Circular No. 30/2019/TT-BLDTBXH guiding the establishment of lists of subjects participating in health insurance under the management of the Ministry of Labor, War Invalids and Social Affairs.

CIRCULAR

Guidelines for compiling lists of subjects participating in health insurance

managed by the Ministry of Labor, Invalids and Social Affairs

_________________________

On the basis of Law on Health Insurance dated November 14, 2008;

On the basis of Law Amending and Supplementing Certain Provisions of the Law on Health Insurance dated June 13, 2014;

Decree No. Decision No. 146/2018/NĐ-CP dated October 17, 2018 of the Government detailing and guiding the implementation of certain provisions of the Law on Health Insurance;

Decree No. Article 14/2017/ND-CP dated February 17, 2017 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Labor - Invalids and Social Affairs;

At the request of the Director of the Legal Department,

The Minister of Labor, Invalids and Social Affairs issues this Circular to guide the compilation of lists of subjects participating in health insurance managed by the Ministry of Labor, Invalids and Social Affairs.

Article 1. Scope of Regulation and Applicability

Article 1. This Circular guides the compilation of lists of subjects participating in health insurance managed by the Ministry of Labor, Invalids and Social Affairs in accordance with Clause 4, Article 1 of the Law Amending and Supplementing Certain Provisions of the Law on Health Insurance and Point b, Clause 4, Article 42 of Decision No. 146/2018/NĐ-CP dated October 17, 2018 of the Government detailing and guiding the implementation of certain provisions of the Law on Health Insurance.

Article 2. This Circular applies to agencies, organizations, and individuals related to the compilation of lists of subjects participating in health insurance managed by the Ministry of Labor, Invalids and Social Affairs.

Article 3. Subjects participating in health insurance

1. Persons who have rendered meritorious service to the revolution as stipulated in the Ordinance on Preferential Treatment for Persons who have Rendered Meritorious Service to the Revolution;

2. Relatives of persons who have rendered meritorious service to the revolution include:

a) Father, mother, wife or husband, child of烈士，请提供完整的句子或段落以便我可以准确翻译。看起来输入在“2”之后中断了，但还有更多的内容需要翻译。请提供完整的内容。

b) Father, mother, wife, husband, child from over six to under eighteen years old or from eighteen years old and above if still continuing education or suffering from severe disability or extremely severe disability of the following subjects: Persons who were engaged in revolutionary activities before January 1, 1945; persons who were engaged in revolutionary activities from January 1, 1945 to the August Revolution in 1945; National Hero of the People's Armed Forces, National Labor Hero during the resistance war; war invalids, disabled veterans, persons who were engaged in the resistance war and exposed to toxic chemicals with a rate of body damage of 61% or more;

b) Child from six years old and above of persons who were engaged in the resistance war and exposed to toxic chemicals and suffer from deformities and disabilities and are currently receiving monthly allowances;

3. Persons serving those who have rendered meritorious service to the revolution, including:

a) Persons serving the Mother Vietnam Heroine living in her family;

b) Persons serving war invalids, disabled veterans, persons who were engaged in the resistance war and exposed to toxic chemicals with a rate of body damage of 81% or more living in their families;

4. Former combatants, including:

a) Former combatants participating in the resistance war before April 30, 1975 as stipulated in Clauses 1, 2, 3, and 4 of Article 2 of Decree No. 150/2006/ND-CP dated December 12, 2006 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on former combatants (hereinafter referred to as Decree No. 150/2006/ND-CP), amended and supplemented by Clause 1 of Article 1 of Decree No. 157/2016/ND-CP dated November 24, 2016 of the Government amending and supplementing Decree No. 150/2006/ND-CP dated December 12, 2006 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on former combatants (hereinafter referred to as Decree No. 157/2016/ND-CP);

b) Former combatants participating in the resistance war after April 30, 1975 as stipulated in Clause 5 of Article 2 of Decree No. 150/2006/ND-CP dated December 12, 2006 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on former combatants and at Clause 1 of Article 1 of Decree No. 157/2016/ND-CP dated November 24, 2016 of the Government amending and supplementing Decree No. 150/2006/ND-CP of the Government, including:

- Military personnel, defense industry workers who have been enjoying allowances pursuant to Decision No. 62/2011/QD-TTg dated November 9, 2011 of the Prime Minister on policies for individuals participating in wars to protect the country and international missions in Cambodia and assisting Laos after April 30, 1975 who have retired, discharged, or resigned (hereinafter referred to as Decision No. 62/2011/QD-TTg);

- Officers, professional military personnel, non-commissioned officers, soldiers, defense industry workers directly participating in wars to protect the country and international missions in Cambodia and assisting Laos after April 30, 1975 working in agencies, organizations, enterprises (not entitled to allowances pursuant to Decision No. 62/2011/QD-TTg);

- Officers, professional military personnel who have completed their duties in the armed forces during the period of building and defending the country who have retired, retired from service, or transferred to other sectors working in agencies, organizations, enterprises;

- Militia, self-defense force members who participated in combat and directly served in combat after April 30, 1975 who have been enjoying allowances pursuant to Decision No. 62/2011/QD-TTg;

5. Persons participating in the resistance war and protecting the country, including:

a) Persons participating in the resistance war against the United States to save the nation who have been enjoying allowances pursuant to one of the following documents: Decision No. 290/2005/QD-TTg dated November 8, 2005 of the Prime Minister on policies for certain individuals directly participating in the resistance war against the United States to save the nation but not yet benefiting from the policies of the Party and State; Decision No. 188/2007/QD-TTg dated December 6, 2007 of the Prime Minister amending and supplementing Decision No. 290/2005/QD-TTg; Decision No. 142/2008/QD-TTg dated October 27, 2008 of the Prime Minister on implementing policies for military personnel participating in the resistance war against the United States with less than twenty years of service in the military who have retired, discharged, and returned to their localities;

b) Persons enjoying policies pursuant to Decision No. 62/2011/QD-TTg dated November 9, 2011 of the Prime Minister on policies for individuals participating in wars to protect the country and international missions in Cambodia and assisting Laos after April 30, 1975 who have retired, discharged, or resigned;

c) Police officers enjoying policies pursuant to Decision No. 53/2010/QD-TTg dated August 20, 2010 of the Prime Minister on policies for police officers participating in the resistance war against the United States with less than twenty years of service in the police who have resigned, discharged, and returned to their localities.

d) Young volunteers shall enjoy benefits as prescribed in Decision No. 170/2008/QD-TTg dated December 18, 2008 of the Government Chairman on health insurance and funeral allowance for young volunteers during the anti-French resistance war, Decision No. 40/2011/QD-TTg dated July 27, 2011 of the Government Chairman on benefits for young volunteers who have completed their tasks during the resistance war, and Decree No. 112/2017/ND-CP dated October 6, 2017 of the Government on benefits and policies for young volunteers in the South participating in the resistance war from 1965 to 1975.

đ) Civilian fire-line workers participating in the anti-French, anti-American resistance wars, the defense of the Fatherland, and international missions as prescribed in Decision No. 49/2015/QD-TTg dated October 14, 2015 of the Government Chairman on certain benefits and policies for civilian fire-line workers participating in the anti-French, anti-American resistance wars, and international missions.

6. Persons aged 80 years or older receiving monthly pension benefits as prescribed by laws on social insurance.

7. Persons eligible for monthly social assistance benefits as prescribed by laws on elderly persons, persons with disabilities, and social welfare beneficiaries.

8. Children under six years old.

9. Members of poor households; ethnic minority people residing in areas with difficult economic and social conditions; people residing in areas with particularly difficult economic and social conditions; people residing in island communes and districts, specifically:

a) Members of poor households based on income criteria, members of multi-dimensional poor households lacking health insurance as prescribed in Decision No. 59/2015/QD-TTg dated November 19, 2015 of the Government Chairman on issuing multidimensional poverty standards applicable from 2016 to 2020 and other decisions of competent authorities amending, supplementing, or replacing poverty standards for each period.

b) Ethnic minority people residing in areas with difficult economic and social conditions as prescribed by the Government and the Government Chairman.

c) People residing in areas with particularly difficult economic and social conditions as prescribed by the Government and the Government Chairman.

d) People residing in island communes and districts as prescribed by the Government and the Government Chairman.

10. Members of near-poor households based on near-poverty standards as prescribed by the Government and the Government Chairman.

11. Members of multi-dimensional poor households not falling within the cases prescribed in Point a, Clause 9 of this Article.

12. Students enrolled at vocational education institutions managed by the Ministry of Labor, Invalids, and Social Affairs.

13. Members of households engaged in agriculture, forestry, fisheries, and salt production with average living standards as prescribed by the Government and the Government Chairman.

Article 3. Principles for compiling lists

1. In cases where a person belongs to multiple categories eligible for health insurance, only the category with the highest level of health insurance shall be listed.

2. The compilation of lists of individuals eligible for health insurance managed by the Ministry of Labor, Invalids, and Social Affairs must be based on documents and files issued by competent authorities.

3. Lists of individuals eligible for health insurance must comply with the form attached to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law (hereinafter referred to as Decree No. 146/2018/ND-CP).

Article 4. Competence to establish lists

1. Persons residing in the community shall be listed by the People's Committee of the commune, town, or ward (hereinafter referred to as the People's Committee of the commune).

2. Persons regularly cared for in the Care and Rehabilitation Center for War Invalids and Families of Martyrs, Social Assistance Center (hereinafter referred to as the Care Center) shall be listed by the Care Center.

3. Students studying at vocational education institutions under the Ministry of Labor, War Invalids, and Social Affairs shall be listed by such vocational education institutions.

Article 5. Documents serving as basis for determining the subjects participating in health insurance

1. Persons who have rendered meritorious service to the revolution.

Based on the Decision recognizing their status issued by the competent authority or the Decision implementing their benefits issued by the Director of the Department of Labor, War Invalids, and Social Affairs of the province or centrally-administered city.

2. Relatives of persons who have rendered meritorious service to the revolution, persons raising martyrs, and persons serving those who have rendered meritorious service to the revolution.

Based on the Decision implementing their benefits issued by the Director of the Department of Labor, War Invalids, and Social Affairs of the province or centrally-administered city; in cases where there is no decision, based on the list of payments for persons who have rendered meritorious service to the revolution and their relatives.

3. Persons who participated in the resistance war and national defense, former combatants.

Based on the Decision granting allowances issued by the competent authority.

4. Persons entitled to social assistance benefits according to the laws on the elderly and persons with disabilities.

a) Persons entitled to monthly social assistance benefits: based on the Decision on social assistance issued by the Chairman of the People's Committee of the district, county, or town (hereinafter referred to as the People's Committee of the district).

b) Severely and extremely severely disabled persons not entitled to monthly social assistance benefits: based on a copy of the disability confirmation certificate.

5. Persons aged 80 years or older receiving monthly pension benefits according to the laws on social insurance.

Based on the Decision on monthly pension benefits issued by the competent authority.

6. Children under six years old.

Based on the guidance provided in Circular Joint No. 05/2015/TTLT-BTP-BCA-BYT dated May 15, 2015, jointly issued by the Ministry of Justice, Ministry of Public Security, and Ministry of Health guiding the implementation of interlinked administrative procedures for birth registration, permanent residence registration, and issuance of health insurance cards for children under six years old.

7. Members of poor households, members of near-poor households; ethnic minorities living in areas with difficult socio-economic conditions; persons living in areas with particularly difficult socio-economic conditions; persons living on island communes or islands; members of households engaged in agriculture, forestry, fisheries, and salt production with average income levels.

Based on the list confirmed annually by the Chairman of the People's Committee of the commune.

8. Persons who have rendered meritorious service to the revolution and social assistance recipients being cared for in the Care Center.

Based on the Care Center’s care list.

9. For students studying at vocational education institutions under the management of the Ministry of Labor, War Invalids, and Social Affairs.

Based on the student list of the vocational education institution.

Article 6. Procedures for compiling the list

1. For individuals residing in the community:

a) The labor, war invalids, and social affairs officer at the commune level or the person assigned based on Article 5 of this Circular shall review, compile statistics, and prepare the list of individuals participating in health insurance according to the model issued under Decree No. 146/2018/ND-CP for approval by the Chairman of the Commune People's Committee.

b) The Chairman of the Commune People's Committee shall send the approved list to the District People's Committee (the specialized agency on labor under the District People's Committee) and the district social insurance agency.

c) Within five working days from the date of receipt of the list, the specialized agency on labor under the District People's Committee shall coordinate with the district social insurance agency to review and check the list.

In case of discovering incorrect individuals or incomplete information about the individuals, the specialized agency on labor at the district level shall transfer the list back to the Commune People's Committee to recompile the list.

d) Within ten working days from the date of receipt of the list, the district social insurance agency shall issue health insurance cards to the individuals.

e) The district social insurance agency shall transfer the list along with the health insurance cards of the individuals to the Commune People's Committee for handover to the individuals.

The district social insurance agency must send the list of individuals who have been issued health insurance cards to the specialized agency on labor under the District People's Committee for monitoring and management.

2. For individuals being regularly cared for in care facilities:

a) The care facility shall compile the list according to the model prescribed in Decree No. 146/2018/ND-CP and submit it to the district social insurance agency.

b) Within ten working days from the date of receipt of the list, the district social insurance agency shall verify and issue health insurance cards to the individuals.

c) The district social insurance agency shall transfer the list along with the health insurance cards of the individuals to the care facility.

3. For students and trainees studying at vocational education institutions managed by the Ministry of Labor, War Invalids, and Social Affairs:

a) The vocational education institution shall compile the list according to the model prescribed in Decree No. 146/2018/ND-CP and submit it to the district social insurance agency.

b) Within ten working days from the date of receipt of the list, the district social insurance agency shall verify and issue health insurance cards to the individuals.

c) The district social insurance agency shall transfer the list along with the health insurance cards of the individuals to the vocational education institution for handover to the individuals.

Article 7. Implementation Organization

1. People's Committees at all levels

a) Provincial and centrally-administered city People's Committees: direct and guide the district and commune-level People's Committees to implement this Circular; ensure the correct identification of individuals participating in health insurance and monitor the implementation, resolving difficulties and issues arising during the process.

b) District-level People's Committees: direct the specialized agency on labor at the district level to review, verify, and cross-check the lists of individuals participating in health insurance; report annually to the specialized agency on labor under the provincial People's Committee on the results of issuing health insurance cards in their jurisdiction.

c) Commune-level People's Committees: compile the list of individuals participating in health insurance in their jurisdiction according to this Circular; quarterly review increases and decreases in the number of individuals participating in health insurance and submit them to the specialized agency on labor under the district People's Committee and the district social insurance agency.

2. Care facilities and vocational education institutions: compile the list of individuals participating in health insurance at care facilities according to this Circular; quarterly review increases and decreases in the number of individuals participating in health insurance and submit them to the specialized agency on labor under the district People's Committee and the district social insurance agency.

3. Vietnam Social Security: direct the implementation and provide guidance on business operations within the social security system; direct social insurance agencies at all levels to cooperate with relevant agencies to issue health insurance cards to individuals managed by the Ministry of Labor, War Invalids, and Social Affairs.

8. Effective Date

1. This Circular takes effect from February 12, 2020. Circular No. 25/2016/TT-BLDTBXH dated July 26, 2016, issued by the Minister of Labor, War Invalids, and Social Affairs regarding guidelines for identifying and managing individuals participating in health insurance under Clause 4, Article 1 of the Law Amending and Supplementing Certain Provisions of the Health Insurance Law, shall cease to be effective from the date this Circular takes effect.

2. Documents and files stipulated by the referenced documents in this Circular that are replaced or amended shall be implemented according to the replacing or amending documents.

3. The Ministry of Labor, War Invalids, and Social Affairs and Vietnam Social Security shall conduct joint inspections and disseminate, popularize, and train those responsible for issuing health insurance cards according to this Circular.

4. Any difficulties encountered during implementation should be reported to the Ministry of Labor, War Invalids, and Social Affairs for research and appropriate amendments and supplements.