This Circular stipulates the planning, revenue and expenditure, reporting, and settlement audit of the health insurance fund (HIF) for Vietnamese health insurance organizations and provinces/cities. It also addresses the formation sources of the risk reserve fund and its usage to support health insurance units facing difficulties.
적용 범위
This Circular applies to Vietnam Health Insurance and provincial/municipal health insurances directly under the central government.
핵심 사항
- Annual and quarterly revenue and expenditure plans shall be established.
- Accounting records and periodic reports shall be prepared in accordance with the regulations of the Ministry of Finance.
- Settlement audits shall be conducted in accordance with Circular No. 15-TC/HCVX.
- A risk reserve fund shall be established from 1.5% of the mandatory and voluntary health insurance revenue.
- Develop the health insurance industry by setting up funds from surplus revenues.
🌐 이 문서의 사회적 영향
- Ensure financial resources for the medical examination and treatment activities of health insurance participants.
- Support health insurance units facing difficulties in payment capacity.
- Develop the health insurance industry through the establishment of funds from surplus revenues.
❓ 자주 묻는 질문
When does this Circular take effect?
This Circular shall take effect from the date of issuance.
What should health insurance units do if they encounter difficulties during implementation?
If encountering difficulties or obstacles, health insurance units need to report to the Joint Ministry for support and guidance.
전문
| NATIONAL ASSEMBLY OFFICE | VIETNAM LEGAL DATABASE |
LAWDATA
CIRCULAR
JOINT MINISTRY OF HEALTH AND FINANCE DECREE NO. 01-TT/LB DATED FEBRUARY 20, 1993 GUIDING THE SYSTEM OF COLLECTION AND EXPENDITURE OF THE HEALTH INSURANCE FUND
Pursuant to Article 6 and Article 20 of the Health Insurance Regulation issued together with Decree No. 299/HĐBT dated August 15, 1992 of the Council of Ministers on the establishment, utilization, and management of the health insurance fund, the Joint Ministry of Health and Finance guides the financial collection and expenditure system of the health insurance fund as follows:
I. SOURCES OF INCOME FOR THE HEALTH INSURANCE FUND:
1. Income from compulsory health insurance contributions of subjects specified in Point 1, Section I of Circular No. 12-TT/LB dated September 18, 1992 of the Joint Ministry of Health, Finance, Labor, War Invalids, and Social Affairs guiding the implementation of the aforementioned decree.
2. Income from voluntary health insurance contributions of subjects specified in Point 2, Section I of Circular No. 12-TT/LB.
3. In addition, there are the following sources of income:
a. Contributions from agencies, enterprises, charitable organizations, and individuals within the country to the health insurance fund.
b. Donations and grants from international organizations and individuals abroad.
c. Other sources of income.
II. DISTRIBUTION AND USE OF INCOME FROM THE HEALTH INSURANCE FUND
The above-mentioned sources of income are distributed and utilized according to the level of health insurance fund management as follows:
1. Health insurance agents at commune and ward levels responsible for collecting health insurance premiums
a. Are allowed to retain 20% of the income mentioned in Point 2, Section I of this Circular to provide primary healthcare services for the people in their communes and wards, which can be used for the following purposes:
+ 75% for purchasing medicine and medical equipment.
+ 25% for compensating those directly involved in collecting health insurance premiums.
b. 80% of the income mentioned in Point 2, Section I of this Circular must be remitted to the provincial health insurance fund for management.
2. Provincial health insurance funds include the following sources of income:
a. Income from compulsory health insurance contributions of subjects specified in Point 1, Section I of this Circular.
b. 80% of the income collected by commune and ward health insurance funds.
The above-mentioned sources of income at Points 2(a) and (b) are used as follows:
- 2% remitted to the National Health Insurance Fund.
- 90% for medical examination and treatment expenses.
- 8% for administrative and public service management expenses of health insurance.
c. Income from the sources specified in Point 3, Section I of this Circular is used according to the intended purpose of donations and grants.
3. National Health Insurance Fund: includes the following sources of income:
a. The 2% remitted by provincial health insurance funds is used as follows:
- 1.5% to establish a centralized reserve fund to regulate health insurance funds of provinces and cities when encountering objective risks that may jeopardize the safety of the health insurance fund (called the risk reserve fund).
- 0.5% for administrative and public service management expenses of health insurance.
b. Income from the compulsory health insurance subjects directly managed by the National Health Insurance Fund (of which 90% is allocated for medical examination and treatment expenses, 1.5% for the risk reserve fund of the National Health Insurance Fund, and 8.5% for the management and public service fund).
c. Income from the sources specified in Point 3, Section I of this Circular is used according to the intended purpose of donations and grants.
III. CONTENTS OF EXPENDITURE FROM THE HEALTH INSURANCE FUND
1. Expenditure for medical examination and treatment
This is the expenditure for health insurance contributors to receive medical examination and treatment at medical facilities according to contracts between health insurance and medical facilities based on:
The average cost of one unit of treatment is the total cost of all medical examination and treatment expenses for both inpatient and outpatient care averaged per day/bed according to each technical level and type of hospital, set according to the prices of each period by the Ministry of Health for each period to suit price fluctuations.
2. Administrative and public service management expenses of health insurance.
a. This expenditure is made according to the levels specified in the points under Section II of this Circular.
Quarterly and annually, provincial health insurance funds must prepare revenue and expenditure plans to be reviewed and approved by the competent authority as stipulated in Section IV of this Circular.
b. Administrative and public service management expenses of health insurance are aggregated according to the content of the state budget item list and in accordance with the current expenditure regulations applicable to units in the administrative and public service sector, divided into the following main groups:
- Group 1: expenditure for personnel including salary, allowances, social insurance, health insurance, trade union fees, and collective welfare expenses.
- Group 2: expenditure for operations including business fees, official duties fees, travel expenses, and rewards.
- Group 3: expenditure for fixed asset purchases and repairs of buildings, equipment, and transportation means.
Group 4: expenditure for outbound and inbound delegations.
Specific details of expenditures in the above groups are attached in the revenue and expenditure plan accompanying this Circular.
For branch offices of health insurance at district and urban district levels, if established, administrative and public service management expenses of health insurance have a reporting nature and must be budgeted by the Director of the provincial health insurance fund for each expense item and must ensure expenditure according to the approved content of each expense item.
3. Use and management of the risk reserve fund:
The risk reserve fund aims to support provincial health insurance funds when encountering objective risks that may jeopardize the safety of the health insurance fund.
Sources forming the risk reserve fund are extracted from 1.5% of the income from compulsory and voluntary health insurance subjects directly managed by provincial health insurance funds, and 1.5% of the income from compulsory health insurance subjects directly managed by the National Health Insurance Fund.
If provincial health insurance funds encounter objective risks or difficulties in payment capacity during the process of using and managing the health insurance fund, they will be eligible for loans from the National Health Insurance Fund upon confirmation by the provincial People's Committee or the head of the relevant ministry based on loan agreements and must repay the loan without interest within the agreed timeframe.
The risk reserve fund accumulates gradually, is deposited in savings accounts, and purchased in treasury bills to generate additional interest to supplement the fund for the development of the health insurance cause.
4. Expenditure for the development of the health insurance cause:
At the end of the year, if the health insurance fund has surplus revenues (total income exceeds total expenditure excluding the portion allocated to the risk reserve fund), the health insurance fund can allocate the surplus as follows:
- For the development of the health insurance cause: 80% of the surplus to improve the benefits of insured persons.
- For the reward and welfare fund: 20% of the surplus to reward medical facilities and individuals who have outstanding achievements in serving the health insurance cause, and to enhance welfare for health insurance facilities. However, the maximum amount shall not exceed six months' basic salary and wage supplements (if any).
IV. WORK ON PREPARATION OF REVENUE AND EXPENDITURE PLANS AND REPORTS
SETTLEMENT, REVIEW AND AUDIT OF SETTLEMENT
COLLECTION AND EXPENDITURE OF THE HEALTH INSURANCE FUND
1. Regarding the work of planning collection and expenditure of the health insurance fund.
The preparation of the annual plan for collection and expenditure of health insurance (as attached to this Circular) must be carried out annually (divided into each quarter) in accordance with the following procedures:
- Health Insurance of provinces and cities, after the plan for collection and expenditure has been agreed upon by Health Insurance of the province or city, will submit it to the Department of Health for approval by the People's Committee of the province or city to officially assign the targets for collection and expenditure of health insurance for the year.
- Health Insurance of Vietnam shall be reviewed and assigned the targets for collection and expenditure of health insurance for the year by the Minister of Health.
In case Health Insurance of provinces and cities have branches of Health Insurance at district and county levels, the director of Health Insurance of the province or city shall be responsible for reviewing the plans for collection and expenditure of these branches based on the officially approved budget estimates for collection and expenditure of health insurance of the province or city.
2. Regarding accounting entries and accounting reports:
Health Insurance of provinces and cities, Health Insurance of Vietnam shall implement accounting entries, accounting books, and periodic accounting reporting systems which will be applied according to the provisions of Decision No. 257-TC/CĐKT dated June 11, 1990 issued by the Minister of Finance.
The submission of quarterly and annual settlement reports shall be as follows:
- The Director of Health Insurance of the province or city shall submit the report for review by the Management Board of Health Insurance of the province or city, then send it to the Department of Finance and Price of the province or city for verification and official approval, and also send a copy to Health Insurance of Vietnam.
- The Director of Health Insurance of Vietnam shall submit it to the Ministry of Health for review and signature, then send it to the Ministry of Finance for verification and official approval.
3. Regarding audit and review of settlement.
The verification and review of the settlement of collection and expenditure of health insurance shall be conducted in accordance with the provisions of Circular No. 15-TC/HCVX dated May 19, 1992 issued by the Ministry of Finance.
V. IMPLEMENTATION PROVISIONS
This Circular applies to Health Insurance of Vietnam, Health Insurance of provinces and centrally governed cities, and takes effect from the date of signing. During the implementation process, if there are any difficulties or obstacles, they should be reported back to the Joint Ministries for research and supplementation and amendment.
HEALTH INSURANCE
QUARTERLY AND ANNUAL INCOME AND EXPENDITURE PLAN
|
Item |
Content of Income and Expenditure |
Amount |
|
59 64 65 68 69 70 72 73 74 75 80 81 97 85 86 |
REVENUE SECTION: 1. Collection of compulsory health insurance contributions from eligible groups. 2. Collection of voluntary health insurance contributions. 3. Other income: aid, support... Total Revenue: EXPENDITURE SECTION: I. Expenditure for medical examination and treatment: (90%) 1. Expenditure for payment of inpatient medical examination and treatment. 2. Expenditure for payment at multi-disciplinary outpatient clinics and hospitals. 3. Other expenditure for medical examination and treatment. II. Expenditure for Health Insurance of Vietnam (2%): 1. Expenditure for the reserve fund (1.5%). 2. Expenditure for management costs (0.5%). III. Management Costs: 8% Group 1: Expenditure for the administrative staff (with a ratio of 35-40% of total management costs) - Electricity subsidy (according to regulations) - Salary (number of people x basic salary per person per month x 3 months) - Allowance (number of people x allowance per person x 3 months) - Social insurance, trade union fees, health insurance contributions according to the deduction system. - Bonus: bonus level per person x 3 months x number of people. - Welfare benefits: such as travel expenses for leave, hardship allowances, uniforms for officials, lunch subsidies, price stabilization allowances. Basic salary per person x number of people x 3 months. Group 2: Expenditure for work (with a ratio of 40-45% of total management costs) Travel expenses: Including train and bus fares, travel allowances, accommodation, payment for accommodation. Basic salary per person x number of people x 3 months. Conference expenses. Conference expenses. - Mid-year conference. Official expenses - Postage, telephone, stamps. - Electricity, water, rent for office premises. - Raw materials, office supplies. Small miscellaneous expenses. - Stamps, seals, newspapers. - Security, fire protection, office. - Drinking water for staff and guests. - Vehicle insurance, traffic fees. - Hospitality expenses. - Fuel for cars, generators. - Other expenses, transportation of goods. Based on actual usage to prepare plans more accurately. * Business expenses: - Expenses for transactions and exploitation of health insurance. - Training and seminar expenses for staff. - Expenses for the activities of health insurance agents. - Expenses for tax authority supervision with enterprises. - Protection, development, research expenses. - Other expenses; + Expenses for outgoing delegations. + Expenses for incoming delegations. +Other expenses. Group III: Purchase and repair (ratio 10-15% of total management costs) - Purchase of fixed assets. Repair of fixed assets and small construction works. IV. EXPENDITURE FOR DEVELOPMENT OF HEALTH INSURANCE BUSINESS: (Revenue > Expenditure) (excluding the portion allocated 2% for Health Insurance of Vietnam). - Expenditure for the development of the healthcare industry. Expenditure for awards and welfare. Total Expenditure (I + II + III + IV) |
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Date...month...year... Head of the unit |
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