Are employees entitled to health insurance benefits when the employer is late in paying health insurance in Vietnam?
- Are employees entitled to health insurance benefits when the employer is late in paying health insurance in Vietnam?
- What is the penalty level of the enterprise for late payment of health insurance for employees in Vietnam?
- How to resolve the disputes over health insurance between employees and employers in Vietnam?
Are employees entitled to health insurance benefits when the employer is late in paying health insurance in Vietnam?
Article 49 of the Law on Health Insurance 2008 as amended by Clause 28, Article 1 of the Law on amendments to the Law on Health insurance 2014 provides for the handling of violations as follows:
Handling of violations
1. Any person who violates the regulations of this Law or relevant law regulations on health insurance shall be disciplined, penalized for administrative violations or liable to criminal prosecution according to nature and severity of the violations. In case of any damage, compensation must be offered under the regulations of the law.
2. Any organization and association that violates the regulations of this Law or relevant law regulations on health insurance shall be penalized for administrative violations. In case of any damage, a compensation must be offered under the regulations of the law.
3. The employers in charge of paying health insurance that fail to discharge their duties shall be penalized as follows:
a) The employers must pay the unpaid premiums and the interest as twice as the inter-bank interest rate calculated according to the unpaid premiums and time; if they do not follow the regulations, the State Treasuries shall deduct the money from the deposit account of the employers to transfer the unpaid premiums and their interest to the account of the health insurance fund according to the request of other competent persons, banks or credit institutions.
b) The employers must pay all the expenditures for the employees within their scope of benefits, benefit levels that the employees pay during the time they are not provided with the health insurance cards.
Thus, according to the above provisions, employees are not entitled to the health insurance regime. However, the enterprise will have to refund the entire cost to the employee within the scope of benefits and health insurance benefits that the employee has paid during the time when the health insurance card is not available.
Are employees entitled to health insurance benefits when the employer is late in paying health insurance in Vietnam? (Image from the Internet)
What is the penalty level of the enterprise for late payment of health insurance for employees in Vietnam?
Penalties for late payment of health insurance by enterprises are specified in Clause 2, Article 80 of Decree 117/2020/ND-CP as follows:
Violations against regulations on health insurance contributions
1. A warning or a fine ranging from VND 300.000 to VND 500.000 shall be imposed upon a compulsory health insurance policyholder for failing to make health insurance contributions.
2. The following fines shall be imposed upon an employer for failing to pay, insufficiently or lately paying health insurance contributions for his/her employees who are subjected to compulsory health insurance, or evading payment of health insurance contributions:
a) A fine ranging from VND 1.000.000 to VND 3.000.000 shall be imposed for the violation involving less than 10 employees;
b) A fine ranging from VND 3.000.000 to VND 5.000.000 shall be imposed for the violation involving from 10 to less than 50 employees;
c) A fine ranging from VND 5.000.000 to VND 10.000.000 shall be imposed for the violation involving from 50 to less than 100 employees;
…
5. Remedial measures:
a) The violating entity is compelled to make compensations for any damage incurred by health insurance policyholders in case of commission of the violation in Clause 2, 3 or 4 of this Article. Any payments which cannot be made to payers shall be paid to state budget in accordance with regulations of law;
b) Any benefits illegally obtained from the violation in Clause 2, 3 or 4 of this Article shall be paid to account of the health insurance fund.
* Note: The above sanction applies to individuals, the sanctioning level for organizations is twice the level of sanctioning for individuals.
Thus, according to the above regulations, the sanction will depend on the number of employees that the enterprise is late in paying health insurance premiums. In addition, the enterprise is forced to refund the amount of money that the insured person suffers from damage (if any) for the acts specified in Clauses 2, 3 and 4, Article 80 of Decree 117/2020/ND-CP.
If the refund cannot be made to the subject, it shall be remitted to the state budget according to the provisions of law.
Forcible payment of illegally obtained profits to the collection account of the health insurance fund for the acts specified in Clauses 2, 3 and 4, Article 80 of Decree 117/2020/ND-CP.
How to resolve the disputes over health insurance between employees and employers in Vietnam?
Disputes over health insurance are regulated in Article 48 of the Law on Health Insurance 2008:
Health insurance disputes
1. Health insurance disputes are disputes related to health insurance rights, duties and liabilities of the following:
a/ The insured defined in Article 12 of this Law and their representatives;
b/ Health insurance premium-paying organizations and individuals defined in Clause 1, Article 13 of this Law;
c/ Health insurance institutions;
d/ Health insurance-covered medical care providers.
2. Health insurance disputes shall be settled as follows:
a/ The disputing parties shall reconcile their dispute;
b/ In case of unsuccessful reconciliation, the disputing parties may initiate a lawsuit at a court in accordance with law.
Thus, in the event that an employee and an employer have a dispute over health insurance, the parties are responsible for conciliating the content of the dispute. In case of unsuccessful conciliation, the parties have the right to initiate a lawsuit at the Court in accordance with law.
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