Chương VII Luật Bảo hiểm xã hội 2014: Trình tự, thủ tục thực hiện bảo hiểm xã hội

Chapter VII

ORDER AND PROCEDURES FOR SOCIAL INSURANCE IMPLEMENTATION

Section 1. ORDER AND PROCEDURES FOR PARTICIPATION IN SOCIAL INSURANCE

Article 96. Social insurance books

1. A social insurance book shall be granted to every employee for monitoring the payment of social insurance premiums and enjoyment of social insurance benefits, and must serve as a basis for settlement of social insurance benefits in accordance with this Law.

2. By 2020, social insurance books shall be replaced with social insurance cards.

3. The Government shall stipulate the order and procedures for participation in social insurance and settlement of social insurance benefits in electronic form.

Article 97. Registration dossiers for participation in social insurance and grant of social insurance books

1. A registration dossier for first-time participation in social insurance must comprise:

a/ An employer’s declaration form for participation in social insurance, enclosed with a list of employees to participate in social insurance;

b/ Employees' declaration forms for participation in social insurance.

2. A dossier for re-grant of a lost or damaged social insurance book must comprise:

a/ An employee’s application for re-grant of a social insurance book;

b/ The social insurance book, in case it is damaged.

3. The Government shall stipulate the procedures and dossier for participation in social insurance and grant of social insurance books for the subjects defined at Point e, Clause 1, Article 2 of this Law.

Article 98. Adjustment of information of participation in social insurance

1. Employers shall notify in writing social insurance agencies of any changes in information of participation in social insurance.

2. A dossier for adjustment of an employee’s personal information of participation in social insurance must comprise:

a/ A declaration form for adjustment of personal information;

b/ The social insurance book;

c/ Copies of competent state agencies’ papers related to the adjustment of personal information as prescribed by law.

Article 99. Settlement of registration for participation in social insurance and grant of social insurance books

1. Registration for first-time participation in social insurance shall be settled as follows:

a/ Within 30 days after signing a labor contract or working contract with an employee or after recruiting an employee, the employer shall submit a dossier specified in Clause 1, Article 97 of this Law to the social insurance agency.

b/ An employee to be covered by voluntary social insurance shall submit a dossier specified at Point b, Clause 1, Article 97 of this Law to the social insurance agency.

2. An employee shall submit a dossier for re-grant of a social insurance book as specified in Clause 2, Article 97 of this Law to the social insurance agency.

3. The social insurance agency shall grant a social insurance book within:

a/ 20 days after receiving a complete and valid dossier, for persons who participate for the first time in compulsory social insurance;

b/ 7 days after receiving a complete and valid dossier, for persons who participate for the first time in voluntary social insurance;

c/ 15 days after receiving a complete and valid dossier, in case of re-grant of social insurance books; or 45 days, if the verification of the period of social insurance premium payment is complicated. If refusing to grant a social insurance book, the social insurance agency shall issue a written reply clearly stating the reason;

d/ 10 days after receiving a complete and valid dossier, in case of re-grant of social insurance books for employees who wish to have their information of participation in social insurance adjusted. If refusing to re-grant a social insurance book, the social insurance agency shall issue a written reply clearly stating the reason.

4. The Minister of Labor, War Invalids and Social Affairs shall stipulate in detail the order and procedures for participation in social insurance and settlement of social insurance benefits for employees defined at Point b, Clause 1, Article 2 of this Law.

Section 2. ORDER AND PROCEDURES FOR SETTLEMENT OF SOCIAL INSURANCE BENEFITS

Article 100. Dossier for enjoyment of the sickness benefits

1. An original or a copy of the hospital discharge paper, for employees or their children undergoing inpatient treatment; in case of outpatient treatment, the certificate of their leave under the social insurance benefits is required.

2. In case employees or their children take medical examination or treatment abroad, the paper specified in Clause 1 of this Article shall be replaced with a Vietnamese translation of the medical record issued by a foreign health establishment.

3. The employer-made list of employees taking leave under the sickness benefits.

4. The Minister of Health shall stipulate the form, and order and competence for grant, of certificate of an employee’s leave under the social insurance benefits, hospital discharge paper and the papers specified at Points c, d and dd, Clause 1, Article 101 of this Law.

Article 101. Dossier for enjoyment of the maternity benefits

1. A dossier for a female employee to enjoy the maternity benefits must comprise:

a/ A copy of the birth registration certificate or birth certificate of the child;

b/ A copy of the child’s death certificate, in case the child dies, or copy of the mother’s death certificate, in case the mother dies in childbirth;

c/ A competent health establishment’s certificate stating that the mother is at postnatal risk that makes her unable to take care of the child;

d/ An extract of the mother’s medical record or hospital discharge paper in case the child dies after birth without being granted the birth certificate;

dd/ A competent health establishment’s certificate stating that the female employee has to take leave for pregnancy care, in the case specified in Clause 3, Article 31 of this Law.

2. Female employees who have prenatal checks-up, miscarriage, abortion, stillbirth or pathological abortion, or employees who apply contraceptive measures specified in Clause 1, Article 37 of this Law shall produce a certificate of their leave under the social insurance benefits, in case of outpatient treatment, or an original or a copy of the hospital discharge paper, in case of inpatient treatment.

3. Employees who adopt under-6-month children shall produce a child adoption certificate.

4. Male employees who wish to take leave due to their wives’ childbirth shall produce a copy of the child’s birth certificate or birth registration certificate, and a health establishment’s certificate, in case their wives have a surgical birth or give birth to children under 32 weeks of pregnancy.

5. The employer-made list of employees taking leave for enjoyment of the maternity benefits.

Article 102. Settlement of the sickness and maternity benefits

1. Within 45 days after return to work, an employee shall submit the dossier specified in Clause 1 or 2, Article 100, or Clause 1, 2, 3 or 4, Article 101, of this Law to his/her employer.

An employee who ceases working before the time of childbirth or child adoption shall submit the dossier specified in Clause 1 or 3, Article 101 of this Law and produce his/her social insurance book to the social insurance agency.

2. Within 10 days after receiving a complete dossier from an employee, the employer shall make a dossier as specified in Article 100 or 101 of this Law and submit it to the social insurance agency.

3. Responsibilities of the social insurance agency:

a/ To settle the social insurance benefits and make payment to the employee within 10 days after receiving a complete and valid dossier from an employer;

b/ To settle the social insurance benefits and make payment to the employee within 5 working days after receiving a complete and valid dossier from an employee who ceases working before the time of childbirth or child adoption.

4. If refusing to settle the social insurance benefits, the social insurance agency shall issue a written reply clearly stating the reason.

Article 103. Settlement of convalescence and health rehabilitation allowance after sickness or maternity leave

1. Within 10 days after the date an employee fully satisfies the conditions for enjoying the convalescence and health rehabilitation allowance after sickness or maternity leave, the employer shall make a list of employees and submit it to the social insurance agency.

2. Within 10 days after receiving a complete and valid dossier, the social insurance agency shall settle the social insurance benefits for and pay the convalescence and health rehabilitation allowance to employees; or issue a written reply clearly stating the reason for its refusal to settle the benefits.

Article 104. Dossier for enjoyment of the occupational accident benefits

1. The social insurance book.

2. The investigation record of the occupational accident; for an employee suffers a traffic accident confirmed as a occupational accident, a written record of the traffic accident or a written record of scene examination and the accident scene plan are required.

3. The hospital discharge paper after occupational accident treatment.

4. The written record of assessment of the working capacity decrease, made by the Medical Assessment Council.

5. The written request for settlement of the occupational accident benefits.

Article 105. Dossier for enjoyment of the occupational disease benefits

1. The social insurance book.

2. A written record of environmental survey with toxic elements; in case a written record is made for many employees, its copy shall be included in the dossier of every employee.

3. The hospital discharge paper after occupational disease treatment; in case of outpatient treatment, an occupational disease examination paper is required.

4. The written record of assessment of the working capacity decrease, made by the Medical Assessment Council.

5. The written request for settlement of the occupational disease benefits.

Article 106. Settlement of occupational accident and occupational disease benefits

1. Employers shall submit dossiers to social insurance agencies as prescribed in Articles 104 and 105 of this Law.

2. Within 15 days after receiving a complete dossier, social insurance agencies shall settle occupational accident and occupational disease benefits; or issue a written reply clearly stating the reason for their refusal to settle the benefits.

Article 107. Settlement of convalescence and health rehabilitation allowance after occupational accident or occupational disease

1. An employer shall make a list of employees whose health has not yet recovered after enjoying the occupational accident or occupational disease benefits and submit it to the social insurance agency.

2. Within 15 days after receiving a complete and valid dossier, the social insurance agency shall settle the convalescence and health rehabilitation benefits for employees and transfer the convalescence and health rehabilitation allowance to the employer; or issue a written reply clearly stating the reason for their refusal to settle the benefits.

3. Within 10 days after receiving the allowance from the social insurance agency, the employer shall pay such allowance to employees.

Article 108. Dossier for pension enjoyment

1. A dossier for pension enjoyment for employees covered by compulsory social insurance must comprise:

a/ The social insurance book;

b/ The decision permitting an employee to stop working under the retirement benefits or the document terminating a labor contract with an employee for enjoying the retirement benefits;

c/ The written record of assessment of the working capacity decrease, made by the Medical Assessment Council, for employees who retire under Article 55 of this Law, or the certificate of HIV/AIDS infection due to occupational risks, for the employees defined in Article 54 of this Law.

2. A dossier for pension enjoyment for employees covered by voluntary social insurance or employees having their period of social insurance premium payment reserved, including those who are serving imprisonment sentences, must comprise:

a/ The social insurance book;

b/ The application for pension enjoyment;

c/ The written authorization for carrying out procedures for settlement of the retirement benefits and enjoyment of pension, for those who are serving imprisonment sentences;

d/ A competent state agency’s document permitting an illegal emigrant to legally repatriate and settle in the country;

dd/ The court’s legally effective decision annulling the decision on declaration to be missing, for missing people who reappear.

Article 109. Dossier for enjoyment of lump-sum social insurance allowance

1. The social insurance book.

2. The employee’s application for enjoyment of lump-sum social insurance allowance.

3. For persons who settle abroad, a copy of the competent agency’s written certification of renunciation of Vietnamese nationality, or a certified or notarized Vietnamese translation of one of the following papers:

a/ Passport issued by a foreign country;

b/ Visa issued by a competent foreign agency, certifying such country’s permission for entry for overseas residence;

c/ Paper certifying such person is carrying out procedures for naturalization in a foreign country; paper certifying residence or permanent residence card or residence card of a term of 5 years or more, issued by a competent foreign agency.

4. Extract of the medical record, in the case specified at Point c, Clause 1, Article 60, or Point c, Clause 1, Article 77, of this Law.

5. For employees defined in Article 65, and Clause 5, Article 77, of this Law, a dossier for enjoyment of lump-sum social insurance allowance must comply with Clauses 2 and 3 of this Article.

Article 110. Settlement of pension or lump-sum social insurance allowance

1. Within 30 days by the time an employee enjoys pension, the employer shall submit a dossier specified in Clause 1, Article 108 of this Law to the social insurance agency.

2. Within 30 days by the time an employee enjoys pension, employees having their period of social insurance premium payment reserved or employees covered by voluntary social insurance shall submit a dossier specified in Clause 2, Article 108 of this Law to the social insurance agency.

3. Within 30 days by the time an employee becomes eligible and requests payment of lump-sum social insurance allowance, he/she shall submit a dossier specified in Article 109 of this Law to the social insurance agency.

4. Within 20 days after receiving a complete and valid dossier, for to-be- pensioners, or within 10 days after receiving a complete and valid dossier, for persons to enjoy a lump-sum social insurance allowance, the social insurance agency shall settle the enjoyment of pension or lump-sum allowance and make payment to employees; or issue a written reply clearly stating the reason for its refusal to settle such enjoyment.

Article 111. Dossier for enjoyment of the survivorship allowance benefits

1. For persons paying social insurance premiums or persons having their period of social insurance premium payment reserved, a dossier for enjoyment of the survivorship allowance benefits must comprise:

a/ The social insurance book;

b/ A copy of the death certificate or death notice or a copy of the court's legally effective decision on the death declaration;

c/ The dead person’s relatives’ declaration and the minutes of their meeting, for those eligible for monthly allowance but choosing a lump-sum allowance;

d/ The investigation record of the occupational accident; for persons getting a traffic accident identified as a occupational accident, a record of the traffic accident or a record of the scene examination and the accident scene plan as specified in Clause 2, Article 104 of this Law are required; or a copy of the medical record of occupational disease treatment, for persons who die of an occupational disease;

dd/ A written record of assessment of the working capacity decrease, for relatives who suffer a working capacity decrease of 81% or more.

2. For persons currently enjoying or persons suspended from enjoying pension or monthly occupational accident or occupational disease allowance, a dossier for enjoyment of the survivorship allowance benefits must comprise:

a/ A copy of the death certificate or death notice or the court's legally effective decision on death declaration;

b/ The dead person’s relatives’ declaration and the minutes of their meeting, for those eligible for monthly allowance but choosing to receive a lump- sum allowance;

c/ A written record of assessment of the working capacity decrease, for relatives who suffer a working capacity decrease of 81% or more.

Article 112. Settlement of the survivorship allowance benefits

1. Within 90 days after the death of a person having his/her period of social insurance premium payment reserved, a person covered by voluntary social insurance or a person on pension or monthly occupational accident or occupational disease allowance, his/her relative shall submit the dossier specified in Article 111 of this Law to the social insurance agency.

Within 90 days after the death of a person currently paying compulsory social insurance premiums, his/her relative shall submit the dossier specified in Clause 1, Article 111 of this Law to the employer.

2. Within 30 days after receiving a complete dossier from the employee’s relative, the employer shall submit the dossier specified in Clause 1, Article 111 of this Law to the social insurance agency.

3. Within 15 days after receiving a complete dossier, the social insurance agency shall settle the survivorship allowance benefits and make payment to the employee’s relative; or issue a written reply stating the reason for its refusal to settle the benefits.

Article 113. Dossier for continued enjoyment of pension or monthly social insurance allowance for illegal emigrants who legally repatriate to settle in the country or persons declared missing by the court who reappear

1. An application for continued enjoyment of pension or monthly social insurance allowance.

2. A competent state agency’s document permitting the illegal emigrant to legally repatriate to settle in the country.

3. The court’s legally effective decision annulling the decision on declaration to be missing, for persons declared missing by the court who reappear.

Article 114. Settlement of continued enjoyment of pension or monthly social insurance allowance for illegal emigrants who legally repatriate and settle in the country or persons declared missing by the court who reappear

1. Employees shall submit the dossier specified in Article 113 of this Law to the social insurance agency.

2. Within 15 days after receiving a complete and valid dossier, the social insurance agencies shall settle the continued enjoyment of pension or monthly social insurance allowance, or issue a written reply clearly stating the reason for its refusal to settle such continuation of enjoyment.

Article 115. Change of places for receiving pension or social insurance allowance

When a person on pension or monthly social insurance allowance moves to another place of residence within the country and wishes to receive social insurance allowance at the new place of residence, he/she shall submit an application to the social insurance agency of the place where he/she currently receives the allowance.

Within 5 working days after receiving such application, the social insurance agency shall settle the receipt of pension or social insurance allowance by the employee at the new place of residence, or issue a written reply clearly stating the reason for its refusal to settle such receipt.

Article 116. Delayed settlement of enjoyment of social insurance benefits

1. If the settlement of enjoyment of social insurance benefits is delayed after the time limit specified in Clause 1 or 2, Article 102, Clause 1, Article 103, Clause 1 or 2, Article 110, or Clause 1 or 2, Article 112, of this Law, a written explanation shall be made.

2. In case the submission of dossiers and settlement of enjoyment of social insurance benefits are delayed after the prescribed time limits, thus damaging the lawful rights and interests of eligible beneficiaries, compensation shall be paid in accordance with law, except cases where such delay is due to the fault of employees or their relatives.

Article 117. Dossiers and order for assessment of working capacity decrease to settle social insurance benefits

1. The Minister of Health shall stipulate dossiers and the order for assessment of working capacity decrease to settle social insurance benefits.

2. The examination for assessment of working capacity decrease must ensure accuracy, publicity and transparency. The Medical Assessment Council shall take responsibility for the accuracy of its assessment results in accordance with law.

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