Quyết định 1018/QĐ-BHXH năm 2014 sửa đổi quyết định quy định quản lý thu, chi bảo hiểm xã hội, bảo hiểm y tế do Tổng Giám đốc Bảo hiểm xã hội Việt Nam ban hành

DECISION

AMENDING DECISIONS ON ENFORCING REGULATIONS ON MANAGING RECEIPTS AND EXPENDITURES OF SOCIAL AND HEALTH INSURANCE FUNDS

THE GENERAL DIRECTOR OF VIETNAM SOCIAL SECURITY

Pursuant to the Law on Social Insurance No.71/2006/QH11 dated June 29, 2006;

Pursuant to the Law on Health Insurance No.25/2008/QH12 dated November 14, 2008;

Pursuant to the Government’s Decree No.05/2014/NĐ-CP dated January 17, 2014 on regulating functions, tasks, powers and organizational structure of Vietnam Social Security;  

Pursuant to the Government’s Resolution No.19/NQ-CP dated March 18, 2014 on regulating major tasks and solutions to improving the business environment and enhancing national competitiveness;

In order to reduce unnecessary procedures and saving time for the labor-consuming enterprise and individuals who are engaged in transactions with social insurance authorities, and in consideration of the Head of affiliates of Vietnam Social Security,

HEREBY DECIDES:

Article 1. Adjustments and amendments shall be made to several provisions set out in the regulations on managing the receipt of social insurance (briefly called SI), health insurance (briefly called HI); SI book and HI cards issued together with the Decision No.1111/QĐ-BHXH dated October 25, 2011 by Vietnam Social Security as follows:

1. Deleting "written request” (Form No.D01b-TS) stipulated in Articles 19, 20, 21, 23, 26, 32, 33, 34.

2. Deleting one (01) list of employees participating in SI and HI (Form D02-TS) stipulated in Articles 17, 18, 19, 20, 21, 22, 23, 24, 26, 27.

3. Removing the requirement “attach 02 color photos, 3x4 cm in size (01 photo affixed to the application for participation in SI and HI; 01 photo enclosed with that application used to serve the purpose of creating database)" stipulated in Articles 17, 26, 28.

4. Removing "written request” (form No.D01-TS) stipulated in Clause 4 Article 24; Clause 3 Article 27; Article 34.

5. Replacing “Application for participation in SI and HI (Form No.A01-TS); “Application for participation in mandatory SI" (Form No.A02-TS) and “Application for participation in HI” (Form No.A03-TS) with “Application for participation in SI and HI” (Form No.TK1-TS) and “Application for adjustment to information about the SI and HI policyholders" (Form No.TK2-TS).

6. Deleting columns such as “birth date”; “gender”; “old contribution rate”; “till month and year”; “HI card is not returned”; “SI books already held” at the List of employees participating in SI and HI (Form No.D02-TS).

7. Deleting columns such as “birth date”; “gender”; “residence address”; “the place of first registration of health examination and disease treatment”; “benefit”; “ID number”; “receipt”; “rate of contributions” at the List of SI policyholders (Form No.D03-TS);

8. Amending and adjusting Point 2.1 Clause 2 Article 3 as follows:

“d) Reissue the cover of SI books to the policyholders who are granted lump-sum benefits and then proceed to take another job.

dd) Adjust information printed on the SI book that was provided before 1995 unless such information is inaccurate as against the information provided in the applications verified by Social Security authorities”.

9. Amending and adjusting Point 3.1 Clause 3 Article 32 as follows:

"3.1. Required documents required in the application dossiers:

3.1.1. In respect of the policyholders of mandatory SI:

a) SI book;

b) Application for adjustment to information about the SI, HI policyholders (Form No.TK2-TS).

3.1.2. In respect of the policyholders of obligatory SI and occupational accident insurance:

a) SI book;

b) Application for adjustment to information about the SI, HI policyholders (Form No.TK2-TS).”

10. Amending and adjusting Article 39 as follows:

10.1. Amend and adjust Point 1.2 Clause 1 as follows:

“1.2. Filing applications within a period of 30 days as from the date on which labor or employment contracts, or as from the date on which the decision on job offers comes into effect:

a) In case applications are electronically filed, procedures for providing information and delivering applications shall comply with the regulations on electronic transactions;

b) In case information is exchanged and checked via Internet connection methods, the report on these applications as prescribed in Article 17, 18 shall be made once a month and then submitted to social security authorities".

10.2. Remove Point 1.7 Clause 1.

11. Amending and adjusting Point 1.4 Clause 1 Article 40 as follows:

“1.4. Receiving applications from the division insurance books and cards; collecting SI books, HI cards, relevant documents and Form No.C12-TS to hand over to the labor-consuming enterprises and policyholders; the rest of application documents shall be reserved at social security authorities."

12. Amending and adjusting Point 1.4 Clause 1 Article 71 as follows:

“1.4. Retrieve HI card held by employees who quit their jobs, change residences and are on paid leaves, which will be then forwarded to social security authorities, or send the Form No.D02-ASSETS by Internet-based information exchange or application e-transaction system in order to make any adjustment to the amount receivable (except for the case in which the policyholder died).   In the case of sending the Form No.D02-TS by Internet-based information exchange, the HI card shall be moved to social security authorities at the end of the month. Any cost incurred by the health examination and disease treatment and covered by HI (if any) as of the period from the notification of decreases in insurance contributions to social security authorities' receipt of HI cards shall be paid by labor-consuming enterprises or collecting agents”.

13. Countersigning applications for participation in SI and HI; applications for adjustment to information about SI and HI policyholders; list of employees participating in SI and HI shall comply with instructions on the usage of forms and charts.

Article 2. Adjustments and amendments shall be made to several contents specified in the regulation on applications and procedures for paying SI benefits and allowances issued together with the Decision No.01/QĐ-BHXH dated January 03, 2014 by Vietnam Social Security as follows:

1. A photocopy is an uncertified copy of an original.

2. If either an original or a copy of application documents are needed, employees, relatives and employers can submit certified copy or a photocopy enclosed with the original for the social security authority's inspection (except for those stipulated in Clause 6 Article 14); If only an original of application documents is acceptable, the original must be submitted.

3. The officer who is in charge of receiving these application documents shall be responsible for checking a photocopy with an original, give their confirmation “already checked with the original” on the first page of such photocopy, and bear their signature, full name and date of confirmation on it. After that, the original shall be returned to the applicants.

4. In respect of application documents for the purpose of granting SI benefits to policyholders, the employer, employees and employee’s relatives must submit one (01) set of such application documents to social security authority.

Article 3. Amendments and adjustments shall be made to the regulations on managing the payments for SI benefits issued together with the Decision No.488/QĐ-BHXH dated May 23, 2012 by Vietnam Social Security as follows:

1. Bank accounts that enable account holders to perform transactions through ATMs and other personal bank accounts opened at Vietnam Commercial Bank shall be referred to as personal accounts.

2. Eliminating the written request for the receipt of unpaid sum (Form No.17-CBH) if the applicant being a new beneficiary or a person coming from a different province has not been granted pension or SI benefits in some months. 

3. Removing the written request for continuing to receive monthly SI benefits (Form No.19-CBH) if policyholders who receive pensions or allowances through personal accounts continue to receive their benefits in the subsequent month of the period for which they have made their confirmation.

Article 4. Amendments and adjustments shall be made to the regulations on implementing the contract for medical examination, treatment, inspecting payments for these costs, managing and using HI funds, issued together with the Decision 82/QĐ-BHXH dated January 20, 2010 by Vietnam Social Security as follows:

1. Item 2.2.1 Point 2 Section I Part I:

1.1. In respect of Public place of medical examination and disease treatment (briefly called public hospital):

a) Removing the requirement for submitting a notarized copy of the Establishment Decision and hospital ratings;

b) Removing the list of medicines, consumable and alternative medical supplies used at hospitals, stipulated by the Ministry of Health.

1.2. In respect of non-public hospitals:

a) Removing the notarized copy of Certificate of Business Registration or the Investment License in accordance with legal regulations; the notarized copy of the Certificate of eligibility for the private medical practicing; the notarized copy of eligibility for the private pharmaceutical practicing, and the Decision on approval of scope of professional works.  

b) Removing the list of medicines, consumable and alternative medical supplies used at hospitals, stipulated by the Ministry of Health; the commitment to pay medical costs which do not exceed the hospital fees regulated at public HI-funded hospitals equivalent to professional and technical hospitals or ranked the same as those regulated by the Ministry of Health, and the agreement to refuse to collect any further cost from insured patients that have been paid by HI benefits in accordance with the Law on Health Insurance.   

2. Point 3 Section IV Part I:

Removing the content “If insured patients are transferred to another hospital, the hospital which agrees to transfer patients to another hospital must provide the copy of hospital transfer issued by the prior hospital (except for emergency case) enclosed with a set of supporting documents for that hospital transfer."

Article 5. Amendments and adjustments shall be made to the regulations on receiving application documents and informing the result of dealing with administrative procedures for SI and HI, issued together with the Decision No.884/QĐ-BHXH dated August 25, 2011 by Vietnam Social Security as follows:

1. Prohibiting the issuance of any further administrative procedure; publicly disclosing a required set of administrative documentation through mass media, sectorial information website and single-window administration division of Social Security Authority of a province, district to facilitate transactions between authorities and applicants. 

2. Director of Social Security Authority of a province, district shall assign an officer of the single-window administration division to receive applicant’s documents and return the result of dealing with administrative procedures at labor-consuming entities. If it is impossible to assign such officer, a contract with mail service providers is needed. The time of receiving application documents and response to applicants shall be decided under the agreement between the Director of Social Security Authority and the employers.

Article 6. This Decision shall come into force as from November 01, 2014.

The Head of affiliates of Vietnam Social Security, the Director of Social Security Authority of centrally-governed cities and provinces bear full responsibility for the implementation of this Decision./.

APPLICATION FOR PARTICIPATION

IN SOCIAL INSURANCE AND HEALTH INSURANCE

A. POLICYHOLDER'S PARTICULARS:

[01]. Full name (written in capital letters):………………………………………………..

[03]. Gender: Male 0   Female 0 [04]. Ethnicity:.................., [05]. Nationality:..............

[06]. Place of issuance of birth certificate (registered permanent residence): [06.1]. Commune or ward:....................................  

[06.2]. Urban or rural district:....................................................... [06.3]. City or province....................

[07]. Relatives

[07.1]. Parent or guardian:........................................................................................  

[07.2]. Other relatives:………………………………………………………………

[09]. Residence address registered in the family record book: [09.1]. Identification number of house, street or village:.....................................  

[09.2]. Commune or ward....................... [09.3]. Urban or rural district:....................... [09.4]. City or province....................

[10]. Contact address (residence address): [10.1]. Identification number of house, street or village:........................

[10.2]. Commune or ward....................... [10.3]. Urban or rural district:....................... [10.4]. City or province....................

[11]. Telephone:..................................................... [12]. Email address:.....................................

[13]. Place of first registration of health examination and disease treatment :......................................................................

B. PARTICIPATION IN SOCIAL INSURANCE AND HEALTH INSURANCE:

I. PARTICIPATION IN BOTH SOCIAL INSURANCE AND HEALTH INSURANCE

[14]. Decision on job offer and labor contract (employment contract): No.....................dated on....................... that comes into force from....................and contract type is...................................

[15]. Entity's name:...............................………………………………………………..

[16]. Post, title and working position:............................................................................  

[17]. Main salary:........................................ [18]. Allowance: [18.1]. Post allowance:........................  

[18.2]. Extra-seniority allowance:………….. [18.3]. Job seniority:…………..[18.4]. Other:…………  

II. PARTICIPATION IN MANDATORY SOCIAL INSURANCE

[19]. Monthly pay as a basis for paying contributions to mandatory Social Insurance:……

[20]. Method of payments for contributions:………………………………………….

III. PARTICIPATION IN ONLY HEALTH INSURANCE

[21]. Participating in health insurance designed for specific policyholders:…..………

[22]. Monetary amount as a basis for paying Health Insurance contributions:…..………

[23]. Method of payments for contributions:………………………………………….

ANNEX

WORKING TIME WITH PAYMENTS FOR SOCIAL INSURANCE CONTRIBUTIONS AND LUMP-SUM PAYMENT OF BENEFITS THAT HAS NOT BEEN MADE YET

APPLICATION FOR CHANGES TO INFORMATION

ABOUT SOCIAL INSURANCE AND HEALTH INSURANCE POLICYHOLDERS

Dear, Social Security Authority of ……………………….. 

I. Full name (written in capital letters):………………………………………………..

III. Changed contents:

[01]. Full name (written in capital letters):………………………………………………..

[03]. Gender: Male 0  Female 0 [04]. Ethnicity:.................., [05]. Nationality:..............

[06]. Family relatives

[06.1]. Parent or guardian:........................................................................................  

[06.2]. Other relatives:………………………………………………………………

[08]. Residence address registered in the family record book: [08.1]. Identification number of house, street or village:.....................................  

[08.2]. Commune or ward....................... [08.3]. Urban or rural district:....................... [08.4]. Province, city....................

[09]. Contact address (current residence address): [9.1]. Identification number of house, street or village:........................

[9.2]. Commune or ward:....................... [9.3]. Urban or rural district:....................... [9.4]. City, province....................

[9.5]. Telephone:..................................................... [9.6]. Email address:.....................................

[10]. Place of first registration of health examination and disease treatment: :......................................................................

[11]. Monthly pay as a basis for paying contributions to mandatory Social Insurance:……

[11.1]. Method of payment for contributions:………………………………………….

[12]. Other contents:………………………………………………………………

IV. Supporting documents

.......................................................................................................................................

Entity's name:...............................………………………………………………..

Nominal number:………………………………….

Address:………………..........................................

Rate of State Budget used for payment of insurance benefits or allowances:

Persons eligible to participate in the social security:

Entity's name:...............................………………………………………………..

Nominal number:………………………………….

Address:………………..........................................

SUMMARY SECTION

LIST OF THE POLICYHOLDERS OF MANDATORY SI

No.:……………month………………year…………….