Discovering and punishing violations in social insurance and health insurance to safeguard participant benefits

19/02/2024 09:05 PM


The Vietnam Social Security (VSS) has consistently taken proactive and coordinated measures with relevant ministries, agencies, and localities to detect, prevent, and penalize violations related to social insurance and health insurance. This includes addressing delays in payment for social insurance, health insurance, and unemployment insurance premiums, as well as preventing the misuse of social insurance and health insurance funds. These efforts are aimed at fostering the growth, security, and long-term viability of the funds to guarantee the full disbursement of social insurance and health insurance benefits for participants.

In 2023, the world faced complicated development in terms of both politics, security, economy and society. Meanwhile, the Covid-19 pandemic had widespread socio-economic impacts across the globe.

In Vietnam, the economy faced many difficulties and challenges while the pandemic, climate change, drought and storms and flood kept developing complicatedly and negatively affected the country’s economy and the life of people as well as the implementation of social security policies of the Vietnam social security industry.

VSS Director General Nguyen The Manh talked with workers about the implementation of social insurance and health insurance policies among businesses

Consultancy, coordination and completion of policies

Identifying the legal framework as the most crucial factor in establishing the foundation and conditions for the collection of social insurance, health insurance, and unemployment insurance premiums, the VSS has closely collaborated with relevant ministries and sectors to develop and revise policies and laws related to social insurance, health insurance, and unemployment insurance. This includes amendments to the Law on Social Insurance and the Law on Health Insurance, as well as providing input on the draft regulation on data sharing and coordination with the Ministry of Health and the Ministry of Public Security for the implementation of Project No 06.

The VSS has also actively coordinated with relevant ministries and sectors to consult and propose to the Government to submit to the National Assembly the inclusion of offenses related to social insurance, health insurance, and unemployment insurance in the Penal Code and Resolution No 05/NQ-HĐTP for approval.

In particular, during the drafting of the amended Law on Social Insurance for submission to the 15th National Assembly at the sixth session in 2023, the VSS actively and proactively collaborated with the Ministry of Labour, Invalids, and Social Affairs, as well as relevant agencies, to enhance and supplement regulations aimed at preventing and mitigating delays in the payment of social insurance, health insurance, and unemployment insurance premiums. These efforts included the introduction of new regulations permitting authorised agencies to suspend the issuance of invoices to enterprises that have been identified as owing social insurance payments for a period of six months or more, as well as prohibiting business owners who have outstanding social insurance premiums for 12 months or more from conducting business activities.

 The VSS and the Ministry of Health often coordinate in implementing health insurance policy

The VSS also proposed several solutions to safeguard the interests of workers whose social insurance, health insurance, and unemployment insurance payments were delayed due to the dissolution or bankruptcy of businesses. Additionally, they aimed to encourage employees to opt for delayed payment of retirement pension instead of receiving a one-time social insurance claim.

Regarding health insurance, the VSS has actively contributed to the development of numerous legal documents pertaining to the execution of health insurance policies and benefits such as the draft amended Law on Health Insurance. Additionally, the organization has overseen the completion of various reports intended for submission to the National Assembly, the Government, and pertinent ministries. Furthermore, the VSS has collaborated with relevant ministries and agencies to draft other legal documents, such as the amended Price Law, the draft Decree on Medical Examination and Treatment for armed forces, as well as documents and circulars related to medical examination and treatment services, and regulations on bidding and procurement of drugs and medical materials.

The VSS also took many measures to effective manage the Health Insurance Fund to ensure correct and timely spending on medical examination and treatment activities to take care of people’s health as well as ensure the interests of health insurance participants.

Mobilising the participation of relevant agencies and authorities

The VSS has requested the People’s Committees of provinces and cities to oversee and direct relevant State management agencies in intensifying their inspection and supervision of the implementation of regulations pertaining to social insurance, health insurance, and unemployment insurance by local agencies, units, and enterprises.

The Vietnam’s social security industry consistently monitors the production and trade activities of units and enterprises to implement suitable measures for preventing delayed payment of social insurance premiums.

The VSS convenes monthly meetings for the entire industry to assess the collection of insurance premiums and devise specific solutions tailored to the circumstances of each province and city, aimed at preventing delayed payments.

The participation of local authorities is an important factor in implementing social and health insurance

Enhancing inspection and recovering late payment  

The VSS is assigned to carry out inspection about payment for social insurance, health insurance and unemployment insurance. This is considered a strong and effective tool that has been actively implemented by the VSS.

The Vietnam social security industry has always been proactive in coordinating with relevant ministries and agencies in inspection activities; issuing and implementing inspection plans; guiding and directing social insurance agencies of provinces and cities to build, adjust and supplement yearly inspection plans, focusing on units and enterprises that have signs of late payment of social insurance and health insurance.

It has also conducted regular and unexpected examinations at medical establishments that have higher rate of payment for health checkup and treatment covered by health insurance than estimate; reviewed and analysed related data using professional software to improve the efficiency and quality of inspection activities; taken measures to prevent the abuse of social insurance, health insurance and unemployment insurance funds; and strictly punished those violating regulations about late payment of social insurance, health insurance and unemployment insurance.

As a result, the industry proactively detected, prevented and handled late payment and the abuse of social insurance, health insurance and unemployment insurance funds.

The Vietnam’s social security industry has also actively coordinated with relevant ministries and agencies to have measures to prevent violations of laws about social insurance, health insurance and unemployment insurance, ensuring the legitimate rights and interests of participants.

Inspection and examination tasks of the Vietnam social security industry has brought in positive results

The VSS has recently leveraged information technology to drive digital transformation in its inspection and examination activities, resulting in time and cost savings, as well as enhanced efficiency and quality of inspections.

In 2023, the VSS took the lead in coordinating inspections at 18,707 units and enterprises, uncovering a total of over VND1.5 trillion ($61.2 million) in late payments. Following the inspections, VND909.8 billion was successfully recovered, representing 60.5 percent of the total late payments. Furthermore, inspectors identified 44,859 instances of violations related to payment subjects and rates, leading to the recovery of VND132.6 billion ($5.4 million).

In 2023, the combined collection of social insurance, health insurance, and unemployment insurance premiums surged by 8.55 per cent compared to 2022, surpassing the target set by the Prime Minister at 101.41 per cent.

Moreover, the late payment rate for social insurance, health insurance, and unemployment insurance hit a record low in 2023, plummeting to 2.69 per cent from 6 per cent in 2016.

These accomplishments underscore the effectiveness of the inspection task and other collection strategies within Vietnam's social security industry. They play a vital role in ensuring the growth, safety, and sustainability of social insurance, health insurance, and unemployment insurance funds. This, in turn, guarantees full payment of policies for participants and beneficiaries while also enhancing awareness among employers and employees regarding the implementation of these policies./.