What is voluntary health insurance for an employee. Voluntary medical insurance (VHI) for company employees

Travel preparation must begin with insurance. It will help you relax, enjoy your vacation to the fullest. The content of the insurance contract depends on the holiday program. If you are planning to go diving, it is worth taking care of purchasing quality health insurance. For scuba diving, it is important to take out exactly the insurance for the diver. This insurance policy guarantees specialized medical assistance.

Risks related to sports are not included in the regular insurance program. Insurance agents assure divers that the additional option of insurance for injuries sustained from extreme sports is quite suitable for diving. After the occurrence of the insured event, it turns out that this is not entirely true, and the insurance contract is powerless.

Few companies provide insurance for divers. Special injuries are possible when diving:

hypothermia of the body, due to prolonged exposure to water
dehydration of the body
oxygen starvation, poisoning
injections of sea urchins
allergic reactions from contact with poisonous plants and fish
electric shock from touching a stingray, eel
damage to internal organs, ruptures, bleeding

The usual ambulance team will not be able to provide the necessary therapy. An ambulance is required, equipped with equipment for assisted respiration, ventilation of the lungs, and control of cardiac activity. Specialists trained in a special dive physiologist program can provide assistance. Underwater activities are associated with the difficult conditions of evacuation from the bottom, the risk of developing decompression sickness. A sharp ascent provokes decompression sickness. Pressure rises, blood circulation is disturbed, blood vessels rupture, a coma is possible, a fatal outcome.

In some cases, emergency recompression in water is carried out. Pressure chambers create high pressure inside, they are used to treat a number of diseases. All these services are very expensive. An hour in a pressure chamber costs 500-750 dollars. Divers are unable to pay for treatment on their own. Adequate insurance covers necessary expenses... The relatively low price of the policy is justified in the event of an insurance accident. And if you don't have to use it, tourists won't be upset.

Insurance programs

A medical diving policy provides assistance for underwater injuries. Diving centers do not allow anyone without Dive Insurance Policy (DIP) to dive.

There are several types of insurance programs:

Silver - operates in Russia and the CIS countries. This includes ongoing support, emergency assistance from dive doctors, inpatient treatment in the hyperbaric department, transportation to the country of permanent residence. Insurance limit - 150 thousand euros
Gold - for diving abroad (all countries except Russia and the CIS) the same services are included. In case of recurrence of the disease, after remission, follow-up treatment is carried out. The annual policy insures underwater equipment against loss by negligence at a depth in the amount of 1000 euros
Gold plus - in addition to the gold program, medical service and maintenance are provided not only for diving, but also for other injuries, illnesses, injuries
Platinum - covers all countries of the world. Equipment cover - 1800 euros. Insurance is paid in case of disability, death - 6500 euros
Platinum plus - covers medical costs for all cases
Instructor - designed for diving instructors, valid in all countries. The limit is 300 thousand euros. Covers the provision of emergency medical support abroad, in case of insurance events

The insured persons can count on the replacement of return air tickets, additional accommodation costs, if the treatment has not yet been completed, and transportation is contraindicated.

Design features

When purchasing a diver's insurance contract, pay attention to the depth limits. Often, only injuries sustained at a depth of 30 m are provided with coverage. Reputable organizations guarantee assistance with an underwater deepening of up to 40 m. Deep-sea diving is practically not insured. Professional divers must be certified by the International Scuba Diving Association. This document confirms the skill of the athlete, serves as proof of the innocence of the insured person in the accident. Diving to a depth unacceptable by the certification is considered deliberate criminal activity.

Calculate the cost online on the Liberty website
Calculate the cost online on the Renaissance website
Calculate the cost online on the VTB website
Calculate the cost online on the Ingosstrakh website
Calculate the cost online on the website of the VSK Insurance House
Calculate the cost of the policy online on the Zetta website
Calculate the cost online on the site Consent
Calculate the cost of the TCD policy on the AlfaStrakhovanie website
Calculate the cost of the policy online on the Tinkoff website

Training sessions are held not far from the coast, at a shallow depth. Be aware that beginners are at greater risk of health problems (such as barotrauma to the ear) than experienced divers. Determine the terms of search and rescue activities, if necessary add this clause to the agreement. A DIP agreement cannot be concluded by people registered with the PND, suffering from tuberculosis, skin and venereal diseases. There is an age limit of 70 years. If the client has undergone surgery within the last 3 months, he will be denied insurance indemnity expenses. Learn the effect of insurance in case of individual diving methods, free free diving without an instructor, violation of safety regulations.

Price

If you are planning frequent diving trips abroad, it is beneficial to purchase an annual insurance plan right away. For people over 50, multiplying factors are applied. One and a half insurance rate - up to 55 years, double - 60 years, 250% - from 60 to 65 years, triple - for tourists over 65 years old.

The voluntary health insurance system is an integral part of the social package given to the employee. Involves costs on the part of the employer.

What is VHI?

VHI is one of the tools for expanding the list of medical services provided. In this case, the company with employees is considered to be the policyholder. The money for insurance is accumulated from the company's profits, which is stipulated by Article 17 of Law No. 1499. Voluntary medical insurance is provided on the basis of the insurance program. The document includes a summary of all the basic information: insurance company, the amount of insurance, responsible persons etc.

How it works? On occasion, provided by insurance, an employee of the company can go to a medical institution prescribed in the contract and receive appropriate assistance for the specified amount. An insured event may be an injury or an acute illness. Not all cases of medical care are paid by the employer. For example, the list of insured events does not include:

Preventive research carried out at the voluntary request of the employee.
Treatment that is not urgently needed.
Getting help at a medical facility that is not specified in the insurance contract.

This is a general checklist. Advanced is determined by the specific insurance program.

Benefits of VHI

The following advantages of insurance for a company can be highlighted:

Increased motivation to work, employee loyalty.
Increasing the competitiveness of the company.
Reducing the tax base.
Increasing the prestige of the organization.

Consider the benefits of insurance for employees:

Access to quality medical services.
Prompt assistance for illnesses and injuries.
In some cases, treatment in sanatorium and spa conditions.
Receiving dental services.

At the expense of the employer, the employee gets the opportunity to receive treatment in better conditions... As a rule, VHI is issued by large companies that value their specialists and take care of their health. Insurance is rarely offered by organizations with high turnover rates. For example, VHI is almost never registered for sellers in chain stores, since the turnover of these employees is constant.

Flaws

There are also disadvantages to voluntary insurance. Minuses:

Serious financial contributions of the company.
Time-consuming registration if new employees constantly come to the organization.
The risk of receiving substandard services.

Voluntary insurance is practically pointless for young and healthy employees.

Design features

The employer must first select an insurance company. Then you need to draw up and send an appeal to this company. The obligation to formalize voluntary medical insurance should be included in the collective and labor contracts. The following information is prescribed in the insurance agreement:

Information about the insurer (company), the insured (employer) and persons who will be able to receive medical services under the VHI (employees).
Insurance subject.
Rights and obligations of all parties.
Responsibility for failure to comply with the conditions that are spelled out in the agreement.
The period of the agreement.
Insurance amount and premium of the insurance company.
The procedure for payment of compensation.
The procedure for paying insurance premiums.

At the request of the employer, insurance can extend not only to employees, but also to their family members.

Who offers VHI?

Many insurance companies offer corporate policies. Relevant offers can be found from the following organizations:

AlfaStrakhovanie.
Ingosstrakh.
Renaissance and many others.

Individual insurance programs are provided by Sberbank.

How much is it?

The cost of services depends on what exactly is included in voluntary insurance:

Treatment on an outpatient basis - from 10 to 200 thousand rubles.
Treatment on an outpatient basis, dentistry - from 15 to 220 thousand rubles.
Outpatient treatment, dentistry, calling an ambulance, inpatient treatment - from 20 to 270 thousand rubles.
All of the services listed above, as well as emergency and planned inpatient treatment - from 30 to 310 thousand rubles.

IMPORTANT! VHI costs are included in labor remuneration.

The list of medical services that are included in the insurance contract depends on the specifics of the company and the wishes of its management. It is possible to design various programs for ordinary employees and specialists. This will motivate employees to advance their careers.

NOTE! It is profitable for the company to draw up an insurance contract for a long time. This option is less expensive.

VHI tax accounting

The money for VHI is taken from the company's profits. Accordingly, its the tax base... However, this benefit can only be used if the following conditions are met:

The period of validity of the insurance agreement is at least a year.
Money for the VHI program is included in tax-free spending in the amount of no more than 6% of the amount spent that is used to pay salaries. An exception is VHI for freelance specialists.
When calculating payments under the VHI program, either payments from the insurance company, or compensation of employees' expenses for medical care under an insurance agreement are recorded.

If these conditions exist, expenses are included in expenses. This rule is stipulated by article 255 of the Tax Code of the Russian Federation.

The employer has the right to issue several insurance policies for one employee. However, according to the letter of the Ministry of Finance dated July 29, 2013 No. 03-03-06 / 1/30023, it is required to take into account the limit of spending on wages. The standard includes spending on wages for all employees, not just insured persons. It also combines the remuneration of individuals who work with the company under civil law contracts.

If the insurance agreement is valid for several periods, the base is calculated as follows:

An increasing total from the date of the agreement until the end of the current period.
From the next period until the end of the agreement.

These rules are established by a letter from the Federal Tax Service dated May 6, 2010. Insurance expenses will not be taken into account earlier than the reporting period in which the premium was transferred. They are distributed evenly throughout the term of the agreement. Money transferred under insurance contracts will not be subject to personal income tax. This rule is governed by paragraph 3 of Article 213 of the Tax Code of the Russian Federation. Also, insurance premiums are not deducted from payments. However, this is only relevant if the insurance contract is valid for at least a year.

Accounting

In accounting, expenses on voluntary medical insurance are included in the list of expenses during the period in which they are paid. This rule is established by a number of regulations. The cost of insurance is recorded in the debit of the expense account. For example, it can be account 20, 26, 44. If the company transferred insurance premiums for employees who do not work for the company on the basis of an employment contract, the resulting expenses are recognized as other. They are recorded in the debit of subaccount 91.02 "Other expenses".

In tax accounting, expenses must comply with the standards. In accounting, expenses are recorded without restrictions. If there is a difference between the two forms of accounting, the amount is reflected in accounting.

Voluntary health insurance(VHI) is one of the types of insurance products offered by medical insurance organizations.

Unlike compulsory health insurance (MHI), it is additional and is entered into by a person voluntarily in a separate procedure. VHI can issue a contract as individual and legal, by purchasing a corporate package for their employees.

Dear reader! Our articles tell about typical ways of solving legal issues, but each case is unique.

If you want to know how to solve exactly your problem - contact the online consultant form on the right or call by phone.

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What is VHI for employees?

Voluntary health insurance for employees is an agreement for the provision of a range of services for the organization and financing of medical care, concluded between the employer and the insurance company.

The volume and quality of assistance and other measures is prescribed in a special agreement, based on programs drawn up by mutual agreement of the insured (employer) and the insurer (insurance company) and provided to the insured (employees of the insured company and their families) in accordance with the contract.

Voluntary health insurance programs are drawn up taking into account funding and provide the right for the insured employee to apply to the medical institution specified in the contract to provide him with:

consultations,
diagnostics,
treatment,
rehabilitation,
prevention,
spa treatment.

The VHI policy allows the insured person to receive medical care in accordance with the specified list in the contract.

There are several types of VHI packages. The standard basic includes:

Medical reception and treatment in the clinic and at home.
Calling an ambulance.
Inpatient treatment in a planned or emergency manner.
Rehabilitation, including in sanatoriums.
Dentist and family doctor services.

In addition, there is a complete, extended, and "constructor" -type package.

Advantages of applying for a corporate insurance package

When registering a corporate VHI package, each employee receives:

Full insurance coverage of the costs of providing assistance in accordance with the list of prescribed services.
Professional long-term management from the moment of his appeal to the dispatching console of the insurance organization upon the occurrence insured event... The insured gets the opportunity to contact the company's consultant around the clock, who is an intermediary between the client and the medical institution and builds optimal interaction between them.
In the absence of certain paid services in the VHI package, the insured has the opportunity to receive this service with a certain discount in case of its obligatory need.
The ability to carry out an examination of the conformity of the quality of the provision of services, as well as upholding the rights and protecting the interests of the insured.

Also, there are pluses for the company or the insured company:

An effective “leverage” appears to increase the motivation or retention of their employees, reducing the “turnover” of staff.
An additional social guarantee (as part of a social package) is being formed to attract more qualified workers in addition to the level wages.
Preferential taxation is provided, since up to 6% of employees' salaries are deducted for insurance coverage and are not subject to personal income tax.
The level of competitiveness and reputation among similar companies is increasing.
The level of corporate and legal culture is improving.
Timeliness of assistance is ensured, which significantly reduces the duration of general disability and increases the efficiency of each insured person.
The time spent on annual medical examinations and preventive measures (for example, vaccinations) is minimized.

Minuses

However, in addition to the merits, there are certain negative aspects for the employer:

Relatively high cost of the VHI service package.
The need for additional tax and accounting and accounting (increase in workflow).
In litigation with the insurance company, all costs are at the expense of the employer.
The policyholder is also liable for the employee's unfair behavior (transfer of the policy to another person).

There are certain disadvantages for the team itself:

There may be territorial attachment to inconvenient and distant medical institutions.
Late entry by the insurer of the employee into the list of insured persons will entail personal expenses sick without the right to compensation.
The exclusion list may include some chronic pathologies that the employee has. In this case, insurance premium will not return.

A thorough study of the VHI contract and the choice of a reliable insurance company will significantly reduce the likelihood of these shortcomings.

Features of the conclusion of the contract

Before signing, you should pay attention to certain nuances:

It is necessary to carefully study all the clauses of the agreement before signing it with the obligatory indication and reservation of those conditions that do not suit the policyholder. Moreover, it must be an officially certified document.
Review the entire list of exemptions for medical treatment waiver. according to the statute. It is also worth notifying your employees about this, including under their personal signature.
When signing an agreement, it is important to pay attention to the term of the current license. insurance company for the provision of these services. It may happen that it expires before the end of the proposed contract.
In the event of a dispute, the regulation of relations between the policyholder and the insurer is carried out using the rules established by the Civil Code of the Russian Federation (Chapter 48, Articles 927 - 970) and the specific provisions of the concluded VHI contract.
Mandatory registration of a VHI policy is made in the case of hiring foreign citizens. The conclusion of contracts also applies to members of their families (spouse, children under 18 and dependent children) from the date of their official entry into the territory of Russia. This item is mandatory and is prescribed in employment contract... The main condition is that the employee must be highly qualified, that is, experienced or having certain achievements in his field of activity.

For unskilled and skilled workers, this obligation does not apply.

How to issue a VHI package (step by step instructions)

The contract with the insurer is usually concluded by the HR manager of the company. And he has 2 main tasks:

Keep within the budget allocated for these purposes.
Choose the optimal program, taking into account the wishes of the majority of employees in order to maintain their motivation.

To do this, you need to conduct a preliminary analysis of the needs of the organization's employees in a certain amount of medical care:

By categories of the formation of VHI programs (depending on the length of service, position and risks).
By filling the package, taking into account the necessary medical institutions (clinic, hospital, ambulance).
Connecting a complex of additional services (treatment abroad, preventive measures, accident insurance, as well as the inclusion of close relatives in the program).

An order is printed on the establishment of VHI at the enterprise (written in free form).
Changes are being made to labor or collective agreements (who, in what order and in what volume can use the VHI package).

Only after the consistent fulfillment of all the above points is an agreement concluded with the selected medical insurance organization.

How to choose a policyholder?

Each insurance organization has its own VHI programs with certain packages for the provision of medical care and other services.

Therefore, it is necessary to follow a certain algorithm of actions to select the optimal insurer:

The big name of the insurance company does not play a decisive role. The interests of our own employees should come first. Only after evaluating all of the above points should one proceed with the development and approval of the contract with the selected insurer company.

Where can you get VHI for employees?

A VHI policy for employees can be obtained from most insurance companies. Among them are such organizations as Rossgosstrakh, Sogaz, Alfa Insurance, Ingosstrakh, VSK, as well as Sberbank, VTB - Insurance, Uralsib, Alliance and others.

Corporate package cost

Covered risks with a full list of the volume and quality of medical care are determined only by the employer.

This affects the cost of the VHI policy for an employee, as well as the level and price category of a medical institution under the insurance program.

Depending on the options for filling programs for organizations and companies, the following approximate cost of a corporate VHI package in rubles is possible:

Outpatient care (+ home help) - from 10,000 to 200,000.
+ dentistry - from 15,000 to 220,000.
+ ambulance and hospital - from 20,000 to 270,000.
+ emergency and planned assistance - from 30,000 to 310,000.

VHI for relatives of employees

To increase motivation, some employers issue a VHI policy not only for employees, but also for their relatives - wife (husband) and children under 18 years of age. Upon request, the list of insured persons can be expanded.

This is especially important for employees who care not only about their health. This leads to an increase in their productivity and a decrease in staff turnover.

So, we can conclude that voluntary health insurance for employees, with the right choice of an insurance organization, only benefits the employer, increasing the prestige of the company and the corporate culture of the team. And employees provided with a high-quality social package are more efficient, which is also a positive moment for the functioning of the entire enterprise.

Every citizen Russian Federation having compulsory medical insurance policy(compulsory health insurance), it is possible to use the services provided by state polyclinics free of charge.

But such services cannot always satisfy us. Alternatively, people can enter into a voluntary health insurance contract and start using quality, paid health care.

A VHI agreement is an agreement that is concluded among themselves insurance organization(the insurer) and any company (the insured).

Thanks to him, the policyholder can receive medical care organized by the insurer in accordance with the selected program, while paying the price for the services provided in the contract.

The policy can also be a contract or act as a certificate of the possibility of receiving services.

The agreement contains more complete list conditions of voluntary health insurance, and the policy is a brief summary. Therefore, when concluding a VHI contract, the client will be provided with a policy.

Conditions

The contract can include either one service or a whole program. It must be in writing and contain a certain list of nuances and requirements, without which this document is considered invalid.

It is also very important to prescribe in the contract the term of its validity and the types of insured events.

The list of services provided and medical institutions included in the voluntary health insurance program are usually found in the form of an annex to the main document.

Overall in official document availability is important:

Full name, passport and contact details of the policyholder and the insurer;
the chosen insurance program;
accessible medical institutions providing services;
full insurance conditions;
contract time;
the amount of insurance premiums;
information on the rights and obligations of the parties;
terms of termination of the contract;
in case of a collective agreement - a list of insured persons, their passport and contact details;
other information.

Features of the validity period

Usually, such a document is concluded annually.

But the terms may vary depending on the agreement between the two officials - the head of the company and the representative of the insurance organization.

The contract comes into force from the moment of its signing, but it can become valid in another case: at the first payment for medical services.

In addition, there is a special period of the contract, which lawyers call a wait-and-see period.

If any insured events occur during this period, the insurer will have to be liable after the end of such period.

How the collective differs from the individual

There are two types of voluntary health insurance contract:

Individual.
Collective.

Depending on the type, the application for the provision of medical services is completed either personally by the insured or by an employee of the company. If the agreement is collective, then the policyholder is the head of the company, and insured persons - his subordinates, employees.

The document must necessarily contain the types of insured events, for example, the appeal of the insured person to the clinic from the list of institutions that are included in the VHI program.

As well as exceptions, that is, such cases for which the insurance does not apply (receiving medical care due to an injury sustained in an alcoholic or drug state).

The main difference between a collective voluntary health insurance contract and an individual contract is the procedure for making contributions for the insured. If the employer pays, then he chooses the insurance program.

If a private person pays for himself, then the terms of the VHI contract can be chosen more flexible, for himself.

What services are provided

In addition to the individual and collective agreement, there is a standard voluntary health insurance policy and a policy with additional insurance programs.

The list of services of a standard VHI policy usually includes the following:

calling a doctor home;
calling an ambulance;
basic dentistry services (filling, X-ray, root canal treatment);
standard examinations and procedures;
outpatient service;
visiting polyclinics from the list of participating in the VHI program;
hospitalization and medicines.

A policy with additional insurance programs costs a little more than the standard one, but may include others medical services depending on your desire.

It can be:

extended dental services (installation of prostheses, etc.);
medical services abroad;
pregnancy management, childbirth;
Spa treatment;
medical services of a personal doctor;
tick bite treatment and much more.

What do they write in small print?

Like any other contract, voluntary health insurance has its own pitfalls. When drawing up a document, you need to pay attention to the following:

make sure that the insurer is licensed to provide services for the type of insurance you have chosen;
get acquainted with the rating of the insurance company and the reviews of its clients;
you cannot hide data on the health status of the insured person, in this case the contract may be considered invalid;
choose exactly the list of services that are needed;
if the list of services includes such as calling a doctor or an ambulance at home, you need to make sure that the insured's residential address is included in the service area;
the contract must indicate the contacts where you can contact in case of problems or questions;
the document being drawn up must have clearly spelled out conditions under which the contract becomes invalid and is considered invalid.

After drawing up the contract, you need to carefully check the correctness of its completion and the availability key points.

When signing the contract, it is important to read it carefully several times and make sure that all the necessary points in it are taken into account.

In addition, the following points should be considered:

Availability of a valid license for the provision of services of this type.
The composition of the insurance program should not include "services by default", that is, those services that are not urgently needed, but which increase the cost of insurance.
In advance, you need to discuss the possibility of disputable situations and ways to resolve them and register as a separate clause in the contract.
The documents must indicate the contacts of the insurance company, where you can contact in case of problems or questions.

Model rights and obligations of the parties

In a standard voluntary agreement health care the rights and obligations of both the insurance organization and the policyholder are very clearly spelled out.

The main duties of the insured persons include:

Make payments at the set time.
Follow the recommendations of the attending physicians.
Timely inform the insurance company of any changes affecting the policyholder.
Store documents without transferring from third parties.
In case of early termination of the contract, return the policy to the insurer on time.

The insurance company must comply with the following points:

1. At the set time, issue VHI policies.

2. Ensure the provision of medical services in accordance with the approved insurance program.

3. Do not transfer confidential data to third parties.

4. Protect the interests of the insured.

Order how to conclude

It is very easy to get a VHI policy. To do this, you need to have an idea of the list of services that you want to receive, and, of course, money for insurance premiums. The first step is to choose an insurance company.

This can be done on the advice of friends and acquaintances, or according to reviews and statistics on the Internet. Next, you need to present your passport and fill out a standard application.

Sometimes, in order to avoid unnecessary risks, you may be asked to complete a short medical questionnaire and provide supporting documents. Then you will be prompted to choose insurance program and medical services included in it.

Choose only the medical services you need. Remember that with each new service included in the list of the VHI program, the cost of insurance increases.

After that, a list of medical institutions that participate in the program is drawn up, and the term of the contract is established. The amount of insurance premiums is calculated.

Then a contract of the established form is drawn up, which is signed by the insured person and the representative of the insurance company. Further, the insurer issues a VHI policy to the policyholder, and the insurance begins to operate.

To conclude a VHI agreement, you only need a passport and, possibly, some other documents required to calculate the amount of insurance premiums.

Sample

A voluntary health insurance contract must be concluded in writing... According to article 940, paragraph 3 of the Civil Code of the Russian Federation, each insurance company has its own standard sample of the contract. The main requirement for the execution of any VHI contract is the presence of the following points in it:

document validity period
number, passport and contact details of insured persons
types of established insured events
amount and term of payment of insurance premiums
rights and obligations of both parties

At the request of the policyholder, amendments or additions can be made to the contract.

This is what a voluntary medical insurance policy might look like:

And the VHI contract has the usual printed form... You can download samples of contracts by following the link:

Sample 2018 Model contract LCA,.

Sample VHI contract for employees,.

Questions about receiving insurance premiums

The contract must clearly state the amount of the insurance premium, the term and procedure for its payment. The amount of the insurance premium is set in accordance with the rates of the insurance organization and the list of services provided.

In the event of a specified insured event, the insured person receives the medical assistance included in the program, and the medical institution receives payment for the services provided.

The term for making the insurance premium must be fixed in the contract, in accordance with which you can pay for the services provided at a time or use an installment plan and split the amount of the insurance premium into several payments.

Useful video

An interesting video about whether employers will refuse VHI insurance during a crisis:

Procedure in the event of an insured event

According to the standard policy, the list of insured events may include the following:

consulting or medical appointments of doctors;
ambulatory treatment;
hospitalization;
laboratory tests and other diagnostics;
calling a doctor or ambulance at home.

In the event of an insured event specified in the current contract, you must contact the necessary specialist in a medical institution that is included in the list of your insurance program.

In this case, you need to have a passport or other identity document, and a VHI policy.

It is important to take care of your health and get help from qualified doctors.

If you are not satisfied with the medical services provided free of charge to any citizen of the Russian Federation, you can always conclude a VHI contract with an insurance company and start using high-quality medical services.

In contact with

Many managers provide their employees with additional guarantees to receive quality medical care in the form of voluntary medical insurance.

Dear reader! Our articles tell about typical ways of solving legal issues, but each case is unique.

If you want to know how to solve exactly your problem - contact the online consultant form on the right or call by phone.

It's fast and free!

We will talk about what voluntary insurance gives, how to choose a company that provides such a service, and we will also provide instructions on how to draw up a policy, a list of documents and we will guide you in the cost of services.

What is VHI?

DMS abbreviation stands for as follows - voluntary medical insurance... It differs from compulsory insurance the fact that insured workers are given the opportunity to receive additional medical services in private clinics.

If an employee is forced to go to a hospital for treatment, then thanks to the VHI policy, he will be able to stay in the hospital for the entire period in a paid ward.

In this case, all costs for paid treatment will be paid by the insurance company in which the policy was drawn up.

Important! Voluntary health insurance today is fully regulated by Federal legislation. But, in some commercial organizations, different conditions may be provided on this issue. Each employee has legal right refuse such a policy if he works in that branch of the national economy where compulsory insurance is not required.

What is it for?

VHI allows people to independently choose for themselves the most suitable insurance program in terms of parameters.

The presence of an insurance package allows insured employees to use the following services:

calling a paid ambulance team;
services of a highly qualified family doctor with whom the insurance company has entered into an agreement;
receiving medical services in private clinics, in particular VIP and business class;
inpatient treatment in a comfortable ward with no more than 2 beds, a TV, refrigerator, shower;
receiving dental services in private clinics and offices (except for cosmetic services and prosthetics);
Spa treatment.

Advantages and Disadvantages of Voluntary Health Insurance

Each insurance policy has both advantages and disadvantages. VHI insurance is no exception.

Its main disadvantage is the rather high cost, that is, the insurance premium, which falls on the budget of the organization that deals with the registration.

Also, a few more points can be ranked among the disadvantages:

complex registration process;
collection and preparation of a large amount of documentation;
formation of lists of insured workers;
the need to agree on the terms of the program with each employee.

To the advantages of the VHI, which is drawn up by the management commercial organization for full-time employees, the following can be added:

the opportunity to significantly increase the prestige of the enterprise;
increasing the efficiency of the team;
stimulating staff to develop corporate culture;
the ability to attract valuable workers to cooperation, for example, to lure away from competitors;
improve the quality of work.

As for the advantages of VHI in relation to employees, there are also several points that can be highlighted:

the opportunity to receive better medical care;
the opportunity to purchase medicines at decent discounts;
the ability to undergo high-quality diagnostics using modern equipment;
the opportunity to undergo recovery and rehabilitation after treatment in well-equipped centers;
the ability to independently choose medical institutions for service, as well as the level of qualifications of staff.

Important! Workers of firms that received VHI insurance, as practice shows, significantly improve their labor performance. This, in turn, has a positive effect on their earnings. It is also worth noting that all compensation payments that the employee will receive will not be included in his total income, therefore, will not be taxed.

Why is voluntary MS better than compulsory health insurance?

VHI differs from compulsory health insurance as follows:

Features of VHI for employees

Today large firms include VHI in the social package for workers. The insured is the organization that insures its personnel.

As for the contributions to VHI, they are taken from the profit of the enterprise, in accordance with the regulations of Article 17 of the Federal Law No. 1499-1. At the same time, a bilateral agreement is signed between the insurance organization and the employing firm.

Important! Employees are given the opportunity to independently choose an insurance program, in which mandatory the list of available medical services is indicated. Also indicated are the medical institutions in which you can receive services, the total amount of insurance.

Employees of companies for which VHI policies have been issued can use the services (within the amounts stipulated by the contract) upon the occurrence of insured events:

development of an acute form of pathology;
injury;
other cases in which the worker requires immediate medical attention.

Situations that do not belong to the category of insured events:

preventive examinations, which are carried out on the personal initiative of the worker;
receiving medical services, the feasibility of which has not been documented;
services in medical institutions that are not on the list of the insurance company.

The features of VHI include the following:

a policy (individual) is drawn up by a citizen, both for himself and for his family members;
the insurance is issued by the entity entrepreneurial activity for full-time workers;
when issuing a policy for corporate program newly hired employees are included in the list of insured workers only after passing a probationary period at their enterprise;
upon dismissal, the employee is excluded from the insurance program and in the future will not be able to use the services under the VHI policy;
after insurance is issued, each client is given a list of medical institutions with which the insurance company cooperates.

Registration

In accordance with the regulations of the Federal legislation, the following categories of citizens will not be able to issue a VHI policy:

Workers diagnosed with AIDS.
Employees who are HIV-positive.
Alcoholics and drug addicts who are registered with the relevant medical institutions.
Workers who have various mental disorders.
People who have venereal and oncological pathologies.
Employees who have been diagnosed with tuberculosis.
People with disabilities of groups 1 and 2.

Important! A VHI policy is issued for only 1 year. After this period, the insurance is issued anew. Under such a policy, a Russian citizen receives medical services in the amount of 200,000 rubles or more. Maximum amount exceeds 1,000,000 rubles.

Where to register?

Each commercial organization should be very responsible when choosing an insurer. Such a company must necessarily have appropriate permits and licenses.

When choosing an insurance company, you need to rely on the following criteria:

Availability positive story insurance payments.
Lack of a large number of complaints and court proceedings.
High rating on "RA" or "NRA" (the insurance company must be included in the top thirty insurers).
Availability of highly qualified specialists who have the appropriate education and experience in working with VHI.
A wide range of partner medical institutions that specialize in different areas.
Pricing policy (since VHI is voluntary insurance, insurers independently form the prices for such policies).

What is needed for that?

After the management of a commercial organization has decided on the type of insurance program, it is necessary to prepare a package of documentation:

All constituent and registration documents of the company (OGRN, TIN).
Application addressed to the insurer.
List of staff members who will take part in insurance.

Important! Once the collective agreement has been concluded, the insured employees should contact the insurer and collect their policies. They will also be provided with a list of medical institutions - partners of the insurer, in which they can receive services.

How to register?

To conclude an agreement on VHI with an insurer, a business entity must first of all choose an insurance company. After that, you should carefully study the proposed programs. Next, the commercial organization needs to act according to the plan.

The procedure for issuing voluntary medical insurance for an organization

The process of issuing VHI policies for workers includes several important stages:

The head of the organization issues an order on the introduction of voluntary health insurance for staff members. This document describes the procedure for obtaining insurance, and also a responsible worker is appointed who will deal with these issues.
A business entity issues a local normative act. He will regulate all issues related to voluntary insurance full-time workers. Instead of this act, the head makes additions to the existing collective agreement. Further, each employee gets acquainted with decisions taken manuals, which is signed in the corresponding register.
Insurance programs are selected for full-time workers.
An agreement is concluded with an insurance company.
Payment is made to the insurer.
Employees receive policies.

Voluntary health insurance agreement

When concluding an agreement on VHI with an insurance company, a business entity should pay attention to the following points:

It should be indicated which of the employees are provided with insurance services.
All insured events are indicated.
Should fit in sum insured, within which medical services are provided.
The term of the agreement is indicated.
When new workers are hired, the procedure for concluding a VHI agreement will remain unchanged.
The term of the agreement does not exceed 1 year, since the amount is fear. contributions are calculated at the time of calculating the profits of the organization.
Information about the insurer, insured employees and the insured must be present.
The responsibilities and rights of the parties are described.
The procedure for payment of compensation and payment of fear is indicated. contributions.

Insurance regulation in the organization

The regulation on VHI insurance in a commercial organization includes the following items:

general provisions.
Conditions.
Restrictions.
Terms of termination of the VHI agreement.
The procedure for concluding an insurance agreement.
The procedure for obtaining policies by workers.

How much does VHI cost?

Price insurance policy VHI directly depends on the following factors:

the chosen insurance program;
insurance conditions;
the volume of medical services provided.

The cost of the policy can be increased by Additional services, for example, dental. Also, the insurance indicator will be influenced by the number of employees included in the list who will participate in the program.

The cost of the policy directly depends on the amount allocated by the company for one worker limit. As a rule, this amount varies in the range of 50,000 - 100,000 rubles. the average value of one policy ranges from 5,000 to 30,000 rubles.

Insurance premiums

The amount of the insurance premium for 1 insured worker depends on the sum insured.

For example, with the insured amount of 60 thousand rubles under the basic program with a duration of 1 year, the amount of the insurance premium will start from 5 thousand rubles. Insurance premiums the firm pays the insurer upon conclusion of the agreement in full.

VHI upon dismissal of a worker

If the worker leaves, then the previously concluded agreement loses legal force if these terms are provided.

After that, the employer informs the insurer in writing about the incident. The insurer recalculates the total premium and returns the excess to the company.

Corporate VHI

Corporate insurance is convenient for employees, since they do not have to independently deal with the preparation and collection of documents.

Insurance from VTB

VTB clients can take part in insurance on preferential terms. Programs with a list of the nearest medical facilities are offered. Customer support. With an increase in the number of insured workers, the insurance rate decreases.

Insurance from Sberbank

Sberbank clients fill out a questionnaire online. Telephone advisory support. VHI policies are issued for relatives.

Alpha insurance

Alfastrakhovanie's clients are provided with round-the-clock access to medical care. A list is available, which includes more than 3 thousand Russian medical institutions. Telephone advisory support. An extensive package of documentation is required to issue a policy.

Worker's family policy

Close relatives of a full-time worker are allowed to participate in VHI insurance programs. As a rule, these are the wife (husband), children.

But organizations can expand the list on their own. This step is taken to further stimulate staff to work productively in the company.

VHI and taxation

The amount of insurance is included in the expenses of the company, in the amount of 6% of the wage fund (Article 255 of the Tax Code)... With regard to taxation, the amount is fear. contributions are not assessed USN (Article 238 Tax Code), and Personal income tax (Article 213 of the Tax Code).

Additional types of employee insurance

When insuring workers, it is allowed to expand the list of services:

accidents;
travel abroad;
cancellation of a foreign trip;
Civil responsibility.

The legislative framework

VHI insurance is regulated by the following regulations:

Tax code;
ФЗ №1499-1;
ФЗ №125;
ФЗ №212;
letter N 406-19 02/27/2010;
ФЗ №323.

Take action!

If you decide to insure your employees - proceed:

Choose an insurer.
Collect the documentation.
Make an agreement.
Pay insurance premiums.
Issue policies to employees.