Nghị định 01/2016/NĐ-CP quy định chức năng, nhiệm vụ, quyền hạn và cơ cấu tổ chức của Bảo hiểm xã hội Việt Nam

DECREE

PRESCRIBING THE FUNCTIONS, DUTIES, POWER AND ORGANIZATIONAL STRUCTURE OF VIET NAM SOCIAL SECURITY

Pursuant to the Law on Government Organization dated June 19, 2015;

Pursuant to the Law on Employment dated November 16, 2013;

Pursuant to the Law on Health Insurance dated November 14, 2008 and the Law amending and supplementing a number of articles of the Law on Health Insurance dated June 13, 2014;

Pursuant to the Law on Social Insurance dated November 20, 2014;

At the request of the General Director of Viet Nam Social Security,

The Government promulgates the Decree prescribing the functions, duties, power and organizational structure of Viet Nam Social Security.

Article 1. Position and functions

1. Viet Nam Social Security is a Government-attached agency and has the functions of organizing the implementation of social and health insurance policies; organizing the collection and payment of unemployment insurance money; managing and using funds: social insurance funds, unemployment funds and health insurance funds; inspecting the payment of social insurance, unemployment insurance and health insurance in compliance with the law.

2. Viet Nam Social Insurance Agency is under the management of the Ministry of Labor - War Invalids and Social Affairs in terms of social and unemployment insurance; of the Ministry of Health and the Ministry of Finance in terms of financial mechanism of social insurance, unemployment insurance and health insurance funds.

Article 2. Duties and power

1. Propose functions, power and organizational structure of Viet Nam Social Security to the Government. 

2. Propose the strategies for development of Vietnam’s social security authorities; long-term plans, five-year plans and annual plans for the operation of Viet Nam Social Security; plan for preservation and growth of social insurance, health insurance and unemployment insurance funds after the approval of Viet Nam Social Security Management Board to the Prime Minister; organize the implementation of those strategies and plans once they are approved.

3. Responsibilities of Viet Nam Social Security to other Ministries in terms of social, health and unemployment insurance and their financial mechanism:

a) To the Ministry of Labor - War Invalids and Social Affairs: Propose further construction, amendments to the benefits of the above insurance; propose inspection of organizations and individuals in their provisions of social and unemployment insurance; facilitate inspections by the Ministry of Labor - War Invalids and Social Affairs in the implementation of the regulations of the law on social and unemployment insurance; make annual reports and irregular reports to the Ministry of Labor - War Invalids and Social Affairs on the implementation of the insurance benefits, revenues, expenses and management of the insurance premiums.

To the Ministry of Health: Propose health insurance policies and amendments thereto; work in liaison with the Ministry of Health to determine the level of payment, benefits covered by insurance, level of benefits for patients according to the health insurance benefits and the paying system for medical fees; the price of medical services, list of drugs, medical supplies and technical services covered by health insurance; Request the Ministry of Health to inspect and supervise other organizations’ and individuals’ compliance with health insurance policies as prescribed in the law; facilitate inspections by the Ministry of Health in compliance with the regulations of the law on health insurance; make annual and irregular reports to the Ministry of Health on the implementation of social insurance policies, collection, management and spending of health insurance funds. 

To the Ministry of Finance: Propose financial mechanisms applied to social insurance, unemployment insurance, health insurance funds and Vietnam Social Security thereto; facilitate inspections by the Ministry of Finance in compliance with the regulations of the law on social insurance, unemployment insurance, health insurance funds; submit annual and irregular reports to the Ministry of Finance on the collection, management and spending of the social insurance, unemployment insurance and health insurance funds.

Cooperate with the Ministry of Labor - War Invalids and Social Affairs, the Ministry of Finance, the Ministry of Health to manage collection and spending, preservation, growth and balance of social insurance, unemployment insurance and health insurance funds.

4. Promulgate guidance documents on social and health insurance procedures, collection of social, health and unemployment insurance premiums and provision of insurance benefits in compliance with the law; promulgate circumstance-based documents with one-time effect and internal documents for internal control.

5. Propagate the policies, benefits and the law on social, unemployment and health insurance; organize registration, supervision and management of people covered by social insurance, unemployment insurance and health insurance.

6.  Provide specimens of the social insurance and unemployment insurance books and applications, health insurance cards and issue social insurance books and health insurance cards to policyholders according to the regulations of the law.

7. Organize collection of social insurance and health insurance premiums from organizations, employers and individuals according to the regulations of the law. Use funding from State Budget to provide social insurance and health insurance benefits according to the law. 

8. Receive insurance claims and handle cases of illness and maternity; occupational accidents and occupational diseases; pension; death; convalescence after illness and pregnancy and after treatment for occupational accidents and occupational diseases; conduct medical examination and treatment in compliance with the law.

9. Pay pension and occupational accident benefits, occupational disease benefits, maternal allowance, benefits for people with decreased working capacity, convalescence benefits (paid after treatment of illness, occupational accidents and occupational diseases) and death benefits; reimburse medical examination and treatment costs in a convenient and timely manner.  

10.  Collect unemployment insurance premiums from organizations, employers and individuals; pay unemployment benefits; provide support in vocational training and job seeking process and pay health insurance premiums for people on unemployment benefits according to the regulations of the law.

11. Manage and use social insurance, health insurance and unemployment insurance funds including: Pension funds and death benefit funds; occupational accident and occupational disease funds; funds for illness and maternity; unemployment insurance funds; health insurance funds in a consistent, publicly open and transparent way in compliance with the law; execute book-keeping process of social insurance, unemployment insurance and health insurance funds.

12. Sign contracts with medical facilities that meet technical and professional standards and supervise the execution of the terms in the contracts by such medical facilities; supervise the procedures and quality of medical examination and treatment covered by health insurance; check and evaluate the prescription of treatments, drugs, chemicals, medical supplies and technical services; supervise and determine the costs of medical examination and treatment;  protect the right of policyholders and avoid overuse of health insurance benefits; refer employees and their families to Medical Assessment Council for assessment of level of diminished working capability.

13. Sign contracts with social insurance and health insurance agents to collect insurance premiums and provide insurance benefits in compliance with the law.

14. Provide specialized training for Social Security Departments of the Ministry of National Defense and the Ministry of Public Security; work in collaboration with them to supervise the implementation of social and health insurance within the Ministry of National Defense and the Ministry of Public Security.

15. Inspect payment of social, health and unemployment insurance premiums; impose administrative penalties for violations against social, health and unemployment insurance policies according to the regulations of the law.

16. Inspect contract conclusion process, payment of social, health and unemployment insurance premiums by organizations, employers, individuals and medical facilities; reject illegal payments and claims.

17. Handle complaints or denunciations in compliance with the law on complaints and denunciations or file civil lawsuits to request the court to protect public and state benefits in terms of social, health and unemployment insurance.

18. Promote international cooperation in social, health and unemployment insurance according to the regulations of the law.

19. Manage and organize the organizational structure, decide the quantity and positions of officials and public employees in accordance with regulations applied to public service providers; make decisions regarding reassignment, retirement, appointment, designation, dismissal, commendation, punishment and training policies for officials and public employees; recruitment and salaries of officials and public employees in compliance with the law.

20. Manage finance and assets of Viet Nam Social Security and produce statistics and accounting documents on social, health and unemployment insurance.

21. Set and carry out plans to reform the administrative system of Viet Nam Social Security based on the targets, requirements, program and plan to carry out administrative reform of the Government and commands from the Prime Minister; apply single-window system to provisions of social insurance, unemployment insurance and health insurance benefits.

22. Carry out E-transactions in social, unemployment and health insurance according to the law.23. Retain dossiers on policyholders of social, health and unemployment insurance according to the regulations of the law.

24. Conduct researches and apply research findings and information technology in keeping statistics and managing social, health and unemployment insurance.

25. Provide training in social, health and unemployment insurance.

26. Submit biannual reports to Management Council of Viet Nam Social Security about the implementation of social, health and unemployment insurance policies. Submit annual reports to the Government about the management and use of social insurance, unemployment insurance and health insurance funds.

27. Provide timely and sufficient information on the insurance premium payment, insurance coverage, procedures for provision of social, health and unemployment insurance benefits at the request of employers, employees or organizations. Provide relevant information and documents at the request of competent authorities in timely and sufficient manner.

28. Receive information from local labor authorities about employment situation in their areas on a six-month basis. Be provided with tax identification numbers of organizations and individuals by tax authorities; provide information annually on the total salary payment as a basis for tax declaration by enterprises or organizations.

29.  Take charge and cooperate with regulatory agencies, socio-political organizations, social organizations and other relevant parties in handling problems related to provisions of social, health and unemployment insurance benefits.

30. Cooperate with competent authorities at their requests in conducting specialized social, health and unemployment insurance-related inspections; request competent authorities to handle violations against the law on social, health and unemployment insurance.

31. Perform other tasks and duties assigned by The Government and the Prime Minister.

Article 3. Management Council of Viet Nam Social Security

1. Viet Nam Social Security Management Council (hereinafter referred to as “Management Council”) shall assist the Government and The Prime Minister in giving commands and supervising the operation of Viet Nam Social Security and advise them on social, health and unemployment insurance policies.

2. The Management Council includes senior representatives from The Ministry of Labor - War Invalids and Social Affairs, The Ministry of Finance, Ministry of Home Affairs, Vietnam General Confederation of Labor, Vietnam Chamber of Commerce and Industry, Vietnam Cooperative Alliance, Vietnam Farmer’s Union, General Director of Viet Nam Social Security and other members assigned by the Government.

3. The Management Council has one Chairperson, several Vice Chairpersons and members who, at the request of the Minister of Home Affairs, shall be appointed and dismissed by the Prime Minister; each Management Board shall serve a five-year tenure.

4. The Management Council has an assisting office. The assisting office will perform specific tasks assigned by The Management Council.

5. Duties and power:

a) Give commands and grant approval for the development strategies of Viet Nam’s social security authorities, long-term plans, five-year plans and annual plans for the implementation of social, health and unemployment insurance policies, plan for preservation and growth of the insurance funds before they are submitted to the Prime Minister for approval; inspect and supervise the General Director of Viet Nam Social Security (hereinafter referred to as “The General Director”) in implementing those plans once they are approved. 

Supervise the implementation of payment and collection plan, management and use of social, unemployment and health insurance funds.  Propose amendments to State policies on social, health and unemployment insurance to ensure the safety of the abovementioned insurance funds.

Consider approving annual estimates of revenues and expenses of social insurance, unemployment insurance and health insurance funds; managerial cost of the insurance funds before they are submitted by Viet Nam Social Security to competent authorities for approval.<

Consider approving annual report on the implementation of the insurance policies; the management and use of the insurance funds before they are submitted by Viet Nam Social Security to competent authorities.

dd) Make decisions on and take responsibility to the Government for the methods and rates of investment from the insurance funds on the basis of suggestions from the General Director.0}

Members of The Management Council shall be responsible for reporting relevant matters to their Ministers.

Make suggestions to competent authorities about further construction and amendments to policies and law on social, health and unemployment insurance and the development strategies of the Department; file lawsuits against the entire Viet Nam Social Security’s system and management mechanism of the insurance funds.

Propose the appointment and dismissal of The General Director and Deputy General Directors of Viet Nam Social Security to The Prime Minister.

Article 4: Working regimes

1. Management Board works collectively with meetings being held on a three-month basis for considering matters related to duties and power as provided for in Clause 5 Article 3 of this Decree. Regarding matters that do not need to be discussed in the meetings, The Chairperson shall send enquiry forms to every member of The Management Council. The Management Council can convene a meeting anytime to handle pressing matters when such meeting is requested by the Chairperson or the General Director or by more than 50 percent of Management Council member.

2. The Chairperson or the Vice Chairpersons of The Management Council authorized by the Chairperson hold the responsibility for convening and presiding over the meetings of The Management Council. Documents and matters that will be discussed in the meetings shall be sent to members of The Management Council at least five working days before the date of the meeting.  Members of The Management Council shall prepare to raise their own voices in the discussion and in the process of promulgating a new Resolution by The Management Council.

3. Meetings shall be held in the presence of at least two thirds of the number of members of The Management Council.  A resolution by The Management Council is considered effective upon approval of more than 50 percent of the total members of The Management Council.  An enquiry form shall be sent to absentees. In case of a deadlock, the Chairperson of The Management Council shall have the casting vote.  The Chairperson of The Management Council shall report the matters that have not been agreed upon by members of The Management Council to the Prime Minister for decision. Members of The Management Council shall have their opinions recorded.

4. Upon discussion of matter related to a specific Ministry, regulatory authority or an agency under Viet Nam Social Security, The Management Council shall request the attendance of representatives of that Ministry or Department, or Head of the agency under Viet Nam Social Security at the meeting.  Representatives of relevant agencies attending the meeting shall have the right to raise their voices but retain no right to join in the voting process.

5. Resolutions by The Management Council shall be sent to its members and the General Director for implementation.

6. Members of The Management Council shall have the right to request information, documents on the power and duties of The Management Council from the General Director. The General Director shall hold the responsibility for providing timely and sufficient information and document.

7.  The Management Council shall submit annual report to the Prime Minister about its performance.

8. The operational cost of The Management Council shall be covered by Viet Nam Social Security. The working location of The Management Council, Permanent Vice Chairperson and the assisting office shall be arranged by Viet Nam Social Security. The Management Council shall use the seal of Viet Nam Social Security for operation.

9. Members of The Management Council shall employ assistants from their own ministries. Remuneration for members of The Council shall be decided by the Prime Minister.

Article 5. The General Director

1. The General Director shall be the legal representative of Viet Nam Social Security and shall be appointed or dismissed by the Prime Minister at the request of The Management Council. The General Director shall bear responsibility to the Government, the Prime Minister, the Management Council and members of the Government assigned to be in charge of Viet Nam Social Security for the implementation of the insurance benefits, the management and use of the insurance funds in accordance with the law and shall perform tasks provided for in Article 2 of this Decree.

2. Assistants to the General Director are Deputy General Directors; Deputy Directors who are assigned by the General Director to perform specific tasks and shall take responsibility to the General Director for the tasks assigned to them. In the absence of the General Director, an authorized Deputy General Director shall lead and supervise the operation of Viet Nam Social Security. Deputy General Directors shall be appointed or dismissed by the Prime Minister at the request of the Management Council and the General Director.

The number of Deputy General Directors shall not exceed five.

3. Working regime, duties and power of the General Director:

The General Director shall work under the regime of head ship; ensure the principles of Democratic Centralism; promulgate working regulations, information and report regime of Viet Nam Social Security, give commands and inspect the implementation of those regulations.

b) The General Director shall assign or authorize a Deputy General Director to handle matters within his/her competence. The General Director shall be responsible for decisions made by authorized or assigned Deputy General Director.

c) The General Director shall be responsible for preparing matters provided for in Clause 5 Article 3 of this Decree to report to the Management Council of Viet Nam Social Security for review and approval and shall implement resolutions by the Management Council;

d) The General Director shall bear legal responsibility upon deficit in the insurance funds due to his/her illegal management of those funds.

dd) The General Director shall introduce detailed regulations regarding standards of positions and procedures of appointment and dismissal of leading and managerial personnel in the organizational structure of Viet Nam Social Security.

Article 6. Organizational Structure

Viet Nam Social Security is organized and managed in a vertical, concentrated and consistent system from central to local, including:

1. Viet Nam Social Security holds the central position.

2. At the level of central-affiliated cities and provinces, there are Provincial Social Security Authorities and central-affiliated cities (hereinafter referred to as “Provincial Social Security Authorities”) affiliated to Viet Nam Social Security.

3. At the level of districts and central-affiliated cities, there are Social Security Authorities of districts and central-affiliated cities (hereinafter referred to as “Social Security Authorities of districts”) affiliated to Provincial Social Security Authorities.

Article 7. The Central structure of Viet Nam Social Security

1. Department of Finance - Accounting.

2. Department of International Cooperation.

3. Department of Inspection.

4. Department of Emulation and Commendation.

5. Department of Planning and Investment.

6. Department of Personnel and Organization.

7. Department of Legal Affairs.

8. Department of Investment Fund Management.

9. Department of Internal Audit.

10. Social Insurance Implementation Department.

11. Health Insurance Implementation Department.

12. Contribution Collection Department.

13. Department for Social Insurance Books and Health Insurance Cards.

14. Department for Pharmaceuticals and Medical Supplies.

15. The Office (with a representative office located in Ho Chi Minh City).

16. Institute for Social Security Science.

17. Media Center.

18. Information Technology Center.

19. Archives Center.

20. North Center for Medical Review and Tertiary Care Payment.

21. South Center for Medical Review and Tertiary Care Payment.

22. Training School for Social Security Operations.

23. Social Security Newspaper.

24. Social Insurance Magazine.

In this Article, organizations provided for from Clause 1 to Clause 15 are specialized units assisting the General Director; organizations from Clause 16 to Clause 24 are affiliated service provider.

The General Director shall regulate the functions, duties, power, organizational structure, payroll, appointment or dismissal of heads and deputy heads of organizations under Viet Nam Social Security, heads of division and deputy heads of division of specialized units assisting the General Director.

The number of deputy heads of organizations under Viet Nam Social Security shall not exceed three.

Heads of affiliated service providers shall appoint or dismiss heads of division, deputy heads of division of affiliated divisions according to the standards of positions promulgated by competent authorities and shall follow the procedures of appointment and dismissal promulgated by the General Director of Viet Nam Social Security.

Article 8. Provincial Social Security Authorities

1. Each Provincial Social Security Authority shall have its legal entity status, its own seal, bank account and departments.

2. The General Director shall regulate the functions, duties, organizational structure, payroll, appointment or dismissal of Directors, Deputy Directors of each Provincial Social Security Authority and set its operational cost. The number of Deputy Directors of each Provincial Social Security Authority shall not exceed 03; four for Ho Chi Minh City and Ha Noi.

3. The General Director shall make decisions on establishing or dissolving Provincial Social Security Authorities when there are decisions to merge or divide provincial-level administrative units from competent authorities.

4. The director of each Provincial Social Security Authority shall appoint or dismiss duty heads of division, deputy heads of division of each provincial-affiliated social security authority according to standards of positions and procedures of dismissal promulgated by the General Director of Viet Nam Social Security.

5. The director of each Provincial Social Security Authority shall hold the responsibility for the management and use of officials, public employees, civil servants, finance and assets that fall under its management according to the regulations of Viet Nam Social Security.

Article 9. Social Security Authority of each district

1. The General Director shall regulate the functions, duties, organizational structure, payroll and the operational cost of the Social Security Authority of each district; make decisions on establishing or dissolving the Social Security Authority of each district when there is a decision to merge or divide district-level administrative units from competent authorities.

3. The director of each Provincial Social Security Authority shall appoint or dismiss Directors and Deputy Directors of the Social Security Authority of each district according to standards of positions and procedures of appointment and dismissal promulgated by the General Director of Viet Nam Social Security.  The number of Deputy Directors of the Social Security Authority of each district shall not exceed three.

4. The director of the Social Security Authority of each district shall hold the responsibility for the management and use of officials, public employees, civil servants, finance and assets that fall under its management according to the regulations of Viet Nam Social Security and Provincial Social Security Authorities.

Article 10. Validity

1. This Decree comes into force from February 20, 2016.

2. This Decree is released in replacement of Decree No. 05/2014/ND-CP dated January 17, 2014 by the Government prescribing the functions, duties, power and organizational structure of Viet Nam Social Security.

Article 11. Responsibility for implementation

Ministers, Ministers of ministerial agencies, heads of Governmental Agencies, Chairpersons of People's Committees of provinces, central-affiliated cities, The Management Council and General Director of Viet Nam Social Security shall be responsible for the implementation of this Decree.