Relations
under the compulsory and voluntary health insurance shall be regulated by the
Health Insurance Act (HIA).
Health
insurance shall be implemented via collection and spending the monetary funds –
insured persons and contributors participate in the health insurance system
with social security contributions, and in case of an insurance event the
insured persons shall obtain medical aid as prestation.
Compulsory
health insurance is an activity related to managing and spending the funds from
compulsory health insurance contributions for payment of health related
activities, which is carried out by the National Health Insurance Fund (NHIF)
and its territorial divisions - regional health insurance funds. The compulsory
health insurance provides for a basic package of health related activities
guaranteed by the budget of NHIF.
The body,
which carried out and manages the compulsory health insurance, is NHIF – it
organizes the collection, management and distribution of the funds for
compulsory health insurance. The compulsory health insurance contributions are
collected by the National Revenue Agency (§ 20 of the Transitional and Final
Provisions of the Health Insurance Act).
Basic
principles:
.....
compulsory participation in the collection of the contributions;
.....
participation of the state, the insured persons and the employers in the
management of NHIF;
.....
solidarity of insured persons in the use of the collected funds…….
The health
insurance contributions shall be paid:
..... through
a bank transfer – the social security contributions under the Health Insurance
Act shall be paid into the accounts for collecting health insurance
contributions of the territorial directorates of NRA. See the bank accounts and
the codes for types of payment
..... by
postal order.
Insured
individuals
1. All
Bulgarian citizens who are not simultaneously citizens of another country;
2. Bulgarian
citizens who are also citizens of another country and reside permanently on the
territory of the Republic of Bulgaria.
3. Foreign
citizens or stateless persons who have obtained permission for permanent
residence in the Republic of Bulgaria, unless stipulated otherwise in an
international contract to which the Republic of Bulgaria is a party.
4.
Individuals who have been granted statute of a refugee, humanitarian statute,
or right of asylum.
5. Foreign
students and PhD students admitted for training in higher schools and
scientific organizations in Bulgaria pursuant to the procedure established by
Decree of the Council of Ministers No 103 of 1993 on the Implementation of
Educational Activities amongst Bulgarians Abroad, and Decree of the Council of
Ministers No 228 of 1997 on the Admission of Citizens of the Republic of
Macedonia as Students in the State Higher Schools of the Republic of Bulgaria
6. Persons
beyond those indicated in items 1 – 5, to whom the legislation of the Republic
of Bulgaria is applied pursuant to the rules for coordination of the social
security systems.
"Rules
for Coordination of the Social Security Systems” shall be the rules introduced
by Council Regulation (EEC) No 1408/71 on the application of social security
schemes to employed persons moving within the Community – employed,
self-employed persons and the members of their families who are not covered by
compulsory health insurance on other grounds, by Council Regulation (EEC) No
574/72 determining the procedure for implementing Council Regulation (EEC) No
1408/71, and by any other Regulations which amend, supplement or supersede them
/§ 1, item 22 of the Supplementary Provisions of the Health Insurance Act/.
The persons
who, pursuant to the rules for coordination of the social security systems, are
liable to health insurance in another Member State shall not be compulsorily
insured in NHIF.
Amount of the
health insurance contribution – it shall be fixed every year by the NHIF Budget
Act – 8 per cent for the year 2011.
For the year
2011 the distribution of the health insurance contributions between the
contributor and the insured person shall be in a 60:40 ratio, as follows:
- 3.2 per cent at the expense of the
insured person;
- 4.8 per cent at the expense of the
contributor;
The health
insurance contribution of the self-insured persons shall be completely at their
expense and shall amount to 8 per cent for the year 2011.
The insurable
earnings for the purposes of the compulsory health insurance are fixed in the
Act or shall be determined depending on the accrued/paid or non-accrued
remunerations, indemnifications or the income chosen by the self-insured
person, which may not be smaller than the minimal monthly insurable earnings
pursuant to the State Social Security Budget Act /SSSBA/ for the respective
year.
The following
amounts of monthly insurable earnings have been determined for the year 2011 by
Art. 8 of the SSSBA:
- minimal monthly amount of the insurable
earnings during the calendar year according to basic economic activities and
qualification groups of professions in accordance with Annex No 1 to Art. 8,
Item 1 of the SSSBA for the year 2011;
By Order No
RD 01-1082/30.12.2009 of the Minister of Labor and Social Policy the following
were ratified: a list with included new positions; a list of positions with
changed titles, and a list of positions with changed codes included in the
National Classification of Professions and Positions 2005.
.......
minimal monthly amount of the insurable earnings for self-insured persons in
conformity with their insurable earnings for 2009 as self-insured persons:
- up to BGN 5
400 – BGN 420;
- from BGN 5
401 to BGN 6 500 – BGN 450;
- from BGN 6
501 to BGN 7 500 – BGN 500;
- more than
BGN 7 500 – BGN 550;
.......
minimal monthly amount of the insurable earnings for registered agricultural
manufacturers and tobacco growers – BGN 240;
The maximal
amount of the monthly earnings, on the basis of which the health insurance
contribution shall be calculated, shall be the maximal income determined by the
SSSBA (Art. 40, Para. 7 of the Health Insurance Act) – BGN 2 000 for the year
2011.
The insurable
earnings, on the basis of which the contribution shall be calculated, shall be
established according to payrolls and other documents for paid or accrued but
unpaid remunerations, according to pension records, paid medical certificates,
paid indemnifications for unemployed persons, and according to the tax returns
under the Personal Income Tax Act (Art. 42 of the Health Insurance Act).
The income,
terms and method for payment of the health insurance contributions for insured
persons are stipulated in Art. 40 of the Health Insurance Act.
The health
insurance rights of the persons, who are obligated to pay social security contributions
at their expense, shall be interrupted in case that the persons have not paid
more than three monthly social security contributions due for a period of 36
months up to the beginning of the month preceding the month of the medical aid
rendered. The persons with interrupted health insurance rights shall pay for
the medical aid rendered to them.
Persons, who
have not paid more than three monthly social security contributions due for a
period of 36 months up to the beginning of the month preceding the medical aid
rendered, shall restore their health insurance rights provided that they pay
all the health insurance contributions due for the last 36 months. The health
insurance rights shall be restored as of the date of the payment of all health
insurance contributions due for this period /Art. 109 of the Health Insurance
Act/.
See How can I
restore my health insurance rights
The Health
Insurance Act stipulates a special procedure for the social security of
Bulgarian citizens, inclusive of those with dual citizenship, who reside abroad
for a long time. Under certain conditions, these persons are provided with the
opportunity to be exempted from the obligation to pay social security
contributions – from the date of leaving the country.
Pursuant to
Art. 40а of the Health Insurance Act, Bulgarian citizens, inclusive of those
with dual citizenship, who shall be obligated to secure themselves and reside
abroad for more than 183 days during one calendar year, may choose not to pay
health insurance contributions until the end of the respective calendar year
counted from the date of leaving the country and for each following calendar
year, after a preliminarily filed application to the National Revenue Agency.
The health
insurance rights of the abovementioned persons shall be restored after their
return to the country after the expiration of 6 consecutive months, during
which the person has been covered by health insurance in accordance with the
procedure established by Art. 40.
Beyond these
cases, the health insurance rights of the persons may be restored after their
return to the country after a lump sum payment amounting to 12 health insurance
contributions determined in accordance with the procedure established by Art.
29, Para. 3 of the Health Insurance Act on the basis of the minimal monthly
amount of the insurable earnings for self- insured persons stipulated by the
State Social Security Budget Act as of the time of payment of the
contributions.
On the
grounds of § 19i, Para. 1 of the Transitional and Final Provisions of the
Health Insurance Act, Bulgarian citizens who resided out of the country for
more than 183 days during one calendar year for the period 1 July 1999 - 31
December 2007 and owe health insurance contributions at their expense for the
period they were abroad, shall be exempted from the obligation to pay these
contributions if they did not use medical aid paid for by NHIF.
In these
events the individuals shall submit to the competent territorial directorate of
NRA a declaration following a template ratified by an order issued by the
Minister of Finance - in person or via an authorized person. The declaration
may also be submitted by a licensed mail operator or by electronic means
through use of a universal electronic signature of the sender.
The procedure
for restoring the health insurance rights of these persons shall be:
- after the expiration of 6 consecutive
months, during which the person has been covered by health insurance under the
procedure of Art. 40 of the Health Insurance Act; or
- after a lump sum payment of a sum
amounting to 12 health insurance contributions determined in accordance with
the procedure established by Art. 29, Para. 3 of the Health Insurance Act on
the basis of the minimal monthly amount of the insurable earnings for
self-insured persons defined in the State Social Security Budget Act as at the
time of payment of the contributions.
