If enterprises suspend social insurance premium payment due to Covid-19, can employees use health insurance for medical examination and treatment in Vietnam?

If enterprises suspend social insurance premium payment due to Covid-19, can employees use health insurance for medical examination and treatment in Vietnam? (Illustrative photo)

According to the provisions of the Law on Social Insurance 2014, social insurance (SI) is understood as a guarantee to replace or compensate a part of the income of employees when they lose or reduce income due to illness, maternity, labor accidents, occupational diseases, retirement age, or death, based on contributions to the social insurance fund in Vietnam.

Employees (EEs) and employers (ERs) who are subject to participate in social insurance have the responsibility to contribute to the social insurance fund at the rates prescribed by law, as follows:

- Employees: 10.5%; and

- Employers: 21.5%.

However, according to Article 88 of the Law on Social Insurance 2014, if employers face difficulties and must temporarily suspend production or business activities, leading to incapacity to contribute to social insurance, the enterprise is allowed to temporarily suspend contributions to the retirement and survivorship fund for a period not exceeding 12 months.

Thus, employers will be permitted to temporarily suspend contributions to the retirement and survivorship fund under the following conditions:

- Temporarily suspend production or business for one month or more due to restructuring, technological changes, economic crisis, economic downturn, or implementing state policies during economic restructuring or performing international commitments;

- Face difficulties due to natural disasters, fires, epidemics, or crop failures.

But they must ensure the following conditions:

- Unable to arrange work for employees, where the number of employees participating in social insurance having to temporarily leave work accounts for at least 50% of the total employees present before suspending production or business;

- Suffer damage exceeding 50% of total asset value due to natural disasters, fires, epidemics, or crop failures (excluding land asset value).

Most recently, on August 10, 2020, the Vietnam Social Security also issued Official Dispatch 2533/BHXH-BT regarding the continued implementation of the suspension of contributions to the retirement and survivorship fund. In Official Dispatch 2533, the Vietnam Social Security guides the continuation of suspending contributions to the retirement and survivorship fund as follows:

- For employers encountering difficulties due to the Covid-19 pandemic who have already suspended contributions to the retirement and survivorship fund but still face difficulties, continue to suspend contributions to this fund, maximally until the end of December 2020;

- For employers encountering difficulties due to the Covid-19 pandemic who have met all conditions to suspend contributions to the retirement and survivorship fund (for the first time) as guided in Official Dispatch 1511/LDTBXH-BHXH, implement according to current regulations and previous guidelines on suspending contributions to the retirement and survivorship fund by social insurance, maximally until the end of December 2020;

- Authority, documentation, and procedures are according to regulations and guidance in Official Dispatch 1511/LDTBXH-BHXH.

Regarding whether employees can use health insurance for medical examination and treatment, it can be seen that the suspension of social insurance contributions merely means suspending contributions to the retirement and survivorship fund. Meanwhile, contributions to the social insurance fund include:

- Sickness and maternity fund;

- Labor accident and occupational disease fund;

- Retirement and survivorship fund;

- Unemployment insurance fund, and

- Health insurance fund.

Thus, enterprises must continue to contribute fully and promptly to the sickness and maternity fund, labor accident and occupational disease fund, health insurance fund, and unemployment insurance fund to ensure employees' benefits. Therefore, in this case, employees can still use health insurance for medical examination and treatment if enterprises temporarily suspend social insurance contributions.

This is a matter of significant concern, especially at a time when the Covid-19 pandemic is evolving complicatedly, leading to many enterprises temporarily suspending mandatory social insurance contributions to the retirement and survivorship fund. Employees need to equip themselves with knowledge on this matter to ensure their rights.

Thuy Tram

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