H S V THI HN GII QUYT

(Ban hnh km theo Quyt nh s 1111/Q-BHXH ngy

25/10/2011 ca Tng Gim c Bo him x hi Vit Nam)
I. H s mi tham gia BHXH, BHYT, BHTN bt buc.
Th tc h s:
- Bn sao Q thnh lp hoc Giy chng nhn ng k KD, Giy php
hot ng.
- Danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q 1111/QBHXH ngy 25/10/2011) (02 bn)
- T khai tham gia BHXH, BHYT (Mu A01-TS Q 1111/Q-BHXH ngy
25/10/2011)
- 2 nh mu 3x4
- Vn bn ng k phng thc ng ca n v (Mu D01b-TS Q
1111/Q-BHXH ngy 25/10/2011) km phng n sn xut, kinh doanh ca
n v i vi n v c ang k ng theo qu hoc 6thng 1ln.
- Giy XN thi gian ng BHTN cha hng BHTN do c quan BHXH
cp (nu c).
- Giy t lin quan ( hng quyn li BHYT cao hn).
S lng: 01 b.
II. i tng ch tham gia BHXH bt buc.
Th tc h s:
1. n v ng cho ngi lao ng:
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011).
- S BHXH.
S lng h s: 01 b.
2. Thn nhn ca ngi lao ng cht t ng cho c quan BHXH ni c
tr.
- S BHXH.
- n ngh ca thn nhn ngi lao ng (Mu D01-TS Q 1111/QBHXH ngy 25/10/2011).
S lng h s: 01 b.

3. Ngi lao ng c thi hn nc ngoi t ng k ng BHXH.

- n ngh ca ngi lao ng (Mu D01-TS Q 1111/Q-BHXH ngy
25/10/2011).
- Bn sao hp ng lao ng i lm vic c thi hn nc ngoi hoc
hp ng c gia hn hoc hp ng c k mi ngay ti nc tip nhn
lao ng.
- S BHXH.
S lng: 01 b.
III. H s mi ch tham gia BHYT bt buc.
Th tc h s:
- Danh sch i tng tham gia BHYT bt buc (Mu D03-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Giy t chng minh vi ngi c hng quyn li BHYT cao hn
- Giy xc nhn hin b phn c th.
S lng: 01 b.
IV. Bo tng lao ng.
Th tc h s:
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- T khai tham gia BHXH, BHYT (Mu A01-TS Q 1111/Q-BHXH ngy
25/10/2011)
- 02 nh 3x4cm
- Giy xc nhn thi gian ng BHTN cha hng BHTN do c quan
BHXH ni gii quyt BHXH mt ln.
- Giy t lin quan ( hng quyn li BHYT cao hn).
S lng: 01 b.
V. Bo gim lao ng v xc nhn s.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)

- Quyt nh chm dt hp ng lao ng, hp ng lm vic, thuyn

chuyn., ngh vic hng ch hoc hp ng lao ng, hp ng lm vic
va ht thi hn.
- S BHXH
- Th BHYT cn thi hn s dng (tr trng hp cht)
S lng: 01 b.
VI. Thay i mc ng, iu kin ng, cn c ng.
Th tc h s:
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Bn sao quyt nh v tin lng hoc hp ng lao ng, hp ng lm
vic tng ng thi gian ngh iu chnh
S lng: 01 b.
VII. n v thay i php nhn, ch quyn s hu, sp nhp.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Quyt nh hoc vn bn v vic thay i php nhn, chuyn quyn s
hu, sp nhp.
- S BHXH
S lng: 01 b.
VIII. n v b gii th, ph sn, chm dt hp ng.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Quyt nh hoc vn bn ca c quan nh nc c thm quyn v vic
gii th, ph sn, chm dt hot ng.
- S BHXH.
- Th BHYT cn hn s dng.

S lng: 01 b.
IX. Tm dng ng vo qu hu tr, t tut.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Quyt nh tm dng ng vo qu hu tr, t tut ca Th tng
Chnh Ph
- Quyt nh tm dng ng vo qu hu tr, t tut ca B trng B
Lao ng Thng binh v X hi;
- Quyt nh tm dng ng vo qu hu tr, t tut ca Th trng c
quan qun l nh nc v bo him x hi cp tnh.
- S BHXH.
S lng: 01 b.
X. Truy thu do vi phm php lut.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Bng thanh ton tin lng, tin cng ca n v tng ng thi gian
truy thu
- Bin bn v quyt nh x l vi phm hnh chnh v BHXH, BHYT,
BHTN ca c quan nh nc c thm quyn
- T khai tham gia BHXH, BHYT (Mu A01-TS Q 1111/Q-BHXH ngy
25/10/2011)
- 02 nh 3x4cm
- Giy xc nhn thi gian ng BHTN cha hng BHTN do c quan
BHXH ni gii quyt BHXH mt ln.
- Giy t lin quan ( hng quyn li BHYT cao hn).
- S BHXH.XI
XI. Truy Thu do thay i mc ng.
Th tc h s:

- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)

- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011).
- Bn sao quyt nh v tin lng hoc hp ng lao ng, hp ng lm
vic tng ng thi gian ngh iu chnh.
S lng: 01 b.
XII. Truy thu i vi ngi lao ng c thi hn nc ngoi sau khi v
nc.
- n ngh ca ngi lao ng (Mu D01-TS Q 1111/Q-BHXH ngy
25/10/2011).
- Bn sao hp ng lao ng i lm vic c thi hn nc ngoi, hp
ng lao ng c gia hn hoc c k mi ngay ti .
- S BHXH.
S lng h s: 01 b
XIII. Hon tr bt buc.
Th tc h s:
- Vn bn ngh (Mu D01b-TS Q 1111/Q-BHXH ngy 25/10/2011)
- 02 bn danh sch lao ng tham gia BHXH, BHYT (Mu D02-TS Q
1111/Q-BHXH ngy 25/10/2011)
- Bn sao quyt nh hoc vn bn ca c quan Nh nc c thm quyn
v vic gii th, ph sn, chm dt hot ng.
- S BHXH
- Th BHYT cn thi hn s dng (tr trng hp cht)
S lng: 01 b.
XIV. iu chnh s liu thu BHXH, BHYT, BHTN.
- Vn bn ca n v ngh iu chnh (Mu D01b-TS Q 1111/QBHXH ngy 25/10/2011)
- Chng t chuyn tin, thng bo thu ca k c lin quan (bn chnh)
S lng: 01 b.
XV. H s tham gia BHXH t nguyn.
Th tc h s:

- T khai tham gia BHXH t nguyn (Mu A02-TS Q 1111/Q-BHXH

ngy 25/10/2011 )
- 2 nh 3x4
- S BHXH
- n ngh thay i mc ng, phng thc ng (Mu D01-TS Q
1111/Q-BHXH ngy 25/10/2011)
S lng: 01 b
XVI. H s tham gia BHYT t nguyn.
Th tc h s:
- T khai tham gia BHYT t nguyn (Mu A03-TS Q 1111/Q-BHXH
ngy 25/10/2011)
- Bo sao h khu hoc Giy ng k tm tr theo h gia nh
- Bn sao giy t hng quyn li cao hn
- n ngh (truy gim Mu D01-TS Q 1111/Q-BHXH ngy
25/10/2011)
- Th BHYT (truy gim).
S lng: 01 b