Questions and answers

Insurance medicine will enable your employees, regardless of their income, to receive the entire volume of medical care, including both routine inpatient care and drug provision, as well as highly specialized medical services, rehabilitation support, consulting and diagnostic assistance, nursing care and palliative care. For example, if your employee is seriously ill today, he needs expensive treatment and is forced to take long sick leave. Not having sufficient personal funds to pay for medical services, he applies for material assistance to his employer and the staff of the enterprise, which entails significant material costs for all parties. In the context of social medical insurance, all the costs of treatment, care and rehabilitation for a sick worker are covered by the Medical Insurance Fund. In addition, it should be noted that the contributions of employers and employees will be directed, first of all, to expand the primary health care system, prevent diseases in order to reduce hospitalizations, and accordingly reduce the loss of working time due to effective outpatient care. At the same time, today in the labor market, only a part of employers can offer their employees a full social package, including medical insurance, using this as an advantage in attracting highly qualified personnel. With the introduction of compulsory health insurance, this social package will become an affordable and universal advantage for all participants in the labor market, which will simplify the solution of personnel problems. For example, in countries with developed economies, high levels of labor productivity, they preferred the model of compulsory medical insurance. Since this model provides undeniable economic benefits for the business through cost reduction, production growth and increased profit for the enterprise. The main benefit from the introduction of medical insurance is to reduce production losses associated with temporary disability of workers. Thus, according to statistics, in Kazakhstan annually more than 2.6 million employees issue sick leave certificates due to temporary disability. If we proceed from the fact that every day, on average, each employee produces products (or provides services) for 12.6 thousand tenge, then the annual losses of employers amount to about 370 billion tenge. The opportunity to receive high-quality primary care, the necessary drug provision, effective treatment and expensive specialized care in the best clinics of the country within the framework of the compulsory health insurance will, in the aggregate, preserve the health of employed citizens, reduce the duration of sick leave and, as a result, reduce the losses of employers.

If you are an employer , then according to the proposed amendments to the law on compulsory health insurance, you will make monthly insurance contributions to the Fund, starting

• from July 1, 2017 - 1% of the income of each employee;
• from January 1, 2018 - 1.5% of the income of each employee;
• from January 1, 2020 - 2% of the income of each employee;

The procedure for payment to employers is already familiar, according to the same scheme they pay contributions to the Pension Fund. By the 15th day of each month following the reporting period, the employer must provide information on the contributions made to his employees.

The payment can be made through any STB or Kazpost office to the account of the Government for Citizens state corporation (along with other social security payments) indicating the payment purpose code (KNP) for employers - 121 .

Further, the state corporation itself distributes payments to the Medical Insurance Fund. You must also verify your refund within 2-3 business days. The most likely mistakes when sending deductions: erroneous indication of IIN or full name, incorrectly calculated rates and excess of the deduction base in excess of 15 minimum wages.

It is also necessary to deduct from the employee's salary to the Fund monthly in 2020. 1%. At the same time, the monthly income accepted for calculating deductions / contributions should not exceed 10 times the minimum wage.

Insurance deductions and contributions are not paid to the Fund from the following types of income:

• compensation for business trips and traveling nature of work;
• field allowance for workers;
• expenses related to the delivery of workers for training, benefits and compensation from the budget;
• allowance for health leave, payments for payment of medical services, at the birth of a child, for burial within 8 minimum wages (MW);
• scholarships;
• insurance premiums.

The employer is exempt from payments for employees belonging to socially vulnerable categories of citizens, as well as for military personnel, employees of special government agencies and law enforcement officers.

The calculation and transfer of deductions and / or contributions of employees is carried out by the employer on a monthly basis.

Accrued deductions and / or contributions are transferred through the State Corporation to the Fund's account by legal entities no later than the 25th day of the month following the month of income payment.

In accordance with paragraph 1 of Article 14 of the Law of the Republic of Kazakhstan dated November 16, 2015 No. 405-V "On compulsory social health insurance" (hereinafter referred to as the Law), the payer of contributions for compulsory social health insurance (hereinafter referred to as OSMS) is the employer. In accordance with paragraph 2 of the same article, the payers of contributions are an employee, individual entrepreneurs, individuals who receive income under contracts of a civil law nature.

If you are an individual entrepreneur, then, in accordance with the law, he was obliged to pay contributions for himself in the amount of 5% of 2 times the minimum wage approved by the law on the republican budget, in the period from July 1, 2017. For example, in 2017, the monthly amount of his contribution is 2,446 tenge (the formula is 24,459 tenge (the minimum wage) x 2 x 5%, rounded off).

In 2018 and 2019, individual entrepreneurs are exempted from paying contributions. From 2020 - 5% of 1.4 minimum wages monthly. Payment can be made through any branch of STB or Kazpost to the account of the state corporation "Government for Citizens" (along with other social security payments) indicating the payment purpose code (KNP) for individual entrepreneurs and individuals working under civil law contracts - 122.

Further, the state corporation itself distributes payments to the Medical Insurance Fund. You must also verify your refund within 2-3 business days. The most likely mistakes when sending deductions: erroneous indication of IIN or full name, incorrectly calculated rates and excess of the deduction base in excess of 15 minimum wages.

For employers, the amount of deductions is provided from July 1, 2017 - 1% of the employee's accrued income, from January 1, 2018 - 1.5%, from January 1, 2020 - 2%.

For an employee, contributions are stipulated from January 1, 2020 - 1%.

For each employee under an employment contract, the employer, in accordance with the draft law, is obliged to monthly calculate and list:

- deductions for compulsory health insurance in the amount of 1% of the accrued income starting from July 1, 2017 at the expense of the income of an individual entrepreneur. Example: for July 2017, the salary of employee N was calculated in the amount of 60,000 tenge, the amount of deductions for compulsory health insurance for July will be 600 tenge (formula: 60,000 tenge x 1%).

- employee contributions to compulsory health insurance from January 1, 2020 in the amount of 1% of the accrued income by deducting this amount from the employee's salary. Example: the salary of employee N was calculated for July 2020 in the amount of 60,000 tenge, the amount of his contribution to the compulsory health insurance for July will be 600 tenge (formula: 60,000 tenge x 1%).

And so for each employee.

If the individual entrepreneur has suspended his activities, and the entrepreneur has no other income, then the citizen will pay 5% of the minimum wage as an independent payer, starting from January 1, 2020.

If a former or an active entrepreneur belongs to the list of privileged categories of the population, then the state goes first, i.e. for a person belonging to 13 preferential categories, the state pays contributions from January 1, 2020. In this case, the individual entrepreneur himself is not obliged to pay.

As a rule, the head of the farm is an individual entrepreneur. This means that he pays 5% of 1.4 minimum wages for himself from January 1, 2020.

If there are members of a peasant farm, and they are not individual entrepreneurs, then they will have to pay contributions on their own from January 1, 2020 in the amount of 5% of the minimum wage.

If a farm has hired workers, then in relation to them the farm acts as an employer, and, accordingly, will make deductions for its employees from the object of calculations - the employee's income, but not exceeding the mark of 10 times the minimum wage on a monthly basis.

For seasonal workers, wages will be paid for a specific month, for which deductions will need to be made.

If in the future this category of citizens will not have a permanent job, they will fall under the category of self-payers and will be obliged to pay for their own insurance: from January 1, 2020 in the amount of 5% of the minimum wage. Let me remind you that they will still have the opportunity to receive medical care within 3 months from the date of the last payment of contributions.

Market traders, if they are not registered as individual entrepreneurs, pay contributions as inactive population in the amount of 5% of the minimum wage (minimum wage). If the trader is an employee (market sellers), deductions and contributions are calculated and paid from the income accrued by the employer.

A single aggregate payment is intended for such categories as: employees of personal subsidiary plots, unpaid employees of family enterprises, entrepreneurs who do not have employees, with a turnover of less than 1,175 MCI per year. Payment, distribution and transfer of a single aggregate payment in the form of individual income tax and social payments, as well as their refund, are carried out in accordance with the Rules approved by the Decree of the Government of the Republic of Kazakhstan dated January 18, 2019 No. 4. Individuals who are entitled to recognize themselves as payers of a single aggregate payment, carrying out entrepreneurial activity, do not use the labor of hired workers.

The monthly size of a single aggregate payment is: 1 MCI - for individuals living in cities of republican significance, the capital and regional significance; 0.5 MCI - for individuals living in other localities.

An individual entrepreneur does not pay contributions and deductions if he himself or his employees, or an accountant are persons from the following categories:

1) children (under the age of 18);

2) recipients of pension payments, including participants and invalids of the Great Patriotic War;

3) mothers with many children, awarded with pendants "Altyn alka", "Kumis alka" or previously received the title "Mother Heroine", as well as awarded with the orders of "Maternal Glory" I and II degree;

4) disabled people;

5) persons studying full-time in organizations of secondary, technical and vocational, post-secondary, higher education, as well as postgraduate education.

Contribution for an individual with whom a civil law contract for the provision of services has been concluded - in the amount of 1% of the amount of the contract with an individual starting from January 1, 2020.

According to the law, monthly contributions of individuals working under GPC contracts are 1% of income (contract amount) from 2020.

For this category of payers, the same mechanism for paying contributions is in place as for individual entrepreneurs, in the amount of 5% of 1.4 minimum wages from January 1, 2020.

Yes, of course they can. Social health insurance will enable your employees to receive highly specialized medical care, the cost of which can significantly exceed the amount of payments made by both the employer and the employees themselves in the aggregate.

The principles of solidarity and fairness of the compulsory health insurance system provide for the payment of contributions to the system from the available income and receive medical assistance in the required volume, regardless of the amount of contributions.

According to the Law, payers of contributions and contributions have the right to request and receive free of charge from the Fund the necessary information about the transferred amounts of contributions or contributions.

For seasonal workers, if there is income, his employer pays contributions, in the period when there is no income, he can independently make contributions to the FSMS through a second-tier bank or Kazpost offices in the amount of 5% of the minimum wage.

No you can not. In case of compulsory health insurance, the employee himself chooses a medical organization to receive medical services.

The employer chooses a medical organization only with voluntary medical insurance.

The employer enters into a contract for voluntary medical insurance (VHI) for his employees, which involves receiving a certain amount of medical care, limited by the amount of the employer's deductions. Above this limit, medical assistance under the VHI will not be provided. Compulsory health insurance does not limit the amount and amount of medical care provided.

At the same time, the list of medical services that is not included in the compulsory health insurance package may be stipulated in the VHI contract at the choice of the employer and the consent of the employee. Certain types of medical services that are not included in the compulsory health insurance package can be paid through voluntary medical insurance, for example: dentistry for adults, mandatory periodic medical examinations for workers working in hazardous industries, spa treatment, cosmetology, etc.

In addition, in VHI there are risks of inflated bills for services provided by private clinics, which entails unjustified costs for employers. Also, in voluntary medical insurance, the customer (in this case, the employer) has practically no leverage over the quality of the medical services provided by the supplier. In the CHI system, the Fund ensures quality control of medical care, protects the rights and interests of insured citizens.

The OSHI is based on the principles of obligatory payment of contributions or contributions and joint responsibility of the state, employers and citizens.

Unfortunately, the risk of hiding income and "shadow" wages exists in any economy as a way to avoid taxes. To solve this problem, there are various methods of struggle on the part of the fiscal authorities.

The tax authorities will accept declarations of transfers to the Fund, on the basis of which the control and collection of debts will be carried out.

In addition, employees themselves can control contributions to the Fund, since according to the law, the employer must provide them with information on the funds transferred for them on a monthly basis.

It should be noted that today we are witnessing a significant increase in employment in the economy. More than 6.5 million hired workers work at domestic enterprises; monthly employers donate 53 billion tenge to the Unified Accumulative Pension Fund and 23 billion tenge to the Social Insurance Fund in favor of their employees. At the same time, the state takes on the lion's share of the obligations to pay contributions to the FSMS for the economically inactive population. All this as a whole creates the preconditions for the stable functioning of the implemented medical insurance system.

The system of taxes and fees in the economy is an instrument of the state to fairly distribute income from the rich to the less rich. At the same time, mechanisms are applied to restrain the desire to reduce official revenues and their flow into the shadow sector, usually this is the establishment of an upper limit for collections from revenues equal to about 2-3 times the size of revenues. The OSMS system also uses the specified mechanism in the form of setting an upper limit on deductions and contributions, and it is approximately 2.5 times the size of the average wage in the country's economy.

The state revenue authorities (tax committee) monitor the timely and complete calculation and transfer of deductions and contributions.

If an individual entrepreneur evades paying contributions and (or) deductions, then in accordance with Article 92-1 of the Code of the Republic of Kazakhstan on Administrative Offenses, administrative liability is provided in the following order:

1. Non-fulfillment or improper fulfillment by the payer of deductions and (or) contributions for compulsory social health insurance of the obligations stipulated by the legislation of the Republic of Kazakhstan on compulsory social health insurance, made in the form of:

1) Аailure to submit lists of payers of contributions and (or) contributions to compulsory social health insurance to the state revenue authorities;

2) Тon-payment (non-transfer), untimely and (or) incomplete payment (untimely and (or) incomplete transfer) of deductions and (or) contributions for compulsory social health insurance by employers, individual entrepreneurs, private notaries, private bailiffs, lawyers, professional mediators - entails a warning.

2. Acts committed repeatedly within a year after the imposition of an administrative penalty - entail a fine for small businesses in the amount of twenty, for medium-sized businesses - in the amount of thirty, for large businesses - in the amount of fifty percent of the amount unpaid (not listed), untimely and (or) incompletely paid (listed) deductions and (or) contributions for compulsory social health insurance.

In such cases, the accrued social benefits for temporary incapacity for work are considered income.

No, it will not. Deductions paid by employers whose employees do not apply to medical organizations for a year are not refundable. This contradicts the basic principles of the social insurance system - solidarity and equality of all participants in the system. The funds paid will be used to pay for medical care for those insured citizens who fell ill and applied for medical help during this period.

The OSHI is based on the principles of joint responsibility of the state, employers and citizens.

According to the draft law under discussion, in order to obtain the status of the insured, it is necessary to pay off the debt for the previous 12 months. Within 3 months of debt, a citizen retains the right to receive medical care within the framework of the compulsory health insurance package.

The current legislation does not provide for such rules for the payment of incentive payments or the provision of incentive measures.

In international practice, the social health insurance system also lacks such examples.

Deductions and contributions to the FSMS are mandatory for everyone in accordance with the current law "On the Compulsory Health Insurance" and you must pay them on time to the Medical Insurance Fund. As for your medical unit, it, like other medical organizations, has the right to participate in the competition held by the Foundation for the provision of both outpatient and inpatient care, earning additional money on this.

Employees of nongovernmental organizations (NGOs) are employees who are paid by the administration of the NGO. If, however, an employee of an NGO belongs to the categories of persons for whom the state pays contributions, then the NGO is exempt from paying deductions and contributions for these employees.

According to paragraphs 4 and 5 of the Protocol on the provision of medical care to workers of the Member States and family members (Appendix No. 30 to the Treaty on the EAEU), the Member States on their territory grant the workers of the Member States and family members the right to receive free of charge in emergency and urgent forms in the same manner and under the same conditions as for citizens of the state of employment. Emergency and urgent care is provided to these persons free of charge, regardless of whether they have a medical insurance policy. In the case of continuing treatment after the immediate threat to the patient's life or the health of others has been eliminated, payment for the actual cost of the services provided is carried out directly by the patient or from other sources not prohibited by the legislation of the state of employment, at tariffs or negotiated prices.

In accordance with paragraph 10 of the Rules for the provision of medical care to immigrants, approved by order of the Minister of Health of the Republic of Kazakhstan dated September 30, 2011 No. 665, within the framework of the guaranteed medical care, immigrants are provided with free medical care for acute diseases that pose a danger to others, in accordance with the list of diseases. In other cases, medical care is provided on a paid basis.

The volume of medical care within the guaranteed volume of medical care for foreigners - labor migrants from the EAEU is determined by the Treaty on the EAEU, i.e. they are provided with emergency and urgent medical care.

In addition, foreigners can receive medical assistance for diseases that pose a danger to others, according to the order of the Minister of Health and Social Development of the Republic of Kazakhstan dated April 1, 2015 No. 194 (registered with the Ministry of Justice of the Republic of Kazakhstan on June 11, 2015 No. 11317) "On approval of the list acute diseases that pose a danger to others, in which foreigners and stateless persons who are on the territory of the Republic of Kazakhstan have the right to receive a guaranteed volume of free medical care ”(19 infectious diseases).

1. Diphtheria
2. Measles
3. Rubella
4. Whooping cough
5. Scarlet fever
6. Wind spas
7. Mumps
8. Paragraphs A, B C
9. Poliomyelitis
10. Forms of flu are typical
11. Meningococcal infection
12. Cholera
13. Typhoid fever
14. Tuberculosis (pulmonary tuberculosis with bacterial excretion until a twofold conversion of a sputum smear for the presence of mycobacterium tuberculosis; acutely progressive forms of tuberculosis (meningitis, miliary tuberculosis) until a state that does not pose a threat to the patient's life and achieving a double conversion of a sputum smear for the presence of tuberculosis; spine, complicated by dysfunction of the spinal cord, until reaching a state that allows you to move independently without medical assistance)
15. Pulmonary anthrax
16. Plague
17. Hemorrhagic viral fevers
18. Viral hepatitis A, E
19. Malaria

According to clauses 2 and 3 of the Law "On OSHI", foreigners permanently residing in the territory of the Republic of Kazakhstan, as well as oralmans, enjoy the rights and bear obligations in the OSHI system on an equal basis with citizens of the Republic of Kazakhstan. Foreigners and members of their families temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of an international treaty enjoy the rights and bear obligations in the OSHI system on an equal basis with citizens of the Republic of Kazakhstan. Family members of foreigners are spouses and children living together.

According to paragraph 3 of Article 98 of the Treaty on the EAEU, social security (except for retirement) for workers of the member states and family members is carried out on the same conditions and in the same manner as citizens of the state of employment.

In accordance with paragraph 9 of Clause 5 of Article 96 of the Treaty on the EAEU, social security is compulsory insurance in case of temporary disability and in connection with maternity, compulsory insurance against industrial accidents and occupational diseases and compulsory health insurance.

For foreigners-citizens of the state of the Treaty of the EAEU, permanently and temporarily residing in the territory of the Republic of Kazakhstan and oralmans, their employers are obliged to pay deductions to the compulsory health insurance system in order to receive medical assistance by these foreigners in the compulsory health insurance system.

Employers' contributions payable to the Fund are established in the amount of:

• from July 1, 2017 - 1 percent of the income accrued to the employee;
• from January 1, 2018 - 1.5 percent of the income accrued to the employee;
• from January 1, 2020 - 2 percent of the income accrued to the employee;
• from January 1, 2022 - 3 percent of the income accrued to the employee.

According to paragraphs 2 and 3 of the Law "On Compulsory Health Insurance", foreigners permanently residing in the territory of the Republic of Kazakhstan, as well as oralmans, enjoy the rights and bear responsibilities in the compulsory health insurance system on an equal basis with citizens of the Republic of Kazakhstan. Foreigners and members of their families temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of an international treaty enjoy the rights and bear obligations in the OSHI system on an equal basis with citizens of the Republic of Kazakhstan. Family members of foreigners are spouses and children living together.

According to paragraph 3 of Article 98 of the Treaty on the EAEU, social security (except for retirement) of workers of the member states and family members is carried out on the same conditions and in the same manner as citizens of the state of employment.

In accordance with paragraph 9 of Clause 5 of Article 96 of the Treaty on the EAEU, social security is compulsory insurance in case of temporary disability and in connection with maternity, compulsory insurance against industrial accidents and occupational diseases and compulsory health insurance.

In accordance with paragraph nine of clause 5 of Article 96 of the Treaty on the EAEU, labor activity is an activity on the basis of an employment contract or an activity to perform work (provide services) on the basis of a civil law contract, carried out in the territory of the state of employment in accordance with the legislation of this state.

If a foreigner-citizen of a state party to the EAEU Treaty is a permanent resident in the territory of the Republic of Kazakhstan or an oralman, then he has the same obligations as citizens of the Republic of Kazakhstan, including the payment of contributions to the compulsory health insurance.

Considering that the OSHI system is based on the principle of joint responsibility of the state, employers and citizens, other foreign workers who are citizens of the EAEU Treaty member states, including those operating on the basis of a civil contract and their family members, are also obliged to pay contributions to the OSHI on an equal basis with citizens of the Republic of Kazakhstan.

Contributions of employees to be paid to the fund are established in the amount of:

• from January 1, 2019 - 1 percent of salary;
• from January 1, 2020 - 2 percent of salary.

Contributions of individuals who receive income under agreements of a civil nature, from July 1, 2017, are set at 5 percent of the income received under such an agreement.

Contributions of foreigners - family members of foreign workers - citizens of the states parties to the Treaty on the EAEU are set from January 1, 2018 at 5 percent of the minimum wage.

In accordance with paragraph 1 of Article 5 of the Law "On OSHI", the right to medical care in the OSHI system is granted to persons for whom the payment of deductions and (or) contributions to the Fund was made, as well as those exempt from paying contributions to the Fund in accordance with paragraph 7 of Article 28 Law. According to clauses 2 and 3 of the Law "On OSHI", foreigners and stateless persons permanently residing in the territory of the Republic of Kazakhstan, as well as oralmans, enjoy the rights and bear responsibilities in the OSHI system on an equal basis with citizens of the Republic of Kazakhstan. Foreigners and members of their families temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of an international treaty enjoy the rights and bear obligations in the OSHI system on an equal basis with citizens of the Republic of Kazakhstan. Family members of foreigners are spouses and children living together. According to paragraph 3 of Article 98 of the Treaty on the EAEU, social security (except for retirement benefits) of workers of the member states and family members is carried out on the same conditions and in the same manner as citizens of the state of employment. In accordance with paragraph nine of Clause 5 of Article 96 of the EAEU Treaty, social security is compulsory insurance in the event of temporary disability and in connection with maternity, compulsory insurance against industrial accidents and occupational diseases and compulsory health insurance. Foreigners-citizens of the states parties to the Treaty on the EAEU, permanently and temporarily residing in the territory of the Republic of Kazakhstan and oralmans, will have the right to receive medical care in the compulsory health insurance system, on the same conditions as citizens of the Republic of Kazakhstan.