How to decipher FFOMS contributions. Federal Compulsory Health Insurance Fund (FFOMS)

Which funds are contributed to?

Mandatory insurance contributions are charged to three extra-budgetary funds: Pension (PFR), Medical (FFOMS) and Social Insurance Fund (SIF). The essence of compulsory insurance is as follows. The payer makes regular payments, and the fund makes payments established by law when an insured event occurs. For example, when a person reaches retirement age, the Pension Fund of the Russian Federation accrues him a pension; in case of illness, the Social Insurance Fund pays sick leave benefits, etc. Types of mandatory insurance premiums There are four types of insurance premiums.

1 - pension contributions (contributions to the Pension Fund). They are divided into two parts: contributions to the insurance part of the pension and contributions to the funded part of the pension.

2 - medical contributions (contributions to the FFOMS).

3 - contributions to the Social Insurance Fund for compulsory social insurance in case of temporary disability and in connection with maternity. Using these contributions, the Social Insurance Fund pays sick leave benefits and maternity benefits.

4 - contributions to the Social Insurance Fund for insurance against accidents at work and occupational diseases. Their unofficial name is “injury” contributions.

Legislative framework for insurance premiums

Contributions to the Pension Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Social Insurance Fund (the first three contributions) are regulated by Federal Law No. 212 of July 24, 2009 "On insurance contributions to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and territorial compulsory medical insurance funds" (hereinafter referred to as Law No. 212-FZ). The calculation and payment of contributions “for injuries” is regulated by Federal Law No. 125-FZ dated July 24, 1998 (hereinafter referred to as Law No. 125-FZ).

Who pays insurance premiums

Organizations that pay salaries to employees and (or) pay remuneration to contractors - individuals;

Individual entrepreneurs who pay wages to employees and (or) pay remuneration to contractors - individuals;

Individuals without individual entrepreneur status who pay salaries to employees and (or) pay remuneration to contractors - individuals;

Individual entrepreneurs and persons engaged in private practice (lawyers, notaries, etc.); that is, those who work “for themselves” and not for the employer.

It often happens that the same person fits several of the above definitions at once. In this case, insurance premiums must be paid for each reason. The most common example is an individual entrepreneur who works “for himself” and at the same time has a staff of employees. Such an individual entrepreneur must separately accrue contributions on his own income and separately on the salaries of his employees.

What are contributions calculated for?

Payments to employees Employers-organizations and employers-individual entrepreneurs charge contributions for payments made to employees under employment contracts. Such payments include, first of all, wages, bonuses based on the results of work for a month, quarter or year, as well as vacation pay and compensation for unused vacation.

Payments to contractors Pension and medical contributions are accrued on payments in favor of individuals who are not on staff if such payments are made under copyright or civil law contracts. There is an exception: the customer of work or services is released from the obligation to charge contributions in the case where the contractor has the status of an individual entrepreneur and pays contributions “for himself.” Also, contributions do not include amounts issued to a citizen for property or property rights acquired or leased from him (for example, contributions are not charged on amounts paid when renting an employee’s personal car). Contributions to the Social Insurance Fund for insurance in case of temporary disability and in connection with maternity are not accrued for payments under any civil contracts (including copyright and contract agreements). Contributions to the Social Insurance Fund for “injuries” from payments under civil contracts are accrued only if the payment of contributions is provided for by the contract itself.

Insurance premium rates

For most payers in 2012 and 2013, the contribution rates indicated in the table apply. This is for those who do not benefit from benefits.

Tariffs of insurance premiums in 2012-2013 for payers not belonging to the preferential category

Reduced tariffs have been established for some categories of payers. Thus, “simplified workers” who are engaged in certain types of activities (food production, textile production, etc.) in 2012 and 2013 pay only contributions to the Pension Fund at a rate of 20 percent. Contributions to the Federal Compulsory Compulsory Medical Insurance Fund and the Social Insurance Fund for insurance in case of temporary disability and in connection with maternity are set at zero rates.

Tariffs for contributions “for injuries” depend on the occupational risk class assigned to the organization or enterprise. For example, for food wholesalers, the first risk class and the corresponding insurance rate of 0.2% are established.

78. Personal income tax.

Personal income tax is a direct federal tax, since the obligation to pay it falls on individuals from the income they receive, is regulated by the Tax Code of the Russian Federation and is mandatory throughout the Russian Federation.

Health insurance is one of the forms of social protection of the population in case of loss of health for any reason.

Purpose of health insurance guarantee that citizens, in the event of an insured event (illness), receive medical care from accumulated funds and financing of preventive measures.

The Law of the Russian Federation of June 28, 1991 “On Medical Insurance of Citizens” was fully put into effect on January 18, 1993. The introduction of compulsory health insurance meant for public health care a transition to a mixed financing system, namely, to a budget-insurance system.

Budgetary funds provide funding for the non-working population (pensioners, housewives, students), and extra-budgetary funds provide funding for working citizens.

The insured are the executive bodies of the constituent entities of the Russian Federation, local governments and business entities, as well as citizens - entrepreneurs.

To implement this law and implement state policies in the field of compulsory medical care. insurance, federal and territorial compulsory medical funds were formed. insurance. Compulsory medical insurance funds are independent non-profit financial institutions. They are intended to accumulate financial resources for compulsory medical care. insurance, ensuring the financial stability of the state compulsory medical insurance system and financial equalization. Resources for its implementation.

The Federal Compulsory Medical Insurance Fund was created by a resolution of the Supreme Council of the Russian Federation dated January 24, 1993. The federal fund is entrusted with the following functions:

Creation of conditions for the activities of territorial compulsory medical insurance funds to ensure financing of compulsory medical programs. insurance.

Financing of targeted programs within the framework of compulsory medical care. insurance.

Development of normative and methodological documents ensuring the implementation of the law “On Medical Sciences”. insurance of citizens of the Russian Federation"

Organization of training of compulsory medical insurance specialists

Participation in the creation of territorial compulsory medical insurance funds and in the development of compulsory health insurance programs.

The fund's financial assets are generated from:

Insurance contributions from employers in the form of mandatory contributions.

Contributions from territorial compulsory medical insurance funds for the implementation of joint programs carried out on a contractual basis.

Due to allocations from the federal budget for the implementation of republican compulsory medical insurance programs.

Due to income from the use of temporary free financial resources of the federal fund.

Due to the normalized safety stock of the fund's financial resources.

At the expense of voluntary contributions and other income not prohibited by the legislation of the Russian Federation.

Territorial compulsory medical insurance funds are created by local authorities and operate on the basis of the regulations on the territorial compulsory medical insurance fund. Which was approved by a resolution of the Supreme Council on February 24, 1993.

Branches can be created in regions (regions, territories, republics). The territorial fund is created to finance territorial compulsory medical insurance programs. The territorial compulsory medical insurance fund performs the following functions:

Accumulates financial resources of the territorial fund for compulsory medical insurance.

Provides financing for the territorial compulsory medical insurance program.

Carries out financial credit activities to ensure the operation of the compulsory medical insurance system.

Equalizes the financial resources of cities, districts and other territories.

Monitors the timely and complete receipt of insurance contributions to the territorial fund.

Interacts with the federal fund and other territorial funds.

The main income from compulsory health insurance is insurance premiums from employers and insurance payments for the non-working population (90% of total income)

The procedure for crediting insurance premiums is determined by the Federal Treasury and the Ministry of Finance. As for insurance premiums for the non-working population, they are regulated by the government of the constituent entities of the federation and local administrations at the expense of funds provided in the budgets.

The Federal Compulsory Medical Insurance Fund (FFOMS) is a state extra-budgetary fund created to finance medical care for Russian citizens under the compulsory medical insurance program. This article examines what tasks and functions the FFOMS faces, what structure it has, how the budget is formed, and for what purposes the accumulated funds of the fund are used.

Structure and management of the FFOMS

The FFOMS was created on February 24, 1993 by resolution of the Supreme Council of the Russian Federation No. 4543-I. The activities of the fund are regulated by the Budget Code of the Russian Federation and the Federal Law “On Compulsory Medical Insurance of Citizens in the Russian Federation,” as well as other legislative and regulatory acts. The Regulations on the Fund were approved on February 24, 1993, and on July 29, 1998, a charter was adopted in its place. In accordance with the current tax legislation, when paying wages, the employer is obliged to transfer insurance contributions to three extra-budgetary funds:

Pension Fund - 22% of the employee’s taxable income;
Social Insurance Fund - 2.9% of taxable income;
FFOMS - 5.1%.

Contributions to the FFOMS are deducted from wages by the employer and go to the fund every month. Payments to the compulsory health insurance organization are mandatory. The functioning of this organization is regulated by a number of legislative norms and acts, including the Budget Code, the law “On compulsory health insurance of citizens of the Russian Federation” and the internal fund charter. The general structural diagram of the FFOMS is presented in the diagram below.

Figure - Structural diagram of the compulsory medical insurance fund in 2018

All divisions form a single system, and each has its own functions and powers in the field of providing citizens with the right to medical care and monitoring compliance with legislation in this area. The Russian compulsory insurance system provides for financing the activities of healthcare institutions through the work of insurance companies and funds; Such structures are required to obtain a license for this type of activity. The interaction between organizations works as follows:

The insurance company draws up an agreement with a healthcare institution (hospital, clinic);
The insurance company initiates the signing of a cooperation agreement with the local compulsory medical insurance fund;
The territorial fund allocates funds transferred to the account of the insurance organization; it spends them on paying for medical services provided to citizens who have a compulsory medical insurance policy.

In addition, the legislation provides for the financing of healthcare institutions without the participation of insurance companies, directly through regional funds and branches, but this technique is practiced less frequently. The use of different methods of distribution and transfer of funds is required due to the fact that the management structure of each region has its own characteristics. When choosing a method of transfer and distribution, such points as the financial situation of a particular subject of the federation, political situation, national characteristics and other aspects are taken into account.

As a percentage, citizens of the country registered in the compulsory medical insurance system are unevenly assigned to insurance companies. Statistics show that over 70% of people using free healthcare services are affiliated with the 15 largest and most well-known insurance organizations.

Objectives and areas of activity of the FFOMS

As a government organization, the federal compulsory health insurance fund exists to implement legislative norms governing the provision of budgetary medical services. In other words, the goal of the fund is that every person can claim free medical care and regulate the implementation of this requirement. The range of tasks of the organization is formulated in legislative acts as follows:

Financial support for civil rights to receive medical care in the required amount on a free basis;
Organization of cash injections that serve to ensure a stable position of the compulsory health insurance system;
Development of new and support of existing programs, distribution of priorities in the field of insurance;
Distribution of funding for the implementation of targeted programs and projects.

The implementation of these tasks is carried out within the framework of all the activities of the fund, and its main functions are as follows:

Control and balancing of finances distributed to branches and controlled funds for the implementation of basic tasks;
Regulating the amount of contributions that go to support the compulsory medical insurance program;
Allocation of finances for the implementation of regional programs aimed at solving problems specific to a specific region or locality;
Monitoring the regularity of transfers of contributions from organizations and entrepreneurs at different levels of existing funds;
Checking expenses, controlling target costs, which allows you to spend money most rationally and prevent financial leakage;
Creation and modification of methodological instructions for smooth operation and interaction of funds and branches with each other;
Making proposals to improve the existing system, including adjusting regulations to improve the quality of work;
Monitoring and adjusting aspects of the basic compulsory insurance program to expand the range of services;
Preparation of analytical reports and transfer of information to government agencies;
Conducting training courses for personnel to work in the field of public health insurance;
Checking regulatory documents and regulations;
Research in the medical insurance sector;
Cooperation with other associations at the international level, discussion of pressing problems in the field of life and health insurance;
Development of a project on the formation of a fund budget, preparation and transmission of reports on the implementation of budget money.

In fulfillment of its established functions, the Compulsory Medical Insurance Fund accumulates financial resources to ensure the financial stability of the system, equalizes the financial conditions of the activities of the Compulsory Medical Insurance Fund within the framework of the basic compulsory medical insurance program by directing financial resources to the Compulsory Medical Insurance Fund for the implementation of territorial compulsory medical insurance programs within the framework of the basic compulsory medical insurance program, the national project "Health", a pilot project in the constituent entities of the Russian Federation, aimed at improving the quality of healthcare services.

Sources of income and expense items of the fund

The expenditure of FFOMS funds is carried out exclusively for the purposes determined by the legislation regulating its activities, in accordance with the budget approved by federal law. The successful work of the FFOMS is directly related to the uninterrupted replenishment of the budget, and the following entities are used:

Legal entities (companies, individual entrepreneurs) who make insurance payments for people listed as employees. The contribution amount is 3.6% of the payment fund, and of this, 0.2% is transferred to the federal Compulsory Medical Insurance Fund, and the rest to regional divisions. From this distribution it can be seen that most of the money paid out remains in regional funds;
Budgets that transfer contributions to citizens who are not officially employed (minors, retired citizens, unemployed);
Voluntary contributions made by citizens or organizations (sponsorship, donations, etc.);
FFOMS investments, when an organization uses available available funds for investment in order to obtain short-term or long-term profit.

Russian legislation defines a list of categories within which the fund’s budget is spent. The main items of expenditure (over 60% of the budget funds are allocated to them) are considered to be payment for medical services provided to citizens free of charge, salaries of employees involved in compulsory medical insurance, financing of insurance companies and healthcare institutions, and maintenance of reserve (emergency) funds.

Opportunities for citizens insured in the system

Any citizen has the right to claim high-quality free care from doctors and medical staff, and basic rights are regulated by the Compulsory Medical Insurance Fund. The work of the organization allows you to apply for full assistance on the territory of Russia and abroad, namely, to receive emergency medical care in the country and abroad, to choose a clinic, treating specialists, methods of therapy if there are several options, to choose an insurance organization issuing a policy, and also to receive professional help.

Conclusion

The FFOMS, founded in 1993, is designed to provide free medical care to citizens of the Russian Federation and monitor the implementation of the basic compulsory medical insurance program. In addition, one of the main functions of the fund is the distribution of funding to territorial funds and medical institutions of the state.

to the Pension Fund of Russia (PFR);
to the Health Insurance Fund (FFOMS);
for social insurance against illnesses and injuries or maternity (in the Social Insurance Fund).
for insurance against accidents and occupational diseases (also in the Social Insurance Fund).

Also, contributions are paid from payments made to those employees who are registered with the company under civil contracts.

to the Pension Fund;
in FFOMS;
for social insurance against accidents and occupational diseases, if this is specified in the contract.

Payments subject to insurance premiums

Insurance premiums are levied on payments to employees based on labor relations and in accordance with civil contracts for the performance of work, provision of services and copyright orders.

Payments for which contributions are not paid are listed in Art. 422 Tax Code of the Russian Federation:

State benefits;
Compensation payments upon dismissal, payments for damages, payment for housing or food, payment for sports or dress uniforms, provision of allowances in kind, etc.;
Amounts of one-time financial assistance, for example, upon the birth or adoption of a child, upon the loss of a family member, during a natural disaster and other emergency circumstances;
Income, in addition to wages, received by members of indigenous communities from the sale of traditional craft products;
Insurance payments for compulsory and voluntary personal insurance;
And other types of payments and compensation.

What are the maximum bases for calculating insurance premiums?

Contributions to the Pension Fund and the Social Insurance Fund are limited by the maximum bases for calculating contributions, which are annually indexed based on the growth of average wages:

The maximum base for contributions to the Pension Fund in 2019 is 1,150,000 rubles.

The maximum base is calculated based on the employee’s income on an accrual basis. As soon as his income for the year reaches the maximum base, future contributions must be paid according to new rules. When paying contributions at the basic tariff, if this base is exceeded, contributions are paid at a reduced rate - 10%. If the organization is on a reduced tariff, then if it is exceeded, contributions are not paid.

The maximum base for contributions to the Social Insurance Fund in 2019 is 865,000 rubles.

If the base is exceeded, then there is no need to pay contributions.

For contributions to compulsory medical insurance and injuries, a maximum base is not established, therefore all income received by the employee is subject to contributions.

Insurance premium rates in 2019

Let's look at the main rates of insurance premiums for employees in 2019:

For compulsory pension insurance - 22%.
For compulsory health insurance - 5.1%.
In case of temporary disability and maternity - 2.9%;
For injuries - from 0.2% to 8.5%, depending on the occupational risk class assigned to the main type of activity performed.

The table shows special reduced contribution rates for certain categories of payers established in 2019.

Insured category	on OPS, %	on compulsory medical insurance, %	at VNiM, %	General tariff, %	Pension Fund from amounts above the base, %
Basic tariff, no benefits	22	5,1	2,9	30	10
IT organizations	8	4	2	14	-
Residents of a technology-innovation or tourist-recreational special economic zone	8	4	2	14	-
Economic societies created by budgetary scientific institutions	8	4	2	14	-
Participants of the Skolkovo project	14	0	0	14	-
Payers to ship crew members in relation to payments to ship crew members	0	0	0	0	-
Non-profit organizations on the simplified tax system in the field of social services, science, education, healthcare, culture, art or mass sports	20	0	0	20	-
Charitable organizations on the simplified tax system	20	0	0	20	-
Participants in the free economic zone of Crimea and Sevastopol	6	0,1	1,5	7,6	-
Residents of the territory of rapid socio-economic development	6	0,1	1,5	7,6	-
Residents of the special economic zone in the Kaliningrad region	6	0,1	1,5	7,6	-
Organizations that produce and sell animation or audiovisual products	8,0	2,0	4,0	14	-

There have been significant changes in the reduced rates for insurance premiums since 2019. Several categories of policyholders switched to basic tariffs at once:

Organizations and individual entrepreneurs on the simplified tax system, except for charitable organizations and non-profit organizations on the simplified tax system, conducting certain types of activities;
Organizations and entrepreneurs on UTII conducting pharmaceutical activities or maintaining pharmacies;
Individual entrepreneurs on a patent.

Since 2019, these categories pay contributions at the general rate - 30%, and if the maximum base for calculating contributions to compulsory pension insurance is exceeded, the payment is not canceled, but the percentage of contributions to the Pension Fund is reduced to 10%.

Business companies and partnerships involved in the implementation of the results of intellectual work, as well as organizations and entrepreneurs that entered into an agreement on technical innovation activities with special economic zones, lost their right to reduced insurance contributions to the pension fund. In 2018, the contribution rate for compulsory pension insurance was 13%, from 2019 - 20%.

Deadlines for payment of insurance premiums in 2019

Insurance premiums are transferred to the Federal Tax Service for each month before the 15th day of the following month. If the last day of payment is a weekend or holiday, then you can pay contributions on the next working day. With contributions for injuries, the procedure is similar, but they must still be paid to the Social Insurance Fund.

Entrepreneurs pay insurance premiums for themselves at other times. Contributions for the previous year must be paid before the end of the year or on the next business day. For 2019, transfer the money to the tax office by December 31, and if your income exceeded 300,000 rubles, then transfer the additional payment to the Federal Tax Service by July 1, 2020.

Keep records in Kontur.Accounting - a convenient online service for calculating salaries and sending reports to the Federal Tax Service, Pension Fund and Social Insurance Fund. The service is suitable for comfortable collaboration between an accountant and a director.

The Federal Compulsory Health Insurance Fund is a state fund, but not a budget fund. It was created in 1993 to finance medical care for citizens of the Russian Federation, since medical insurance in the Russian Federation is mandatory.

Activities of the Federal Compulsory Health Insurance Fund

Federal, as mentioned above, created to provide financing for medical care for citizens . Medical insurance is one of the forms of social protection of citizens of the Russian Federation, and with the help of the Compulsory Medical Insurance Fund, citizens are guaranteed the right to free medical care.

The main objectives of the MHIF , according to the approved regulations on February 24, 1993 and the adopted charter of the fund, are the following:

Equalization of working conditions for territorial MHIFs to ensure financing of compulsory health insurance programs.
Financing of targeted programs within the framework of compulsory health insurance;
Control over the targeted use of financial resources of the compulsory medical education system.

The work of the compulsory health insurance fund is regulated The Budget Code of the Russian Federation and the federal law “On compulsory medical insurance of citizens of the Russian Federation”.

Sources of formation of the Compulsory Medical Insurance Fund

Like any fund, The MHIF must be constantly filled with funds to ensure guarantees of medical care for citizens of the Russian Federation. The compulsory medical insurance fund is replenished according to the following items:

The MHIF is owned by the state and is subordinate to the Government of the Russian Federation. The funds of the fund are off-budget and are not subject to withdrawal.

Who is the payer of insurance premiums to the Federal Compulsory Medical Insurance Fund of the Russian Federation?

Payer of insurance premiums to the compulsory health insurance fund are:

It happens that the same person fits several payer categories at once. In this case, contributions must be paid on a case-by-case basis.

A report on timely payment of insurance premiums to the Compulsory Medical Insurance Fund should be submitted no later than the 15th day of the second month of the next reporting period. If the last day of the report falls on a weekend or holiday, the report can be submitted on the first working day following it. This will not be considered late.

How much percent of income must be paid to the Compulsory Medical Insurance Fund in 2014

Rates insurance contributions to the compulsory medical insurance fund in the Russian Federation are fixed and may change only based on the category of the insured.

The rate is calculated based on total income and becomes preferential if it exceeds 624 thousand rubles.

All policyholders whose income does not exceed 624 thousand rubles - the rate is 5.1% of income.
All policyholders whose income exceeds 624 thousand rubles - the rate is 0.0% of income.

Also by law reduced rates available for certain categories of citizens.

Thus, a rate of 3.7% is set for the following categories: