KINGDOM OF CAMBODIA EII, SHI & PENSION SCHEME

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1 KINGDOM OF CAMBODIA EII, SHI & PENSION SCHEME Prepared by: National Social Security Fund (NSSF)

2 Outlines 1- EMPLOYMENT INJURY SCHEME 2- HEALTH CARE SCHEME 3- PENSION SCHEME

3 1.Employment Injury Scheme

4 EII Coverage Total staff: 457 (185 government officials) 24 branch offices 92 Public Hospitals and 01 Private Clinic 1 Call Center (Hot line 24h/day) Hotline: 1286

5

6 BENEFITS OF EII MEDICAL CARE CARE TAKER TEMPORARY DISABILITY PERMANENT DISABILITY (<20%) PERMANEN T DISABILITY ( 20%) FUNERAL GRANT (1,000$) SURVIVOR PENSION REHAB

7 Provider Network 92 Contracted Health Facilities 89 Public Health Facilities 03 Private Health Facilities

8 Law Enforcement

9 Challenges From Enterprise Side Incompleteness of workers data Poor cooperation with providing the number of the workers, wages and company s branches Late monthly worker declaration and contribution payment Inaccurate/late work injury report notification causing difficulty in investigating the root of work injury and providing benefits to the injured Late notification of benefit claim document resulted in lately providing compensation because the employers/owners of enterprises/establishments kept the documents until the end of the month or waited more documents before sending to NSSF. From Worker Side Incomplete understanding of the implementation of the Social Security Scheme, the Employment Injury Insurance No personal documents, using other documents (such as national identity cards, residential letter and family book or abnormal documents) which causing difficulty in registration and document verification on benefit provision No marriage certificate leading to not be eligible for the survivors benefit Utilization of medical services in non-recognized health facilities and unnecessary services Difficulty in demanding the non-work injury compensation of medical treatment and care from the workers

10 Challenges From Provider Side Quality of the medical treatment and care service provision is limited Service provision without the respect of the principles of the Ministry of Health, the medical principles, unnecessary medical services, cost exaggeration, and difficulty in claiming the medical documents Use of ambulance service for transportation of the worker charged in high cost

11 Solutions To disseminate and explain to the owners of enterprises/establishments, local trade unions and workers to understand the implementation of the policy of the Social Security Schemes especially the Employment Injury Insurance and Health Care which is launching in 2015 To place NSSF s agents to facilitate with the recognized health facilities in order to provide better services. To take administrative measures on enterprises/establishments which do not comply with the law To train the human resources, develop the information technology systems, improve the formality and working procedures, and develop the complaint system both in hardware and software To modify the Hot Line management system To set up the notifying system of qualified contribution payment period and contribution payment mechanism via smart phone (ACLEDA Unity) To develop the mechanism of demanding work injury report from enterprises/establishments and health facilities To inform enterprises/establishments and workers about the result of work injury investigation in order that they can apply for benefits as soon as possible To have the workers registered again To facilitate with recognized health facilities to provide better services and have meetings to deal with the challenges

12 Statistics Registration between 2013 and 2014 Number of Enterprises and Workers Paid Contribution in 2013 and 2014

13 Statistics Registered Workers and Work Injuries between 2013 and 2014 Claim of the Work Injury Benefit

14 Success Factors for EII performance

15 2. 2. HEALTH CARE SCHEME Drafted: Sub-decree on the Establishment of Health Care Scheme Prakas on benefit package Prakas on Contribution rate Prakas on Health Provider Payment Mechanism Prakas on Chronic Disease

16 SHI from pilot to national scheme October 2016 HIP pilot project under Gret NGO management Under MoU with MoLVT and GMAC HIP pilot scheme under NSSF management National Scheme OBJECTIVE Stabilize statistic and financial data in order to calculate the right premium rate for NSSF Develop tools and skills to be transferred to NSSF OBJECTIVE Get familiar with SHI management Build in-house capacity Platform to build on the National scheme NSSF will maintain HIP pilot until they start their mandatory National Social Health Insurance planned in early of 2016

17 Our way to National scheme Activities Status Comment Benefit Package Done Health care benefit (cashless system) and Compensation Benefit (Sick leave and Maternity leave) Payment Provider Mechanism(PPM) Done Case based (include 36 cases) Premium Calculation Done Calculation by ILO expert Identification of member via NSSF ID card Management and Information System Done Done Data collection started beginning of December 2014 HIP MIS has been upgraded and is under testing by NSSF team NSSF plan to launch the national scheme stepwise Early 2016 for 600 factories (around 360,000 workers) in Phnom Penh.

18 3. PENSION SCHEME PENSION SCHEME IS UNDER CONSTRUCTION

19 Future Plans Strengthening current scheme(eii) (SME, Construction, Study to improve contribution payment mechanism) Preparing to start SHI in 2016 Preparing to start pension scheme in 2017

20 Thank You for Your Attention

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