OECS Reciprocal Agreement

The OECS Reciprocal Agreement was ratified in Grenada on 21st June, 1991.

Persons covered under the Agreement

Insured persons and their dependants who have worked in one or more of the following countries:

  • Antigua
  • Anguilla
  • Barbuda
  • British Virgin Island
  • Dominica
  • Grenada
  • Monstserrat
  • St.Skitts & Nevis
  • St. Lucia
  • St. Vincent & Grenadines

 

Benefits covered under the agreement

Initially, all benefits were covered. However, the Caricom Reciprocal Agreement has superseded the OECS Regulations, so only the short-term benefits apply under the OECS Agreement.

Provisions Determining the Law to be Applied

The provisions are similar those under the Caricom Reciprocal Agreement.

Claims for Long-term Benefits

Claims for Long-term benefits must be submitted to the OECS Social Security/NIS Office in the territory where the claimant normally resides, or to the office from which he/she is entitled to receive benefits. Such claims and their accompanying documents must be submitted at the time and in the manner prescribed by the law which that Institution applies.

Procedures for Processing Claims Under the Reciprocal Agreement

Upon obtaining the relevant information required for processing the claim, and having been satisfied that the claimant has met the conditions for benefit entitlement, each territory shall calculate the Notional AmountActual Amount and the Local Amount of benefit which the claimant qualifies for.

Notional Amount – This is determined by first adding the total of contributions paid in all the participating states in order to determine the corresponding payable percentage. That percentage is then multiplied by the Claimant’s relevant Average Annual Insurable Earnings.

Actual Amount – This is determined by dividing the total contributions paid in the competent state by the total of contributions paid in all the participating states, and multiplying the ration obtained by the Average Annual Insurable Earnings.

Local Amount – This is the amount of benefit which would have been paid to the claimant under the Competent State’s local laws if there was no Reciprocal Agreement.

The following is an example of how a claim under this agreement is calculated:

COUNTRY PERIOD NO. OF CONTRIBUTION AAIE NOTIONAL AMT. ACTUAL AMT. LOCAL AMOUNT
TERRITORY A 1965 – 1974 500 (30%) $15,300.00 $ 15, 300.00 $4, 357.14 $9000.00
TERRITORY B 1975 – 1984 525 (30%) $2,500.00 $12,750.00 $1250.00 $7,500.00
TERRITORY C 1983 – 1995 550 (31%) $10,000.00 $ 5,100.00 $1780.95 $3,100.00
TOTAL 1575 (51%)

(Percentage is based on legislation where the first 500 contributions is equivalent to 30% with an additional 1% for every 50 Contributions over 500)

Sickness and Maternity Benefit

Claims for Sickness and Maternity must be submitted at the prescribed time and in the prescribed manner to the institution where the claimant resides or where he/she was last subject. The claim will be processed using all relevant contribution periods, including, where necessary, relevant contributions from other participating states.

Benefits are paid by the competent state, in the territory or the participating state where the claimant resides. If however, the competent state, say Territory A, and the State of the place of residence, say, Territory B are different, cash benefits may be paid out directly by the state of residence i.e. Territory B, on behalf and at the expense of the competent institution in Territory A.

Case 1 (Based on Article 35)
Where a woman is entitled to a Maternity or Sickness Benefit from the competent institution (NIS in St. Vincent) but resides in Grenada, SVG NIS can sign an agreement with the NIS in Grenada to have the benefit paid to her and the SVG NIS would then refund this institution or she can be paid directly by SVG NIS.
Case 2 (Based on Article 37)
Where a woman was receiving a benefit from St. Vincent (Competent State) and moves to another State (St. Lucia) the benefit will continue from the Competent State or an agreement can be reached between the two, where the other State will continue the payment and be repaid by the Competent State.

It is to be assumed that the payments are calculated on the insurable earnings of the Competent State (St.Vincent) only. However, where both States’ contributions apply, e.g. in the case of Sickness Benefit, 8 contributions would be used from St. Vincent and 5 from St. Lucia.

Filing of Claims

  • If a claimant resides in a country other than the country from where he/she is entitled to receive benefits, the claim can be filed with the office in that state where he/she is resident.
  • Should an institution require a medical examination in order to settle a claim, this can be done in the country where the claimant actually resides

 

Currency in which the benefit will be paid
  • Cash benefits shall be calculated in the currency of the country where the benefit is due, however, if the claimant resides in another country where the currency is different, the benefit will be converted into the currency of this country when it is being paid (BVI is the exception; the US Currency is used in that Country.
  • If a scheme has to refund another scheme for benefits paid, the refund will be made in the currency of the scheme receiving the refund unless they have agreed among themselves to do otherwise.

 

Handling of disputes
  • If a dispute arises between two or more participating states, every effort will be made to negotiate a settlement about the issue.
  • If the dispute cannot be settled within 3 months from the date when negotiations, it will submitted to arbitration addressed to the Director of the OECS
  • A dispute for arbitration will be referred to a tribunal consisting of 3 arbitrators, one to be nominated by each party to the dispute. The 2 arbitrators shall approve the third member of the tribunal (Chairman). This person must have a legal background.