Công văn 2229/BHXH-CSYT của Bảo hiểm xã hội Việt Nam về việc thực hiện bảo hiểm y tế cho các đối tượng quy định tại điểm c và d khoản 2 Điều 51 Luật Bảo hiểm y tế

THE VIETNAM SOCIAL INSURANCE

Official Dispatch No.2229/BHXH-CSYT dated June 25, 2014 of the Vietnam Social Insuranceon issues related to Health insurance of the entities prescribed in Point c and Point d Clause 2 Article 51 of the Law on Health insurance

To:Social insurance agencies of centrally-affiliated cities and provinces

The Vietnam Social insurance agency has been receiving opinions of the Social insurance agencies of centrally-affiliated cities and provinces (hereinafter referred to as Social insurance agencies of provinces) on the issues related to Health insurance of the entities prescribed in Points c and d, Clause 2, Article 51 of the Law on Health insurance. After the Official Dispatch No. 2262/BYT-BH dated April 25, 2014 is issued by the Ministry of Health, the Vietnam Social insurance shall instruct the Social insurance agencies of provinces to deal with the abovementioned entities as follows:

1. Responsibility to determine entities

1.1. Relatives of employees living in the same households that the employees liable to rear

Each employee is responsible for making a list of their relatives living in the same household that (s)he is liable to rear using the form A03-TS (the formsA03-TS, D03-TS issued together with the Decision No. 1111/QD-BHXH of the Vietnam Social Insurance on the Regulations on management of collection of Social insurance, Health insurance and management of Social insurance books and Health insurance cards)and sending such list to the employer to apply for Health insurance under the regulations in Point b, Clause 5, Article 3 of the Joint Circular No. 09/2009/TTLT-BYT-BTC of the Ministry of Health and Ministry of Finance giving instructions on the implementation of health insurance dated August 14, 2009. The employer shall confirm: Full names, dates of birth, gender and relationship between the dependants and the employee; the employee shall state other contents using the form A03-TS and take responsibility for them.

1.2. Members of households engaged in agriculture, forestry, aquaculture and salt making; members of cooperatives; business households

The abovementioned persons shall state their own information using the form A03-TS and take responsibility for their statements. Each member of a cooperative or business household shall directly pay their Health insurance premium to the Social insurance agency under the regulations in Clause 6, Article 3 of the Joint Circular No. 09/2009/TTLT-BYT-BTC issued by the Ministry of Health and Ministry of Finance giving instructions on the implementation of Health insurance dated August 14, 2009.

1.3. Persons prescribed in the Decision No. 32/2014/QD-TTg of the Prime Minister on the criteria of households engaged in agriculture, forestry, aquaculture and salt making having average living standards from 2014 to 2015 dated May 27, 2014 (which has not come into effect) whose payment for Health insurance premiums is not supported by the State budget.

2. Application forms for Health insurance and List of persons applying for only Health insurance:

2.1. Application form for Health insurance (form A03-TS):

- The application form for Health insurance (form A03-TS) is added criterion No. [14] – Occupation, which is used to identify the occupation of the insured.

- In case there are 2 or more members living in the same household engaged in agriculture, forestry, aquaculture and salt making, the second one and the followings shall be written in the Appendix “Attendant of Social Insurance" and their occupations shall be written on the column “Note”

2.2. List of persons applying for only Health insurance (form D03-TS):

- The Agents shall compile the Lists of persons applying for only Health insurance if those persons are members of the households engaged in agriculture, forestry, aquaculture and salt making and write their occupations on the column “Note”.

- The employers shall compile the Lists of persons applying for only Health insurance if those persons are relatives of the employees and write the relationship between the employees and their relatives on the column “Note”.

3. Procedures

3.1. Members of the households engaged in agriculture, forestry, aquaculture and salt making; members of cooperatives; business households shall apply for Health insurance through the Agents of Collection or Social insurance agencies of the districts where they live.

3.2. Relatives of the employees shall apply for Health insurance through the employers:

- Each employee shall make a list of their relatives using the application form for Health insurance (form A03-TS) to register the Health insurance cards;

- Each employer shall make a list of the persons applying for only Health insurance (form D03-TS);

- The employers shall pay the monthly Health insurance premiums for the relatives of the employees at the time such employers pay their Health insurance and Social insurance premiums according to the lists of the relatives of the employees. The payments for the Health insurance of the relatives of the employees shall be deducted from the wages of the employees.

4. From January 01, 2014, the Health insurance cards of the abovementioned insured applying for household health insurance shall be effective from their payment for the health insurance. Their Health insurance benefit levels and scope of benefits are similar to those of the persons liable to purchase Health insurance.

Any difficulty or obstacle that arises should be reported to the Vietnam Social insurance for consideration./.

For the General Manager of the Vietnam Social Insurance

The Deputy General Manager

Nguyen Minh Thao