BI:

Anh A k hp ng lao ng lm cng nhn khai thc than vi cng ty than CP t

thng 2/1999. Thng 10/2015, A b pht hin mc bnh ngh nghip phi iu tr 2
thng. Sau khi ra vin, A c kt lun suy gim kh nng lao ng 61%.
Thng 1/2016, do 52 tui v sc khe yu nn anh A lm n xin ngh hng
ch hu tr. Trong thi gian ngh ch gii quyt ch , A b m phi vo bnh
vin iu tr 30 ngy v cht. c bit A cn mt con nh ( 14 tui ) ang i hc
THCS v 1 con b d tt suy gim kh nng lao ng 84%, m v anh 70 tui l v
lit s, sng cng gia nh anh, v anh ang lm vic mt c quan nh nc.
Hy xc nh cc ch an sinh x hi i vi anh A v gia nh ca anh trong
tnh hung trn.
BI LM:
Cc ch an sinh x hi i vi anh A v gia nh ca anh trong tnh hung trn
c xc nh nh sau:
A. BO HIM X HI
1. Ch bnh ngh nghip:
- C s xc nh quyn li hng ch bnh ngh nghip ca anh A:
Th nht: Theo bi th anh A tham gia Bo him x hi t thng 2/1999 n
thng 10/1015, nh vy anh A c 16 nm , 8 thng ng BHXH bt buc. Theo
iu 42 v iu 2 Lut bo him x hi 2014 th anh A thuc i tng p dng
ch bnh ngh nghip.
Th hai: Anh A c iu kin hng ch bnh ngh nghip theo iu 44
Lut bo him x hi 2014:
iu 44. iu kin hng ch bnh ngh nghip:
Ngi lao ng c hng ch bnh ngh nghip khi c cc iu kin sau
y:
1. B bnh thuc danh mc bnh ngh nghip do B Y t v B Lao ng - Thng
binh v X hi ban hnh khi lm vic trong mi trng hoc ngh c yu t c
hi;

2. Suy gim kh nng lao ng t 5% tr ln do b bnh quy nh ti khon 1 iu

ny.
Trong bi c nu, thng 10/2015 anh A b pht hin mc bnh ngh nghip nn
ta mc nhin coi rng bnh m anh A mc phi thuc danh mc bnh ngh nghip
do B y t v B Lao ng Thng binh v X hi ban hnh. Hn na, mc suy
gim kh nng lao ng do bnh ngh nghip ca anh A c xc nh l 61%
m bo iu kin suy gim kh nng lao ng t 5% tr ln. Nh vy, anh A
c iu kin hng ch bnh ngh nghip
- Ch vi ngi b bnh ngh nghip:
Theo Lut bo him x hi 2014 th ch i vi ngi lao ng b bnh ngh
nghip bao gm: c gim nh kh nng lao ng; hng tr cp hng thng
hoc tr cp mt ln; tr cp phng tin, tr gip sinh hot, dng c chnh hnh;
tr cp phc v nu nh t l suy gim kh nng lao ng t 81% tr ln; ch
dng sc, phc hi sc khe sau iu tr v tr cp mt ln khi cht do tai nn lao
ng, bnh ngh nghip.
p dng vi trng hp trn ta thy ng A s ch c hng khon tr cp hng
thng v c gim li kh nng lao ng nu c yu cu.
- V thi gian hng:
Do b suy gim 61% kh nng lao ng v vy anh A s c hng tr cp hng
thng p dng i vi ngi lao ng b suy gim kh nng lao ng t 31% tr
ln do bnh ngh nghip (theo Khon 1 iu 47 Lut bo him x hi 2014). Thi
im c hng tr cp tnh t thng anh A iu tr xong v ra vin. Theo bi,
anh A b xc nh mc bnh ngh nghip t thng 10/2015, thi gian iu tr l 2
thng nn anh A s c hng ch bnh ngh nghip t thng 12/2015 n khi
cht.
- Mc tr cp:
Mc tr cp anh A c hng gm 2 khon sau:
Th nht: Tnh theo mc suy gim kh nng lao ng th suy gim 31% kh
nng lao ng th c hng bng 30% mc lng c s, sau c suy gim
thm 1% th c hng thm 2% mc lng c s. Mc suy gim kh nng lao

ng ca anh A l 61%, p dng cch tnh trn th mi thng anh A s c hng

30% + 2% * (61% - 31%) = 90% mc lng c s. Cn c vo Ngh nh
66/2013/N-CP quy nh mc lng c s i vi cn b, cng chc, vin chc
v lc lng v trang th mc lng c s ti thng 1/2016 l 1.150.000
ng/thng, nh vy anh A s nhn c tr cp bnh ngh nghip tnh theo mc
suy gim kh nng lao ng l 1.150.000 *90% =1.035.000 ng /thng.
Th hai, theo thm nin ng bo him x hi th nu ng bo him t mt nm
tr xung c tnh bng 0,5%, sau c thm mi nm ng bo him x hi
c tnh thm 0,3% mc tin lng ng bo him x hi ca thng lin k trc
khi ngh vic iu tr. Anh A ngh vic iu tr t thng 10/2015 v tnh n
lc A ng bo him x hi c 16 nm 8 thng nn mi thng anh A cn
nhn c thm khon tin tr cp l 0,5% + 0,3% * 15 = 5% mc tin lng ng
bo him x hi ca thng 9/2015.
Nh vy, s tin tr cp hng thng m anh A nhn c s l:
1.035.000 ng + 5% mc tin lng ng bo him x hi ca thng 9/2015
ca anh A.
2. Ch hu tr
Ch hu tr ca anh A:
Theo nh bi th anh A k hp ng lao ng lm cng nhn khai thc than vi
cng ty than CP t thng 2/1999 n thng 1/2016 do 52 tui v c xc nh
b suy gim kh nng lao ng 61% nn anh A lm n xin ngh hng ch hu
tr. Tc l anh A c 16 nm ng bo him x hi tng ng l 16 nm lm
cng vic khai thc than.
im c khon 1 iu 54 Lut Bo him x hi nm 2014 quy nh v iu kin
hng lng hu c ni dung nh sau: Ngi lao ng t 50 tui n 55
tui v c 20 nm ng bo him x hi tr ln m trong c 15 nm lm
cng vic khai thc than trong hm l. V im a khon 1 iu 60 Lut Bo him
x hi nm 2014 c quy nh: Ngi lao ng quy nh ti khon 1 iu 2 ca
Lut ny m c yu cu th c hng bo him x hi mt ln nu thuc mt
trong cc trng hp sau y:
a)
tui hng lng hu theo quy nh ti cc khon 1, 2 v 4 iu 54 ca
Lut ny m cha 20 nm ng bo him x hi hoc theo quy nh ti khon 3

iu 54 ca Lut ny m cha 15 nm ng bo him x hi v khng tip tc

tham gia bo him x hi t nguyn.
Theo cc quy nh nu trn th i vi trng hp ca anh A, anh tui hng
lng hu nhng cha 20 nm ng bo him x hi nn khi anh np n xin
ngh hng ch hu tr, anh s c hng ch bo him x hi mt ln.
Tuy nhin, trong thi gian ngh ch gii quyt ch hu tr, A b m v cht, do
, A s khng c hng ch bo him x hi mt ln na.
3. Ch m au
-iu kin hng:
Th nht, cn c theo quy nh ti iu 24 Lut bo him x hi nm 2014 v
im a khon 1 iu 2 Lut bo him x hi 2014: Ngi lm vic theo hp ng
lao ng khng xc nh thi hn, hp ng lao ng xc nh thi hn,. V
theo nh bi c nu r anh A k hp ng lao ng lm cng nhn khai thc
than ca cng ty than CP t thng 2/1999 ng ngha vi vic anh thuc i tng
phi ng bo him x hi bt buc bt u t thng 2/1999. Do , theo Lut bo
him x hi th anh A thuc i tng c th s c hng cc ch m au.
Th hai, iu 25 Lut bo him x hi 2014 quy nh ngi lao ng tham gia bo
him x hi bt buc c hng ch m au khi: b m au, tai nn m khng
phi l tai nn lao ng phi ngh vic v c xc nhn ca c s khm bnh, cha
bnh c thm quyn theo quy nh ca B Y t, tr trng hp b m au, tai nn
do t hy hoi sc khe, do say ru hoc s dng cht ma ty, tin cht ma ty.
Trong tnh hung trn th, vo thng 1/2016, do 52 tui v sc khe yu nn anh
A lm n xin ngh hng ch hu tr, trong thi gian ngh ch gii quyt ch
, A b m phi vo bnh vin iu tr 30 ngy v cht. Do vo vin iu tr 30
ngy c th khng nh rng anh A c giy xc nhn ca c s khm bnh, cha
bnh c thm quyn. V vy, anh A iu kin c hng ch bo him
m au.
-Thi gian hng tr cp m au.
Thi gian ngh m au c quy nh c th ti iu 26 Lut bo him x hi nm
2014 nh sau:

1. Thi gian ti a hng ch m au trong mt nm i vi ngi lao ng

quy nh ti cc im a, b, c, d v h khon 1 iu 2 ca Lut ny tnh theo ngy
lm vic khng k ngy ngh l, ngh Tt, ngy ngh hng tun v c quy nh
nh sau:
a) Lm vic trong iu kin bnh thng th c hng 30 ngy nu ng bo
him x hi di 15 nm; 40 ngy nu ng t 15 nm n di 30 nm; 60
ngy nu ng t 30 nm tr ln;
b) Lm ngh hoc cng vic nng nhc, c hi, nguy him hoc c bit nng
nhc, c hi, nguy him thuc danh mc do B Lao ng - Thng binh v X
hi, B Y t ban hnh hoc lm vic ni c ph cp khu vc h s t 0,7 tr ln
th c hng 40 ngy nu ng bo him x hi di 15 nm; 50 ngy nu
ng t 15 nm n di 30 nm; 70 ngy nu ng t 30 nm tr
ln.
Nh ni trn, anh A tham gia bo him x hi t thng 2/1999, v n thng
1/2016 th anh xin ngh hng ch hu tr, nh vy, anh A tham gia bo him
x hi bt buc c 16 nm 11 thng. Hn na, anh A l cng nhn khai thc
than, thuc i tng cng vic nng nhc, c hi, nguy him theo quyt nh
1435/LTBXH-Q ngy 13/10/1995 v quyt nh 915 LTBXH-Q ngy
30/7/1996; cho nn anh A c ngh hng ch m au l 50 ngy lm vic
trong 1 nm. Trong trng hp ny anh A ngh khm cha bnh l 30 ngy th anh
A vn c hng tr cp m au.
-Mc hng.
Tng ng cho trng hp c nu trn th anh A c hng ch m au
theo khon 1 iu 28 Lut bo him nm 2014 l c hng 75% mc tin lng
ng bo him x hi ca thng lin k trc khi ngh vic.
4. Ch t tut
Th nht, theo bi nu anh A tham gia ng Bo him x hi t thng
2/1999 n thng 10/2015, nh vy anh A c 16 nm, 8 thng ng BHXH bt
buc. Trong thi gian anh A ch gii quyt ch , anh vo vin iu tr 30 ngy
do b bnh ngh nghip v cht trong qu trnh iu tr. V vy theo im b khon 1
iu 66 lut bo him x hi 2014 th ngi lo mai tng cho anh A c nhn mt
ln tr cp mai tng vi mc hng l bng 10 thng lng c s ti thng m anh

A cht (thng 1/2016). Cn c vo ngh nh 66/2013/N-CP quy nh mc lng

c s i vi cn b, cng chc, vin chc v lc lng v trang, th mc lng c
s ti thng 1/2016 l 1.150.000 ng/thng, nh vy h s nhn c tr cp mai
tng cho anh A l 11.500.000ng.
Th hai, ngoi ra v anh A ng BHXH 15 nm tr ln (c th l 16
nm) v cha hng BHXH mt ln nn thn nhn anh A cn c hng ch
tut. i tng c hng ch tut hng thng da theo khon 2 iu 67 lut
bo him x hi 2014.
Nh vy xc nh nh sau: ta thy v anh A bi khng nu r bao nhiu
tui nhng hin ang lm vic ti mt c quan nh nc nn chc chn l ngi c
thu nhp, v khng thp hn mc lng c s nn v anh A s khng c hng
tr cp tut hng thng. Anh A cn mt con nh 14 tui ang i hc THCS v mt
con b d tt suy gim kh nng lao ng l 84% nn cn c vo im a khon 2
iu 67 th 2 con ca anh A s c hng tr cp tut hng thng. Hin ti m v
70 tui ang sng cng vi gia nh anh A nn theo lut hn nhn v gia nh, anh
A l ngi c ngha v nui dng m v. Tuy nhin php lut c quy nh hn
ch ch nu nh m ca v trong gia nh m ngi ang tham gia bo him
c ngha v nui dng ch c hng tr cp tut hng thng nu khi ngi ny
cht nu nh m v khng c thu nhp hoc c thu nhp hng thng nhng thp
hn mc lng c s, khon thu nhp ny khng bao gm khon tr cp theo quy
nh ca php lut v u i ngi c cng. M ca v anh A l v lit s nn
s nhn c khon tin t chnh sch u i i vi ngi c cng hng thng,
nu nh ngoi khon tin ny m m v anh A khng c khon thu nhp no khc
hoc nu c nhng thp hn mc lng c s th b vn c nhn tr cp tut
hng thng ca anh A.
Mc hng tr cp tut hng thng:
Mc hng tr cp tut hng thng i vi mi thn nhn bng 50% mc lng c
s; trng hp thn nhn khng c ngi trc tip nui dng th mc tr cp tut
hng thng bng 70%mc lng c s.Trong trng hp ny v anh A cht nhng
cn c v l ngi trc tip nui dng 2 con v m v nn thn nhn ca anh A
ch c hng ch tut hng thng vi mc 50 % mc lng c s , thi im
hng bt u t thng lin k sau thng anh A cht.

Ngoi ra thn nhn ca anh A nu c nguyn vng th con 14 tui v m v ca

anh A vn c th c hng tr cp tut mt ln (Khon 3 iu 69 lut BHXH
2014), c mi nm tnh bng 1,5 thng mc bnh qun tin lng ng BHXH cho
nhng nm ng BHXH trc 2014 v bng 2 thng mc bnh qun tin lng
thng ng BHXH cho cc nm t nm 2014 tr i.
B. CH BO HIM Y T
*i vi anh A:
Bo him y t l hnh thc bo him c p dng trong lnh vc chm sc sc
khe, khng v mc ch li nhun, do Nh nc t chc thc hin v cc i
tng c trch nhim tham gia (khon 1 iu 2 Lut bo him y t nm 2008 sa
i b sung nm 2014). Theo , im a khon 1 iu 12 Lut bo him y t nm
2008 (sa i b sung nm 2014) quy nh v i tng tham gia bo him y t
nh sau: Ngi lao ng lm vic theo hp ng lao ng khng xc nh thi
hn, hp ng lao ng c thi hn t 3 thng tr ln theo quy nh ca php
lut v lao ng. Nh vy, anh A thuc i tng c trch nhim tham gia bo
him y t.
-iu kin hng.
Anh A thuc i tng c trch nhim tham gia bo him y t, nhng anh ch c
cc quyn li lin quan n bo him y t khi tha mn iu kin:
Th nht, trch nhim ng bo him y t: Mc ng hng thng ca i
tng quy nh ti khon 1 v khon 2 iu 12 ca Lut ny ti a bng 6% mc
tin lng, tin cng thng ca ngi lao ng, trong ngi s dng lao ng
ng 2/3 v ngi lao ng ng 1/3 (im a khon 1 iu 13 Lut bo him y t
sa i b sung nm 2014). V im a khon 1 iu 2 Ngh nh s 105/2014/N
CP quy nh t 1/1/2015, mc ng bo him y t hng thng ca anh A l 4,5%
tin lng thng; v trong thi gian ngh vic hng ch m au t 14 ngy tr
ln trong thng theo quy nh ca php lut v bo him x hi th khng phi
ng bo him y t nhng vn c hng quyn li bo him y t.
Th hai, th bo him y t: sau khi ng bo him y t, ngi tham gia bo
him y t c cp th bo him y t. y l c s php l lm cn c ngi
tham gia bo him c hng cc quyn li v bo him y t.

-Mc hng.
V thuc i tng c hng ch bo him y t, nn cn c theo quy
nh ti iu 22 Lut bo him x hi nm 2008 (sa i b sung nm 2014) th
anh A c hng 80% chi ph khm bnh, cha bnh.
*i vi gia nh anh A
-Con nh ( 14 tui ) ang i hc THCS: con nh ca anh A s c nh nc
h tr mc ng bo him y t v c hng 80% chi ph khm bnh, cha
bnh theo quy nh.
-Con b d tt suy gim kh nng lao ng 84% : c Nh nc cp th bo
him y t v c hng 100 % chi ph khm bnh, cha bnh.
-M v anh 70 tui l v lit s, sng cng gia nh anh : c Nh nc mua
bo him y t v c hng 100 % chi ph khm bnh, cha bnh.
C. TR GIP X HI
- C s c hng:
Theo php lut hin hnh, ch tr gip x hi ch yu bao gm ch tr gip
thng xuyn v ch tr gip t xut, ngoi ra cn c cc quy nh thc hin
chng trnh xa i gim ngho, v cc quy nh nhm nng , to iu kin
cho nhng ngi lm l, khng may lm vo tnh cnh tr li cuc sng bnh
thng. Trong , khon 6 iu 5 Ngh nh 136/2013/N CP quy nh v i
tng c hng tr cp x hi thng xuyn c Tr em khuyt tt, ngi
khuyt tt thuc din hng tr cp x hi theo quy nh ca php lut v ngi
khuyt tt
Hn na, anh A c mt ngi con b d tt suy gim 84% kh nng lao ng, nn
cn c theo quy nh ti khon 3 iu 4 Ngh nh s 28/2012/N CP v xc
nh mc khuyt tt th ngi con ny ca anh A thuc trng hp ngi
khuyt tt c bit nng. V vy, ngi con b d tt ny ca anh A c hng ch
tr cp hng thng theo quy nh ca php lut (khon 1 iu 44 Lut ngi
khuyt tt nm 2010).
- V mc hng:
Mc hng tr cp x hi ca ngi con ny ph thuc vo hai yu t l h s v
mc chun tr cp, tr gip x hi. Trong :

im a, b khon 1 iu 16 Ngh nh s 12/2010/N CP quy nh:

a) H s hai (2,0) i vi ngi khuyt tt c bit nng;
b) H s hai phy nm (2,5) i vi ngi khuyt tt c bit nng l ngi cao
tui, ngi khuyt tt c bit nng l tr em
V iu 4 Ngh nh s 136/2013/N CP quy nh v mc chun tr cp, tr
gip x hi nh sau:
1. Mc chun tr cp, tr gip x hi (sau y gi chung l mc chun tr gip
x hi) l 270.000 ng.
2. Mc chun tr gip x hi l cn c xc nh mc tr cp x hi, mc tr cp
nui dng ti c s bo tr x hi, nh x hi, mc h tr kinh ph chm sc,
nui dng v cc mc tr gip x hi khc.
3. Cn c vo iu kin c th ca a phng, Ch tch y ban nhn dn tnh,
thnh ph trc thuc Trung ng (sau y gi chung l Ch tch y ban nhn dn
cp tnh) c quyt nh mc tr cp x hi, mc tr cp nui dng, mc h tr
kinh ph chm sc, nui dng v cc mc tr gip x hi khc cao hn cc mc
tng ng quy nh ti Ngh nh ny.
Vy, c hai trng hp xy ra:
Trng hp th nht, ngi con b d tt ca anh A l tr em (ngi di 16 tui
theo quy nh ti iu 1 Lut bo v, chm sc v gio dc tr em nm 2004) th
mc hng l 270.000 * 2,5 = 675.000 ng / thng.
Trng hp th hai, ngi con b d tt ca anh A t 16 tui tr ln th mc
hng bng 270.000 * 2 = 540.000 ng / thng.
Ngoi ra, theo quy nh ti chng II Ngh nh 136/2013/N CP, ngi con b
d tt ca anh A cn c hng cc ch khc lin quan n tr cp x hi
thng xuyn ti cng ng: c Nh nc cp th bo him y t; c tr gip
gio dc, o to v dy ngh; c h tr chi ph mai tang khi ngi ny cht, vi
mc h tr bng 20 ln mc chun tr gip x hi ( tc l bng 20 * 270.000 =
5.400.000 ng).
D. U I X HI

-C s c hng:
Theo bi th m v anh A 70 tui l v lit s . Theo quy nh khon 8 iu 1
Php lnh 04/2012/UBTVQH13 sa i, b sung mt s iu ca Php lnh 2005
v u i ngi c cng vi cch mng th m v anh A c hng cc ch u
i i vi thn nhn lit s nh sau:
+Tr cp tin tut mt ln khi bo t
+Tr cp tin tut hng thng theo cc mc thn nhn ca mt lit s i vi v
ca lit s.
+c Nh nc mua bo him y t; c u tin giao hoc thu t, mt nc,
mt nc bin, vay vn u i sn xut, min hoc gim thu theo quy nh ca
php lut; c h tr v nh theo quy nh.
-Mc tr cp s theo quy nh ti ngh nh s 20/2015/N-CP nh sau:
Mc tr cp u i hng thng : Tr cp tin tut i vi thn nhn ca 1 lit s :
1.318

DANH MC TI LIU THAM KHO

1. Lut bo him x hi 2014
2. Ngh nh 66/2013/N-CP
3. Quyt nh 1435/LTBXH-Q ngy 13/10/1995
4. Quyt nh 915 LTBXH-Q ngy 30/7/1996
5. Ngh nh s 105/2014/N CP
6. Ngh nh 136/2013/N CP
7. Ngh nh s 28/2012/N CP
8. Lut bo him y t nm 2008 (sa i b sung nm 2014)
9. Ngh nh s 12/2010/N CP
10.Php lnh u i ngi c cng vi cch mng s 26/2005/PLUBTVQH11 c sa i b sung theo php lnh s
04/2012/UBTVQH13.