Co-insured status for CASS: who qualifies after the 2025 reform

For years, a family member without income could be covered for health care “on the back of” a relative — the co-insured (coasigurat) status. The 2025 reform sharply narrowed this possibility. For employers and for employees with dependants, it matters to know what is left of co-insurance and what has changed.

What CASS is and what it covers

CASS (contribuția de asigurări sociale de sănătate — the health insurance contribution), at a rate of 10%, gives the right to services in the public health system. Whoever contributes — directly or through a recognised title — is insured; whoever does not risks being uninsured and having to pay retroactively to regain that status.

Insured vs. co-insured

• The insured person has a title of their own: salary (CASS withheld at source), a pension above the threshold, independent activity with CASS paid, and so on.
• The co-insured person was, under the old logic, someone without income of their own who benefited from cover on the basis of a relative’s insurance.

The 2025 reform (Legea 141/2025, in force from 1 August 2025, with amendments to Legea 95/2006 and to the Fiscal Code) changed this mechanism: co-insurance without contribution was essentially abolished — existing co-insured persons kept their insured status only until 1 September 2025. Anyone who no longer has a title of their own must, as a rule, pay their CASS individually.

Who pays or withholds CASS

After the reform, the obligation is distributed as follows:

• employees — CASS of 10% withheld at source by the employer;
• PFA / independent activities, rent, investments — CASS declared and paid individually;
• pensioners — CASS only on the part of the pension above the 3,000 lei threshold;
• people without income who wish to be insured — individual payment of CASS, under the conditions set by law.

The conditions for the co-insured status that remains

Where co-insurance is still possible, the conditions are strict and cumulative. As a rule they cover only certain degrees of kinship (spouse and dependent parents), with income ceilings and other requirements. It is no longer a general umbrella for any family member without income.

Exempt categories

Certain categories are insured without payment, by operation of law (Legea 95/2006 and related acts): children, pupils and students under the conditions set by law, pregnant women, people with certain conditions included in national programmes, and people with disabilities under the prescribed conditions. The exemption is not automatic in every situation — it applies on the basis of the legal classification.

How it is declared

For those without withholding at source, CASS is declared through the single tax return (declarația unică, D212) filed with ANAF (the Romanian tax authority), not through a relative’s employer. The person thereby takes on their insured status individually. Failure to declare can lead to loss of insured status and to retroactive payment.

How Workly helps

For employees, the CASS side stays simple and remains the employer’s responsibility: 10% is withheld from the gross and reported in Declarația 112 (the monthly return). The Workly payroll module applies this withholding automatically and carries it into the SAGA-format export, from which the accountant takes the bases for Declarația 112 — so that the employee’s insured status is clear and documented. For situations outside the salary (co-insurance, individual payment), the employee manages their CASS through ANAF — but the income data in the platform remains the consistent source for any certificate.

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Informational article, accurate at the date of publication. Not tax or legal advice. The rules on co-insurance and CASS have changed recently and involve fine conditions — always check the framework in force at source (ANAF, CNAS, the Fiscal Code, Monitorul Oficial) or consult a specialist before taking a decision.