Quyết định 686/QĐ-BHXH năm 2024 sửa đổi Quy trình giải quyết hưởng các chế độ bảo hiểm xã hội, chi trả các chế độ bảo hiểm xã hội, bảo hiểm thất nghiệp kèm theo Quyết định 166/QĐ-BHXH và Quyết định 3503/QĐ-BHXH sửa đổi Quy trình giải quyết hưởng các chế độ bảo hiểm xã hội, chi trả các chế độ bảo hiểm xã hội, bảo hiểm thất nghiệp kèm theo Quyết định 166/QĐ-BHXH do Bảo hiểm xã hội Việt Nam ban hành

DECISION

ON AMENDMENTS TO THE PROCEDURES FOR SETTLING CLAIMS FOR SOCIAL INSURANCE BENEFITS, PAYING SOCIAL INSURANCE AND UNEMPLOYMENT INSURANCE BENEFITS, AS ISSUED BY DECISION NO. 166/QD-BHXH DATED JANUARY 31, 2019 OF THE GENERAL DIRECTOR OF VIETNAM SOCIAL SECURITY AND DECISION NO. 3503/QD-BHXH OF NOVEMBER 18, 2022 OF THE GENERAL DIRECTOR OF VIETNAM SOCIAL SECURITY ON AMENDMENTS TO THE PROCEDURES FOR SETTLING CLAIMS FOR SOCIAL INSURANCE BENEFITS, PAYING SOCIAL INSURANCE AND UNEMPLOYMENT INSURANCE BENEFITS ISSUED WITH THE DECISION NO. 166/QD-BHXH

GENERAL DIRECTOR OF VIETNAM SOCIAL SECURITY

Pursuant to the Law on Social Insurance dated November 20, 2014;

Pursuant to the Law on Employment dated November 16, 2013;

Pursuant to the Law on Occupational Safety and Hygiene dated June 25, 2015;

Pursuant to the Government's Decree No. 89/2020/ND-CP dated August 4, 2020 defining functions, tasks, powers and organizational structure of Vietnam Social Security;

At the request of the Head of the Social Insurance Policy Implementation Board, Director of the Finance - Accounting Department.

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Article 1. Amendments to the Procedures for settling claims for social insurance (SI) benefits, paying social insurance (SI) and unemployment insurance (UI) benefits issued together with Decision No. 166/QD-SI dated January 31, 2019 of the General Director of Vietnam Social Security:

1. Add the following definitions to Clause 1, Article 1:

Citizen identification card: citizen identification card, identification card.

- employment services.”

2. Add the following definitions to Clause 2, Article 1:

“- Monthly SI includes: pension, SI benefits and monthly allowances.”

3. Amend sub-section 1.1.2, point 1.1, clause 1, Article 2 (as amended in Decision No. 3503/QD-BHXH) as follows:

“b) Prepare a list of beneficiaries of lump-sum payments of SI benefits settled and paid by the province-level Social Security agency; prepare a list of beneficiaries of lump-sum payments of occupational accident and occupational disease benefits, and death benefits paid in cash by other province- or district-level Social Security agencies.

4. Amend sub-section 1.2.3, point 1.2, clause 1, Article 2 (as amended in Decision No. 3503/QD-BHXH) as follows:

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5. Amend Clause 2, Article 2 as follows (amended sub-section a, section 2.1.2, point 2.1 in Decision No. 3503/QD-BHXH):

“2. Decentralization of payment and management of beneficiaries

2.1. Province-level Social Security

2.1.1. Pay claims for sickness, maternity, and recuperative care benefits settled by the province-level Social Security; support for vocational training, support for training and skill enhancement; support for career transition for people with occupational accidents and diseases when returning to work, support for occupational disease examination, support for occupational disease treatment, support for rehabilitation, support for occupational safety and health training, support for re-investigation of occupational accidents and diseases, and medical examination and treatment fees; pay lump-sum SI benefits at the province-level Social Security; pay UI benefits through personal accounts for employees.

2.1.2. Sign a contract with an authorized benefit payer authorizing them to pay and manage beneficiaries.

a) Pay monthly SI benefits, lump-sum cash SI allowances under the monthly SI benefits, and cash UI benefits.

b) Manage beneficiaries receiving monthly SI benefits and report any decreases in beneficiaries according to regulations.

c) Manage and store the list of beneficiaries for payments via personal accounts, the list of beneficiaries with cash payments, documents related to transferring money to beneficiaries through personal accounts, authorization letters, and money receipts signed by beneficiaries when paid by authorized benefit payers, in compliance with applicable laws.

2.2. District-level Social Security

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6. Add clause 14 after clause 13, Article 3 as follows:

“14. If a monthly SI beneficiary requests to update or supplement their personal information based on their citizen identification card, the updated or supplemented information shall not be used as a basis for readjusting the settled social insurance benefits”.

7. Add section 1.2.8 after section 1.2.7, point 1.2, clause 1, Article 6 as follows:

“1.2.8. In case of a request to update or supplement personal information in the monthly SI beneficiary file based on the citizen identification card, the file receipt form should indicate the request to update or supplement personal information based on the citizen identification card, using Form No. 2-CBH (issued with this Decision)”.

8. Amend and supplement the third (-) bullet point sub-section a, section 1.1.2, point 1.1, clause 1, Article 7 as follows:

“- Payment/granting money to purchase daily living aids:

+ For new claims for settlement: Based on the records and types of daily living aids, determine the amount of money and issue a Decision on the provision of daily living aids (Form No. 03P-HSB).

+ For cases that have been granted money to purchase daily living aids but are not yet on the list of beneficiaries for payments: Based on the Decision on the Provision of daily living aids (Form No. 03P-HSB) of the employee or based on the records, term, types, invoices, and documents for purchasing daily living aids, when the beneficiary requests payment, establish a list of approved beneficiaries of daily living aids that are not yet on in the centralized data to update into TCS software (Form No. 31-HSB issued with this Decision) and submit to the Director for approval.

+ Make a list of beneficiaries for payments: Based on the Decision on providing daily living aids (Form No. 03P-HSB) and Form No. 31-HSB to:

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Make List C72a-HD for those who are granted money to purchase daily living aids by term. The software automatically updates the amount periodically according to the daily living aids term.”

9. Add section 1.1.4a after section 1.1.4, point 1.1, clause 1, Article 7 as follows:

“1.1.4a. Update or supplement personal information in the monthly SI beneficiary file based on the citizen identification card.

Access the Policy Management System to check and compare the beneficiary's information with the information on the citizen identification card and the national population database. If the information is verified and accurate, update and supplement the information based on the citizen identification card; submit the updated information to the leader for approval; sign the confirmation of updating personal information in the monthly social insurance benefit file based on the citizen identification card (Form No. 29-HSB issued with this Decision); and then transfer the updated information to the receipt and result return department on the system.

1.1.5. Data cutoff and reports:

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10. Amend Point 2.1, Clause 2, Article 7 (amended in Decision No. 3503/QD-BHXH) as follows:

“2.1. Make a list of beneficiaries for lump-sum payments

2.1.1. Responsibilities of the Social Insurance Benefit Department

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2.1.2. Responsibilities of the Social Insurance Benefit Department

- Daily, based on the data, settle claims for lump-sum SI benefits and allowances; notify conversion to lump-sum payments of occupational accident and occupational disease benefits, death benefits; decision by the competent authority on the deduction of social insurance money; establish C97-HD List according to hierarchy, using the following forms: Payment through a personal account, direct payment in cash, submit to leader for approval and transfer to the planning and finance department.

- Every month, based on the data for settling the lump-sum allowances along with the monthly SI benefits that the beneficiary registers to receive through personal accounts, create List C97-HD simultaneously with creating List C72a-HD for monthly pension and SI allowance payments for the leader to approve and transfer to the planning and finance department for payment or transfer to the planning and finance department according to the decentralization".

11. Amend sub-section 2.2.2, point 2.2, clause 2, Article 7 (as amended in Decision No. 3503/QD-BHXH) as follows:

“2.2.2. Responsibilities of the Social Insurance Benefit Department Receive and process the lists and notices prepared and sent by the district-level Social Security according to section 2.2.1 of this point; receive and process decisions of competent authorities on monthly social insurance deductions; receive and process data on settlement of monthly SI insurance benefits (including increase or decrease the benefit level; updates and supplements to beneficiaries' personal information based on their citizen identification cards) in the province, beneficiaries of SI benefits transferred from other provinces during the month; list 7a-CBH and data on the list of beneficiaries for payments for the month, prepare and submit to the leader for digital signature on the policy management software system (TCS) the following lists and reports:

a) List C72a-HD for the following month with lump-sum allowances (if any) for beneficiaries from the 1st to the last day of the month in the following forms: Payment via personal account, direct payment in cash;

b) List D03-TS (issued with Decision No. 490/QD-BHXH dated March 28, 2023 of the General Director of Vietnam Social Security on amendments to the procedures for collecting social insurance, health insurance, unemployment insurance, occupational accident and disease insurance, managing social insurance books and health insurance cards issued with Decision No. 595/QD-BHXH dated April 14, 2017 of the General Director of Vietnam Social Security and amendments to Article 1 of Decision No. 505/QD-BHXH dated March 27, 2020 of the General Director of Vietnam Social Security) of people receiving monthly SI benefits in detail according to each type in the area...”.

12. Amend clause 3 Article 2 (as amended sub-section b, section 3.1.1 and sub-section b, section 3.1.2, point 3.1 in Decision No. 3503/QD-BHXH) as follows:

“3.1. Responsibilities of the plan and finance department

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3.1.2. Payments to beneficiaries

a) Payments via personal account

Based on the List C97-HD, make payments via personal account: Make the transfer immediately on the same day or the next working day after receiving the List.

In case of failure to pay due to incorrect information: The plan and finance department signs and sends from the centralized accounting software to the TCS software to the social insurance benefit department (according to Form No. 1a-CBH); receive the adjustment information created by the social insurance benefit department and submit it to the leader to sign and transfer from the TCS software to the centralized accounting software (according to Form No. 1b-CBH), and then transfer the allowance amount to the employee's account immediately upon receiving the adjustment request information.

b) Cash payments

Based on List C97-HD and List 7b-CBH, make payments to the beneficiary; based on the request form No. 3-CBH, compare with the managed data to pay for the relatives of the deceased beneficiary who has not yet received the SI benefits.

3.1.3. Based on the revocation decisions of the social insurance benefit department and data from the TCS software, create List C75-HD, enter into the detailed revocation tracking book of each entity managed by the province-level Social Security and summarize the recovery list of the whole province according to regulations.

3.1.4. Monthly, based on List 7b-CBH sent by the plan and finance department of the districts, create List 7b-CBH of the whole province.

3.1.5. Monthly, prepare a summary report on lump-sum SI benefit payment according to Form No. 4-CBH managed by the province-level Social Security and based on the report according to Form No. 4-CBH sent by the plan and finance department of the districts to make a final report of the whole province, transfer to the social insurance benefit department.

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a) Implement Sections 3.1.1, 3.1.2, 3.1.3, 3.1.4, 3.1.5, Point 3.1, Clause 3 of this Article according to the management decentralization of the district-level Social Security.

b) On the last working day of each month, prepare the List 7b-CBH of the district and send it to the plan and finance department.”

13. Amend Point 5.1, Clause 5, Article 7 (amended Section 5.1.1, Point 5.1 in Decision No. 3503/QD-BHXH) as follows:

“5.1. Province-level Post Office

5.1.1. Receive the list, budget; pay monthly SI benefits and lump-sum SI allowances attached to monthly SI benefits in cash, UI benefits in cash; manage beneficiaries; make settlement and implement the reporting regime according to the regulations of Vietnam Social Security and the signed authorization contract;

5.1.2. Store the list of beneficiaries with payments via personal accounts, documents related to transferring money to beneficiaries through personal accounts, the list of beneficiaries with cash payments, authorization letters, and money receipts signed by beneficiaries when paid by the post office, in compliance with applicable laws. Based on the original documents, create, sign, and transfer digital signatures to electronic data and send to the Social Security agency the settlement records and documents of the Payment schedule form No. C74a-HD. Take legal liability for the accuracy between the electronic copy of the settlement records sent to the Social Security agency and the List of beneficiaries for payments, Receipt of money with the signature of the beneficiary kept at the post office; be responsible for providing upon request of the Social Security agency and competent authorities.”

14. Amend sections 5.2.1, 5.2.2, point 5.2, clause 5, Article 7 (amended section 5.2.1, point 5.2 in Decision No. 3503/QD-BHXH) as follows:

“5.2.1. Pay monthly SI benefits and lump-sum SI allowances attached to monthly SI benefits in cash, UI benefits in cash; manage beneficiaries; make settlement with district-level Social Securities agencies and implement the reporting regime according to the regulations of Vietnam Social Security and the signed contract.

5.2.2. Prepare List 7a-CBH, 7c-CBH, Payment schedule Form No. C74a-HD, transfer to electronic data to make settlements with the district-level Social Security in accordance with law on electronic transactions."

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“a1) From the Department of Labor, War Invalids and Social Affairs: Decision on support for training and skill enhancement; from employment service centers: Decision, notification, proposal on receiving UI benefits; Decision on vocational training support as prescribed in Clause 1 and Clause 6, Article 18, Clause 2, Article 19, Clause 1, Article 20, Clause 3, Article 21, Clause 4 and Clause 7, Article 22, Clause 4, Article 25 and Clause 2, Article 27 of Decree No. 28/2015/ND-CP dated March 12, 2015 of the Government, Clause 8, Article 1 of Decree No. 61/2020/ND-CP dated May 29, 2020 of the Government; List of UI benefit decisions, individuals who fail to report their employment status monthly in person, individuals who register for vocational training and job placement services, individuals who apply to preserve their unemployment insurance, individuals who do not receive their UI benefit payout decision (or their UI benefit payout decision is revoked) by electronic means as prescribed in Clause 2, Article 19, Decree No. 166/2016/ND-CP dated December 24, 2016 of the Government.”

16. Amend sub-section a, section 1.1.2, point 1.1, clause 1, Article 8 as follows:

“a) Employment service center: Notice of non-receipt of UI benefits in person (Form No. 14 issued with Circular No. 28/2015/TT-BLDTBXH); Notice of receiving decisions on payout of UI benefits (Form No. 01/TB-HSB issued with this Decision)”.

17. Amend sub-section b, section 2.1.2, point 2.1, clause 2, Article 8 as follows:

"b) If the information is incorrect, insufficient, or if the UI benefits are not in accordance with regulations, send the employment service center a notice of receipt of the decision on payout of UI benefits (Form No. 01/TB-HSB)."

18. Amend sub-section a1 section 2.2.1 point 2.2 clause 2 Article 8 as follows:

“a1) For those receiving UI benefit in the first month: Pursuant to the decision on the grant or revocation of UI benefits, information regarding employees who have failed to receive their UI benefit payout decisions, and those who have failed to report their job seeking activities, create List C72b-HD and submit it to Province-level Social Security head for approval. The payment date is the working day following the date of the list approved by the province-level Social Security head and ensures the time limit as prescribed in Clause 3, Article 46 of the Law on Employment."

19. Amend the content in the third bullet point of content a2, sub-section a, section 2.2.1, point 2.2, clause 2, Article 8 as follows:

In case of receiving a request to continue paying UI benefits, the decision on continued UI benefit payout after deadline for making the prescribed list, a list of beneficiaries for payments shall be made for this case on the same day.

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20. Amend section 2.2.2, point 2.2, clause 2, Article 8 as follows:

The social insurance benefit department receives List C87a-HD from vocational training facilities and the social insurance benefit department; compares it with the information on vocational training support for each employee that has been updated on the System. If benefits are claimed in accordance with the regulations, data entry into the System shall be carried out and a List of unemployed people receiving vocational training support (form No. C87b-HD) will be submitted to the province-level Social Security head for approval.

Assign the Director of the Province-level Social Security to coordinate with the employment service center to agree on the method and time for transferring the decision and electronic data on vocational training support to serve as a basis for making a list of beneficiaries for payments to ensure convenience for beneficiaries, vocational training facilities, and within the prescribed time limit.”

21. Amend point 2.3, clause 2, Article 8 as follows:

“2.3 Transferring the list

2.3.1. Transfer to the plan and finance department: List C72b-HD for funding and payment, List C87b-HD and Payment schedule form C93-HD for payment.

2.3.2. Transfer to the receipt and results return department:

a) The receipt and results return department affiliated to province-level Social Security

- Notice of non-receipt of UI benefits in person (Form No. 14 issued with Circular No. 28/2015/TT-BLDTBXH);

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- List of unemployed people approved for vocational training support (Form No. 87b-HD);

- Payment schedule form C93-HD.

b) The social insurance benefit department shall transfer the receipt and results return department affiliated to district-level Social Security: The list of unemployed people approved for vocational training support (Form No. 87b-HD); Payment schedule form C93-HD.

2.3.3. Transfer the records specified sub-section 1.1.1, section 1.1, clause 1, Article 8 for storage according to regulations."

22. Amend clause 1, Article 12 as follows:

"1. Information Technology Center

Develop, adjust the business software of the Industry to fully meet the regulations in this Document; in case of updating, supplementing personal information of the beneficiary according to the citizen identification card, then supplement the amended content along with the old personal information criteria, ensuring that the social insurance benefit level is not changed at the time of updating; guide, implement and promptly resolve difficulties in the process of using business software.”

Article 2. Lists and forms

1. Update and supplement information on lists and forms (Appendix 1)

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- List of beneficiaries for settlement of sickness, maternity, and health recovery benefits (Form No. C70a-HD);

- List of beneficiaries for settlement of maternity benefits for employees who have quit their jobs, been demobilized, or discharged before giving birth, receiving a child, or adopting a child (Form No. C70b-HD);

- List of beneficiaries for payment of pensions and SI benefits (Form No. C72a-HD); List of beneficiaries for payment of UI benefits (Form No. C72b-HD);

- List of beneficiaries for payment of lump-sum SI benefits (Form No. C97-HD); List of requests for settlement of sickness, maternity, and health recovery benefits (Form No. 01b-HSB);

1.2. Amend instructions for providing information according to the citizen identification card

- Request to change beneficiary information (Form No. 02-CBH);

- Application form (Form No. 14-HSB);

1.3. Amend some contents on payment form

- Decision on payout of monthly occupational accident allowance (Form No. 03A-HSB);

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- Decision on payout of monthly occupational disease allowance (Form No. 03C-HSB);

- Decision on payout of lump-sum occupational disease allowance (Form No. 03D-HSB);

- Decision on payout of monthly occupational accident allowance due to recurrent injury (Form No. 03E-HSB);

- Decision on payout of lump-sum occupational accident allowance due to recurrent injury (Form No. 03G-HSB);

- Decision on payout of monthly occupational disease allowance due to recurrent illness (Form No. 03H-HSB);

- Decision on payout of lump-sum occupational disease allowance due to recurrent illness (Form No. 03K-HSB);

- Decision on payout of monthly occupational accident/disease allowances based on a comprehensive assessment of the level of reduced working capacity (Form No. 03M-HSB);

- Decision on payout of lump-sum occupational accident/disease allowances based on a comprehensive assessment of the level of reduced working capacity (Form No. 03N-HSB);

- Decision on granting money to purchase daily living aids, orthopaedic devices (Form No. 03P-HSB);

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- Decision on payout of lump-sum SI benefits (Form No. 07B-HSB);

- Decision on payout of monthly benefits for commune, ward and town officials (Form No. 07C-HSB);

- Decision on payout of lump-sum allowance (Form No. 07D-HSB);

- Decision on payout of funeral allowance (for relatives of a deceased insured person who was either actively contributing or had deferred their social insurance contributions (Form No. 08A-HSB);

- Decision on payout of funeral allowance (for relatives of a deceased individual who was receiving a monthly pension or social insurance benefit) (Form No. 08B-HSB);

- Decision on payout of monthly death benefit (Form No. 08C-HSB);

- Decision on payout of lump-sum death benefit (for relatives of a deceased insured person who was either actively contributing or had deferred their social insurance contributions (Form No. 08D-HSB);

- Decision on payout of lump-sum death benefit (for relatives of a deceased individual who was receiving a monthly pension or social insurance benefit) (Form No. 08E-HSB);

- Decision on continued payout of monthly SI benefits (Form No. 11-HSB);

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2.1. Confirmation of updating personal information according to citizen identification card (Form No. 29-HSB);

2.2. List of monthly social insurance beneficiaries with discrepancies between social insurance agency records and national population database (Form No. 30-HSB);

2.3. List of approved beneficiaries of daily living aids not yet included in the centralized database for updating in TCS software (Form No. 31-HSB);

2.4. List of beneficiaries with incorrect account information (Form No. 1a-CBH);

2.5. List of beneficiaries with corrected account information (Form 1b-CBH);

Article 3. Implementation

Province-level Social Security agency shall amend the authorized benefit payment agreement for SI benefits, UI benefits, and the management of monthly SI beneficiaries via the postal system, which was previously signed between the province-level Social Security agency and the province-level Post office, to comply with the amendments and supplements stipulated in this Decision.

Article 4. Entry in force

1. This Decision takes effect from June 1, 2024; Clause 7, Section 3.1.2, Point 3.1, Clause 12, Clause 21, Clause 22, Article 1 shall be implemented at the time Vietnam Social Security guides the software implementation.

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3. Annul Official Dispatch No. 1973/BHXH-CSXH dated May 24, 2017 of Vietnam Social Security on strengthening the management of social insurance and unemployment insurance; Official Dispatch No. 2754/BHXH-CSXH dated September 5, 2023 of Vietnam Social Security on issuing health insurance cards to people receiving monthly social insurance who request to update personal information according to the citizen identification card; annul the content in the 3rd bullet point, section b, point 2.3, clause 2, section II of Official Dispatch No. 2373/BHXH-VP dated August 29, 2022 of Vietnam Social Security; the content in the 2nd bullet point, point b, clause 2, Article 9 of Decision No. 706/QD-BHXH dated May 19, 2023 of Vietnam Social Security.

4. Heads of units under Vietnam Social Security, Directors of province-level Social Security agencies shall implement this Decision./.

GENERAL DIRECTOR




Nguyen The Manh