A few tips for buying a VHI policy. How to get access to paid medical services and not overpay? A few tips for buying a VHI policy VHI corporate portal for Sberbank employees

Medical insurance in Russia differs from foreign analogues. Every Russian, regardless of age, income, state of health, has a policy compulsory insurance(CHI), which means that they can receive medical assistance anywhere in the country. Why then do we need VHI and what does it include?

According to the Constitution, every citizen Russian Federation has the right to free medical care and medical assistance. With only one caveat - the list of medical services for CHI is rather limited. Need to expand your list of services? Get them faster? Pay less for emergency examinations or get free consultation a specialist without a queue? Voluntary medical insurance service (VHI) is designed just for this purpose.

What is included in the standard VHI?

There is a standard VHI policy and a policy with additional insurance programs. The standard policy usually includes:

• outpatient care;
• basic dentistry (X-ray, filling, canal treatment);
• basic examinations and procedures;
• hospitalization;
• providing medicines throughout its length;
• Ambulance;
• doctor's house call.

Additionally, by paying an increased insurance premium, the insured may expand the list of voluntary health insurance services. It could be:

• management of pregnancy and childbirth (including services of ultrasound, gynecologist, etc.);
• protection and treatment from a tick bite;
• medical care abroad;
• advanced dentistry, such as prosthetics;
• services of a personal doctor;
• spa treatment and much more.

What are the services offered and why can't they be obtained through compulsory health insurance? Outpatient care involves attaching the insured to one of the clinics with which the insurance company works. The client can receive consultations and treatment from specialized specialists without waiting in line, as well as rely on basic diagnostic tests and physiotherapy. More expensive studies, such as MRI and CT, are not provided under the standard VHI policy.

Each insurance company independently decides how full the list of services included in the standard VHI policy will be. The table below provides examples of VHI programs. offered by the leaders of the insurance market.

What is included in the extended VHI?

As additional services, expanding the scope of insurance coverage of a standard VHI policy, may also include the following programs:

• Pregnancy management is a separate policy with an impressive list of procedures, examinations and activities, which the insured person (pregnant woman) forms independently, depending on their financial capabilities and desires. This is one of the most expensive additional programs VHI;
• Treatment and protection against a tick bite is especially necessary in the spring-summer-autumn period, when cases of infection with encephalitis and borreliosis (aka Lyme disease) are common. When issuing such a policy insurance organization guarantees diagnostic examination of the patient and the tick, inpatient care, resuscitation according to indications, drug treatment, prevention and physiotherapy;
• A VHI policy for tourists will help you not to be left without medical support on short-term trips abroad. In fact, this is VHI under the standard health insurance program, only abroad;
• Extended dentistry - will allow you to include prosthetics and surgical intervention in the policy;
• Personal doctor - for those wishing to be consulted and treated by the same specialist who knows well the peculiarities of the health of the insured person;
• Sanatorium-resort treatment - will provide an opportunity to receive rehabilitation and recovery services in sanatorium-resort institutions that have concluded an agreement with the selected insurance company.

Any kind medical insurance has its drawbacks. In the case of VHI, the insured may be denied medical care under the policy if he suffers from: oncological diseases, mental disorders, diabetes, tuberculosis, kidney and liver failure, hepatitis of any type, venereal and occupational diseases. The client will also be denied insurance coverage if his illness or injury is found to be illegal or malicious, suicidal, or the consequences of alcohol, drug or toxic intoxication.

“Sberbank PJSC made an additional purchase of insurance services for voluntary medical insurance in the interests of bank employees for the period from January 1, 2020 to June 30, 2020, implemented by prolonging existing contracts with the companies Alliance, AlfaStrakhovanie, “ VSK, Ingosstrakh, MAKS, RESO-Garantiya, SOGAZ, previously selected during an open tender as providers of these services,” Sberbank told Interfax-AFI.

Sberbank of Russia has extended contracts for the provision of voluntary medical insurance (VHI) services for bank employees with the insurance companies Alliance, AlfaStrakhovanie, VSK, Ingosstrakh, MAKS, RESO-Garantiya, SOGAZ, follows from message published on the public procurement website.

VHI for employees - advantages and disadvantages

It is this insurance policy that includes everything necessary to prevent and maintain the health of an employee. Quite often, companies offering such insurance make considerable discounts for enterprises that purchase a wholesale amount for the entire staff. So, VHI costs much lower than retail.

1. You should not "buy" for too much cheapness, most likely, either a short term of insurance, or a small list of medical services.
2. When signing the contract, you need to carefully read the proposed text, paying attention to the presence of hidden fees and additional payments.
3. An important issue to be discussed is the return of the unused sum insured upon dismissal of an employee.

Personal account Sogaz

Sogaz JSC is a federal-level insurance company with a regional network of more than 600 outlets, which is part of the Sogaz group, has earned a high reliability rating among rating agencies. The company offers about 100 types of travel, health, life, real estate, auto and other property insurance programs.

Access to the service is implemented through the official website of Sogaz. In the top menu of the site there is a button with a key icon - a link to a single Personal Area Sogaz for corporate and private clients, the entrance to which is carried out by specifying the correct email + password combination. When you click on the button, a previously hidden panel with a quick authorization form is pulled out. From it, you can also go to the registration and password recovery pages.

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Full information about insured events and the amount of payments, as well as the procedure and terms for making insurance payments, is contained in the Memo What to do in the event of insured event? - to the nearest office of JSC "SOGAZ", the exact addresses and telephone numbers are indicated in the section " Contact Information»; - remotely send scans/copies of documents through the "Personal Account" located at: https://lk.sogaz.ru/cabinet/ (after confirmation by the responsible employee of SOGAZ JSC that the scans of documents have been received - send the original documents to SOGAZ JSC ); What documents do I need to provide for insurance payment? When applying for an insurance payment, always provide: a written application for insurance payment according to prescribed form indicating the date, place and reliable circumstances under which the event indicated in it occurred; a copy of the identity document of the Insured person/legal representative/beneficiary (passport copy); a copy of the work book certified by Sberbank (signature of an official and seal) or, if the contract is fixed-term, a copy of the labor agreement (contract).

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Zdorovie com personal account Sberbank VMI

1. associated with the transportation of a patient to a doctor or hospital for primary care in an emergency or accident;
2. providing SSP emergency care on the spot;
3. the cost of used medicines and dressings.

• individual approach for each group of clients;
• taking into account all the wishes of the insured person;
• provision of a full range of medical services;
• the opportunity to be treated by the best doctors and first-class clinics;
• 24/7 telephone support;
• the ability to make changes to the terms of the insurance contract;
• speed of issuance of policies;
• a wide range of programs and a wide network of regional offices of the company;
• own network of medical clinics;
• a large number of insured clients;
• centralized medical expertise;
• good conditions for public sector insurance.

SOGAZ - personal account

Sberbank has a System for Evaluating the Performance of Employees and Performance Management, which take into account both performance and compliance with the values ​​of Sberbank.

variable part wages depends directly on this value. Sberbank specialists receive feedback from managers (especially in cases of discrepancy between self-assessment and final assessment). Managers once a year pass personnel commissions aimed at identifying areas for development. Top management of Sberbank discusses personal results as part of a performance dialogue, as a rule, at the end of each quarter.

The compensation and benefits system at Sberbank is based on fairness and transparency. The remuneration policy is based on an analysis of market demand and supply, which is carried out on a regular basis. Corporate benefits include voluntary health insurance and the corporate pension program of Sberbank.

material motivation

Sberbank takes care of its employees, including by offering them competitive wages and providing them with an extended social package. For this purpose, an annual study of the salaries of competitive companies is carried out, as a result of which a decision is made to increase the level of wages in those divisions where it turned out to be below the market level. In 2016, wage growth amounted to at least 8%, and in a number of regions - up to 12%. Overall, Sberbank's staffing costs increased by 11% year-on-year.

Social package

Voluntary medical insurance program (VMI)

The new VHI Program, in addition to the main programs of comprehensive medical care, offers a number of programs for disease prevention. Thus, "Targeted Screening" provides for preventive examinations to detect cardiovascular and oncological diseases and assess the risk of their development. This Program based on international standards screening and includes tests with a high index of evidence-based recommendations. Option "Dentistry. Prevention” is aimed at prevention and hygienic oral health. The Drug Insurance program for the regions (except Moscow and St. Petersburg) enables employees to receive reimbursement for 80% of the cost of expensive drugs needed to prevent serious illnesses. Sberbank also takes care of the families and friends of its employees – a pilot project has been launched in Moscow and St. Petersburg, which allows employees to choose the “Family” option completely free of charge with co-payment (for spouses and children under 18) and the condition to compensate for only 20% of the cost of services received only when you go to the clinic. This initiative provides comprehensive medical protection for the employee's family and increases the efficiency of Sberbank's spending per insured person.

The VMI program of Sberbank covers all employees who have passed the probationary period.

In 2016, a project was launched to create an IT platform (ecosystem) for managing the health of Sberbank Group employees, which will represent a personal insurance account for VMI "My Health" (www.mzdorovie.com), where each employee can clarify the terms of his Insurance program and learn useful information about a healthy lifestyle.

Corporate pension program

Sberbank provides corporate pensions through NPF Sberbank. The volume of funding for the corporate Pension Program in 2016 increased by 35.3% and amounted to 3.6 billion rubles, while the number of participants increased to 167 thousand people.

Non-material motivation

Sberbank has a system of corporate awards and various practices for identifying the best employees. In 2016, more than 1.5 thousand employees received government and corporate awards, including for their contribution to the development of corporate culture. The best of them took part in significant corporate events as a reward, including those held as part of the celebration of the 175th anniversary of Sberbank.

VHI is a voluntary health insurance that is supplemented by the basic package of medical services established by the state. By purchasing such a policy for its employees, the employer qualitatively develops the corporate culture and VMI significantly improves the social package of the company and makes it more attractive to new employees.

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Currently, those organizations that value the health of their employees and are ready to support it in every possible way are popular. By using compulsory medical insurance policy the employer first of all increases its competitiveness and credibility. Skilled professionals increasingly began to choose exactly those companies that offer an additional improvement in working conditions, such as VHI.

The main advantages of such insurance

1. The efficiency of the enterprise directly depends on the well-being of its employees. The better it is, the more success the organization will have. The worker's ability to work is the most important factor, and VHI is better than all other ways to raise this figure.
2. Also, such insurance acts as an additional motivation for employees of the organization, because very often the cost of insurance or the package of services included in it depends either on the position of the employee or on his personal success. Therefore, many will begin to do their job better and better in order to receive the widest range of services.
3. The presence of VMI policies significantly increases the social package, offered by the organization, and reduces staff turnover, because a company that takes care of its employees deserves respect and you want to work in it without leaving.
4. Very often, employers who are unaware of the existence of VHI policies purchase vouchers for their employees to various sanatoriums or pay for diagnostic annual preventive examinations. Dealing directly with a medical organization. This method is much more expensive and inconvenient. The company has to negotiate with various institutions and pay for everything separately. In comparison, when a VHI policy is purchased, the employer cooperates only with the insurance company, which takes care of all the coordination work. Also a nice bonus will be the presence of all kinds of discounts for corporate clients.
5. The VHI program includes a wide range of services, starting with dental treatment and ending with trips to various sanatoriums and rehabilitation centers.
6. The sum insured is to be included in the list of general labor costs and is not less than 6 percent.
7. Employer paid insurance premiums are not subject to tax, from this we can conclude that in this way the company acquires a separate benefit for itself.
8. All payments made by the insurance company and paid services will not subsequently be deducted from the total salary of the employee, as was the case when applying, for example, for ordinary vouchers to a sanatorium.
9. Also insurance payments not subject to taxation, that is, they will not be deducted income tax at a rate of 13 percent.
10. And the last advantage will be an increase in the prestige of the organization and its popularity among potential, qualified specialists.

But there are also disadvantages of this type of insurance:

1. Acquisition of VMI policies is quite an expensive item in the expenses of the organization and not every employer can afford such insurance for their employees.
2. There are cases when the insurance company tries to deceive the insured by overstating the cost of the services of a medical institution, and in this case it is much more profitable to conclude a direct contract.
3. There may also be disagreements in the issue of price-quality for the services provided.

Benefits for employees when applying for a VHI policy

An employer, taking out such insurance, can independently choose clinics and medical personnel who will serve his employees. The insurance company also offers various service packages, and the company independently chooses certain types of medical care that will be included in the VHI policy.

The list of services offered for inclusion in the policy includes:

1. Outpatient care, that is, an employee may not turn to a local doctor or a specialist from a district clinic, but to the doctor who is declared in the VHI policy. And to be honest, such medical care is often of better quality.
2. Departure of doctors at home at any time of the day.
3. Treatment in dental clinics.
4. Various rehabilitation programs and vouchers to sanatoriums on the territory of resort cities of the Russian Federation.
5. Assistance in the preparation of medical documentation, it includes various certificates and permits.
6. Immunoprophylaxis, that is, the employee will have the right under the VHI policy to produce a set of vaccinations against various diseases.

When applying for VHI, each employee is guaranteed to receive high-quality medical care and an individual approach from doctors. It is also possible to additionally challenge the quality of the services provided and, if you are right, you can receive insurance compensation.

Among other things, when applying for a VHI policy, a citizen gets the opportunity to use medical care without a queue, with the departure of a specialist at home or at the workplace.

Medical insurance for relatives of an employee

In order to improve the efficiency of the team, many companies also offer to issue a VHI policy for close relatives of the employee, most often spouses or children are included in this list. The advantage of such insurance is that an employee who has to think less about the health of his family works much better and more efficiently.

Also, employers use such a service as additional motivation, and issue a VMI policy for relatives as a reward for excellent success or for increasing the competitiveness of the organization. Knowing that labor and good work will be additionally paid, employees begin to perform their tasks better. official duties.

How to apply for a VHI policy

As soon as the employer decides to purchase VHI policies for their employees, flurry of activity to implement this idea:

1. First, you need to decide on the insurance company, which will be the insurer in this case. Now, many large companies are engaged in issuing VHI policies for employees of organizations, so it will be very difficult to choose.
2. After the employer decides on the choice of the insurer, it is necessary to contact him with a written application for the conclusion of an agreement under which a third party will become.
3. The Tax Code allows the purchase of VHI policies to be included in the expenditure item of the company's budget, but certain conditions must be met for this:
4. The employment contract concluded with the employee must provide for the availability of such insurance.
5. The transfer limit is 6 percent of the amount spent on wages. This indicator is considered by adding up the wages of all employees of the organization, and even those who are not covered by VHI insurance.
6. The insurance contract must be concluded for at least one year.

When concluding a contract, it should be remembered that the employee of the organization for which it is purchased will be the beneficiary, and the employer himself will be the insured. The law also provides for two options for paying the insurance premium, this is a lump sum payment or payment in installments. The transfer of expenses for the purchase of insurance to the budget of the organization also depends on this item.

Terms of an agreement

As mentioned above, the conclusion of a collective agreement on VHI, subject to all the necessary conditions, can lead to preferential taxation, but for this information about it must be included not only in the insurance agreement, but also in the employment contract concluded with an individual employee.

Also tax authority will necessarily check the coincidence of the number of insured persons and employees with whom such employment contracts, therefore it is very important that there is no confusion in this area. If a company buys additional VHI policies for relatives of employees, it should be borne in mind that in this case the tax base for these types of profits will not decrease.

The following information must be included in the insurance contract concluded between the insurer and the policyholder:

1. Data on the persons who are parties to the contract, that is, full information about the insurance company, the organization - the insured and the beneficiary, which will be an individual employee, should be included.
2. The subject of insurance, in the form of specific services that will be included in the paid VHI program. Such a package is formed directly by the insured.
3. Rights and obligations of each of the parties.
4. Responsibility that will be for each of the parties, in case of non-compliance with the terms of the contract.
5. Contract time.
6. The sum insured and the paid insurance premium.
7. The procedure for paying insurance premiums can be in installments or in the form of a lump sum payment.
8. The procedure and conditions for payment of compensation to the beneficiary under this policy.

Where can I get

At the moment, many Insurance companies engaged in the sale of VHI policies for corporate clients, so choosing an insurer can take a lot of time and effort. But the leaders in this industry are deservedly considered Sberbank and it is these companies that offer the most profitable terms and have a good reputation.

1. VTB Insurance

The main advantages of this organization include:

1. The presence of various network programs that allow the employer to choose the nearest medical institutions, as well as receive complete list information for each of them.
2. The presence of a round-the-clock hotline, which can be called by any insured citizen and get a free consultation on using the company's services.
3. VTB Insurance offers treatment and diagnostics in expensive and highly qualified clinics and rehabilitation centers.
4. It is also possible to insure relatives of insured persons at the same corporate rates.
5. VTB Insurance guarantees the correct conclusion of the insurance contract so that the insured does not have any problems with obtaining tax benefits in the future.
6. The cost of an annual VHI policy directly depends on the number of insured persons, the list of services provided and medical institutions. There is a system of discounts for in large numbers insured persons.
7. Also, the employer will always be able to arrange insurance for an employee traveling on a business trip.

2. Sberbank Insurance

The company is one of the three leaders in the life insurance market, among companies operating in the territory of the Russian Federation, and is a guarantor of the quality of services provided. When choosing a company, many employers prefer reliable insurers that have good payout statistics and an impeccable reputation. One of these insurance companies is Sberbank Insurance, the number of insured persons under collective agreements in this company exceeds 2.5 million.

Sberbank Insurance is distinguished by its high technological effectiveness in concluding contracts and paying for them. There are special online services, thanks to which you can get insurance without leaving your home. The company also has a 24-hour hotline, upon contacting which you can get all the information of interest.

The cost of health insurance for employees.

The cost of a VHI policy mostly depends on the company's tariff, but there are maximum and minimum values ​​regarding the number of services provided:

1. Outpatient care and home visits- from 10 to 200 thousand rubles.
2. Outpatient treatment, home visits and dental care- from 15 to 220 thousand rubles.
3. Outpatient treatment, home visits, dental care, inpatient treatment- from 20 to 270 thousand rubles.
4. Outpatient treatment, doctor's home visits, dental care, inpatient care of any type, that is, both emergency and planned - from 30 to 310 thousand rubles.

Also on cost insurance policy will be influenced by the number of insured persons and the number of medical institutions chosen to serve.