What are amendments on group of family-based health insurance policyholders in 2023 in Vietnam?

What are amendments on group of family-based health insurance policyholders in 2023 in Vietnam?

Pursuant to Article 5 of the Decree 146/2018/NĐ-CP stipulating group of family-based health insurance policyholders in 2023 in Vietnam as follows:

Group of family-based health insurance policyholders

1. Persons whose names are inscribed in family household records, except those subjects specified in Article 1, 2, 3, 4 and 6 hereof.

2. Persons whose names are inscribed in temporary residence records, except those specified in Article 1, 2, 3, 4 and 6 hereof and those already participating in health insurance as prescribed in clause 1 of this Article.

3. The following persons eligible for family-based participation in health insurance:

a) Dignitaries, sub-dignitaries and clergy;

b) Persons residing in social relief establishments, except for those defined in Articles 1, 2, 3, 4 and 6 hereof without health insurance contributions supported by the state budget.

Pursuant to Clause 1 Article 2 of the Decree 104/2022/NĐ-CP and Clause 2 Article 2 of the Decree 104/2022/NĐ-CP stipulating as follows:

Amendments to certain articles and forms of Decree No. 146/2018/ND-CP dated October 17, 2018 on elaboration and guidelines for the Law on Health Insurance

1. Clause 1, Article 5 shall be amended as follows:

“1. Persons whose names are inscribed in the same household registering their permanent residence, except those persons specified in Article 1, 2, 3, 4 and 6 hereof.”.

2. Clause 2, Article 5 shall be amended as follows:

“2. Persons whose names are inscribed in the same household registering their temporary residence, except those persons specified in Article 1, 2, 3, 4 and 6 hereof and those who have already participated in health insurance as prescribed in Clause 1 of this Article.”.

As regulations above, from 01/03/2023, group of family-based health insurance policyholders includes:

- Persons whose names are inscribed in the same household registering their permanent residence, except:

+ Group of health insurance policyholders whose contributions are paid by both employees and employers.

+ Group of health insurance policyholders whose contributions are paid by social insurance agencies.

+ Group of health insurance policyholders whose contributions are paid by the state budget.

+ Group of health insurance policyholders whose contributions are supported by the state budget.

+ Group of health insurance policyholders whose contributions are paid by employees.

- Persons whose names are inscribed in temporary residence records, except:

+ Group of health insurance policyholders whose contributions are paid by both employees and employers.

+ Group of health insurance policyholders whose contributions are paid by social insurance agencies.

+ Group of health insurance policyholders whose contributions are paid by the state budget.

+ Group of health insurance policyholders whose contributions are supported by the state budget.

+ Group of health insurance policyholders whose contributions are paid by employees.

+ Persons whose names are inscribed in the same household registering their permanent residence.

- The following persons eligible for family-based participation in health insurance:

+ Dignitaries, sub-dignitaries and clergy;

+ Persons residing in social relief establishments, except for those without health insurance contributions supported by the state budget:

+) Group of health insurance policyholders whose contributions are paid by both employees and employers.

+) Group of health insurance policyholders whose contributions are paid by social insurance agencies.

+) Group of health insurance policyholders whose contributions are paid by the state budget.

+) Group of health insurance policyholders whose contributions are supported by the state budget.

+) Group of health insurance policyholders whose contributions are paid by employees.

What are regulations on determination of contribution and support amounts applied to family-based health insurance policyholders in case of the State’s adjustments to health insurance contribution rates and base pay rates in Vietnam?

Pursuant to Clause 3 Article 10 of the Decree 146/2018/NĐ-CP stipulating determination of contribution and support amounts applied to certain policyholders in case of the State’s adjustments to health insurance contribution rates and base pay rates in Vietnam as follows:

Determination of contribution and support amounts applied to certain policyholders in case of the State’s adjustments to health insurance contribution rates and base pay rates

1. With respect to policyholders referred to in Article 4 hereof whose health insurance contributions are wholly supported by the state budget:

a) The amount of the state budget's monthly payment of or support for health insurance contributions shall be defined as the health insurance contribution rate multiplied by (x) the base pay rate. If the state adjusts the health insurance contribution rate and the base pay rate, the amount of health insurance contribution paid or supported by the state budget shall be adjusted from the date of application of the new health insurance contribution rate and the new base pay rate;

b) The amount of health insurance contribution for children under 6 years of age shall be calculated from the date of birth to the date on which children reach 72 months of age. If a Vietnamese child is born abroad, the amount of health insurance contribution shall be calculated from the date on which that child returns and resides in Vietnam in accordance with laws.

2. With respect to those policyholders whose health insurance contributions are partially supported by the state budget in accordance with clause 3 and 4 of Article 4 hereof:

a) The monthly amount of health insurance contribution paid by the policyholder and the state budget’s monthly support for health insurance contributions shall be defined as the health insurance contribution rate multiplied by (x) the base pay rate determined on the date of the policyholder's payment of health insurance contribution;

b) If the State adjusts the health insurance contribution rate or the base pay rate, the policyholder and the state budget shall not be required to make additional payments or shall not be entitled to reimbursement of the difference arising owing to any adjustment to the health insurance contribution rate or the base pay rate for the rest of time during which the policyholder has already paid his/her health insurance contributions.

3. With respect to family-based policyholders as defined in Article 5 hereof:

a) The monthly amount of health insurance contribution shall be defined as the health insurance contribution rate multiplied by (x) the base pay rate determined on the date of payment of health insurance contribution;

b) In case where the State adjusts the health insurance contribution rate or the base pay rate, the policyholder shall not be required to pay additional health insurance contributions or shall not be entitled to reimbursement of the difference arising owing to any adjustment to the health insurance contribution rate or the base pay rate for the remaining time during which the policyholder has already paid health insurance contributions.

4. If the policyholder participates in the health insurance amidst days of a month, the health insurance contribution amount shall be determined in a unit month from the date of payment of health insurance contribution.

As regulations above, determination of contribution and support amounts applied to family-based health insurance policyholders in case of the State’s adjustments to health insurance contribution rates and base pay rates in Vietnam are as follows:

- The monthly amount of health insurance contribution shall be defined as the health insurance contribution rate multiplied by (x) the base pay rate determined on the date of payment of health insurance contribution;

- In case where the State adjusts the health insurance contribution rate or the base pay rate, the policyholder shall not be required to pay additional health insurance contributions or shall not be entitled to reimbursement of the difference arising owing to any adjustment to the health insurance contribution rate or the base pay rate for the remaining time during which the policyholder has already paid health insurance contributions.

What are documents used for identification of health insurance payers for family-based policyholders in Vietnam?

Pursuant to Clause 1 Article 4 of the Circular 30/2020/TT-BYT stipulating documents used for identification of health insurance payers for family-based policyholders in Vietnam as follows:

Identification of health insurance payers, amount and reduction for family-based model

1. Identification of individuals specified under Clause 3 Article 5 of Decree No. 146/2018/ND-CP depends on following documents:

a) For dignitaries, sub-dignitaries and clergy: family register or temporary residence register or lists bearing seals of religious organizations directly overseeing dignitaries, sub-dignitaries and clergy;

b) Persons residing in social security facilities: family register or temporary residence register or lists bearing seals of social security facilities where the individuals are residing.

2. Reduction of health insurance amount for individuals under Article 5 of Decree No. 146/2018/ND-CP shall be implemented as soon as a second individual whose name is included in family register or temporary residence register or list bearing seal of religious organizations, social security facilities specified under Clause 1 of this Article participate in family-based health insurance.

As regulations above, documents used for identification of health insurance payers for family-based policyholders in Vietnam are:

- For dignitaries, sub-dignitaries and clergy: family register or temporary residence register or lists bearing seals of religious organizations directly overseeing dignitaries, sub-dignitaries and clergy;

- Persons residing in social security facilities: family register or temporary residence register or lists bearing seals of social security facilities where the individuals are residing.

Best regards!