Friday, 23 May 2014
SOCIAL INSURANCE
a. Definition and legal basis of the Social Insurance
Social insurance , or generally called Social Security ( national social security system ) is : " insurance program shall be organized by a law , with the aim to provide basic protection for the welfare of the community . Insurance is a social insurance program shall be held by a of Law , with the aim to provide basic protection for the welfare of society . "
Social insurance programs can only be held by the State-Owned Enterprises ( Law no. 2 yr 1992) .
Basic Law :
• Passenger Accident Insurance : Law no . 33 and 34 yr 1964
• Social Security : Law no . 3 yrs in 1992
• Insurance and Old Age Security Death PNS / Armed Forces : Law no . 11 yrs know about Spending Retirement 1956 , Law no . 11/1969 Employee Pension and Retirement know about Widow / Widower Employees
• Health Insurance : Presidential Decree 230/1968 KES to know about Maintenance & Peg State Pension Recipients civil + military and their family members
• Legal Basis Askes à Candy Kes no. 1/1968 à forming Kes Maintenance Fund Administering Agency ( BPDPK )
• Regulation no . 22/1984 à Maintenance Kes for civil servants , Pension Recipients ( civil , military and state officials ) and their family members
b . Principles of Social Insurance
1 ) Compulsion ( Mandatory )
2 ) Set the Level of Benefit ( Benefits are equal / same )
3 ) Floor of Protection ( Protection of fundamental )
4 ) Subsidy ( Subsidy )
5 ) unpredictability of Loss ( Losses are hard to predict ) \
6 ) Conditional Benefits ( Benefit conditional )
7 ) Required Contribution ( There should be a contribution )
8 ) Attachment to Labor Force ( Related to Labor )
9 ) Minimum Advance Funding ( Minimum in the sinking fund )
c . Types of Social Insurance
1 ) Social Insurance Labor
• For Public Servants
• Maintained by PT Savings and Insurance Servants
2 ) For Employees of Private Companies
• Managed by PT Workers' Social Security Insurance ( Social Security)
• To Members ABRI / TNI
• Managed by the Armed Forces Social Insurance Public Corporation
In social security , there are several programs , where risks exist , handled each program , the program includes:
Health Insurance Program ( JPK )
JPK provide protection for workers against the risk of developing health problems or illnesses that result in disruption of the ability of labor productivity . JPK benefits such as health care for the treatment acts promotive and curative . Follow- guaranteed treatment includes outpatient , inpatient , maternity and immunization / vaccination . JPK programs implemented in the form of three models , namely the Social Security program organized by PT.Jamsostek , a program organized by the Health Insurance Insurance agency designated by the employer , as well as Independent JPK programs organized directly by the employer is self-managed .
Accident Insurance Program ( JKK )
JKK program provides protection for workers against the risk of workplace accidents and suffering from various diseases arising from the employment relationship . JKK benefits in the form of comprehensive health services and medical rehabilitation in respect of accidents suffered by workers . In addition to medical services , labor santuan not be able to get to work during a period of treatment and recovery . JKK financing programs through payment of dues to the party organizers are borne by the employer .
Form of accident insurance, namely : 4
Maximum Transport costs : land ( USD 150,000.00 ) , sea ( USD 300,000.00 ) , air (USD 400,000.00 ) . The cost of transport can be used to transport ambulatory .
Replacement wages while unable to work : 120 the second day ( 75 % of wages ) and then 50 % of wages .
The cost of medical care : a maximum of Rp 6,400,000.00
Compensation for permanent partial disability : the percentage of defect types dikaliakn 70 months wages
Compensation for permanent total disability : a lump sum payment ( 70 % x 70 months wages ) , periodic payments ( USD 50.0000 x 24 months ) , less function : % x % less function table x 70 months wages
Compensation death : a lump sum payment ( 70 % x 70 months wages ) , periodic payments ( USD 50.0000 x 24 months ) , funeral costs ( Rp 600.000,00 )
The cost of rehabilitation
4 Sutedi 2009 , Labour Law , Jakarta : Sinar Graphic
Death Assurance Program ( JK )
JK program provides protection for workers against the risk of death due to illness or accidents. Benefits JK satunan form of altogether to the family or heirs upon death workforce . Awarding death benefits aimed at helping the family financially meringankanbeban or heirs of the deceased. JK program funding through the payment of dues to the party organizers are borne by the employer
Old Age Security Program ( JHT )
JHT program provides protection for workers at the time of entering full- bhakti . Benefits JHT form of provision of funds in the form of a lump sum payment in cash to employees or family and heirs . JHT program funding through the payment of dues to the organizers which is shared by workers and employers .
Assurance Retirement (Pension Plan )
Pension Plan guarantees the continuity of payment for labor income at the time of retirement . Pension plan benefits in the form of periodic pension payments kepadatenaga work or family and heirs at the time of entering the labor retirement age . Pension plan funding through the payment of dues to the organizers which is shared by workers and employers . Organizers pension plan can be done through two agencies, the Financial Institution Pension Fund ( Pension Fund) which is registered in the Ministry of Finance and Employer Pension Fund ( EPF ) which is a pension fund management institutions established by the employer . Type pension plans consist of defined contribution pension plan ( PPIP ) and the Defined Benefit Pension Plan ( PPMP ) .
Outside Employment Accident Insurance ( Insurance AKDHK )
AKDHK insurance is a guarantee that gives protectors for workers injured at work at a time outside the employment relationship . This program complements the program JKK organized labor PT.Jamsostek which ensures that an accident at the time of employment. Insurance AKDHK defined by Regulation 7 of 1989 and the Jakarta Governor Decree No.2 of 1990 and was appointed as the organizer of PT . Caravan Insurance Young Son ( Bumida ) . In order to comply with the normative field of employment , the employer shall include in the insurance AKDHK labor .
3 ) Health Insurance : Health Insurance managed by PT ( first PHB )
Health insurance is a type of insurance product that specifically guarantees the cost of health insurance or the members of the care if they fall ill or have an accident . Broadly speaking there are two types of treatments offered by insurance companies , namely hospitalization ( in- patient treatment) and outpatient care ( out - patient treatment) . Health insurance products held either by the social insurance companies , life insurance companies , and insurance companies are also common .
There are two types of Health Insurance :
1 . Hospital Cash Plan
2 . Hospital Benefit
Apart from the use of the words but more importantly it means , namely :
does not require the original receipt , it can be legalized copy hospitals typically are replaced only the cost of the room per day , either for a regular room or ICU . There is also a replacement for a specified number of operations . replacement cost does not depend on the receipt but of hospitalization per day or per occurrence policy taken in accordance operation , replacement of a reimbursement system , so customers pay first and then claim to the insurance company premiums are relatively cheaper because the replacement value too small
original receipt is required . If you have 2 health insurance that requires the original receipt , the procedure is : first determine your claim was first directed to the insurance companies which , if then the value of the claim is not sufficient to pay the hospital then you can ask for the original receipt to claim the remaining payments to insurance companies second . Likewise, if you have 3 or more health insurance
replaced cost includes room , general practitioners , specialist doctors , medical supplies , operating costs ( if any ) , all receipts paid in accordance with the appropriate maximum limit that we take in policy
system of claim is usually directly in the hospital , do not need to be reimbursed . For example , your hospital bill while the ceiling of 10m Rp Rp 8jt total insurance , then you will immediately pay the remaining USD 2jt in the hospital . This could happen only in a hospital partner of insurance companies that you take .
higher premiums . In addition, there are insurance premiums which gives us 100 % money back if no claim sick , it could be categorized as hospital cash plan .
Benefits of Health Insurance :
Compensation hospitalization due to illness or accident .
Compensation surgery due to illness or accident .
Medical Second Opinion Consultation Services .
Does not require a health check at registration .
4 ) Personal Accident Insurance : Managed by PT Insurance Prog
Is an insured where the insurer is PT JASA RAHARJA and the insured person is above PASSENGER PASSENGER and HIGHWAY ACCIDENT , the insured pays a premium to the insurer as a counter- achievement . PT . Prog ( Persero ) is a State Owned Enterprise ( SOE ) are engaged in the area of insurance , under the Ministry of Finance pembinaanya duties and responsibilities is to accumulate funds through dues and donations shall henceforth be channeled back through raharja services compensation to the victim or the heirs of accident victims traffic on the highway . Insurance premium passengers through the transport entrepreneurs held together by a passenger ticket if termination of the insurance bill is not filed within six (6 ) months after the accident
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