Act No. 149 / 1996 Coll.
Act amending and supplementing the Act of the Czech National Council No. 550 / 1991 Coll., on General Health Insurance, as amended, Act of the Czech National Council No. 592 / 1992 Coll., on Insurance for General Health Insurance, as amended, Act of the Czech National Council No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended, and Act of the Czech National Council No. 280 / 1992 Coll., on Resorts, Industry, Business and Other Health Insurance Companies, as amended
Valid
Law
Effective from 01.07.1996
Text versions:
01.07.1996
31.05.1996
149
THE LAW
of 25 April 1996
amending and supplementing the Act of the Czech National Council No. 550 / 1991 Coll., on General Health Insurance, as amended, Act of the Czech National Council No. 592 / 1992 Coll., on Insurance for General Health Insurance, as amended, Act of the Czech National Council No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended, and Act of the Czech National Council No. 280 / 1992 Coll., on Resorts, Business, and Other Health Insurance Companies, as amended
Parliament has decided on this law of the Czech Republic:
Act of the Czech National Council No. 550 / 1991 Coll., on General Health Insurance, as amended by Act of the Czech National Council No. 592 / 1992 Coll., Act of the Czech National Council No. 10 / 1993 Coll., Act of the Czech National Council No. 15 / 1993 Coll., Act No. 161 / 1993 Coll., Act No. 324 / 1993 Coll., Act No. 241 / 1994 Coll., Act No. 59 / 1995 Coll. is amended and supplemented as follows:
1. in Article 6c (1), the following point (m) is added:
"(m) persons referred to in Section 6a (c) who receive sickness insurance benefits. 28)
28) Paragraph 11 (a) (1) of Act No. 54 / 1956 Coll., on staff sickness insurance, as amended. "
2. Paragraph 10 (1) (a), including footnote 29, reads as follows:
"(a) the choice of insurance undertakings carrying out general health insurance, unless otherwise provided for by this law. The health insurance undertaking may be changed once every 12 months only on the first day of the calendar quarter. From the date of entry into liquidation of the health insurance undertaking or from the date of introduction of the compulsory administration of the health insurance undertaking or from the date on which the Ministry, on the basis of a finding of an imbalance in the management of the health insurance company (29), declares in the media, the insured persons of such health insurance undertaking shall be entitled to change the health insurance undertaking even within a shorter period, on the first day of the calendar month but not before the first day of the following calendar month. The change of health insurance undertaking shall be carried out by their legal representative for minors and persons who are not fit to act. When the child is born, the right to choose a health insurance undertaking shall not apply. On the day of birth, the child becomes insured by a health insurance company with which the child's mother is insured on the day of birth. A change in the child's health insurance scheme may be made by his legal representative only after the birth number has been assigned to the child on the date specified in the sentence of the second or third. If the insured person or the legal representative of the insured person requests the health insurance undertaking in accordance with this provision, the health insurance undertaking shall comply with its application. The health insurance undertaking shall not be entitled to determine the period for which the insured person will be insured or to terminate the insured person's relationship with the health insurance undertaking itself. The health insurance undertaking shall not be entitled to accept insured persons within the time limits specified in that provision.
29) Paragraph 7 (1) of Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by Act No. 149 / 1996 Coll. '
3. In Paragraph 13 (1), the following sentence is added at the end: "The competent health insurance undertaking is entitled to a contractual limitation on the payment of the reported health care in case the health institution substantially exceeds the average cost of health performance and the material specifically charged, the prescribed medicines and medical devices and the medical institutions requested care for one insured person. '
4. In Paragraph 13 (3), the second sentence is deleted.
Act of the Czech National Council No. 592 / 1992 Coll., on Insurance for General Health Insurance, as amended by Act of the Czech National Council No. 10 / 1993 Coll., Act of the Czech National Council No. 15 / 1993 Coll., Act No. 161 / 1993 Coll., Act No. 324 / 1993 Coll., Act No. 42 / 1994 Coll., Act No. 241 / 1994 Coll. and Act No. 59 / 1995 Coll., is amended as follows:
1. In Article 3 (7), the words "exceeding 77% of the minimum wage 'are replaced by the words" exceeding the amount which is the basis for the assessment of the person for whom the State of insurance is paying (§ 3c)'.
2. In Article 3a (3), the words "77% of the minimum wage 'are replaced by the words" the amount which is the basis of the assessment of the person for whom the insurance State is paying (§ 3c)'.
3. In the last sentence of Article 3a (4), the words "after deduction of expenditure incurred to achieve, secure and maintain income 'shall be added after the words" income'.
4. In Section 3c, the figure "65 'is replaced by the figure" 80'.
5. In Paragraph 12, the present text becomes paragraph 1 and the following paragraph 2 is added:
"(2) In the case of seasonal fluctuations in payments for health care provided, the Minister of Finance shall be empowered to provide, during the financial year, a return financial assistance payable in the same year and to change the frequency and amount of payments made by the State to the general health insurance scheme within the financial year at the request of the administrator of the special account. The request shall be assessed on the basis of the evolution of revenue and expenditure in the State budget. Adjustments to payments under this authorisation shall not affect the amount budgeted in the approved State budget for State payments under Section 3c of this Act. '.
6. In the second sentence of Article 20 (1), the words "and other income of a special account 'shall be inserted after the words" insurance premiums' and the words "determined in accordance with a special regulation 'shall be deleted.
7. In Paragraph 20 (4), the words "the method of calculating the amount per insured person according to the age structure coefficient 'are deleted.
8. In Paragraph 21 (3), the following is added after the words "for which he is a payer 'and the following words, including footnote 40, are inserted:" periodic penalty payments, fines and other transactions which are the receipt of a special account under this Act or under special laws 40),
40) For example, § 13 (8) of the ČNR Act No. 550 / 1991 Coll., § 6a (5), § 23a (3) of the ČNR Act No. 280 / 1992 Coll., Article IV of the Act No. 60 / 1995 Coll., amending and supplementing the Act No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended, Act No. 280 / 1992 Coll., on the Department, Business, Business and Other Health Insurance Companies, as amended, Act No. 20 / 1966 Coll., on the Care of the People, as amended, and Act No. 185 / 1991 Coll., on Insurance, as amended. '
9. In Paragraph 21 (4), the second word "finance 'is replaced by" health'; the following sentence is inserted after the second sentence: "The penalty is the receipt of a special account. ';
10. In Paragraph 21 (5), the second word "finance 'is replaced by" health' and the following sentence is added at the end: "Penalty is the receipt of a special account '.
11. in Paragraph 23 (1), the following sentence is added at the end: "Infringement of confidentiality is not a mutual provision of information between tax administrators, health and social insurance, which is necessary for the effective control of payers."
The Act of the Czech National Council No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended by the Act of the Czech National Council No. 592 / 1992 Coll., the Act of the Czech National Council No. 10 / 1993 Coll. and Act No. 60 / 1995 Coll., is amended as follows:
1.
"(d) the cost of the insurance undertaking's activities pursuant to Article 2 (1), except those referred to in points (a), (b) and (c); the maximum amount of these costs and the maximum amount of expenditure on the acquisition of tangible and intangible assets shall be determined by the Ministry of Finance by law, '.
2. In Article 6 (5), "finance 'is replaced by" health' and "health 'by" finance'.
3. In Article 7 (1) (b), the words "to supplement the basic health insurance fund 'are replaced by the words" to cover the deficits of the basic fund and to cover health care'. At the end, the comma is replaced by a dot and the following sentence is added: "If this is not the case referred to in the previous sentence, the insurance undertaking is obliged to maintain the reserve fund at the specified level, '.
4. In the first sentence of Section 7a (1), the words "Ministry of Finance 'are replaced by the words" Ministry of Health in cooperation with the Ministry of Finance'.
5. In Paragraph 7a (4), the word "finance 'is replaced by" health' and "health 'by the word" finance'.
6. In Article 7a (5), the word "finance 'is replaced by the word" health'.
7. Article 8 (1) reads as follows:
"(1) The insurance company is required to report to the Ministry of Health every 60 days after the end of the calendar quarter. The method of submitting this information and its scope shall be determined by the Ministry of Health by the measures published in the Collection of Laws. In the event of a balance sheet imbalance, it is also required to submit a draft measure to the Ministry. After consulting the Ministry of Finance, the Ministry of Health will submit a draft measure to the Government. The Ministry of Health shall inform the public about the management of the Insurance Company through the media. ';
8. In Paragraph 18 (1), the second sentence is replaced by the following: "A member of the Insurance or Insurance Insurance Authority and a head of the head of the head office or, where applicable, the head of the lower organisational unit or their representative shall not be a citizen who is in employment or similar relationship with the entity with which the Insurance Company has concluded a health care contract or who is the owner or co-owner or operator or a member of the statutory body of the medical establishment with which the Insurance Company has concluded a health care contract."
9. Paragraph 18 (4) reads as follows:
"(4) The term of office of a member of the insurance or reinsurance undertaking's body shall be four years."
10. In the last sentence of Paragraph 24 (2), the word "by this' is replaced by" special 'and the reference to footnote 8 is added after the word "by law'.
11. in the first sentence of Article 24a (1), the words "or District Insurance Company" shall be added in the first sentence of Article 24a (1) and the words "or District Insurance Company" shall be added in the second sentence of Article 24a (1).
12. In Article 24a (3), the following sentence is added at the end: "Such conduct is not the procedure of the Insurance Company in relation to courts and criminal law enforcement authorities in the exercise of claims by the Insurance Company under the law."
13. in Article 24b (1), "finance" is replaced by "health care."
14. in Article 24b (2), "the competent Ministry" is replaced by "the Ministry of Health."
15. in Article 24b (3), the word "Ministry" shall be replaced by "Ministry of Health" and the words "which imposed it" shall be deleted;
The Act of the Czech National Council No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by the Act of the Czech National Council No. 10 / 1993 Coll., Act of the Czech National Council No. 15 / 1993 Coll. and Act No. 60 / 1995 Coll., is amended as follows:
1. In Paragraph 3 (1), the words "setting up an occupational insurance undertaking 'are replaced by the words" carrying out general health insurance'.
2. in Paragraph 4 (2) (g), the word "liquidation" shall be replaced by the words "cancellation of an employee insurance undertaking."
3. In Article 4 (4), the third word "finance 'is replaced by" health' and "health 'by" finance'.
4. In Article 4a (1) and (3), the words "the establishment of an occupational insurance undertaking 'are replaced by the words" the implementation of general health insurance'.
5.
Termination and cancellation of employee insurance
(1) The employer's insurance undertaking shall cease to exist on the date of removal from the business register. The application for erasure shall be submitted by the sickness insurance company or liquidator that has been acquired. The termination of the employee insurance undertaking shall be preceded by its cancellation without liquidation or with liquidation.
(2) Without liquidation, the employee insurance undertaking is deleted
(a) the merger with the General Health Insurance Company of the Czech Republic; or
(b) by merging or merging with another occupational insurance undertaking.
(3) The merger will be notified by the General Health Insurance Company of the Czech Republic without delay to the Ministry of Health. The merger or merger of employees requires authorisation. This authorisation is issued by the Ministry of Health after the Ministry of Finance has expressed its views. A new health insurance plan shall be submitted with the application for authorisation. Employers' insurance undertakings are obliged to demonstrate that they meet the conditions required for the authorisation to carry out general health insurance, with the exception of the condition laid down in § 4a.
(4) When merged, all assets, liabilities and claims are transferred to the General Health Insurance Company of the Czech Republic or to the Employee Insurance Company with which the cancelled Employee Insurance Company is merged. The general health insurance company of the Czech Republic or the occupational insurance company with which the cancelled occupational insurance company is merged shall also be transferred to all insured persons of the cancelled occupational insurance company. The general health insurance company of the Czech Republic or the occupational insurance undertaking with which the cancelled occupational insurance company is merged may be provided with refundable financial assistance from the state budget up to the amount of liabilities assumed. The application for refundable financial assistance is submitted by the General Health Insurance Company of the Czech Republic or by the Employee Insurance Company of the Ministry of Health. The government, acting on a proposal submitted by the Minister for Health after consulting the Minister for Finance, decides on the provision of repayable financial assistance and its amount. The repayable financial assistance provided shall be used in particular to cover the obligations of occupational insurance undertakings to medical establishments. In the event of a merger, all the assets, liabilities and claims on the new employee insurance undertaking that has been created by the merger shall be transferred; all insured persons of cancelled occupational insurance undertakings are transferred to a newly created occupational insurance company.
(5) The notification of the merger or merger shall be transmitted without delay to the Central Register of Insured Persons maintained by the General Health Insurance Company of the Czech Republic. At the same time as the notification, they shall also transmit to the Central Register the authorisation referred to in paragraph 3 if it was necessary for the merger or merger.
(6) The employer's insurance undertaking is abolished with liquidation if:
(a) it has been withdrawn by the Ministry of Health from the authorisation to carry out general health insurance; or
(b) the Ministry of Health shall apply for this.
(7) The Ministry of Health may withdraw the authorisation referred to in paragraph 6 (a) if:
(a) the measures imposed by the Ministry of Health to remedy the deficiencies in the management, in particular as regards the solvency of the occupational insurance undertaking, have failed to fulfil its purpose and this purpose could not be met by the introduction of forced administration; or
(b) the compulsory administration has failed to fulfil its purpose; or
(c) the government has repeatedly not approved the health insurance plan or has repeatedly not approved the annual report of the occupational insurance undertaking; or
(d) where the occupational insurance undertaking seriously infringes legislation; or
(e) the employee insurance undertaking has not fulfilled its obligations under Article 4 (2) (c), (d) and (f). ';
6. The following Section 6a is inserted after Section 6:
Disposal of employee insurance
(1) The entry into liquidation of the employee insurance company is registered in the Commercial Register on a proposal from the Ministry of Health. For the period of liquidation, the name of the employee insurance company with the sentence "in liquidation 'shall be used.
(2) From the date of registration in the Commercial Register, the liquidator or liquidators appointed by the Ministry of Health shall act on behalf of the employee insurance company in liquidation. The liquidator shall, at the latest on the following working day, notify the date of entry into liquidation of the employee insurance company to the Central Register of Insurers and inform the public of the date of entry into liquidation via the media. Furthermore, the liquidator is obliged to draw up a liquidation balance sheet and an overview of the assets of the employee insurance company at the date of entry into liquidation and transmit these data to the Ministry of Health.
(3) The liquidator only carries out operations aimed at the liquidation of the employee insurance company. In the exercise of that competence, he shall, in particular, make payments for the healthcare provided to medical institutions or other bodies which have provided health care to insured persons of a liquidated health insurance company. In order to cover health care, it is entitled to use the funds of the basic fund, the reserve fund or other special-purpose funds set up by the occupational insurance undertaking, as appropriate.
(4) If the liquidator ascertains over-indebtedness of the employee insurance company, he shall submit an application for bankruptcy without undue delay.
(5) At the end of the liquidation, the liquidator shall draw up the accounts and submit them to the Ministry of Health for approval, together with a final report on the course of the liquidation. At the same time, it will propose the transfer of the remaining funds of the basic fund and reserve fund into the special account of the General Health Insurance Corporation of the Czech Republic for redistribution. In addition, the liquidator shall submit an application for the transfer of the balance of assets where such a balance has resulted from the liquidation, to the applicant for authorisation pursuant to Article 3, who has paid the costs associated with the establishment of the employee insurance undertaking or its legal successor; the balance of assets may be transferred only up to the amount of funds which the applicant has demonstrated to have entered in the employee insurance undertaking. In the absence of an applicant for an authorisation pursuant to § 3, or of his successor in title, or where the applicant or the legal successor has not been transferred the entire balance of assets, he shall propose the transfer of the balance of assets or the remainder of the balance of assets to the special account of the General Health Insurance Authority of the Czech Republic for reallocation. After the accounts have been cleared, the final reports and the proposal to transfer funds by the Ministry of Health the liquidator shall carry out the transfer.
(6) Within 30 days of the end of the liquidation of the employee insurance undertaking, the liquidator shall submit to the registry court an application for the removal of the employee insurance undertaking from the commercial register.
(7) The remuneration of the liquidator is determined by the Ministry of Health. "
Article 7 (1) reads as follows:
"(1) The Ministry of Health shall carry out an audit of the activities of the occupational insurance company in cooperation with the Ministry of Finance. For this purpose, the Employee Insurance Corporation shall report to that Ministry within 30 days of the end of the calendar quarter. The method of submitting this information and its scope shall be determined by the Ministry of Health by the measures published in the Collection of Laws. The Ministry of Health shall inform the public about the management of occupational insurance companies through the media. If the Ministry of Health finds serious deficiencies in the activities of the occupational insurance company, in particular the imbalance in the management of the occupational insurance undertaking (in particular in terms of its solvency), or failure to meet the reserve fund, or failure to comply with this Act or other general health insurance rules or non-compliance with an approved health insurance plan, it shall be justified according to the nature of the deficiency found.
(a) require the employee insurance undertaking to take action within the prescribed period; or
(b) establish compulsory administration for a maximum period of one year. "
8. In Article 7 (4), the first sentence of the sentence "finance 'is replaced by" health' and "health 'by" finance'; the following sentence is inserted after the first sentence: "No later than the following working day following the introduction of the forced administration of the AIFM, the central register of insured persons shall notify the public of the date on which the forced administration was introduced via the media. ';
9. In Article 7 (5), the word "finance 'is replaced by" health'.
10. in Article 7 (6), "Article 6 (1) (b)" is replaced by "Article 6 (7)";
11. in Paragraph 10 (1), the following sentence shall be added at the end: "The consent of the majority of the representatives of the State present shall always be required for the validity of the decisions of the occupational insurance authorities concerning:
(a) a change in the value of the point; or
(b) setting up special-purpose funds; or
(c) approval of the principles of contract policy; or
(d) type-approval of health care contracts; or
(e) applications by an occupational insurance undertaking for credit; or
(f) purchase of real estate; or
(g) purchase of basic funds at a cost of more than CZK 1 000 000; or
(h) taking over the guarantee obligation; or
(i) the use of the resources of the reserve fund to cover the base fund deficit. "
12.
"(d) the cost of the activities of the occupational insurance undertaking referred to in Article 8, except those referred to in (a), (b) and (c); the maximum amount of these costs and the maximum amount of expenditure on the acquisition of tangible and intangible assets shall be determined by the Ministry of Finance by law; ';
13. Paragraph 15 (2) of the first sentence reads: "The Employee Insurance Corporation is required to submit to the Ministry, within the deadlines set by the Ministry of Health, a draft health insurance plan for the following calendar year, the annual accounts and the annual report for the previous calendar year and the audit report; 12) The health insurance plan, financial statements and annual report is presented by the Ministry of Health after discussion with the Ministry of Finance to the Government of the Czech Republic."
14.
"(3) The government shall approve the health insurance plan, the accounts and the annual report. When approving the health insurance plan, in particular, it shall assess the system of contractual health establishments of occupational insurance companies in terms of the availability of health care for insured persons and the balance of income and expenditure of the occupational insurance undertaking. The government has the right to make reservations about the health insurance plan. In that case, the employee insurance undertaking may submit a new proposal within 60 days of the date of application of the reservations. If the government repeatedly fails to approve the annual report or the draft health insurance plan, the Ministry of Health shall decide on the cancellation of the health insurance under Section 6 (6) (a). Until the health insurance plan is approved, the occupational insurance company shall manage the insurance scheme as proposed. The government shall report to the Chamber of Deputies on approved health insurance plans and on the annual reports of employee insurance companies. '
15. the fourth, fifth and sixth sentences of Paragraph 18 (1) shall read:
"The reserve fund serves to cover the deficits of the basic fund and to cover health care in cases of mass illness and natural disasters; the amount of the reserve may in such a case fall below the minimum amount. If the cases referred to in the previous sentence are not the case, the employee insurance undertaking shall maintain the reserve at the specified level. The employer's insurance undertaking shall complete the reserve within three years of the date of the authorisation to carry out general health insurance. '
16. in Article 23a (1), the first sentence, the word "finance" shall be replaced by "health care."
17. in Article 23a (2), the words "competent Ministry" are replaced by the words "Ministry of Health."
Resorts, branch, business and other health insurance companies established or established under existing regulations are considered to be health insurance companies authorised to carry out general health insurance under the Czech National Council Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by Article IV of this Act.
Health insurance plans, financial statements and annual reports of health insurance companies submitted before the effective date of this Act shall be discussed in accordance with this Act.
The department, branch, business and other health insurance companies carrying out general health insurance on the effective date of this Act are obliged to fill the reserve within the time limit laid down in the current regulations.
This Act shall take effect on 1 July 1996.
Uhde v. r.
Havel v. r.
Klaus v. r.
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Regulation Information
| Citation | Act No. 149 / 1996 Coll., amending and supplementing Act No. 550 / 1991 Coll., on General Health Insurance, as amended, Act No. 592 / 1992 Coll., on Insurance against General Health Insurance, as amended, Act No. 551 / 1991 Coll., on General Health Insurance of the Czech Republic, as amended, and Act No. 280 / 1992 Coll. |
|---|---|
| Regulation Type | Law |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 31.05.1996 |
|---|---|
| Effective from | 01.07.1996 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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