Chapter II
LISTING PARTICIPANTS FOR ISSUANCE OF HEALTH INSURANCE CARDS
Article 4. Responsibilities for making a list of participants
1. Employers shall be responsible for making a list of participants as defined in Clause 1, Article 1 hereof and make submission to the social insurance organization.
2. People’s Committees of communes shall make a list of participants as defined in Clauses 2, 3, 4 and 5, Article 1 hereof by household, excluding the participants as defined in Point a, Clause 4 and Point n, Clause 3, Point b, Clause 4, Article 1 hereof and make submission to the social insurance organization at district-level, particularly as follows:
a) In 2015, People’s Committees of communes shall make a list of participants and send it to the social insurance organization at district-level on October 01, 2015 at the latest;
b) On a monthly basis, from 2016 and later, People’s Committees of communes shall revise the list of participants and send it to the social insurance organization at district-level for issuance of health issuance cards respectively;
3. Institutions of education and training, vocational training institutions shall be responsible for making a list of participants managed by the Ministry of Education and Training, the Ministry of Labor, Invalids and Social Affairs as defined in Points n and o, Clause 3, Point b, Clause 4, Article hereof and making submission to the social insurance organization no later than October 31 annually.
4. The social insurance organization that receives the list of participants as defined in Clauses 2, 3 of this Article shall be responsible for presiding over and collaborating with agencies, organizations directly in charge of participants on double-checks before issuance of health insurance cards.
5. Making a list of participants managed by the Ministry of National Defense and the Ministry of Public Security as defined in Point a, Clause 1, Article 1; Points a, l (except children under six) and Point n, Clause 3, Article 1; Point b, Clause 4, Article 1 hereof shall be done according to separate regulation.
Example 4: A child named Q, under 6, is an offspring of the military officer as defined in Point 3, Clause 3, Article 1 hereof According to the provisions as set out in Point b, Clause 1, Article 17 amending, supplementing the Law on Health Insurance, the child is entitled to the health insurance card and People’s Committee of the commune where the child resides is responsible for making the list and sending it to the social insurance organization for issuance of health insurance cards.
6. List of participants shall be established according to the forms issued by the social insurance organization.
Article 5. Health insurance cards
1. Specimen health insurance card shall be issued by Vietnam Social Security after approved by the Ministry of Health. The health insurance card shall contain the following information:
a) Code: the code must be in conformity with the personal identification number granted by regulatory agencies. In case the personal identification number is not yet granted, the Vietnam Social Security shall define codes to the participant ensuring that every participant shall have a unique code.
b) Code of insurance coverage rate granted to participants as stipulated in Article 22 amending, supplementing the Law on Health Insurance and Article 4 of the Decree No. 105/2014/NĐ-CP;
b) The term of validity written on the health insurance card (hereinafter referred to as the term of validity) is defined according to the provisions set out in Clause 3, Article 16 amending and supplementing the Law on Health Insurance as follows:
- For persons entitled to unemployment benefits, the term of validity shall correspond to the term of unemployment benefits written on the unemployment benefits eligibility decision issued by competent agencies;
- For children under six years old, the term of validity shall start from the date of birth to 72 months old. In case the child reaches 72 months old before the school year starts, the term of validity shall be extended to September 30 of the year;
- For ethnics residing in the areas facing extreme socio-economic difficulties, persons residing in island districts and communes, the term of validity shall start from January 01 to December 31 of the same year, or to December 31 of the last year as noted on the health insurance card (in case of the term of validity is multi-year long);
- For participants as members of poor households or nearly poor households who are entitled to 100% of the premium rate provided by the State, the term of validity shall start from January 01 to December 31 of the same year: In case the social insurance organization receives the list of participants as members of poor households or nearly poor households enclosed with the written approval of such participants issued by competent agencies after January 01, the term of validity shall start from the date this approval takes effect;
- For participants as members of nearly poor households who are supported part of the premium rate by the State and participants as members of households who rely on agricultural, forestry, fish farming and salt production with average standard of living, the term of validity shall correspond to the term of entitlement to preferential policy as approved by competent agencies for the aforesaid participants; in case this is the first participation, the term of validity shall start after 30 days since the date of payment of premiums;
- For participants as students, the term of validity shall start from January 01 to December 31 of the same year; for participants as first graders and first-year students, the term of validity start from the day of entering school or the expiration date of the previous health insurance card to December 31 of the following year; for participants as 12th graders and final-year students, the term of validity shall start January 01 to the end of the school year's final month;
- For other categories of participants, the term of validity shall be stipulated by the Vietnam Social Security.
d) As of January 01, 2016, the health insurance card should contain previous continuous period of participation in health insurance by month, at most 60 months, except the cases as defined in Points a, d, e, g, h and i, Clause 3, Article 1 hereof. Continuous period of participation in health insurance means the term of validity of the following card follows closely the expiration date of the previous card; interruption (if any) should not exceed three months;
For participants as employees appointed for studying or working overseas, the continuous period of participation in health insurance means the period from the time of studying or working overseas until a recall is issued by their organization or agency;
For participants as overseas workers, within a period of 60 days since the date of entering the country (Vietnam), if participating in health insurance, the continuous period of participation in health insurance includes the entire period of working overseas up to the date of participating in health insurance;
For participants as employees who are in the process of filing procedures for entitlements to unemployment benefits as stipulated by the Law on Employment, the continuous period of participation in health insurance includes the period for preparing the procedures for entitlements to unemployment benefits according to the Law on Employment in Vietnam.
Example 5: Mr. M has a continuous period of participation in health insurance from December 21, 2013 to December 31, 2015; the continuous period of participation to be written on the health insurance card with the term of validity starting from January 01, 2016 shall be “The continuous period of participation in health insurance up to December 31, 2015: 24 months and 10 days”.
Example 6: Mr. V’s continuous period of participation in health insurance up to December 31, 2015 is 70 months; the continuous period of participation to be written on the health insurance card with the term of validity starting from January 01, 2016 shall be “The continuous period of participation in health insurance up to December 31, 2015: over 60 months”.
Example 7: Ms. K is working in an enterprise and participating in health insurance continuously from January 01, 2013 to January 05, 2015 when her employment contract is terminated. On April 04, 2015, Ms. K submitted the documents to apply for entitlements to unemployment benefits (within three months). On April 20, 2015, the competent agency issued the unemployment benefits entitlement decision (within 20 days). On April 26, 2015, the social insurance organization received the decision and carried out the payment of unemployment benefits to her as of May 01, 2015 (for a term of three months). In this case, the continuous period of participation in health insurance up to April 30, 2015 is 28 months.
2. Issuance of health insurance cards to persons who donate body organs according to the law shall be done as follows:
a) The medical establishment where body organs are taken shall be responsible for noting “body organs have been donated" on the hospital discharge papers;
b) Based on such hospital discharge papers as defined in Point a of this Article, the social insurance organization shall issue the health insurance card to the donor and make a written notice to People’s Committees of communes where such donor resides;
c) The term of validity shall start from the date the donor is discharged from hospital.
Tìm kiếm
Thông tư liên tịch 41/2014/TTLT-BYT-BTC (Bản Word)
Thông tư liên tịch 41/2014/TTLT-BYT-BTC (Bản Pdf)