SHIF: what to do if medical insurance premiums are returned?

“The Social Health Insurance Fund receives applications from employers due to the return of payments to the compulsory health insurance for individual employees. Most often, payments are refunded for full-time students of universities and colleges in the country”,-the press service of the Social Health Insurance Fund reports.

The Fund explained why the refund occurs and what needs to be done”.

The state pays contributions for 15 privileged categories of the population. This is more than 11 million Kazakhstanis. Full-time students in organizations of secondary, technical and professional, post-secondary, higher education, as well as postgraduate education are included in this list. Therefore, employers are exempted from paying health insurance payments for student workers, and students registered as individual entrepreneurs are also exempted. It is for this reason that there is a return of contributions and deductions for compulsory health insurance for beneficiaries. What if there is a refund for an employee who is no longer a student? The list of students is formed by the State Corporation “Government for Citizens” on the basis of data from the information system of the Ministry of Social Protection of the Population of the Republic of Kazakhstan, obtained from the information system of the Ministry of Education and Science of the Republic of Kazakhstan. This list is transferred to the Social Health Insurance Fund for assignment to students as beneficiaries of the insurance status in the compulsory health insurance system.

Note that the Fund does not determine the social status of citizens and does not have the right to make adjustments in the information system of the Ministry of Education and Science of the Republic of Kazakhstan. In order to exclude from the list of citizens who completed their studies in 2021, it is necessary to contact the Department of Digital Transformation of Education of the Ministry of Education and Science of the Republic of Kazakhstan or to your educational institution.

The situation is slightly different with persons on leave in connection with pregnancy and childbirth, adoption or adoption of a newborn child or children, caring for a child or children until they reach the age of three years. Beneficiaries in this category are those who do not carry out entrepreneurial or labor activities and have no income. If a person interrupted parental leave before he reaches the age of three years, then the employer is obliged to transfer payments to the compulsory health insurance for him. Until July 1, 2021, employers faced the return of payments to the compulsory health insurance for this category of workers due to the fact that the JSC “Center for the Development of Labor Resources” of the Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan established format-logical control for accepting payments in its information system “Organization payment processing “.

But from July 14, 2021, the format-logical control was removed. In this connection, we recommend employers to re-transfer payments to the compulsory health insurance in favor of employees who interrupted parental leave before they reach the age of three. This will preserve their insurance status in the compulsory health insurance system.

Let us remind you that consultation on health insurance can be obtained at the Fund through the feedback channels: contact center 1406, mobile application Qoldau 24/7, SaqtandyrýBot in Telegram, website fms.kz.