Can health insurance be paid when an enterprise is late paying health insurance for employees in Vietnam?

Can health insurance be paid when an enterprise is late paying health insurance for employees in Vietnam?

Pursuant to the provisions of Article 49 of the 2008 Health Insurance Law, amended by Clause 28, Article 1 of the 2014 Amended Health Insurance Law, regulations on handling violations in the field of health insurance are as follows:

Handling of violations

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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, employers (enterprises) are responsible for fully paying health insurance for employees according to the provisions of law in Vietnam.

In case an enterprise is late in paying social insurance for its employees, the enterprise is responsible for refunding all expenses to the employee within the scope of health insurance benefits and benefits that the employee has paid while employee doesn't have a health insurance card in Vietnam.

Can health insurance be paid when an enterprise is late paying health insurance for employees in Vietnam?
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What are penalties for businesses that delay paying health insurance for their employees in Vietnam?

Pursuant to the provisions of Clause 2, Article 80 of Decree 117/2020/ND-CP regulating penalties for violations against regulations on health insurance contributions as follows:

Violations against regulations on health insurance contributions

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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;

d) A fine ranging from VND 10.000.000 to VND 20.000.000 shall be imposed for the violation involving from 100 to less than 500 employees;

dd) A fine ranging from VND 20.000.000 to VND 30.000.000 shall be imposed for the violation involving from 500 to less than 1.000 employees;

e) A fine ranging from VND 30.000.000 to VND 40.000.000 shall be imposed for the violation involving from 1.000 employees or more.

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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.

Thus, late payment of health insurance for employees can be administratively sanctioned in the form of a fine from 1,000,000 VND to 40,000,000 VND depending on the number of employees in Vietnam.

Note: The fine level specified above is the fine level for individuals. For the same administrative violation, the fine for organizations is equal to 2 times the fine for individuals (Clause 5, Article 4, Decree 117/2020/ND-CP)

In addition, violators are also forced to repay the amount of money lost by health insurance participants and must pay illegally obtained profits to the health insurance fund's revenue account in Vietnam.

What rights do health insurance participants have in Vietnam?

Pursuant to the provisions of Article 36 of the 2008 Health Insurance Law, amended by Clause 24, Article 1 of the 2014 Amended Health Insurance Law, regulations on rights of the insured are as follows:

Rights of the insured

1. To be granted health insurance cards if paying health insurance premiums.

2. To pay the household health insurance at any health insurance agency in Vietnam; to choose any covered medical provider in accordance with Clause 1 Article 26 of this Law.3. To be entitled to medical care.

4. To get medical care costs paid by health insurance institutions.

5. To request health insurance institutions, health insurance-covered medical care providers and relevant agencies to explain and provide information on health insurance.

6. To complain about or denounce violations of the health insurance law.

Thus, health insurance participants have the following rights in Vietnam:

- Get a health insurance card when paying health insurance.

- Health insurance can be paid by household at health insurance agents nationwide.

- Choose a medical examination and treatment facility covered by initial health insurance according to regulations.

- Get medical examination and treatment.

- Health insurance organizations pay medical examination and treatment costs according to the health insurance regime.

- Request health insurance organizations, health insurance medical examination and treatment facilities and relevant agencies to explain and provide information about health insurance regimes.

- Complain and denounce violations of the law on health insurance.

Best regards!