BAa HIEM XA HQI VIJ;:T NAM CQNG HOA XA. HQI cnO NGHiA VI~T NAM
nAo HIEM XA. HQI TP.HO CHi MINH DQcl~p - T1! do - H~.mhphuc
S6: 'b~40 / TB - BHXH TP.Rd Chi Minh, ngay W thang 12 nam 2014
THONGBAo
V~ vi~c di~u chinh thong bao sA 3894 / TB - BHXH ngay 08/12/2014 cua Giam dAc Bao hi~m xa hQi Thanh phA H6 Chi Minh
Ngay 08/12/2014, Giam d6c Bao hi~m xa hOi Thanh ph6 H6 Chi Minh co ban hanh Thong bao s6 3894 / TB - BHXH v~ vi~c di~u chinh quy trinh ti~p nh~n va tra k~t qua h6 sa theo cO' ch~ mOt cua, thong bao co hi~u h,rc ap dVng VaGngay 15/12/2014. Sau khi ra soM, cac phong chuc nang phat hi~n co sai sot t~i phi~u giao nh~n h6 sa (PGNHS) s6 103. NOi dung sai, thai h~n giai quy~t h6 sO',d6i v6i gia h~n the BHYT la 05 ngay lam vi~c; nay du<;ycdi~u chinh la 10 ngay lam vi~c. Bao hi~m xa hOi Thanh ph6 di~u chinh nOi dung noi tren VaGPGNHS s6 103 (dinh kern PGNHS m6i theo thong bao mly).
Bao hi~m xa hOi Thanh ph6 yeu cftu Phong Cong ngh~ thong tin chiu trach nhi~m ph6i hgp v6i nha cung cc1pphftn m~m ti~p nh~n h6 sO', d~ di~u chinh phftn
m~m theo quy dinh. Cac phong chuc nang co lien quan, Bao hi~m xa hOi
qu0n/hLly~n, cac tf>chuc, d0vi va ca nhan nguai lao dOng chiu trach nhi~m thvc hi~n theo Thong bao nay./.y
N(li nh~n:
- BGD BHXH TP.HCM (b / c) ;
- Tnrang cac phong nghi~p v~;
- Giam d6c BHXH cac qu~m, huy~n;
- Cac dan vi, tel chlrC, ca nhan NLD;
-1!~ll1g \\CbB,I:XI~T~,.1 CM;
- LLiLI. \ I. 1CCB(_b) .
.~
Cao Van Sang
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Phiiu giao nh(m h6 sa nay ap dtmg kd tit ngay 15/12/2014
s6 H6 sO': l03/ .ITHU CQNG HOA XA HQI CHi; NGHiA VI~T NAM
s6 H6 sO': l03/ .ITHU-DC D{}cI~p - Tl]' do - Hl.mh phuc
s6 H6 sO': l03/ .ITHU-GH
PHIEU GIAO NHAN HO sa
~--- ..•~. Loai hB SO" Thu BHXH ,BHYT b~t buoc.
,'Ti-!:---_-lI r,i, Th()'i h~n giai quy~t lo~i hB so' nay: 10 ngay lam vi~c,
, ,,,,'" BAq HI~'JIe ~ 3 so' di~u chinh chu-c danh, mu-c_lU'o'ng: 05 ngay lam vi~c)
1. Ten don 7iiJ(.' ... l' A-."'0 , ...... 11\' ••••••••••••••••••••••••••••••••••• Ma don vr .......... ···· .. ·· .... · .. · .... ·· .. · .. · .... · .. ·
2. Di¢n thqrf. .. ·lltANH·P-HO .. t..........·.......·...Email: ..................................................................
" .
STT ~~~H':%d Lo~i gi~y ti)', bi~u m§u sa
lU'Q'ne:
I. 11(1 so' thU"'lH.lYI'J~· khi co bi~n dQng, g&m:
I. Danh sach laD dOng tham gia BHXH, BHYT (rnfru D02-TS, 01 bim)
- Tru'ong h(lp baa tling lao d{Jng dong BHXH. BHYT, h6 sO' biJ sung:
I. TO' khai tharn gia BHXH, BHYT d6i v6i nguai tharn gia BHXH Iftn dftu (rnfru TKI-TS, 01 ban / ngu(Ji) 2. ~~~~~~~~~~~~~=~~~~~~~~~~~
r.--- i<idy to' co lien quan khac (theo huanf< ddn tgi coni< van 2899 / BHXH - THU) ... " .. " " .... ". (kem theo bim chinh eM adi chiiu)
TO' khai thay doi thong tin ngum tham gia BHXH, BHYT doi v6i ngum da: co so BHXH tir tinh khac chuyen ve (rnau
3. TK02- TS, 0 I ban / ngum)
- Tru'ong h(Jp bOo giam lao d{Jng dong BHXH, BHYT, h6 sO' biJ sung:
I. The BHYT can th()'i h<;msi'r d\,mg (01 the / ngum)
--- -- .
2. IlicJl h'!Jl t1,1the BHYT doi v6i truang hQP dOll vi da: nOp tru6c do - n~u co (Ban chinh)
3. Q,uyel dinh / Thong b~o cham dlrt hQ'P dong laD dOng ... (Ban saD, 01 ban / ngum) hOi;\cQuyet dinh / Thong baD cham dlrt hQ'P dong laD dOng t~p the dinh kern danh sach (Ban saD)
- Tru'o'ng hfJp di€u chinh chkc danh cong vi{!c, mkc luO'ng dong BHXH, BHYT, h6 so' biJ sung:
I. Quy~t dinh di€u chinh chilC danh cong vi~c, Quy~l dinh di€u chinh ti€n luang ... (Ban saD, 01 ban / nguai)
2. TO' khai lhay d6i thong tin ngum tham gia BHXH, BHYT (mfru TK2- TS, 0 I ban / nguai)
r - TW(J'ng hllP di~u chinh chil'c danh ding vj~c co lien quan d~n ding vj~c n~ng nhQc, dQc hlJi, h& sO' bi) sung:
I. Ban saD quyet ainh ho(Jc h(Jp aong lao a¢ng, h(1p aong lam vi¢c, giay to' co lien quan aen vi¢c aieu chinh (theo hu&ng dan
r--~-- .. r(li cong van 2899 / BHXH - THU! " ........... " .. ,(kem theo ban chinh ad adi chiiuJ
1 TiT kiwi lhay c16ithClIlg tin nguai tham gia BHXH, BHYT (mfru TK02-TS, 01 ban / nguai)
- Tru'(J'ng IWp {ruy tlm BHXH, BHYT. h6 so' biJ sung:
I. Van ban giai trinh cua dan vi (rnfru DO 1b- TS)
2. Van ban xiI Iy vi ph\lm v€ BHXH, BHYT, BHTN cua co quan Nha nu6c co thdm quy€n - n~u co (Ban saD)
3. Bang thanh loan tien luang, lien cong cua dan vi (ban saD); hQ'Pdong laD dOng (ban saD, 0 I ban / nguai) tuang img thai gian truy lhu.
I Lu'u I': Dan vi phai luu H(1p dong lao a¢ng: Bang thanh toan tien luong, tien cong thang zing vai thO'i gian truy thu ae phl,lc VI,I cong uic kiem {ra. ddi chidu khi cdn thllt.
- Tru'ong h(Jp co thay d6i no"i dling ky kham. chu'a b{!nh ban dliu, h6 so' biJ sung:
I. To khai thay d6i th6ng tin nguo; tham gia BHXH, BHYT (mfru TK02-TS, 01 ban / nguai)
II. J 11(1 so' gia hl;ln the BIIYT:
----~--_.----~----
I. Van ban d€ nghi gia h\ln the BHYT cua dOll vi (mfru DOlb-TS)
2. Chung tir nOp ti€n - n~u co (Ban saD)
III. H& SO'khac:
I. DiJi v6'ing~roi d,!oc hUOng quyen loi BHYT caD hOll (nguai co cong ... ): them ban saD giay 10' co lien quan (kem theo ban chinh de c10ichieu) de chung minh.
I .....................................................................................................................................................
IV. File dii'li~u: Chuy~n b~ng iBHXH: 0 b~ng USB: 0 b~ng ernail: 0
.. .. .. .
Lu'u y: Tru-ong h9P nguO'l lao a(Jng aU(1c cap Gtay XGC nhgn aa thu hOI so BHXH (mau C 15a-TS) do aa huang tr(1 cap BHXH 0 I lan, thi 19p ho
So' rhea Phidu giao nh(in h6 So' sd 3 J 7 dd aU(1c c6p to- bia s6 BHXH.
Ng,iy tn\ kCt qll~: ./ 1 .
Ngay tra k~l qua h6 sa c1i€u chinh chilc danh, mi'rc luang: .1 ./ (Qua h\Ul tl'a h6 so 30 ngay, cac dan vi chua d~n nh~n, co quan BHXH se chuy~n h6 so vao kho luu trU).
"'''''''''''''' ngay thang nam .
can bi) ti~p nh~n h& SO' Ngu'(l'j nQp hi> so'
(K.i', ghi 179ten) (Ky, ghi h(J ten)