Question:
Our company has a policy that if a short-term labor contract is for more than 3 months, we require the employee to pay 32.5% of social insurance for the company, which we then submit to the Social Insurance Agency (BHXH). Do we need to pay social insurance for short-term contracts lasting more than 3 months, and is it correct to make employees cover the full 32.5% of insurance?
For example, Mr. Nguyen Van A signed a technical drawing contract with us for a project that will take 6 months from the contract signing date. Does Mr. A need to contribute 32.5% of his earnings to the company, which the company will then pay to BHXH?
Answer:
According to the provisions of the Social Insurance Law (BHXH) No. 58/2014/QH13, the social insurance contribution rate is 26%. Within this rate, employees contribute 8% to the retirement and survivorship fund, while employers contribute 18% (with 3% for the sickness and maternity fund, 1% for the occupational accidents and diseases fund, and 14% for the retirement and survivorship fund).
According to the detailed regulations and guidelines of the Health Insurance Law (BHYT) under Government Decree No. 105/2014/NĐ-CP dated November 15, 2014, the health insurance contribution rate is 4.5% (with employees contributing 1.5% and employers contributing 3%).
Under the Employment Law, the unemployment insurance (BHTN) contribution rate is 2% (with employees contributing 1% and employers contributing 1% of the monthly salary). In addition, the central budget provides support of up to 1% of the monthly salary for BHTN contributions.
Based on the above-mentioned laws and regulations, employees who sign labor contracts with companies for more than 3 months fall under the category of mandatory participation in social insurance (BHXH), health insurance (BHYT), and unemployment insurance (BHTN). The total contribution rate for 2016, according to the current regulations, is 32.5%, with employers contributing 22% and employees contributing 10.5% of their monthly salary. The practice of having employees cover the entire 32.5% of insurance contributions is not in accordance with legal regulations.
Question:
I recently participated in a dialogue session with a company organized by the Social Insurance Agency (BHXH). After BHXH answered questions from the companies during the dialogue, I have a few questions:
1. BHXH mentioned that employees can extend their health insurance (BHYT) coverage with their new company to continue participating in BHYT at the same hospital they were previously registered with. I have a case as follows:
An employee resigned from their previous company at the end of July (participating in health insurance in July) and started working at my company in August, also beginning health insurance coverage in August. However, due to some issues, I only reported the increase for this employee at the end of September (still reported from August). In this case, can this employee extend their coverage at Hospital A through an extension, even though Hospital A is not on the list for issuing new BHYT cards? If they can extend coverage, does the company need to submit any additional documents or notes to inform BHXH that this employee is extending coverage at the old hospital, even though Hospital A is not on the list for new registrations?
2. BHXH explained that individuals need to have continuous health insurance participation for 5 years, with gaps not exceeding 3 months. I would like to know if the gap of no more than 3 months applies to the total time within 5 years or if it refers to each gap not exceeding 3 months. For example, if Mr. A has participated in BHYT for 3 years, then stopped and didn’t contribute for 2 months when trying a job at a new company, and then resumed contributing for 1 year before changing companies, with a gap of 2 months, and continues to contribute afterward. If he continues to contribute, will his BHYT card be considered as having 5 continuous years after more than 1 year?
3. When voluntarily participating in BHYT through a household, fees for subsequent participants are reduced. If a family has 4 members, 2 children, and a mother who is participating in BHYT through the company’s policy, when applying for voluntary BHYT for the father, the district where we applied for the insurance said that the father’s insurance fee cannot be reduced because each individual in the family is insured at different hospitals. If we want to enjoy the reduced BHYT fee as stipulated by the law, all individuals in the family must participate in BHYT at the same hospital, according to the district’s response. Is this correct?
Answer:
1. In the case of an employee who has participated in BHYT continuously or with gaps not exceeding 3 months, they can still extend their initial health insurance coverage at the healthcare facility where they were originally registered. When preparing the report of an increased workforce for the new company, you should make a note in the list of BHXH and BHYT participation (form D02-TS) that the employee has continued coverage at the healthcare facility where they initially participated. This should be done even if that healthcare facility is not on the list for issuing new BHYT cards.
2. Regarding the 5-year continuous health insurance participation requirement, the gap of not more than 3 months refers to the total time within the 5-year period. In the example you provided, if Mr. A continues to contribute and, after more than 1 year, his total gap does not exceed 3 months, his BHYT card will be considered to have 5 continuous years.
3. When participating in BHYT voluntarily through a household, the fees for subsequent participants are reduced according to the following rates:
– The first person: contributes at 4.5% of the base salary.
– The second person: contributes at 70% of the contribution of the first person.
– The third person: contributes at 60% of the contribution of the first person.
– The fourth person: contributes at 50% of the contribution of the first person.
– The fifth person and beyond: contribute at 40% of the contribution of the first person.
In your family’s case, with 4 members, including 3 mandatory BHYT participants and one person who wishes to participate voluntarily, the person who wishes to join voluntarily will be considered the first person and will not receive a fee reduction.
Question:
I have participated in health insurance where the registered hospital for medical examination is District 12 Hospital. Last August 2016, I experienced symptoms such as eye strain, headaches, and dizziness when looking at computers, phones, or exposure to light. I requested time off from my company to seek treatment at the Neurology Department of Cho Ray Hospital. The doctor diagnosed me with Arnold’s headache and asthenopia. I believe I need some rest to allow my eyes to recover, as in my accounting profession, staring at a computer is essential, and with these symptoms, I cannot work effectively. The doctor told me to inquire with the clinic assistant to see if I can get leave, so I approached the clinic assistant. However, the assistant told me that Cho Ray Hospital does not provide a medical leave certificate. The reason given was that in my case, I did not have a hospital referral letter; instead, I came to Cho Ray Hospital for the examination on my own, so I am not eligible for a medical leave certificate for BHXH. I’d like to ask whether Cho Ray Hospital did not issue a medical leave certificate for me because I did not get a referral letter? Also, the hospital showed me a document stating that medical leave for medical examinations could not be granted, but my condition required rest. How can I get a medical leave certificate? Other hospitals provide medical leave certificates even if the patient seeks treatment outside their assigned area.
Answer:
– In the case of an employee seeking medical treatment at a hospital outside their registered BHYT area, they should still be issued a medical leave certificate to receive BHXH benefits.
– Regarding Cho Ray Hospital’s refusal to issue a medical leave certificate for BHXH benefits, the BHXH authority has contacted the hospital and received the explanation that if a patient is still physically capable of working after a medical examination, the doctor will not issue a medical leave certificate for BHXH benefits for the day of the examination.
– To seek further clarification, I recommend that you contact the Planning and General Department at Cho Ray Hospital.
