# Dominican Republic social security reforms

> Live situation record from CLSTR: https://clstr.news/situations/dominican-republic-social-security-reforms
> Updated: 2026-08-07T20:45:20.000Z. Sources: 11. Developments: 3.

In late July 2026, the Asociación Nacional de Afiliados a la Seguridad Social (Asonafiss) lodged a formal request with the Consejo Nacional de la Seguridad Social (CNSS) to raise the annual outpatient medication cap from RD$12,000 to RD$30,000, make unused portions cumulative, and allow coverage of multiple complementary drugs when medically justified. The group gave the council a one‑week deadline and warned of peaceful street demonstrations and pickets at health‑risk administrators if the proposal was not acted upon. Asonafiss cited insurer profits of more than RD$20 billion between 2010‑2024 and noted that the change would affect roughly 11 million Dominicans, arguing that a CNSS resolution could implement the reforms without amending the Social Security law. Following the advocacy, the CNSS issued Resolution 641‑04 on 30 July 2026, introducing a new formula for the Common Illness Subsidy for workers with multiple jobs. The subsidy is calculated from the average salary earned in each employment over the previous six months, capped at ten national minimum wages, and set at 60 % of that average for outpatient care and 40 % for hospitalization. Payments start on the fourth day of incapacity and may continue for up to 26 weeks, with the amount divided proportionally among employers. Claims must be filed through the Sisalril platform and supported by a medical certificate. On 7 August 2026, the CNSS further modified regulations under Resolution No. 641-04 to simplify the application process for these subsidies. Medical certificates are now considered valid whether they bear the stamp of the treating physician or the health service provider. To be valid, certificates must include the physician's name, ID, signature, exequatur number, and stamp, along with the affiliate's identification, principal diagnosis, incapacity duration, and start date.

## Timeline

### 2026-08-07: Dominican Republic CNSS simplifies medical subsidy procedures

The Dominican Republic's CNSS has simplified medical certificate requirements for illness subsidies, while ASONAFISS seeks increased medication coverage and better fund management.

3 sources. https://clstr.news/cluster/dominican-republic-cnss-simplifies-medical-subsidy-procedures

### 2026-08-04: Dominican Republic CNSS adopts new formula for multi-employer medical leave

Dominican Republic's CNSS approved Resolution 641‑04, setting a new formula for the Common Illness Subsidy for multi‑employer workers based on six‑month average wages, with payments of 60% (outpatient) or 40% (

4 sources. https://clstr.news/cluster/dominican-republic-cnss-adopts-new-medical-leave-subsidy-formula

### 2026-07-28: Dominican Social Security group pushes to triple medication coverage to RD$30,000

Asonafiss asks the Dominican CNSS to raise annual medication coverage to RD$30,000, make funds cumulative, and allow simultaneous drug coverage, threatening peaceful protests if ignored.

6 sources. https://clstr.news/cluster/asonafiss-pushes-to-triple-dominican-drug-coverage-to-rd30000

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Cite as: Dominican Republic social security reforms. CLSTR, https://clstr.news/situations/dominican-republic-social-security-reforms