Chương I Nghị định 105/2014/NĐ-CP: Đối tượng, mức đóng, mức hỗ trợ và nguồn kinh phí từ ngân sách nhà nước đóng, hỗ trợ đóng bảo hiểm y tế

Chapter I

CONTRIBUTING ENTITIES, CONTRIBUTION RATES, SUBSIDY AMOUNTS, AND STATE EXPENDITURES ON THE CONTRIBUTION AND SUBSIDIZATION OF HEALTH INSURANCE PREMIUMS

Article 1. Contributing entities eligible for health insurance contribution

In addition to the entities stipulated in Clause 1, 2, 3, 4 and 5 Article 12 on amending and supplementing the Law on Health Insurance, other entities stipulated in Clause 6 Article 12 on amending and supplementing the Law on Health Insurance include:

1. Rubber plantation workers who are entitled to the monthly allowance under the Decision No. 206/CP dated May 30, 1979 adopted by the Governmental Council (now called the Government) on the government incentives for post-Liberation workers who used to work in a hazardous and arduous working condition but now quit their jobs due to old age as stipulated in Clause 2 Article 12 on amending and supplementing the Law on Health Insurance.

2. Those who belong to family households, work in agriculture, forestry, aquaculture and salt farming sectors, and only afford an average standard of living as stipulated in Clause 4 Article 12 on amending and supplementing the Law on Health Insurance.

Article 2. Contribution rates

1. As from January 1, 2015, the rate of monthly health insurance contribution for eligible contributing entities shall be specified as follows:

a) Equal 4.5% of monthly pay per an employee who belongs to the entities stipulated at Point a Clause 1 Article 12 on amending and supplementing the Law on Health Insurance.

In respect of female employees entitled to paid maternity leaves from work as stipulated by the Social Security Law, the monthly contribution rate shall equal 4.5% of monthly pay that they receive before taking their maternity leave;

In respect of employees entitled to paid sick leaves from work for the period of more than 14 days off as stipulated by the Social Security Law, their pay shall be exempt from health insurance contribution but still eligible to enjoy the entitlement to their health insurance benefits;

In respect of employees held in detention, custody or temporarily suspended from their work before being investigated or judged guilty or not guilty of their offences, the monthly contribution rate shall equal the proportion of 4.5% to 50% of monthly pay that these employees receive in accordance with laws. Where employees are judged not guilty of any offence by competent agencies, they are required to make retrospective payment for their health insurance contribution arrears in proportion to the amount of retrospective salary payments that they are entitled to receive before being away from work;

Employees sent abroad for study or business trips shall be exempt from health insurance contribution; from such period to the time when they return after receiving the decision made by their employers, their health insurance contribution is kept uninterrupted.

Employees shall be exempt from health insurance contribution for the period when they work abroad; within a period of 60 days since their entry into their home country, if they start participating in the health insurance, a full length of the time when they work overseas and an entire span ranging from the time when they return to the time when they commence their health insurance contribution shall be considered as a continuous term of health insurance contribution.

For the period when employees are processing procedures for their entitlement to unemployment benefits in accordance with regulations laid down in the Law on Employment, if they have not participated health insurance as other groups of the insured have done, such period shall be recorded as their term of health insurance contribution.

b) Equal 4.5% of base pay per an employee who belongs to the entities stipulated at Point b Clause 1 Article 12 on amending and supplementing the Health Insurance Law.

c) Equal 4.5% of retirement pension or incapacity benefit per an employee who belongs to the entities stipulated at Point a Clause 2 Article 12 on amending and supplementing the Law on Health Insurance.

d) Equal 4.5% of base pay per an employee who belongs to the entities stipulated at Point b, c Clause 2 Article 12 on amending and supplementing the Law on Health Insurance, and the entities stipulated at Clause 1 Article 1 hereof.

dd) Equal 4.5% of unemployment benefit per an employee who belongs to the entities stipulated at Point d Clause 2 Article 12 on amending and supplementing the Law on Health Insurance.

e) Equal 4.5% of base pay per an employee who belongs to the entities stipulated at Point b, c, d, dd, e, g, h, i, k, l, m and n Clause 3, and Clause 4, 5 Article 12 on amending and supplementing the Law on Health Insurance, and the entities stipulated at Clause 2 Article 1 hereof.

Where infants have reached the age of 72 months but still wait for the school term, the health insurance card shall be valid till September 30 of such year without having to pay contributions to their health insurance policies.

g) In respect of the health insurance contribution rate for all members of family households stipulated in Clause 5 Article 12 on amending and supplementing the Health Insurance Law, the contribution rate for the first contributor shall equal 4.5% of his/her base pay while the second, third and fourth contributor shall pay 70%, 60% and 50% of the first contributor’s contribution rate respectively; the fifth contributor and so forth shall pay contributions to the health insurance policy at the contribution rate equal to 40% of the first contributor’s contribution rate.

In respect of family households whose health insurance contributions are subsidized by the state budget, deductions from their contribution rate is not applicable in accordance with regulations laid down at Point g Clause 1 of this Article.

2. Based on the practical condition, the Ministry of Health shall take charge of cooperating the Ministry of Finance and relevant entities to send a written request to the Government to adjust the rate of health insurance contributions in order to keep the health insurance fund balanced.

Article 3. State expenditures on the subsidization of health insurance contributions of several contributing entities

1. The subsidization rate for health insurance contributions of members of families living in near poverty in accordance with regulations laid down at Point a Clause 4 Article 12 on amending and supplementing the Health Insurance Law shall conform to the followings:

a) Subsidize 100% of health insurance contributions to which nearly-poor members of families are entitled after newly escaping from poverty with the 5-year subsidization term. Where nearly-poor members of families have escaped from poverty before January 1, 2015 but the span ranging from the poverty escape to January 1, 2015 is less than 05 years, the residual subsidization time shall be at least 01 year;

b) Subsidize 100% of health insurance contributions to which nearly-poor families residing at poor districts are entitled in accordance with regulations laid down in the Government’s Resolution No. 30a/2008/NQ-CP dated December 27, 2008 on incentive programs for quick and sustainable reduction in poverty at 61 poor districts and districts with high poverty rate that are eligible for infrastructural investment mechanism and policy in accordance with the Government’s Resolution No. 30a/2008/NQ-CP dated December 27, 2008;

c) Subsidize at least 70% of health insurance contributions per each of the rest of nearly-poor families.

2. Subsidize at least 30% of health insurance contributions per each learner or student in accordance with regulations laid down at Point b Clause 4 Article 12 on amending and supplementing the Health Insurance Law.

3. Subsidize at least 30% of health insurance contributions per each member of families working in agriculture, forestry, aquaculture and salt farming sectors and just affording an average standard of living under the Prime Minister’s Decision No. 32/2014/QD-TTg dated May 27, 2014 as prescribed in Clause 2 Article 1 hereof.

4. The People’s Committee of centrally-affiliated cities and provinces (hereinafter referred to as provincial People’s Committees) shall refer to the affordability of local government budget and other financial sources, inclusive of 20% of total residual expenditures on health check and disease cure within a specified year in accordance with regulations set out in Clause 3 Article 35 on amending and supplementing the Health Insurance Law (if any) in order to define and request the provincial People’s Councils to define the higher subsidization rate of health insurance contributions to which the entities stipulated at Point c Clause 1, 2, 3 of this Article are entitled.