The Federal Compulsory Medical Insurance Fund (hereinafter FFOMS or the Fund) is a state fund created to finance medical services for the population of the Russian Federation. The fund is extrabudgetary, that is, money for financing is allocated not from the state budget, but from funds received from insurers (citizens and legal entities). FFOMS is a non-profit legal entity, financial and credit organization, has an independent balance sheet and its own property.
Decoding FFOMS
Consider each word from the name. What does it mean and why is it chosen?
- Federal. The fund is centralized at the federal level, has its territorial branches in each subject of the Russian Federation, and the foundations of its activities are governed by federal laws.
- Fund. This is a non-profit organization with its own budget, intended for a specific social and social goal - to provide high-quality free medical care for the population.
- Mandatory. This term means that all citizens of the Russian Federation must be insured without fail. According to the Constitution of the Russian Federation, every citizen has the right to receive free medical care from the state, and in order to organize it correctly, everyone must make insurance contributions (independently or through an employer) to the Fund, from which they will then be spent.
- Medical. The main goal of the Fund is medical care, that is, providing assistance to people who have health problems.
- Insurance. This is a special type of economic relations in the state, in which certain insurance premiums are deducted by citizens , accumulated in one place, and, if necessary, given back to citizens in the form of an insurance amount or insurance service.
Thus, decoding the FFOMS is not difficult - it is enough to have a general understanding of the terms that are used in the Russian Federation to denote important organizations.
State regulation
The activities of the Fund are regulated by the legislation of the Russian Federation at the federal and regional levels. The main documents on the basis of which the main body and its territorial branches act are:
- Constitution of the Russian Federation.
- Federal Law of November 29, 2010, “On Compulsory Health Insurance in the Russian Federation”.
- Foundation Charter.
- Decisions of the Armed Forces "On the procedure for financing mandatory medical insurance of citizens" for each year.
- Budget Code of the Russian Federation.
- Other legislative acts of the Russian Federation.
Fund Functions
The main functions of the FFOMS are those tasks that it performs to achieve the main goal of its creation - to ensure financing of medical care for citizens. They are enshrined in paragraph 8 of Ch. 6 of the Insurance Act and state that the FFOMS:
- Participates in the development of the main program for ensuring free medical services.
- Accumulates and manages financial resources to support the program.
- Levels the conditions for securing financing for territorial bodies.
- It controls the activities of territorial bodies and their intended use of financial resources within the framework of the program.
- Monitors compliance by insurance entities with the terms of use of funds within the program and their mandatory contributions.
- It has the right to charge and recover from the insurers (individuals and legal entities) arrears, fines and penalties that are used to provide medical services to unemployed persons.
- It maintains its own reporting, sets its forms, determines the accounting procedure, issues regulatory legal acts, forms of documents and issues the necessary instructions within its authority.
- It maintains unified registers of organizations providing medical services and medical insurance, registers of quality experts and insured citizens.
- Carries out other functions within its authority.
MHI policy
The main document issued by the Compulsory Medical Insurance Fund and under which a citizen of the Russian Federation has the right to receive free qualified medical care is a policy.
The policy can be obtained from the territorial bodies of the FFOMS or from commercial organizations to which the Fund has delegated its authority to issue policies (health insurance companies).
To apply to the territorial body of the MHIF (or to those organizations to which the necessary insurance authority has been transferred), only a passport is required; when applying for a policy for a child, a birth certificate must also be provided. After receiving the application, employees issue a temporary certificate (for a period of 1 month), which allows you to use all the services of the policy until it is actually received.
What is the fund budget
In order to understand what the budget of the fund is made up of, it is necessary to remember what abbreviation the decoding is. FFOMS receives money from the so-called social contributions, which are paid to the Pension Fund and make up 22% for 2014 (from the annual amount of salary within 624 thousand rubles). The FFOMS tax is 5.1% of this amount. If the annual income exceeds 624 thousand rubles, then the contribution from subsequent amounts to the Pension Fund is 10%, and only 3.7% is deducted to the FFOMS.
In addition, there are certain categories of organizations for which reduced premium rates are set.
The tax is paid to the Pension Fund on a quarterly or monthly basis, depending on the form of organization and tax system (UTII or simplified).
Conclusion
Thus, the decryption of the FFOMS is quite accessible and understandable to all citizens of Russia, because we all seek medical services under the MHI policy and pay taxes to replenish the Fund’s budget.