due to their participatory nature and the correlation between rates and payouts. Efforts have been undertaken to reduce assistance program fraud through payments directly to providers, such as landlords or caregivers, wherever feasible. Food assistance fraud is managed fairly well by linking the benefit to a financial institution account. Implementation of the TSU as the means for accessing most social assistance programs has had a substantial impact on reducing welfare fraud.

Unfortunately, even with sound control measures in place, cases do occur where persons may claim benefits they are not entitled to or benefits may be denied to persons entitled to them. The Fiscal Watchmen Corps investigate all such cases and have a 95% conviction rate for substantiated violations of laws and procedures.

Controversies

The shear volume of more than 212 social insurance trusts makes choosing the best program difficult for most people. Some trusts operate across all programs while others only manage funds for certain schemes, such as old-age pensions or health care. Further complicating matters, some trusts pool their funds across programs while others separate funds only for specific programs. Many employers participate with only a dozen or so trusts which serves to limit the choices of their employees. Many people believe the social insurance system is too complex with too many options while, at the same time, complaining that choices are limited by what is on offer from their employer. Despite this, most workers are satisfied with the benefits provided by social insurance.

For people needing social assistance, many view the application process as arduous. Already a marginalized population due to their low socioeconomic status, many recipients of social assistance feel the program provides inadequate benefits. An expose in Crónicas (lit Chronicles) found benefit amounts rarely brought recipients in line with CNB amounts for their family size and locality. The magazine claims 92% of recipients live at or below 84.5% of CNB even with social assistance. The magazine did attributed some blame to the manner in which CNB is determined by the duchies. As a result, some urban areas have lower CNBs due to being considered along with rural areas that have lower costs. Beneficiaries in these areas, therefore, live below the poverty line, sometimes by considerable amounts. Despite this allegation, no changes have been made in the laws, regulations, or methods for determining benefits and the actual CNB for particular regions.

Although less pronounced, private supplementation is a concern in that persons with means can purchase private health insurance or supplement their pension programs with private-paid schemes. These may or may not incorporate employer contributions, depending on the trust and the firm concerned. Such programs provide additional payments at eligibility and serve primarily to ensure a higher standard of lifestyle. Trusts exist for old-age, sickness, and disability pensions. The private purchase of survivor pension schemes is somewhat popular to ensure a person's spouse or surviving children receive a stipend in the event of the purchaser's death. Nonetheless, the majority of voluntary supplementary program participants are well-to-do.

See also

• Capitalist benevolence
• Health care in Ventora
• Social welfare trust