DECREE No. 146/2018/ND-CP: ELABORATING AND PROVIDING GUIDANCE ON MEASURES TO IMPLEMENT CERTAIN ARTICLES OF LAW ON HEALTH INSURANCE
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CONTRIBUTION RATES, STATE BUDGET SUPPORT RATES AND CONRIBUTION METHODS APPLIED TO CERTAIN POLICYHOLDERS
Article 7. Health insurance contribution rates and health insurance contribution responsibilities
1. Monthly health insurance contribution rates shall be subject to the following regulations:
a) The contribution rate shall be equal to 4.5% of the employee’s monthly pay with respect to those policyholders specified in clause 1, Article 1 of this Decree.
– Employees on sick leaves from at least 14 days per a month in accordance with laws on social insurance shall not be required to pay health insurance contributions and shall be entitled to health insurance benefits;
– With respect to employees that are detained, held in custody or suspended from work for investigations, consideration of judgement whether they have committed violations against laws, the monthly contribution rate shall be defined as 4.5% of 50% of each employee’s monthly pay. In case where a competent authority makes its judgement that none of violations has been committed, the employee shall be required to pay health insurance contributions in proportion to the accrued pay amount that he/she has received;
b) The contribution rate shall be equal to 4.5% of the retirement pension and incapacity benefit with respect to those policyholders specified in clause 1, Article 2 of this Decree;
c) The contribution rate shall be equal to 4.5% of the monthly pay that an employee receives before his/her pregnancy and parental leave with respect to those policyholders specified in clause 5, Article 2 of this Decree;
d) The contribution rate shall be equal to 4.5% of the unemployment benefit with respect to those policyholders specified in clause 6, Article 2 of this Decree;
dd) The contribution rate shall be equal to 4.5% of the base pay rate with respect to those policyholders other than the abovementioned;
e) The health insurance contribution rate of those policyholders defined in Article 5 hereof shall be determined as follows: The first policyholder shall be required to pay 4.5% of the base pay rate; the second, third and fourth policyholder shall be required to pay 70%, 60% and 50%, respectively, of the contribution rate of the first policyholder; the fifth and subsequent policyholder shall be required to pay 40% of the contribution rate of the first policyholder.
Any relief or deduction in the health insurance contribution rate as specified in this point shall be granted only if family members participate in the family-based health insurance within the same financial year.
2. With respect to those policyholders whose contribution rates are supported by the state budget, the relief or deduction in the contribution rate shall not be applied in accordance with point e, clause 1 of this Article.
3. In case where a policyholder referred to in clause 1, Article 1 hereof enters into one more or multiple indefinite-term employment contracts or fixed-term employment contracts, each of which has the term of at least three months, he/she shall be bound to pay the health insurance contribution rate determined on the basis of the employment contract under which the highest pay is agreed upon in comparison with other employment contracts.
4. In case where health insurance policyholders specified in Article 6 hereof and those specified in Article 1, 2, 3 and 4 hereof overlap, health insurance contributions shall be paid in the following order: Health insurance contributions are paid by both employees and employers; by social insurance agencies; by the state budget; by employers.
5. The Ministry of Health shall preside over and cooperate with the Ministry of Finance in appealing to the Government for approval of adjustments to the health insurance contribution rates in order to ensure the balance of the health insurance package, comparability with state budget capabilities and contributions of those responsible for paying health insurance contributions in accordance with the Law on Health Insurance.
Article 8. State budget’s support rate
1. From the entry into force of this Decree, the state budget’s support rates shall be applied to the following policyholders:
a) The state budget’s support shall be paid for 100% of the health insurance contribution rate with respect to members of near-poor families residing in poor districts referred to in the Government’s Resolution No. 30a/2008/NQ-CP dated December 27, 2008 regarding quick and sustainable poverty reduction support programs, and districts where regimes and policies defined in the Resolution No. 30a/2008/NQ-CP are applied;
b) The state budget’s support shall be paid for at least 70% of the health insurance contribution rate with respect to those policyholders referred to in clause 1 and 2 Article 4 hereof;
c) The state budget’s support shall be paid for at least 30% of the health insurance contribution rate with respect to those policyholders referred to in clause 3 and 4, Article 4 hereof.
2. In case where a policyholder falls into multiple beneficiaries of the state budget’s health insurance contribution support as prescribed in clause 1 of this Article, the state budget’s support for the policyholder entitled to the highest support rate shall be applied.
3. People’s Committees of provinces and centrally-affiliated cities shall, based on the local government budget’s capabilities and other legal funding sources, and after taking into account 20% of the funding defined in point a, clause 3, Article 35 of the Law on Health Insurance (if any), formulate and appeal to the provincial-level People’s Councils for their decision on the rate of support for health insurance contributions which is higher than the minimum support rate specified in clause 1 of this Article.
Article 9. Method for paying health insurance contributions by certain policyholders
1. With respect to persons entitled to monthly retirement pensions, incapacity benefits and social insurance benefits covered by the state budget as prescribed in Article 2 and clause 2 of Article 3 hereof: On a monthly basis, social insurance agencies shall pay health insurance contributions for these policyholders by using funds for retirement pensions and social insurance benefits covered by the state budget.
2. With respect to policyholders prescribed in clause 3, 8, 11, 12 and 16 of Article 3 hereof: On a quarterly basis, agencies of labor, war invalids and social affairs shall remit funds derived from state budget spending on implementation of compensation policies for persons rendering meritorious revolutionary services, or funds derived from state budget spending on implementation of social protection policies, into the health insurance package. Not later than December 15 of each year, agencies of labor, war invalids and social affairs must complete payments and fund transfers to the health insurance package during that year.
3. With respect to policyholders referred to in clause 1, 4, 6, 7, 10, 13, 14 and 17 of Article 3, and those specified in clause 1 and 2 of Article 4 hereof of whom 100% of the health insurance contribution has been covered by the state budget’s support: On a quarterly basis, social insurance agencies shall prepare a consolidated report on the number of health insurance cards which have already been issued and the contribution and contribution support amounts according to the Form No. 1 of the Appendix to this Decree, send it to the financial institution to transfer the funds to the health insurance package as stipulated in clause 9 of this Article. The time of calculation of the health insurance contribution payable: Policyholders shall be listed annually and their health insurance contributions shall be calculated as from January 1; with respect to policyholders added to the list, their contributions shall be calculated from the date specified in the Decision on approval of the abovementioned list issued by the competent authority.
4. As for policyholders specified in clause 6 of Article 3 hereof (except policyholders other than those mentioned above, policyholders entitled to retirement pensions, social insurance benefits and benefits for persons rendering meritorious revolutionary services): On a periodic basis, every 3 months, 6 months or 12 months, agencies in charge of management of policyholders shall pay health insurance contributions for these policyholders.
5. With regard to pupils and students specified in clause 3 of Article 4 hereof:
a) On a periodic basis, every 3 months, 6 months or 12 months, pupils and students, or parents or guardians thereof, shall be responsible for paying health insurance contributions on their part as prescribed in clause 2 of Article 10 hereof to social insurance agencies;
b) The state budget shall give support as follows:
– Health insurance contributions of pupils and students studying at educational institutions or vocational training establishments affiliated to ministries and central bodies shall be supported by the central budget. On a periodic basis, every 3 months, 6 months or 12 months, provincial-level Social Insurance agencies shall make general reports on the number of health insurance cards which have already been issued, contribution amounts collected from pupils and students and contribution amounts supported by the state budget by using the Form No. 1 of the Appendix to this Decree and send them to the Vietnam Social Security so that the Vietnam Social Security prepares a consolidated report for submission to the Ministry of Finance in order to transfer the state budget’s support amounts to the health insurance package in accordance with clause 9 of this Article.
– Health insurance contributions of pupils and students studying at educational institutions or other vocational training establishments shall be supported by the budget of the local jurisdictions where these educational entities are located, irrespective of registered permanent residences of pupils and students, including the central budget allocations (if any). On a periodic basis, every 3 months, 6 months or 12 months, social insurance agencies shall make general reports on the number of health insurance cards which have already been issued, contribution amounts collected from pupils and students and contribution amounts supported by the state budget by using the Form No. 1 of the Appendix to this Decree and send them to the financial authority in order to transfer state budget expenditures used for supporting health insurance contributions to the health insurance package in accordance with clause 9 of this Article.
6. With respect to those policyholders whose health insurance contributions are partially supported by the state budget in accordance with clause 4 of Article 4 hereof:
a) On a periodic basis, every 3 months, 6 months or 12 months, representatives of family households shall directly pay health insurance contributions on their part as prescribed in clause 2 of Article 10 hereof to social insurance agencies;
b) On a periodic basis, every 3 months, 6 months or 12 months, social insurance agencies shall make general reports on the number of health insurance cards which have already been issued, contribution amounts collected from policyholders and contribution amounts supported by the state budget by using the Form No. 1 of the Appendix to this Decree and send them to the financial authority in order to transfer state budget expenditures used for supporting health insurance contributions to the health insurance package in accordance with clause 9 of this Article.
7. With respect to family-based policyholders as defined in Article 5 hereof: On a periodic basis, every 3 months, 6 months or 12 months, representatives or members of families participating in the health insurance shall pay health insurance contributions as prescribed in clause 3 of Article 10 hereof to social insurance agencies.
8. With respect to health insurance policyholders referred to in Article 6 hereof, on a monthly basis, employers shall make health insurance contribution payments for them and pay health insurance contributions for their employees in accordance with regulations in force by using the following funding sources:
a) If these employees work for state budget-financed units, state budget allocations shall support health insurance contributions of these policyholders;
b) If these employees work for public service units, their health insurance contributions shall be paid by each unit’s budget in accordance with laws on autonomy mechanisms of public service units;
c) If these employees work for enterprises, their health insurance contributions shall be paid by each enterprise’s budget.
9. Based on regulations on delegation of authority by competent authorities and the general report on policyholders, state budget expenditures on health insurance contributions and health insurance contribution support, sent by social insurance agencies, the financial authority shall be responsible for transferring these expenditures to the health insurance package once every quarter of a financial year. Not later than December 15 of each year, transfer of state budget expenditures to the health insurance package in that year must be completed.
10. With respect to policyholders specified in clause 15 of Article 3 hereof, on a quarterly basis, scholarship-granting entities or organizations shall pay health insurance contributions in accordance with regulations in force into the health insurance package.
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