9 March 2015
On 13 June 2014 the National Assembly issued Law No. 46/2014/QH11 ("Law 46") amending and supplementing some provisions of the Law on Health Insurance. Law 46 took effect on 1 January 2015. In order to provide implementing guidance to Law 46, on 15 November 2014 the Government issued Decree No. 105/2014/TT-NHNN ("Decree 105") providing implementing guidance on some provisions of Law on Health Insurance in terms of payment of health insurance. Decree 105 became effective on 1 January 2015 and replaced Decree No. 69/2009/ND-CP dated 27 July 2009 ("Decree 69") guiding the same issues.
Contribution of Health Insurance
Decree 105 provides some new regulations on payments of health insurance which were not stipulated under Decree 62.
i. An employee who has more than one labour contract at any time will have to pay health insurance contribution calculated on the basis of the labour contract with the highest salary amount;
ii. Female employees will pay health insurance during their maternity leave periods at the rate of 4.5 percent of the monthly wage before maternity leave (of which the employer contributes 3 percent and the employee contributes 1.5 percent). This rate is the same with the usual rate applicable to employees in general. This is a new payment obligation applicable to female employees, which was not required under Decree 62 (Decree 62 was Decree 105's predecessor). Nevertheless, the payment of health insurance during the maternity leave will be borne by the Pubic Insurance Agency;
iii. Employees taking sick leave from 14 days or more per month are exempt from paying health insurance contribution while these employees are still entitled to their health insurance benefits. However, Decree 105 is silent on whether the employers have to cover (x) the employee's salary during the sick leave period, or (y) the employee's health insurance contribution during such period or not;
iv. Employees sent abroad for study or business trips are exempt from payment of health insurance contribution. However, their health insurance contribution is treated as uninterrupted for the study or business trip period. It seems unlikely that, during such period, the State health insurance scheme will cover the employees in the foreign country; however, Decree 105 is silent on this issue;
v. Employees are exempt from payment of health insurance contribution during any period when they work abroad. It seems unlikely that, during such period, the State health insurance scheme will cover the employees in the foreign country; however, Decree 105 is silent on this issue.
Coverage Rates of Health Insurance
The employees who have paid the health insurance contribution in full will be entitled to the payment or reimbursement of medical expenses as follows:
i. 100 percent of medical expenses in case the employees receive the medical treatment at a communal health centre;
ii. 100 percent of medical expenses in case the cost incurred by each medical treatment remains lower than 15 percent of the base salary regulated by the Government which is set out at VND 1.15 million
iii. In cases the employees receive the medical treatment at a health centre other than the one at which they have registered, their medical expenses will be paid as follows:
• at a central health centre: 40 percent of medical expenses;
• at a provincial health centre: 60 percent of medical expenses from 1 January 2015 to 31 Deceber 2020 and 100 percent afterward;
• at a district health centre: 70 percent of medical expenses from 1 January 2015 to 31 December 2015 and 100 percent afterward.