Widya Presisi Solusi

At the end of 2014 National Health Insurance (NHI) became hot topic for companies in Indonesia. Under Presidential Regulation No 111/2013, the companies require to register their employees as participants of BPJS Kesehatan before 1 January 2015. BPJS Kesehatan (Badan Penyelenggara Jaminan Sosial) is a legal entity established to implement National health insurance. At that time both APINDO (Indonesia Employers Association) and Indonesia Labor Forces were disagree with the deadline. They saw some main issues as follows
1. National Health Insurance requires patients to go to First Level Health Care providers which mainly are local health centers that provide very minimal health care service. Then the first level local health care is the one which may refer patients to hospital if local health care cannot handle the patients' case. While most companies provide better health care benefits under non BPJS, so that the employee can go directly to the hospital or appointed credible doctor/clinic. The requirement to go to First Level Health Care providers will be time consuming for employees and may disturb the productivity of employees.
2. The coordination of benefit between current insurance companies and BPJS have some hurdles to be implemented. Without proper coordination, the company pay extra money without getting any benefit under this regulation.
At last on 22 December 2014 both APINDO and BPJS Kesehatan agreed to make Memorandum of Understanding which consists of below points.
1. APINDO commits to support companies to register their employees and their family to become participant of BPJS Kesehatan, before 1 January 2015.
2. Both parties agree that the activation process can be finalized at the latest 30 June 2015 which means the companies which have not activated the virtual account yet can delay the insurance premium payment up to 30 June 2015.
3. BPJS Kesehatan with APINDO will coordinate the readiness of First level Health care service by add more clinics and doctors . work with insurane companies to have better Coordination of benefit mechanism and improve the service level for the benefit of the participant.
4. Sanction based on Government Regulation No 86 2014 is not applicable for the company that has registered.
This MOU has reduced the confusion and worried of many companies. They expect more the first level Health Care providers, Hospitals will join or provide service to BPJS' participants and the coordination of benefit among insurance and BPJS Kesehatan will be well implemented.
As a payroll outsourcing company, I got some questions from my clients which just established business in Indonesia. Is National Health Insurance is an optional ? The answer is NO. It is compulsory.
National Health Insurance is based on Law no 40/2004. It requires that every Indonesian citizen and residents who stay more than 6 months should be registered in National Health Insurance. Law no 24/2011 appoints BPJS Kesehatan as a body to manage the health care in Indonesia. The principle of this National Health Insurance is to share the burden among people whether healthy and unhealthy regardless the status of citizen (rich or poor), so that the contribution of the companies to pay the premium of this program is important for the National Health Insurance.
As stated before Government Regulation no 86 2013 has stated the sanction of not registering the employees for the companies is administrative sanctions as follows.
1. Warning letter
2. Fine 2% from premium after unpaid for 3 month
3. Not obtaining certain public service
Most companies and people concern about not obtaining certain public service, because it may affect to their business license renewal.