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Ensuring benefits for social insurance participants

Implementing the policy of strengthening specialized management, since the beginning of 2025, Social Insurance Region III (Quang Ninh) has focused on promoting inspection, examination, citizen reception and complaint and denunciation settlement (KNTC). This is to ensure the best benefits for participants of social insurance (SI), health insurance (HI), and unemployment insurance (UI).

Báo Quảng NinhBáo Quảng Ninh24/06/2025

Immediately after issuing Decision No. 199/QD-BHXH on the Inspection and Examination Plan for 2025, the regional Social Insurance agency proactively coordinated with departments, branches and People's Committees at all levels to review and develop an interdisciplinary inspection plan, focusing on units at high risk of violations, and at the same time, carried out surprise inspections at enterprises and labor-using establishments in the province.

In the first 5 months of the year, the province conducted inspections and checks at 88 units, including 70 units as planned, 16 surprise specialized inspections and 2 surprise inspections of labor-using units with the goal of promptly detecting and requiring correction of violations.

Dam Ha District Social Insurance cooperated with a number of units to launch the implementation.

Dam Ha District Social Insurance cooperated with a number of units to launch the "Month of promoting the implementation of universal social insurance in 2025".

Through inspection and examination, the Social Insurance agency discovered 22 employees who had not paid social insurance, unemployment insurance, and health insurance within the prescribed time, with the amount of arrears being collected of more than 451 million VND; 119 cases of underpayment or arrears of more than 10 million VND; 6 cases of incorrect payment or overpayment of the adjusted amount of more than 30 million VND. At the same time, regarding the payment work, one case of maternity benefits higher than the regulations was discovered, 8.4 million VND was recovered to the Social Insurance fund, and 2 cases of maternity benefits estimated at more than 46.7 million VND were promptly prevented.

After the inspections and examinations, the Social Insurance Agency of Region III issued a total of 8 documents urging employers to correct violations and implement the inspection conclusions. In the field of health insurance examination and treatment, 12 medical facilities, when inspected and assessed, recovered nearly 150 million VND to the health insurance fund. In addition, the agency issued 4 enforcement decisions with a total administrative fine of up to 102.9 million VND, of which 52.6 million VND was recovered, the rest will continue to be enforced according to regulations.

Not only focusing on inspection and examination, the provincial Social Insurance also seriously implements contents related to receiving citizens and handling complaints and denunciations. In the past 5 months, the agency has received 25 petitions, including denunciations, recommendations and reflections, and organized 80 citizen visits to present their wishes, with a spirit of openness and flexibility. All 26 petitions (including those left over from the beginning of the year) have been resolved completely, not being allowed to be carried over to the next period, creating clear trust among the people in the timely reception and handling attitude of the Social Insurance sector.

City Social Insurance officers distribute documents and explain social insurance policies to small traders in market areas in the area (Photo: Mong Cai City Cultural and Information Center)

Social Insurance officers of Mong Cai City distribute documents and answer questions about social insurance policies for small traders in market areas in the area (Photo: Mong Cai City Cultural and Information Center)

However, the inspection and examination work of the provincial Social Insurance sector still shows some difficulties and shortcomings. The development of an inter-sectoral inspection plan still faces problems in the coordination process between functional units; the professional capacity of some officials in the appraisal and control of health insurance expenditure is not uniform, leading to a situation where inspection is not thorough and handling of violations is not uniform; at the same time, some employers are still not actively cooperating, even avoiding surprise inspections.

Faced with that reality, in the coming time, the provincial Social Insurance will continue to review and complete the inter-sectoral coordination regulations with departments, branches and sectors to build a set of risk indicators, select key inspection subjects, and avoid spreading. At the same time, the sector will also strengthen training and professional development for the team of health insurance inspectors and appraisers, fully equip them with legal knowledge and administrative handling skills, ensuring that each inspection is of high quality, correctly detecting and promptly handling violations.

The sector also promotes communication and propaganda on the rights and obligations of employees and citizens when participating in social insurance, health insurance, and unemployment insurance, as well as the responsibilities of employers, thereby enhancing voluntary compliance. Social Insurance Region III continues to improve the process of receiving citizens and handling petitions, ensuring that all complaints are recorded, processed publicly, transparently and on time. The completion of administrative reform, strong application of information technology in inspection, examination and complaint settlement activities continue to be promoted. The agency will also study and apply an automatic health insurance payment monitoring model, linked to an electronic medical database to detect violations earlier, minimizing the risk of loss of health insurance funds.

With a strong focus on direction, synchronous coordination between levels and sectors and improving staff capacity, Social Insurance Region III is determined to exceed the targets on inspection, examination and settlement of complaints and denunciations. Thereby, contributing to ensuring the legitimate and legal rights and interests of workers, building a healthy, sustainable and transparent labor market.

Thu Nguyet

Source: https://baoquangninh.vn/dam-bao-loi-ich-cho-nguoi-tham-gia-bao-hiem-xa-hoi-3363682.html


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