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Amending Health Insurance Law Effect from 01 Jan 2015
On 13 June 2013, National Assembly approved Amending Social Health Insurance Law 46/2014/QH13 which amends and supplements a number of articles of the Law on Social Health Insurance. There are some important points as follows:
1. Definition about Social health insurance
Law on Social Health Insurance amended and supplemented 2014 confirmed that Social health insurance means a kind of compulsory insurance applying for participants under the provisions of this Law.
2. Salary as basis of health insurance contribution
- Social health insurance contribution shall be defined by percentage of salary which is basis of social insurance compulsory contribution, pension, allowances or basic salary (instead only regulate generic salary and remuneration as before).
- Maximum amount for monthly salary for premium calculation shall not exceed twenty times of basic salary (instead common minimum salary as before).
3. The coverage
Law on Social Health Insurance amended and supplemented 2014 has distributed objects into clear groups, include:
- Group shall be contributed by the employees and employers
- Group shall be contributed by the Social insurance organization
- Group shall be contributed by the State budget
- Group shall be supported contribution rates by the State budget
- Group according to households
In which, the group shall be contributed by the employees and employers include:
- Employees working under unfixed-term contract or fixed-term contracts of 3 months and over; employees working as managers, earning monthly salary; civil servants, governmental officers.
- The person who are not specialized activities in commune/wards/town according to legal regulation
4. Contribution rates and responsibility
The one important change on contribution rates and responsibility is instead regulation during the employees leave for maternity, the employers and employees do not have to contribute the social health insurance premiums and get the benefit as usual as before. Law on Social Health Insurance amended and supplemented 2014 has regulated “during the employees leave for maternity in accordance with law on social insurance is the monthly contribution rate shall be a maximum 6% of their monthly salary before leave for maternity and shall be contributed by the Social insurance organization.
Besides, this document also regulate all members of household must participate in health insurance, the contribution rate shall be a maximum 6% and decrease from second member onward.
5. Extent of social health insurance benefits
Add regulation on payment rates in the case the health insurance participants who use medical examination and treatment services not at the technical rank respectively 40%, 60%, 70%, 100%, depending on the technical rank of hospital
6. Social health insurance benefit exemption
7. Handling of violations
Annual some case social health insurance benefit exemption include:
- Medical checkup and treatment in case of suicide and self-injured cases
- Medical checkup and treatment of physical and mental injury due to the act of law violation caused by self
The employers not yet contribution or not fully contribution is not only the must fully contribution the deficit together with the double interest arising in the late payment period at the prime interest rate announced by the Slate Bank (doubled compare to the previous) but also refund the full cost for employees in the sphere rights and extent of social health insurance benefits that the employees paid in period not have health insurance card
This Law takes effect on 01 January 2015.
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