HD su dung mau bieu 2
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Transcript of HD su dung mau bieu 2
BO HIM X HI VIT NAM
CNG HA X HI CH NGHA VIT NAM
c lp - T do - Hnh phc PHNG PHP LP V S DNG BIU MUQUN L THU BHXH, BHYT; QUN L S BHXH, TH BHYT (Ban hnh km theo Quyt nh s 1111/Q-BHXH ngy 25 thng 10 nm 2011 ca Tng Gim c Bo him x hi Vit Nam) 1. T khai tham gia BHXH, BHYT (Mu s A01-TS). a. Mc ch: k khai cc thng tin lin quan n nhn thn, tin lng, tin cng... khi ng k tham gia BHXH, BHYT v cp s BHXH, th BHYT. b. Trch nhim lp: ngi lao ng (bao gm c ngi lao ng trong lc lng v trang). c. Thi gian lp: khi ng k tham gia BHXH, BHYT ln u v khi c s BHXH nhng ng k ti n v mi. d. Cn c lp: - Chng minh th nhn dn hoc giy khai sinh, h chiu. - H s gc: l lch, Hp ng lao ng (HL), Hp ng lm vic (HLV) cc Quyt nh tuyn dng, tip nhn v cc giy t chng minh quyn li hng BHYT... e. Phng php lp: - M s: nu c cp s BHXH th ghi s s BHXH, nu cha c c quan BHXH cp s BHXH th trng c quan BHXH ghi khi cp m. [01]. H v tn: ghi bng ch in hoa c du. [02]. Gii tnh: l nam hay n th nh du (x) vo trng tng ng. [03]. Ngy, thng, nm sinh: ghi nh trong giy khai sinh hoc h chiu. Trng hp khng xc nh c ngy, thng sinh th ghi ngy 01 thng 01 (quy nh ti Thng t s 01/2008/TT-BTP ngy 02/6/2008 ca B T php hng dn thc hin mt s quy nh ca Ngh nh s 158/2005/N-CP ngy 27/12/2005 ca Chnh ph v ng k v qun l h tch). [04]. Dn tc: ghi nh trong giy khai sinh hoc h chiu. [05]. Quc tch: ghi nh trong giy khai sinh hoc h chiu.-1-
[06]. H khu thng tr hoc tm tr: ghi y a ch x, phng, th trn, qun, huyn, tnh, thnh ph ni ng k h khu thng tr hoc tm tr ti thi im lp t khai. [07]. a ch lin h: Ghi y a ch lin h c quan BHXH gi thng bo kt qu ng BHXH, BHYT. [08]. S in thoi lin h: Ghi s in thoi di ng hoc s in thoi c nh, nu khng c trng. [09]. Chng minh th: ghi s; ni cp; ngy, thng, nm cp chng minh th. [10]. Quyt nh tuyn dng, HL hoc HLV: ghi s, ngy thng nm ca quyt nh hoc HL, HLV; ngy c hiu lc ca quyt nh hoc HL, HLV v ghi loi hp ng (3 thng, 6 thng, 1 nm, 36 thng hay khng xc nh thi hn). [11]. Tn c quan, n v, a ch: ghi tn c quan, n v ni lm vic, a ch ni c quan, n v ng tr s ti thi im ng k (ghi r x, huyn, tnh). [12]. Ni lm vic: ghi a ch ni lm vic (ghi r x, huyn, tnh). [13]. Chc v, chc danh ngh, cng vic: ghi y cp bc, chc v, chc danh ngh, cng vic theo quyt nh hoc HL. [14]. Lng chnh: ghi tin lng, tin cng c hng theo quyt nh hoc HL. Ring hng tin lng, tin cng bng ngoi t th ghi r loi ngoi t. [15] Ph cp (nu c): ghi y cc loi ph cp: chc v, thm nin ngh, thm nin vt khung, khc c hng vo tng ng nu khng c trng (V d: chc v: 0,3; Thm nin vt khung 5%...). [16]. M s s BHXH c cp (nu c): ghi s s BHXH nu c cp s BHXH, nu cha c cp s BHXH th trng. [17]. M s th BHYT c cp (nu c): ghi s th BHYT nu c cp th BHYT, nu cha c s th BHYT th trng. [18]. Ni ng k khm cha bnh ban u: ghi ni khm cha bnh ban u theo hng dn ca c quan BHXH. [19]. Quyn li hng BHYT: ghi i tng tham gia BHYT (V d: cng chc, vin chc, cng nhn... Trng hp c hng quyn li BHYT cao hn nhm i tng khc th ghi tn nhm i tng khc (v d: thng binh, ngi c cng...).-2-
Ph lc. Thi gian lm vic c ng BHXH cha hng mt ln (ch p dng i vi ngi lao ng ng BHXH nhng cha c cp s BHXH) - Ct 1, ct 2 "T thng nm", "n thng nm": ghi t thng, nm n thng nm ca khong thi gian khng thay i mt trong nhng yu t nh: cp bc, chc v, chc danh ngh, cng vic, n v lm vic, a im n v ng, mc tin lng, tin cng v cc loi ph cp lm cn c ng BHXH. Khi c thay i mt trong nhng yu t ny th ghi dng tip theo tng ng vi khong thi gian thay i. - Ct 3 "Din gii: ghi y , chi tit v cp bc, chc v hoc chc danh ngh, cng vic, tn n v. + Cp bc, chc v: ghi cp bc, chc v ca ngi tham gia xc nh tin lng hoc ph cp ng BHXH. + Chc danh ngh, cng vic: ghi chc danh ngh, cng vic ca ngi tham gia xc nh mc cng vic (bnh thng; nng nhc, c hi; c bit nng nhc, c hi). + Tn n v: Ghi tn n v ni ngi tham gia ng BHXH. + Ni lm vic: ghi a ch ni lm vic (x (phng, th trn), huyn (qun, th x, thnh ph trc thuc tnh), tnh (thnh ph) ni ngi tham gia lm vic, xc nh ni lm vic c ph cp khu vc hoc khng c ph cp khu vc. + Tng tin lng ng BHXH (ng Vit Nam): . Lng chnh (h s hoc ng Vit Nam). . Ph cp chc v (h s). . Ph cp thm nin vt khung (%). . Ph cp thm nin ngh (%). . Ph cp khu vc (h s). . H s chnh lch, bo lu (h s). . Ph cp khc (nu c). - Ct 4 "Cn c ng": ghi s tin hoc h s hoc t l cng hng vi cc ni dung din gii ct 3. - Ct 5, ct 6 "t l ng (%):
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+ Ct 5 "BHXH": ghi t l ng BHXH bt buc hoc t nguyn cng hng ghi tng tin lng ng BHXH hoc thu nhp lm cn c ng BHXH t nguyn. + Ct 6 "BHTN": ghi t l ng BHTN cng hng ghi tng tin lng ng BHXH. 2. T khai tham gia BHXH t nguyn (Mu s A02-TS). a. Mc ch: k khai cc thng tin lin quan n nhn thn, mc ng... khi ng k tham gia BHXH t nguyn v cp s BHXH. b. Trch nhim lp: Ngi tham gia BHXH t nguyn. c. Thi gian lp: khi tham gia ng BHXH t nguyn ln u hoc tham gia li sau thi gian gin on. d. Cn c lp: Giy khai sinh, chng minh th nhn dn. e. Phng php lp: - M s: nu c cp s BHXH th ghi s s BHXH, nu cha c c quan BHXH cp s BHXH th trng c quan BHXH ghi khi cp m. [01]. H v tn: ghi bng ch in hoa c du. [02]. Gii tnh: l nam hay n th nh du (x) vo trng tng ng. [03]. Ngy, thng, nm sinh: ghi nh trong giy khai sinh. [04]. Dn tc: ghi nh trong giy khai sinh. [05]. Quc tch: ghi nh trong giy khai sinh. [06]. H khu thng tr hoc tm tr: ghi y a ch x, phng, th trn, qun, huyn, tnh, thnh ph ni ng k h khu thng tr hoc tm tr ti thi im lp t khai. [07]. a ch lin h: Ghi a ch lin h c quan BHXH gi thng bo kt qu ng BHXH. [08]. S in thoi lin h: Ghi s in thoi di ng hoc s in thoi c nh lin h. [09]. Chng minh th: ghi s; ni cp; ngy, thng, nm cp chng minh th. [10]. Tham gia BHXH bt buc: ghi du (x) vo tng ng tham gia hoc cha tham gia. [11]. Tham gia BHYT: ghi du (x) vo tng ng tham gia hoc cha tham gia.-4-
[12]. Mc thu nhp thng ng BHXH t nguyn: ghi thu nhp thng lm cn c ng BHXH t nguyn (theo hng dn ca c quan BHXH hoc i l thu BHXH, BHYT). [13]. Phng thc ng: ghi du (x) v cc tng ng la chn phng thc ng BHXH t nguyn hng thng, hng qu hay 6 thng mt ln. 3. T khai tham gia BHYT (Mu s A03-TS). a. Mc ch: k khai cc thng tin lin quan n nhn thn, thn nhn, mc ng... khi ng k tham gia v cp th BHYT. b. Trch nhim lp: ngi t nguyn tham gia BHYT hoc ngi i din h gia nh k khai cho thn nhn tham gia. c. Thi gian lp: khi tham gia ng BHYT. d. Cn c lp: Giy khai sinh, chng minh th nhn dn, s h khu. e. Phng php lp: - M s: nu c cp s BHXH, th BHYT th ghi s s BHXH hoc s th BHYT nu cha c c quan BHXH cp s BHXH, th BHYT th trng c quan BHXH ghi khi cp m. [01]. H v tn: ghi bng ch in hoa c du. [02]. Gii tnh: l nam hay n th nh du (x) vo trng tng ng. [03]. Ngy, thng, nm sinh: ghi nh trong giy khai sinh hoc h chiu. [04]. Dn tc: ghi nh trong giy khai sinh hoc h chiu. [05]. Quc tch: ghi nh trong giy khai sinh hoc h chiu. [06]. H khu thng tr hoc tm tr: ghi y a ch x, phng, th trn, qun, huyn, tnh, thnh ph ni ng k h khu thng tr hoc tm tr ti thi im lp t khai. [07]. a ch lin h: Ghi y a ch c quan BHXH lin h khi cn thit. [08]. S in thoi lin h: Ghi s in thoi di ng hoc s in thoi c nh, nu khng c trng. [09]. Chng minh th: ghi s; ni cp; ngy, thng, nm cp chng minh th hoc h chiu. [10]. Ni ng k khm cha bnh ban u: ghi ni khm cha bnh ban u theo hng dn ca c quan BHXH hoc i l thu BHXH, BHYT.-5-
[11]. Tham gia BHXH bt buc: ghi du (x) vo tng ng tham gia hoc cha tham gia. [12]. Tham gia BHYT: ghi du (x) vo tng ng tham gia hoc cha tham gia. [13]. S ngi cng tham gia: ghi s ngi cng tham gia nu c Ph lc: Ngi cng tham gia Ct 1: ghi s th t cc thn nhn tham gia BHYT km theo. Ct 2: ghi h v tn cc thn nhn. Ct 3: ghi ngy thng nm sinh ca thn nhn theo chng minh th hoc theo giy khai sinh. Ct 4: gii tnh thn nhn l n th nh du (x), nu l nam th b trng. Ct 5: ghi m s tham gia nu c c quan BHXH cp m s, nu cha c cp th trng. Ct 6: ghi quan h ca thn nhn vi ngi ng khai. Ct 7: ghi a ch ni ng k h khu thng tr (theo s h khu) hoc ni ng k tm tr (theo s tm tr). Ghi r x, phng, th trn, qun, huyn, tnh, thnh ph ng k thng tr hoc tm tr. Ct 8: ghi ni khm cha bnh ban u theo hng dn ca c quan BHXH hoc i l thu. Ct 9, 10: ghi t thng nm n thng nm tham gia ng BHYT. 4. n ngh (Mu s D01-TS) a. Mc ch: ngi tham gia BHXH, BHYT ngh c quan BHXH thay i, iu chnh thng tin v nhn thn trn s BHXH, th BHYT, thay i ni khm cha bnh ban u, thay i quyn li hng BHYT hoc thay i mc thu nhp hoc phng thc ng BHXH t nguyn.... b. Trch nhim lp: ngi tham gia BHXH, BHYT. c. Thi gian lp: khi c pht sinh. d. Cn c lp: h s gc (giy khai sinh, l lch, chng minh th, s h khu, Q, HL...). e. Phng php lp: - Ghi y cc tiu thc in sn trong n ngh:-6-
+ Ni dung: ghi ni dung ngh hoc iu chnh. + L do: ghi l do ngh hoc iu chnh. + H s gi km: k chi tit, s lng cc loi h s gi km. 5. Vn bn ngh (Mu s D01b-TS) a. Mc ch: n v ngh c quan BHXH thay i, iu chnh cc thng tin lin quan n n v v ngi lao ng. b. Trch nhim lp: n v tham gia BHXH, BHYT. c. Thi gian lp: khi c pht sinh. d. Cn c lp: h s gc (giy khai sinh, l lch, chng minh th, s h khu, Q, HL...). e. Phng php lp: - Ghi y cc tiu thc in sn trong n ngh: + Ni dung: ghi ni dung ngh hoc iu chnh. + L do: ghi l do ngh hoc iu chnh. + H s gi km: k chi tit, s lng cc loi h s gi km. + Danh sch gi km: ghi chi tit, h tn v ni dung ngi lao ng ngh iu chnh. 6. Danh sch lao ng tham gia BHXH, BHYT (Mu s D02-TS) a. Mc ch: n v k khai lao ng, tin lng, tin cng tham gia BHXH, BHYT; iu chnh mc ng BHXH, BHYT v ng k cp s BHXH, th BHYT i vi ngi lao ng thuc n v. b. Trch nhim lp: n v s dng lao ng. c. Thi gian lp: khi c pht sinh. d. Cn c lp: - T khai tham gia BHXH, BHYT; HL, HLV, Quyt nh tuyn dng, tip nhn, Quyt nh nng lng, thuyn chuyn v cc h s khc c lin quan. e. Phng php lp: Ghi lao ng tng hay gim v iu chnh v lao ng hay mc ng vo tng mc tng ng, c th:-7-
* Ch tiu theo ct: - Ct 1: ghi s th t t nh n ln theo tng mc. - Ct 2: ghi r h, tn ca tng ngi lao ng v ghi tng ng vo tng mc tng lao ng, tng mc ng hoc gim lao ng, gim mc ng. Trong tng mc li ghi theo th t: ngi c s BHXH ghi trc, ngi cha c s BHXH ghi sau. - Ct 3: ghi s s BHXH i vi ngi c s BHXH; ngi cha c s BHXH th trng. - Ct 4: ghi ngy, thng, nm sinh ca ngi lao ng. - Ct 5: ghi gii tnh ca lao ng n bng cch nh du nhn (x), nu l nam th b trng. - Ct 6: ghi y , chi tit v cp bc, chc v, chc danh ngh, cng vic, iu kin ni lm vic theo quyt nh hoc HL. - Ct 7, 8, 9, 10: ghi tin lng v cc khon ph cp c hng theo mc ng c ca ngi lao ng (nu c). - Ct 11, 12, 13, 14: ghi tin lng v cc khon ph cp c hng theo mc ng mi ca ngi lao ng (nu c). - Ct 15, 16: ghi t thng nm n thng nm ngi lao ng bt u tham gia hoc iu chnh mc ng. - Ct 17: nu lao ng gim m khng tr th th nh du (x) tnh thu BHYT theo gi tr cn li ca th BHYT, nu tr th th b trng. - Ct 18: nu ngi lao ng c c quan BHXH cp s BHXH th ghi du (x) nu cha c cp s BHXH th b trng. - Ct 16: ghi s; ngy, thng, nm ca HL, HLV hoc Quyt nh (tuyn dng, tip nhn). * Ch tiu hng ngang: - Tng: ghi theo th t lao ng tng mi; lao ng iu chnh tng mc ng trong n v. - Gim: ghi theo th t lao ng gim do chuyn i, ngh hng ch BHXH...; lao ng iu chnh gim mc ng trong n v.-8-
Lu : + n v k khai y , chnh xc tin lng, tin cng v cc khon ph cp ng BHXH, BHYT ghi trong Quyt nh hoc HL, HLV ca tng ngi lao ng. + Ngi lao ng thuc i tng hng lng theo thang bng lng do Nh nc quy nh th ghi tin lng v ph cp chc v bng h s; ph cp thm nin vt khung, thm nin ngh ghi bng t l phn trm (%) vo ct tng ng, nu khng hng ph cp no th b trng. + Ngi lao ng thuc i tng hng lng do ngi s dng lao ng quy nh th ghi s tin lng c th. Nu trn HL ca ngi lao ng ghi tin lng h s hoc tin lng c gc ngoi t th phi quy i, ghi bng tin (VN) theo quy nh. + Trng hp ngi lao ng c thi gian truy ng BHXH, BHYT th ghi tng dng, theo tng mc thi gian truy ng. + Nu trong thng n v lp nhiu danh sch lao ng ng BHXH, BHYT th nh s cc danh sch. 7. Tng hp danh sch lao ng tham gia BHXH, BHYT (Mu s D02a-TS). a. Mc ch: tng hp s ngi tham gia BHXH, BHYT theo danh sch lao ng tham gia BHXH, BHYT ca n v lp v tnh tin ng pht sinh ca tng lao ng theo k khai ca n v. b. Trch nhim lp: c quan BHXH tnh, huyn. c. Thi gian lp: hng thng. d. Cn c lp: Danh sch lao ng tham gia BHXH, BHYT (mu D02TS) do n v chuyn n. e. Phng php lp: - Ghi lao ng tng hay gim v iu chnh v lao ng hay mc ng vo tng mc tng ng ca biu. - Ct 1: ghi s th t t nh n ln theo tng mc. - Ct 2: ghi r h, tn ca tng ngi lao ng v ghi tng ng vo tng mc tng lao ng, tng mc ng hoc gim lao ng, gim mc ng. Trong tng mc li ghi theo th t: ngi c s BHXH ghi trc, ngi cha c s
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BHXH ghi sau. Trng hp lao ng l ngi nc ngoi th ghi theo tn phin m quc t trong H chiu. - Ct 3: ghi s s BHXH i vi ngi c s BHXH; ngi cha c s BHXH th trng. - Ct 4, 5, 6, 7, 8, 9, 10, 11, 12, 13: ghi tng t nh hng dn lp danh sch lao ng tham gia BHXH, BHYT (Mu s 02-TS). - Ct 14: ghi s tin ng BHXH pht sinh ca ngi lao ng. - Ct 15: ghi s tin ng BHYT pht sinh ca ngi lao ng. - Ct 16: ghi s tin ng BHTN pht sinh ca ngi lao ng (tnh c 3%). - Ct 17: ghi s; ngy, thng, nm ca HL, HLV hoc Quyt nh (tuyn dng, tip nhn). Phn tng hp: Tng hp s lao ng, s tin ng BHXH, BHYT, BHTN tng, gim c th theo tng tiu thc. 8. Danh sch ngi ch tham gia BHYT (Mu s D03-TS). a. Mc ch: k khai cc thng tin ca ngi ch tham gia BHYT thu, cp th BHYT theo quy nh. b. Trch nhim lp: n v qun l ngi tham gia BHYT hoc i l thu BHXH, BHYT hoc c quan BHXH. c. Thi gian lp: lp khi n v bt u tham gia ng BHYT v khi c bin ng (tng, gim) v ngi tham gia, s tin ng BHYT. d. Phng php lp: - i tng tham gia: ghi loi i tng tham gia BHYT (ngi ngho, ngi c cng, tr em di 6 tui...). - Lng ti thiu chung: ghi mc tin lng ti thiu chung do Nh nc quy nh ti thi im lp danh sch. - T l Ngn sch Nh nc h tr: ghi t l % Ngn sch Nh nc ng, h tr (bao gm t l theo quy nh ca Nh nc, ca a phng v cc ngun khc) i vi mt s loi i tng c quy nh trong Lut BHYT. * Ch tiu theo ct: - Ct 1: ghi s th t t nh n ln theo tng mc: i tng tng, i tng gim.
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- Ct 2: ghi h, tn ngi tham gia BHYT (nu thuc i tng h gia nh, thn nhn ngi lao ng th ghi theo tng thnh vin ng BHYT) v ghi theo th t nh sau: - Ct 3: ghi m s th BHYT ca ngi tham gia nu c c quan BHXH cp m s th BHYT. - Ct 4: ghi ngy, thng, nm sinh ca ngi tham gia BHYT (Trng hp khng xc nh c ngy, thng sinh th ghi ngy 01 thng 01 (quy nh ti Thng t s 01/2008/TT-BTP ngy 02/6/2008 ca B T php hng dn thc hin mt s quy nh ca Ngh nh s 158/2005/N-CP ngy 27/12/2005 ca Chnh ph v ng k v qun l h tch). - Ct 5: ghi gii tnh ca ngi tham gia BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 6: ghi r a ch (x, huyn, tnh) ni thng tr hoc tm tr ca ngi tham gia BHYT. - Ct 7: ghi ni ng k khm cha bnh ban u theo hng dn ca c quan BHXH hoc i l thu BHXH, BHYT. - Ct 8: ch ghi i tng tham gia BHYT c hng quyn li BHYT cao hn so vi nhm i tng tham gia (v d: thng binh, ngi c cng...). - Ct 9: ghi s chng minh th ca ngi tham gia BHYT. - Ct 10, 11: ghi s, ngy ca bin lai thu tin i vi ngi t nguyn tham gia BHYT. - Ct 12, 13: ghi mc ng BHYT c, mi ca ngi tham gia. - Ct 14: ch ghi i vi nhng trng hp tham gia theo h gia nh c gim mc ng (V d: 90%, 80%, 70%, 60%). - Ct 15, 16: ghi ngy thng nm bt u th BHYT c gi tr s dng v s thng c gi tr s dng ca th BHYT. - Ct 17: ghi s tin ng BHYT tng ng vi thi hn s dng ca th BHYT. - Ct 18: ghi ch hoc ghi du (x) i vi nhng ngi gim khng tr c th cn hn s dng. * Ch tiu theo hng ngang: - Tng: ghi th t ngi tham gia BHYT tng. - Gim: ghi th t ngi tham gia BHYT gim.- 11 -
9. Tng hp danh sch ngi ch tham gia BHYT (Mu s D03a-TS). a. Mc ch: tng hp, k khai cc thng tin ca ngi ch tham gia ng BHYT cp th BHYT theo quy nh. b. Trch nhim lp: c quan BHXH tnh, huyn. c. Thi gian lp: hng thng. d. Phng php lp: - i tng tham gia, lng ti thiu chung, t l Ngn sch Nh nc h tr: ghi nh hng dn ti danh sch ngi ch tham gia BHYT (mu s D03-TS). - Ngi tham gia BHYT tng hoc gim ghi vao phn tng ng. A. Phn chi tit: - Ct 1, 2, 3: ghi nh hng dn ti danh sch ngi ch tham gia BHYT (mu s D03-TS). - Ct 4, 5: ghi s, ngy ca danh sch tham gia theo h gia nh hoc danh sch k khai ca i l thu BHXH, BHYT. - Ct 6, 7: ghi mc ng BHYT c, mi ca ngi tham gia. - Ct 8, 9, 10: ghi nh hng dn ti danh sch ngi ch tham gia BHYT (mu s D03-TS). - Ct 11, 12: ghi s tin ng BHYT ca ngi tham gia BHYT nm nay, nm sau theo ct tng ng. - Ct 13, 14: ghi s tin Ngn sch Nh nc v cc ngun khc ng, h tr qu BHYT nm nay, nm sau theo ct tng ng. B. Phn tng hp: tng hp s ngi tham gia s tin i tng ng, s tin Ngn sch Nh nc v cc ngun khc ng, h tr qu BHYT c th theo tng tiu thc. Lu + i vi h gia nh, thn nhn ngi lao ng th ghi danh sch theo tng thnh vin tham gia ng v cp th BHYT. + Trng hp gim i tng c trch nhim tham gia BHYT th phi thu hi th BHYT gi km theo danh sch, nu khng thu hi c th BHYT th phi thu s tin tng ng vi thi hn s dng cn li ca th BHYT (tr trng hp b cht).- 12 -
10. Danh sch iu chnh mc ng cho ngi ch tham gia BHYT (Mu s D04-TS) a. Mc ch: k khai cc thng tin iu chnh mc ng ca ngi ch tham gia ng BHYT nh tng gim lng hu, t l ng BHYT.... b. Trch nhim lp: n v qun l ngi tham gia BHYT, i l thu BHXH, BHYT hoc c quan BHXH. c. Thi gian lp: hng thng khi c pht sinh. d. Phng php lp: * Ch tiu theo ct: - Ct 1: ghi s th t t nh n ln theo tng mc: i tng tng, i tng gim. - Ct 2: ghi h, tn ngi tham gia BHYT (nu thuc i tng h gia nh, thn nhn ngi lao ng th ghi theo tng thnh vin ng BHYT. - Ct 3: ghi m s th BHYT ca ngi tham gia nu c c quan BHXH cp m s th BHYT. - Ct 4: ghi ngy, thng, nm sinh ca ngi tham gia BHYT. - Ct 5: ghi gii tnh ca ngi tham gia BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 6, 7: ghi mc ng BHYT c, mi ca ngi tham gia. - Ct 8: ghi s thng ng BHYT. - Ct 9: ghi s tin ng BHYT iu chnh. * Ch tiu theo hng ngang: - Tng: ghi th t ngi tham gia BHYT iu chnh tng. - Gim: ghi th t ngi tham gia BHYT iu chnh gim. 11. Tng hp danh sch iu chnh mc ng cho ngi ch tham gia BHYT (Mu s D04a-TS). a. Mc ch: tng hp cc thng tin iu chnh mc ng ca ngi ch tham gia ng BHYT. b. Trch nhim lp: c quan BHXH tnh, huyn. c. Thi gian lp: hng thng.- 13 -
d. Phng php lp: Ch tiu theo ct v theo hng ngang: Ghi tng t nh hng dn ti danh sch iu chnh mc ng cho ngi ch tham gia BHYT (mu s D04-TS). 12. Danh sch ngi tham gia BHXH t nguyn (Mu s D05-TS). a. Mc ch: i l thu hoc c quan BHXH huyn k khai nhng ngi tham gia BHXH t nguyn tng mi, ng tip, ng li.. b. Trch nhim lp: i l thu, c quan BHXH huyn. c. Thi gian lp: khi c pht sinh. d. Cn c lp: h s gc (giy khai sinh, chng minh th, s h khu...). e. Phng php lp: - Ct 1: ghi s th t t nh n ln theo tng mc tng mi, ng tip, ng li. - Ct 2: ghi h, tn ngi tham gia BHXH t nguyn v ghi vo tng mc tng mi, ng tip, ng li tng ng. - Ct 3: ghi m s s BHXH hoc th BHYT ca ngi tham gia nu c c quan BHXH cp m s s BHXH hoc th BHYT. - Ct 4: ghi ngy, thng, nm sinh ca ngi tham gia BHXH t nguyn. - Ct 5: ghi gii tnh ca ngi tham gia BHXH t nguyn l n bng cch nh du nhn (x), l nam trng. - Ct 6, 7: ghi s ngy bin lai thu tin ca ngi tham gia BHXH t nguyn. - Ct 8: ghi mc thu nhp thng lm cn c ng BHXH t nguyn do ngi tham gia la chn. - Ct 9: ghi t l % ng BHXH t nguyn theo quy nh ca Lut BHXH. - Ct 10: ghi thng nm bt u tham gia BHXH t nguyn. - Ct 11: ghi s thng ng BHXH t nguyn. - Ct 12: ghi s tin ng BHXH t nguyn tng ng vi s thng ng (ct 12 = ct 8 x ct 9 x ct 11). 13. Tng hp danh sch ngi tham gia BHXH t nguyn (Mu s D05a-TS). a. Mc ch: tng hp s ngi, s tin tham gia BHXH t nguyn tng mi, ng tip, ng li... do i l gi n- 14 -
b. Trch nhim lp: c quan BHXH huyn. c. Thi gian lp: khi c danh sch ngi tham gia BHXH t nguyn (mu s D05-TS) do i l gi ti. d. Cn c lp: Mu s D05-TS. e. Phng php lp: Ghi tng t nh hng dn ti danh sch iu chnh mc ng cho ngi ch tham gia BHYT (mu s D05-TS). 14. Danh sch gim ngi tham gia BHXH t nguyn (Mu s D06a-TS). a. Mc ch: tng hp s ngi tham gia BHXH t nguyn gim khng tip tc tham gia. b. Trch nhim lp: c quan BHXH huyn. c. Thi gian lp: hng thng. d. Cn c lp: c s d liu nhp phn mm qun l ngi tham gia. e. Phng php lp: * Ch tiu theo ct: - Ct 1: ghi s th t t nh n ln theo tng mc gim chuyn i, ngh hng ch , i tng n hn nhng khng ng. - Ct 2: ghi h, tn ngi tham gia BHXH t nguyn v ghi vo tng mc gim chuyn i, ngh hng ch , i tng n hn nhng khng ng. - Ct 3: ghi m s s BHXH ca ngi tham gia. - Ct 4: ghi ngy, thng, nm sinh ca ngi tham gia BHXH t nguyn. - Ct 5: ghi gii tnh ca ngi tham gia BHXH t nguyn l n bng cch nh du nhn (x), l nam trng. - Ct 6: ghi mc thu nhp thng lm cn c ng BHXH t nguyn do ngi tham gia la chn. - Ct 7: ghi t l % ng BHXH t nguyn theo quy nh ca Lut BHXH. - Ct 8: ghi thng nm dng khng tham gia BHXH t nguyn. - Ct 10: ghi s tin ng BHXH t nguyn gim (ct 10 = ct 6 x ct 7). * Ch tiu theo hng ngang: ghi theo th t ngi tham gia chuyn i, ngh hng ch v ngi tham gia n hn nhng khng ng theo tiu thc trn mu quy nh.- 15 -
15. Danh sch ngh thay i thng tin ca ngi tham gia khng thay i mc ng (Mu s D07-TS). a. Mc ch: k khai thng tin ngi tham gia BHXH, BHYT ngh iu chnh thng tin nhn thn ca ngi tham gia BHXH, BHYT. b. Trch nhim lp: c quan, n v qun l ngi tham gia BHXH, BHYT. c. Thi gian lp: hng thng khi c pht sinh. d. Cn c lp: h s gc ca ngi tham gia (giy khai sinh, l lch, chng minh th...). e. Phng php lp: - Ct 1: ghi s th t t nh n ln. - Ct 2: ghi h, tn ngi tham gia BHXH, BHYT. - Ct 3: ghi ngy, thng, nm sinh ca ngi tham gia BHXH, BHYT. - Ct 4: ghi gii tnh ca ngi tham gia BHXH, BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 5: ghi m s s BHXH ca ngi tham gia. - Ct 6, 7: ghi t thng nm n thng nm thay i, iu chnh. - Ct 8: ghi ni dung ngh thay i, iu chnh. 16. Tng hp danh sch ngh thay i thng tin ca ngi tham gia khng thay i mc ng (Mu s D07a-TS). a. Mc ch: tng hp thng tin ngi tham gia BHXH, BHYT ngh iu chnh thng tin nhn thn ca ngi tham gia BHXH, BHYT. b. Trch nhim lp: c quan BHXH tnh, huyn. c. Thi gian lp: hng thng khi c pht sinh. d. Cn c lp: h s gc ca ngi tham gia (giy khai sinh, l lch, chng minh th...), mu s D07-TS do n v lp gi ti. e. Phng php lp: - Ct 1: ghi s th t t nh n ln. - Ct 2: ghi h, tn ngi tham gia BHXH, BHYT. - Ct 3: ghi ngy, thng, nm sinh ca ngi tham gia BHXH, BHYT.- 16 -
- Ct 4: ghi gii tnh ca ngi tham gia BHXH, BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 5: ghi m s s BHXH ca ngi tham gia. - Ct 6, 7: ghi t thng nm n thng nm thay i, iu chnh. - Ct 8: ghi ni dung ngh thay i, iu chnh. 17. Danh sch ngi tham gia n hn phi ng BHXH, BHYT t nguyn (Mu s D08a-TS). a. Mc ch: tng hp thng tin ngi tham gia BHXH, BHYT t nguyn n hn phi ng tip BHXH, BHYT t nguyn. b. Trch nhim lp: c quan BHXH huyn. c. Thi gian lp: hng thng khi c pht sinh. d. Cn c lp: c s d liu v thi gian tham gia BHXH, BHYT ca ngi tham gia nhp vo phn mm qun l. e. Phng php lp: - Ct 1: ghi s th t t nh n ln theo tng mc BHXH t nguyn, BHYT t nguyn. - Ct 2: ghi h, tn ngi tham gia BHXH, BHYT t nguyn vo mc tng ng BHXH t nguyn, BHYT t nguyn. - Ct 3: ghi m s s BHXH hoc th BHYT ca ngi tham gia. - Ct 4: ghi ngy, thng, nm sinh ca ngi tham gia BHXH, BHYT t nguyn. - Ct 5: ghi gii tnh ca ngi tham gia BHXH, BHYT t nguyn l n bng cch nh du nhn (x), l nam trng. - Ct 6: ghi thu nhp lm cn c ng BHXH t nguyn do ngi tham gia la chn hoc mc tham gia BHYT t nguyn. - Ct 7: ghi t l % ng BHXH, BHYT t nguyn. - Ct 8: ghi thng cui cng tham gia ng BHXH, BHYT t nguyn. 18. Danh sch cp s BHXH (Mu s D09a-TS). a. Mc ch: i chiu, kim k s ngi iu kin c cp s BHXH v cha c cp s BHXH.
- 17 -
b. Trch nhim lp: do BHXH tnh hoc BHXH huyn ni pht hnh s BHXH lp. c. Phng php lp: - Ct 1: ghi s th t xp ring tng phn, gm: phn I l danh sch ngi c cp s BHXH, phn II l danh sch ngi cha c cp s BHXH. - Ct 2: ghi h v tn ngi tham gia. - Ct 3: ghi ngy, thng, nm sinh - Ct 4: ghi gii tnh ca ngi tham gia BHXH, BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 5: ghi tn n v s dng lao ng hoc a ch ni c tr ca ngi tham gia BHXH t nguyn. - Ct 6: ghi m s ca ngi c cp s BHXH (nu c). - Ct 7: ghi s lng ba s BHXH cp. - Ct 8: ghi s lng t ri s BHXH cp. - Ct 9: ghi ch thng tin cn lu . 19. Danh sch cp th BHYT (Mu s D10a-TS). a. Mc ch: i chiu, kim k s ngi c cp th BHYT v theo di thi gian tham gia lin tc theo m s ca tng ngi. b. Trch nhim lp: do BHXH tnh hoc BHXH huyn ni pht hnh th BHYT lp. c. Phng php lp: - Ct 1: ghi s th t. - Ct 2: h v tn ngi c cp th BHYT. - Ct 3: ghi m s ca ngi c th BHYT. - Ct 4: ghi ngy, thng, nm sinh. - Ct 5: ghi gii tnh ca ngi tham gia BHXH, BHYT l n bng cch nh du nhn (x), l nam trng. - Ct 6: ghi quyn li BHYT c hng. - Ct 7, 8: ghi tn v m c s KCB ban u nh trn th BHYT. - Ct 9, 10: ghi thi hn s dng nh trn th BHYT.- 18 -
- Ct 11: ghi thng tin cn lu , nh: Hun chng khng chin, Hun chng chin thng.... 20. Tng hp s phi thu BHXH, BHYT (Mu s C01-TS). a. Mc ch: tng hp s phi thu BHXH, BHYT ca tng n v gi b phn k hoch ti chnh hch ton s phi thu BHXH, BHYT. b. Trch nhim lp: phng thu c quan BHXH tnh, b phn thu c quan BHXH huyn. c. Thi gian lp: hng thng. d. Cn c lp: danh sch lao ng tham gia BHXH, BHYT ca n v v danh sch ngi ch tham gia BHYT, danh sch ngi tham gia BHXH t nguyn nhp vo c s d liu phn mm qun l. e. Phng php lp: * Ch tiu theo ct: - Ct 1: ghi s th t t nh n ln. - Ct 2: tn n v tham gia BHXH, BHYT, i l thu BHXH, BHYT t nguyn. - Ct 3: ghi m n v tham gia BHXH, BHYT, m i l thu BHXH, BHYT t nguyn. - Ct 4: ghi s ngi tham gia BHXH thuc n v hoc i l thu. - Ct 5: ghi s tin ng BHXH ca n v hoc i l thu. - Ct 6: ghi s tin li chm ng BHXH pht sinh ca n v. - Ct 7: ghi s ngi tham gia BHYT thuc n v hoc i l thu. - Ct 8, 9: ghi s tin ngi tham gia BHYT phi ng vo ct nm nay, nm sau tng ng. - Ct 10, 11: Ghi s tin Ngn sch Nh nc ng, h tr ngi tham gia BHYT vo ct nm nay, nm sau tng ng. - Ct 12: ghi s tin li chm ng BHYT pht sinh ca n v. - Ct 13: ghi s ngi tham gia BHTN thuc n v. - Ct 14: ghi s tin ngi tham gia BHTN phi ng. - Ct 15: ghi s tin Ngn sch Nh nc ng, h tr ngi tham gia BHTN.- 19 -
- Ct 16: ghi s tin li chm ng BHTN pht sinh ca n v. * Ch tiu hng ngang: Ghi th t n v c Ngn sch Trung ng v Ngn sch a phng theo tiu thc trn biu. 21. Phiu iu chnh (Mu s C02-TS). a. Mc ch: iu chnh cc s liu v thu BHXH, BHYT, BHTN v tin li chm ng... do cc b phn thuc c quan BHXH ghi chp, cp nht khng ng vi h s gc. b. Trch nhim lp: c quan BHXH. c. Thi gian lp: khi c pht sinh. d. Cn c lp: - Bin bn lm vic hoc vn bn gii trnh lin quan n vic iu chnh tin lng hoc s tin thu v s tin li chm ng BHXH, BHYT, BHTN ca ngi lao ng, n v s dng lao ng. - Cng vn ca n v ngh thoi thu hoc iu chnh s liu. . Phng php lp: b phn ngh ghi ni dung ngh iu chnh v cc h s gi km iu chnh gi b phn iu chnh thc hin iu chnh theo yu cu. 22. Bin bn thm nh s liu thu BHXH, BHYT (Mu s C03-TS). a. Mc ch: thm nh kt qu thc hin thu BHXH, BHYT ca c quan BHXH cp trn vi c quan BHXH cp di. b. Thi gian lp: + BHXH tnh thm nh i vi BHXH huyn hng qu, nm. + BHXH Vit Nam lp khi kim tra, thm nh s liu qu, nm. c. Cn c lp: - i vi BHXH cc tnh, thnh ph: Cn c s liu mu s B02a-TS tng hp s liu vo cc ch tiu tng ng. - i vi BHXH Vit Nam: Cn c s liu mu s B02b-TS tng hp s liu vo cc ch tiu tng ng. 23. Hp ng ng BHYT (Mu s C04-TS). a. Mc ch: xc nh trch nhim ca c quan qun l i tng tham gia BHYT bt buc v ca c quan BHXH trong vic thc hin ng BHYT v cp th BHYT cho ngi tham gia BHYT theo quy nh ca php lut.- 20 -
b. Phng php v trch nhim lp: - C quan trc tip qun l ngi tham gia BHYT lp danh sch, k hp ng chuyn tin theo i tng v thi gian ng k khm cha bnh (khng nht thit loi i tng no cng phi lp hp ng tham gia BHYT). - Ngoi mt s iu khon c nh in sn trong mu, hai bn c th tho thun mt s iu khon chi tit khc lp v k kt nhng khng c tri vi quy nh ca Nh nc v qun l ti chnh, ch chnh sch BHYT. - Hp ng c lp thnh 4 bn mi bn gi 2 bn. 24. Bin bn thanh l Hp ng ng BHYT (Mu s C04a-TS). a. Mc ch: xc nh trch nhim, phm vi thc hin hp ng ca c quan BHXH v n v qun l i tng. b. Phng php v trch nhim ghi: - Cn c vo hp ng v cc ph lc hp ng (nu c) c thc hin, c quan BHXH v n v qun l i tng cng tin hnh lp Bin bn thanh l hp ng ng BHYT theo cc quy nh ti hp ng ng BHYT c k kt. - Cn c cc danh sch i tng tham gia BHYT, s tin phi ng, ng BHYT. - Bin bn thanh l hp ng c lp thnh 4 bn mi bn gi 2 bn. 25. Bin bn i chiu thu, np BHXH, BHYT (Mu s C05-TS). a. Mc ch: c quan BHXH v n v cng i chiu s liu thu, np BHXH, BHYT nhm xc nh chnh xc s phi thu, cn n ca n v. b. Trch nhim lp: Phng thu c quan BHXH tnh, b phn thu c quan BHXH huyn. c. Thi gian lp: khi n v c s n BHXH, BHYT ln thi gian n ko di t 3 thng tr ln. d. Cn c lp: danh sch lao ng tham gia BHXH, BHYT nhp vo c s d liu phn mm qun l, cc chng t np tin ca n v. e. Phng php lp: - Cn c vo danh sch lao ng tham gia BHXH, BHYT nhp vo c s d liu phn mm qun l, cc chng t np tin ca n v, h s tham gia BHXH, BHYT lu ti n v i chiu v cc bo co tng hp thu BHXH,- 21 -
BHYT qu nm ca n v c quan BHXH v n v cng tin hnh lp Bin bn i chiu s liu thu, np BHXH, BHYT theo cc tiu thc tng ng. - Bin bn i chiu s liu thu, np BHXH, BHYT c lp thnh 2 bn mi bn gi 1 bn. 26. Phiu s dng phi ba s BHXH (Mu s C06-TS). a. Mc ch: theo di s lng phi s s dng khi pht hnh s. b. Trch nhim lp: cn b chuyn qun in vo cui mi ngy. c. Phng php lp: * Ch tiu theo ct: - Ct 1: ghi s th t. - Ct 2: ghi cc ni dung s dng phi ba s BHXH. - Ct 3: ghi s lng phi ba s BHXH s dng. * Ch tiu hng ngang: ghi y theo tiu thc quy nh. 27. Phiu s dng phi th BHYT (Mu s C07-TS). a. Mc ch: theo di s lng phi th s dng khi pht hnh th. b. Trch nhim lp: cn b chuyn qun in vo cui mi ngy. c. Phng php lp: * Ch tiu theo ct: - Ct 1: ghi s th t. - Ct 2: ghi cc ni dung s dng phi th BHYT. - Ct 3: ghi s lng phi th BHYT s dng. - Ct 4, 5: ghi s serial ca phi th. * Ch tiu hng ngang: - Ch tiu t 1 n 8: ch ghi cc ni dung ti cc ct 1, 2 v 3. - Ch tiu 9 v 10: ghi y cc ni dung trn biu. 28. Phiu giao nhn phi s BHXH, th BHYT (Mu s C08-TS). a. Mc ch: theo di s lng phi s hoc th c giao, nhn. b. Trch nhim lp: cn b qun l phi lp khi cp pht.- 22 -
c. Phng php lp: - Ct 1: ghi s th t. - Ct 2: ghi tn phi giao, nhn, nh: phi s BHXH hoc phi th BHYT. - Ct 3: ghi s lng phi. - Ct 4, 5: ghi s serial t phi th nht n phi cui cng (nu s lng phi lin tc). Trng hp phi l th ch ghi s serial ct t. 29. Phiu giao nhn h s (Mu s C09-TS). a. Mc ch: ghi s lng, loi h s giao nhn gia cc b phn nghip v thuc c quan BHXH. b. Trch nhim lp: b phn giao thuc c quan BHXH. c. Thi gian lp: khi c pht sinh. d. Phng php lp: - Ct 1: ghi s th t h s giao nhn. - Ct 2: ghi tn, loi vn bn hoc ghi trch yu ca vn bn giao nhn. - Ct 3: ghi s h s giao. - Ct 4: ghi ngy thng nm h s giao. - Ct 5: ghi k hiu h s giao. - Ct 6: ghi s lng t ca h s giao. - Ct 7: ghi ch. 30. Bin bn hy s BHXH, th BHYT (Mu s C10-TS). a. Mc ch: hy ba s BHXH, th BHYT hng khng s dng c trong nm. b. Trch nhim lp: do BHXH tnh, thnh ph lp khi tin hnh hy s BHXH, th BHYT. c. Phng php lp: ghi y cc ni dung trn Bin bn. Tng thnh vin thuc thnh phn ca Hi ng k, ghi r h tn vo Bin bn (khng k thay). Vic hy s BHXH ch thc hin i vi nhng s BHXH hng trong qu trnh in hoc hng do bo qun. 31. Bin bn thu hi, tm gi th BHYT (Mu s C11-TS). - Mc ch: ghi nhn vic thu hi, tm gi th BHYT b pht hin c hnh vi vi phm iu 20 Lut BHYT trong qu trnh cp v s dng th BHYT.- 23 -
- Trch nhim lp: cn b gim nh BHYT ti cc c s KCB. - Phng php lp: ghi y cc ni dung trn bin bn. i tng vi phm v cn b lp bin bn cng k v ghi r h tn vo bin bn. 32. Thng bo kt qu ng BHXH, BHYT (Mu s C12-TS). a. Mc ch: thng bo chi tit kt qu thc hin ng BHXH, BHYT, BHTN i vi cc n v tham gia BHXH, BHYT. b. Trch nhim lp: c quan BHXH tnh, huyn. c. Thi gian lp: hng thng. d. Cn c lp: cn c s liu mu s D02a-TS, D03-TS, D04a-TS, D05aTS, C01-TS v cc chng t np tin ca n v. e. Phng php lp: - Cc ct 1, 2, 3: ghi s liu cc tiu thc trn mu s D02a-TS, D03-TS, D04a-TS, D05a-TS, C01-TS v cc chng t np tin ca n v theo thng v theo tng qu thnh phn vo tng ng vi cc tiu thc v tng qu thnh phn trong thng bo. - Ct 4 = Ct 1 + Ct 2 + Ct 3 theo cc ch tiu tng ng. Lu : - Xc nh kt qu n v ng BHXH, BHTN cho ngi lao ng tnh n ht thng.... nm....: tng ng vi s tin n v ng BHXH, BHTN cho ngi lao ng nh sau: + n v khng n BHXH, BHTN th xc nhn thi gian ng BHXH, BHTN cho ngi lao ng n ht thng ra thng bo. + n v n BHXH, BHTN th xc nhn thi gian ng BHXH cho ngi lao ng tng ng vi s tin n v ng BHXH. Phng php xc nh: Ly tng s tin n BHXH (ct 2) tr (-) tng cng s tin phi ng BHXH ca tng thng cho n khi kt qu bng (=) 0 hoc nh hn (
