Chương II: Thông tư 20/2016/TT-BTC Cơ chế quản lý tài chính về bảo hiểm xã hội, bảo hiểm y tế, bảo hiểm thất nghiệp

Chapter II

FINANCIAL MANAGEMENT MECHANISM

Article 3. Cost estimation

1. Contents of a cost estimate:

a) Estimation of social, health and unemployment insurance receipts and expenses by policy holder, beneficiary; receipts and expenses for social insurance benefits by group of policy holder according to the regulations on social, health and unemployment insurance (forms 01, 02, 03 and 04 enclosed herewith);

b) Estimation of administrative expenses (See form 05 enclosed herewith);

c) Plan of investment from social, health and unemployment insurance funds (Hereinafter referred to as “the investment plan”) (See form 06 enclosed herewith).

2. Cost estimating process:

a) The units affiliated to Vietnam Social Security shall make an estimate of receipts and expenses as prescribed in Points a and b, Clause 1 of this Article and report to general director of Vietnam Social Security;

b) Insurance agencies affiliated to the Ministry of Defence, Ministry of Public Security shall make an estimate of receipts and expenses as prescribed in Points a and b, Clause 1, this Article and report to Vietnam Social Security;

c) The Ministry of Labor, Invalids and Social Affairs shall make an estimate of expenses for unemployment insurance benefits and unemployment insurance administrative expenses as prescribed in Points a and b, Clause 1 of this Article, and report to Vietnam Social Security (forms 04 and 05 enclosed herewith).

3. Vietnam Social Security shall be responsible for compiling the estimates from the agencies prescribed in Clause 2 of this Article and the investment plan prescribed in Point c, Clause 1 of this Article, and reporting to management board of Vietnam Social Security for approval and making submission to the Ministry of Finance, Ministry of Labor, Invalids and Social Affairs, Ministry of Health, Ministry of Planning and Investment (forms 01, 02, 03, 04, 05 and 06 enclosed herewith).

4. Regarding the estimation of social, health and unemployment insurance administrative expenses, the total amount of expenses should not exceed annual administrative expenses prescribed in Clause 2, Article 8 of the Decision No. 60/2015/QD-TTg. The estimation of expenses for development investment must be enclosed with a list of investment projects according to the regulations on public investment and construction.

Article 4. Allocation of estimates, transfer of state-guaranteed expenditures for payment of pensions and social insurance benefits 

1. Based on the state budget spending estimate allocated by competent authorities, Vietnam Social Security shall allocate detailed estimates as prescribed in Article 27 of the Government’s Decision No. 115/2015/ND-CP dated November 11, 2015 and report to the Ministry of Finance for assessment according to the Law on State budget.

2. Before 25^th every month, the Ministry of Finance shall transfer an amount equivalent to a monthly average expenditure according the annual estimate allocated by competent authorities to Vietnam Social Security for making payment of insurance benefits to beneficiaries in the following month.

3. After the annual estimate is approved, if the funds transferred by the Ministry of Finance to Vietnam Social Security are greater than the estimate, Vietnam Social Security must return the difference the central budget. If the funds transferred are less than the estimate, the Ministry of Finance shall make a written request to competent authorities for allocation of the difference to Vietnam Social Security.

Article 5. Method for determination of interests on premiums delayed, evaded or appropriated

1. Monthly interests on delayed premiums shall be determined in the following formula:

Where:

- (n) Month in which the interests on delayed premiums are determined.

- (n-2) Month preceding two months of month (n).

- Interest rate (%/month) is the monthly average interest rate published by Vietnam Social Security at the beginning of year as prescribed in Point c, Clause 3, Article 6 of the Decision No.60/2015/QD-TTg.

2. If payment of premiums is detected by Vietnam Social Security, competent authorities as being evaded, insufficient or appropriated (hereinafter referred to as “delayed payments”) as of January 01, 2016, in addition to the payables enforced according to laws, the breaching person or entity shall pay the interests on the delayed payments as follows:

a) Interest rate on delayed payments before January 01, 2016 shall be conformable with the interest rate of 2016;

b) Interest rate on delayed payments as of January 01, 2016 shall be conformable with the interest rate of individual years and determined according to the formula in Clause 1 of this Article.

Example 1: On January 20, 2016, a social insurance agency detects Enterprise M has delayed a payment of VND 100 million as the premiums for its employees for 12 months (recorded to the end of December 2015), assuming that the interest rate of 2015 for investment of social insurance funds is 0.7%/month as published by Vietnam Social Security:

- According to Clause 3, Article 122 of the Law on Social Security 2014, in addition to an amount of VND 100 million, Enterprise M has to pay VND 16.8 million as the interests on delayed payments (VND 100 million x 12 month x 2 x 0.7%/month).

- If Enterprise M fails to make the payment or makes insufficient payments during January 2016, such delayed payments shall be transferred to February 2106 to calculate the interests according to the formula in Clause 1 of this Article.

3. The interests on delayed payments in the month includes interests on payments delayed to the end of last month and interests on delayed payments arising in the month as prescribed in Clause 1 of this Article.

Example 2: To the end of December 2015, Enterprise A's delayed payment is VND 700 million (in which the premiums delayed to the end of November is VND 600 million and the premiums delayed in December 12 VND 100 million), and the interest on the delayed payment is VND 50 million. Assuming that the average interest rate on investments of social insurance funds in 2015 is 0.7%/month. According to Clause 3, Article 122 of the Law on Social Security in 2014, the interest on Enterprise A’s delayed payment in January 2016 (month n) is determined as follows:

- In January 2016: In addition to VND 600 million as the amount delayed to the end of November 2015 (month n-2), Enterprise A has to pay the interest twice the average interest rate in 2015 on the amount of VND 600 million. The interest on delayed payment in January 2016 is VND 8.4 million (VND 600 million x 2 x 0.7%).

- Concerning VND 100 million as the delayed amount in December 2015, no interest thereon shall be imposed if Enterprise A fulfills the payment in January 2016. Otherwise, the delayed amount in December shall be transferred to the following month (February 2016) to calculate interests.

- Total interest on the amount delayed to the end of January 2016 Enterprise A has to pay is VND 58.4 million including VND 50 million in December 2015 and VND 8.4 million in January 2016.

4. On a monthly basis, social insurance agencies shall issue a written notice of payment of premiums to employers according to the instructions from Vietnam Social Security specifying the delayed amount and the interests thereon (if any).

Article 6. Payment of pensions, social and unemployment insurance benefits

1. On a monthly basis, social insurance agencies shall transfer money to the paying agents who then make payments of insurance benefits to beneficiaries according to terms and conditions of the signed contract.

2. The paying agents shall be responsible for making payments to beneficiaries in a timely manner.

3. During the duration of the contract, social insurance agencies shall be responsible for appointing staff to inspect and monitor the payment. Expenses paid to the paying agents for carrying out payments are prescribed in Clause 3, Article 8 herein.

Article 7. Management and use of funds for medical examination and treatment under health insurance coverage remaining from January 2015 to December 31, 2020

1. Vietnam Social Security:

a) When appraising the annual balance sheet of the medical examination and treatment fund of the provincial social security, Vietnam Social Security shall record in the appraisal record a 20% of the funds for medical examination and treatment remaining (if any) shall be used for localities as prescribed in Point b, Clause 4, Article 6 of the Government’s Decree No. 105/2014/ND-CP dated November 15, 2014 providing instructions on the implementation of a number of articles of the Law on Health insurance (hereinafter referred to as “a 20% of the funds).

b) Within one month since management board of Vietnam Social Security passes the annual balance sheet of the health insurance fund, Vietnam Social Security shall issue a written notice to the People’s committees of provinces, the Service of Health, the Service of Finance stating that a 20% of the funds shall be used for localities, and at the same transfer all of this amount to the provincial social security according to decisions by the People’s Committees of provinces;

c) Compile the used funds as prescribed in Clause 3 and Clause 4 of this Article into the balance sheet of the health insurance fund.

2. The Service of Health:

a) Based on the written notice from Vietnam Social Security, the Service of Health shall preside over and cooperate with the Service of Finance and the provincial social security in making a fund use plan in order of priority as prescribed in Point a, Clause 3, Article 35 amending and supplementing the Law on Health insurance, making submission to the People’s committees of provinces for approval and reporting to provincial People’s Councils;

b) Preside over and cooperate with the provincial social security in inspecting management and use of funds for procuring medical and transport equipment by relevant units.

3. The provincial social security:

a) Upon receipt of approval from presidents of the People's committees of provinces, the provincial social security shall:

- In case of supporting the fund for medical examination and treatment for the poor: Transfer money to the fund for medical examination and treatment for the poor according to the Ministry of Health, the Ministry of Finance’ Joint Circular No. 33/2013/TTLT-BYT-BTC dated October 18, 2013 providing instructions on implementation of the Prime Minister’s Decision No. 14/2012/QD-TTg dated March 01, 2012 amending a number of articles of the Prime Minister's Decision No. 139/2002/QD-TTg dated October 15, 2002 on medical examination and treatment to the poor; and at the same time, compile the transferred money into the spending estimate of the provincial health insurance fund (within a 20% of the funds);

- In case of supporting payment of premiums by some category of policy holders: Account for health insurance premiums and make the spending estimate from the provincial health insurance fund (within a 20% of the funds) based on the list of policy holders eligible for supports and support levels;

- In case of procuring medical and patient transport equipment at district level: Transfer funds to the deposit account belonging to relevant units according to the procurement schedule as prescribed in the regulations on bidding and compile the used funds into expenditures of the provincial health insurance fund (within 20% of the funds).

b) Cooperate with the Service of Health in inspecting the use of funds by relevant units to ensure the funds are used in a right and transparent way;

c) Within 12 months since the written notice from Vietnam Social Security is issued as prescribed in Point b, Clause 1 of this Article, the funds allocated for localities leftover or un-used shall be recovered and returned to Vietnam Social Security.

4. Social insurance agencies affiliated to the Ministry of National Defense, Ministry of Public Security:

If funds for medical examination and treatment for soldiers, people's public security forces and cipher forces are greater than expenses for medical examination and treatment and transportation in the year: After management board of Vietnam Social Security passes its annual balance sheet, the funds remaining shall be used according to Clause 2, Article 21 of the Government’s Decree No. 70/2015/ND-CP dated September 01, 2015 and compiled into expenditures for medical examination and treatment of social insurance agencies affiliated to the Ministry of National Defense, Ministry of Public Security.

5. The units allocated the funds for procurement of medical and transport equipment shall:

a) Manage and use the funds according to the regulations on procurement of assets and include them in other sources of funds of the unit according to the Law on State budget and guiding documents;

b) Finalize the funds allocated with the provincial social security or with social insurance agencies affiliated to the Ministry of Defence, Ministry of Public Security (if relevant units are under the management of the Ministry of Defence, Ministry of Public Security).