Voluntary health insurance- this is insurance that allows you to receive medical care in clinics that do not work under the compulsory health insurance program. Roughly speaking, with an ordinary policy they turn to a state clinic, with a VHI policy - to a paid one.

If a compulsory insurance regulates the law, then there is no additional separate document. That is, each insurance company sets its own rules and decides for itself what conditions to include in the contract.

Usually the policy is the constructor. That is, you are offered a basic service, and to it - a set of additional ones. The base is the minimum service in the clinic, and the list of possible options is endless. This is a doctor's call to the house, and emergency care, and dentistry, and much more.

In Russia, VHI is usually issued by employers; this is part of an attractive social package for employment. But is it worth doing additional policy if he is not at work and is not expected?

Benefits of voluntary health insurance

The benefits are the same as for paid treatment before free:

1. Service in private clinics with a higher level of comfort and technical equipment.
2. No queues.
3. Quality service. This includes the courteous treatment of the staff, and such small things as free shoe covers and other disposable supplies.

In addition, the patient pays for the VHI policy once, and then the insurance reimburses the costs medical institution. This approach reduces the number of unnecessary examinations and appointments that doctors sometimes make in paid centers: the insurance company simply will not approve manipulations that are not included in the standard of care.

Disadvantages of voluntary insurance

The disadvantage of DMS is one, but a huge one. It is expensive.

The VHI policy is not a subscription with a discount on hospital visits, but an insurance product.

It is unprofitable for the insurance company that you get sick a lot and spend all the money that you paid for the policy in hospitals, so VHI has many restrictions. The final calculations are often not in favor of the patient.

What you need to know when applying for a policy

If you are thinking about buying insurance or got a job where employees are provided with VHI, and want to connect relatives to the program, be sure to clarify a number of questions:

1. List of diseases and conditions under which the policy is not issued. In preparing the article, I re-read the insurance rules of a dozen and a half companies. And everywhere they refuse to conclude a VHI agreement with carriers of HIV and, as well as people over 65 and people with chronic diseases of the cardiovascular system. From an insurance point of view, this is unprofitable.
2. Rules for applying to a medical organization. Under the terms of the contract, it may turn out that before visiting the clinic you need to contact the insurance company, and the local operator will refer you to the doctor. And if this is not done, then the treatment will be at your expense.
3. Clinics with which he works insurance organization. The smaller the choice and the more modest the clinics, the more likely it is that doctors will not be able to conduct a particular examination or manipulation. Then you have to go somewhere else and spend your money.

In addition, carefully read all the insurance rules and the contract itself, which indicates which cases will be insured and which will not.

What is not covered by insurance

All insurance companies have different terms and conditions. It is possible that in your contract for a certain price there will be something that is not in other contracts. But the standard policies in most cases are the same. In addition to the already mentioned cases of HIV infection and malignant neoplasms, they do not cover the costs of:

1. Medicines. You will have to buy pills for your own money.
2. Preventive visits to the doctor. Let's say that nothing bothers you, but you know that you need to visit the dentist and gynecologist every year or even twice a year. If you take care of yourself, the doctor will confirm that you are healthy. And this appeal will not be considered an insured event. The same can be said about visiting a doctor, when you need to put a stamp on the certificate, for example.
3. Pregnancy and childbirth. These events are not considered an insured event, and insurance companies and clinics have separate offers for medical support for pregnancy.
4. Psychiatric help. You will talk about stress, burnout and depression with a psychotherapist for your money.

It’s easier to say when the basic policy works: when something got sick, you went to the doctor and got cured on an outpatient basis. Everything else, including hospitalization (in a comfortable room), is additional chips for extra money.

How to understand whether it is worth buying a VHI policy

There are a few things you need to do to figure out if it's worth buying a policy:

1. Calculate how much you spend on treatment.
2. Find out which service packages you need.
3. Check in which insurance companies and for what amount the policy is provided.

Last year, I did not spend much on treatment in commercial clinics and sought help mainly for preventive examinations (in the table - rounded data, prices are relevant for my region):

The calculator of one of the insurance companies calculated that the minimum policy, which will include the services of a dentist, will cost me 35,000 rubles a year. At the same time, I will also spend money on treatment, because all prevention, according to the rules of insurance, will completely fall on my wallet. That is, massage, and the purchase of drugs - the most expensive items on my list - will remain out of insurance.

You can purchase a policy that will cover these costs. But its price will be sky-high - under a hundred thousand rubles.

For interest, I called two more insurance companies, where honest employees directly said that the VHI policy is unprofitable for individuals, and if I worry about the risk of injury or illness, then it is more logical to conclude an accident or illness insurance contract: it is many times cheaper .

When does it make sense to buy a VHI policy

Voluntary health insurance is beneficial in several cases:

1. With the help of the employer, you connect relatives to the insurance program on favorable terms.
2. You get sick a lot and are treated in paid clinics.
3. You have a lot of money and want to receive medical care with maximum comfort.

If this is not your case, then leave VHI for employers who think about subordinates, want to be attractive to cool specialists and not lose people because they spent the whole day in line at the doctor because of a common cold.

It is becoming more and more difficult to attract an employee only with a salary. Therefore, various "social packages" appeared not only in large, but also in small companies. Almost an obligatory component of the social package is medical insurance. To learn how to properly arrange such insurance and how to calculate taxes and contributions related to voluntary medical insurance (VHI) of an employee at the expense of the employer, read in this article.

Types of insurance

Let's make a reservation right away that the taxation rules, especially in part, are highly dependent on the type of insurance that the employer decided to include in the "social package". So, there may be insurance in case of disability or death. In addition, the legislation provides for the possibility of insurance in case of temporary disability.

However, these insurance options are rather exotic, which most accountants do not have to deal with. Most often, the social package includes voluntary medical insurance policies that give employees the opportunity to receive medical care in medical institutions accredited by the insurance company (polyclinics, hospitals, emergency rooms, sanatoriums, etc.). We will focus on this type of insurance.

Three conditions for VHI

So, the company's management decided to provide employees medical insurance. To do this, the company will need to conclude a voluntary agreement with the insurance company. personal insurance in favor of third parties (employees).

Accordingly, it is the responsibility of the employer to pay for such insurance, and employees will directly use the services of medical institutions. The tax code allows you to take into account the cost of paying for such insurance. True, there are several "buts".

So, firstly, the obligation to provide employees with insurance should be fixed in the labor or in the collective agreement (clause 1 of article 255 of the Tax Code of the Russian Federation). Secondly, only those amounts that are listed in the payment of employee insurance can be included in expenses, i.e. persons with whom the organization has an employment contract. Thirdly, the amount that can be expensed is limited to six percent of total amount labor costs. Finally, fourthly, the insurance contract itself must be concluded for a period of at least a year. Let's consider these conditions in detail.

What do we write in the contract

Let's start with the employment contract. It is clear that this condition must be fixed in employment contracts with employees, but this can be done in different ways.

So, this may be a direct indication in the contract that the employer is obliged to insure the employee under the VHI program. Or maybe a link to a local normative act- Regulations on social guarantees, Internal labor regulations, etc., which contain a similar condition. Moreover, if the first option is chosen, then all the “particulars” (such as: from what moment the insurance is provided, whether it is valid upon dismissal, transfer, transfer to another position, the amount of this insurance) must be fixed either also in the contract, or by referring to corresponding local act.

You also need to make sure that the list of insured persons matches the list of employees of the organization. After all, only those amounts that are paid under insurance contracts of persons who have a valid employment contract with an organization can fall into expenses taken into account when taxing profits. Of course, payment of insurance for family members of employees or for persons with whom the organization has civil law contracts is possible. But tax base in terms of profit, such costs will not be reduced.

Cost rationing

Let's move on to normalization. Income tax expenses include payments under VHI agreements in the amount of not more than six percent of the amount of labor costs.

Please note that for the purposes of calculating the standard, labor costs include the wages of all employees of the enterprise, and not just those who are insured. It is also important to remember that the limit is determined in the same period when insurance costs are recorded.

Cost allocation

Let's now see when the costs of VHI are taken into account. To do this, we turn to paragraph 6 of Article 272 of the Tax Code. It says that the procedure for recognizing expenses for paying insurance under contracts concluded for a period of more than one reporting period (in the case of VHI, costs for shorter contracts simply do not fall into expenses, because according to the Tax Code of the Russian Federation the minimum period is one year) depends on how the company pays for the services of the insurance company. The tax code offers two possible options - a one-time payment and several payments for periods of insurance.

In the first case (one-time payment), the amount paid under the insurance contract is charged to expenses evenly throughout the entire term of the contract, in proportion to the number of calendar days of the contract in reporting period.

In the second case (several payments for insurance periods), each payment must be recognized evenly over the period corresponding to the period for which the payment was transferred, again in proportion to the number of calendar days of the contract in the current reporting period.

In practice, a third option is also possible, which in tax code not described. We are talking about cases of installment payment, when the contract does not clearly indicate for which period each specific payment is made. This is a regular installment plan, when the contract only sets the dates for making the next payment, but there is no binding of this payment to the insurance period. How to act in such a case, the Tax Code does not say. If we apply here the logic used in Article 272 of the Tax Code of the Russian Federation, it turns out that each payment must be evenly distributed over the period from the date of transfer of the payment to the date of the end of the insurance period.

personal income tax and contributions to funds

The insurance premiums that the employer pays under the VHI agreement do not create taxable income for the insured employees due to the direct indication of this in paragraph 3 of Article 213 of the Tax Code of the Russian Federation. Please note that, unlike income tax, there is no rationing in part. Even if the employer could not fully take into account the amount paid under the insurance contract in expenses, personal income tax does not arise for employees insured under such an agreement.

There is no obligation to calculate personal income tax and in terms of cost medical services, which insured employees receive under the VMI program paid by the employer. This is stated in subparagraph 3 of paragraph 1 of Article 213 of the Tax Code of the Russian Federation. The only exception is payment through health resort treatment insurance. Here personal income tax arises, but not the employer, but the insurance company is recognized as an agent for this payment (clause 1, article 226 of the Tax Code of the Russian Federation). It is she who will have to calculate personal income tax from the cost of the tour, if possible, withhold it and transfer it to the budget, or inform the inspectors about the impossibility of withholding (clause 5 of article 226 of the Tax Code of the Russian Federation, determination of the Supreme Arbitration Court of the Russian Federation dated 10.11.10 No. VAS-14352 / 10). So the accountant of the employing organization has nothing to worry about.

The issue of contributions to off-budget funds is solved in a similar way. According to subparagraph 5 of paragraph 1 of Article 9 federal law dated July 24, 2009 No. 212-FZ, payments under contracts of voluntary personal insurance of employees that provide for payment for medical services and are concluded for a period of at least one year are exempted from the calculation of contributions. At the same time, the legislator, as in the case of personal income tax, has not established any standards for this benefit. This means that it is not necessary to accrue contributions for payments in favor of employees, even if part of the costs under the contract is not taken into account when taxing profits.

Along with compulsory health insurance, there is an alternative in the Russian health care system - voluntary health insurance. This program allows you to receive timely medical assistance and solve various health problems without waiting in lines and without paying for additional services at the clinic. How does DMS work?

Voluntary health insurance has long been known to Russians. Despite the economic crisis, many VHI programs are affordable and can help solve health problems or find time for a full examination and prevention.

What is DMS?

VHI (voluntary medical insurance) is a type of insurance in which the insurer, for a certain fee (insurance fee), organizes the provision of medical services to the insured in selected clinics upon the occurrence of insured event- free and fast. According to the terms of the contract and the chosen program, upon the occurrence of an insured event (the need to contact a medical institution), the insured person has the right to receive assistance within the sum insured or receive this amount to his account and use it to eliminate the consequences of the insured event. After signing the contract with the insurance company, the insured person is issued a VHI policy. It allows you to receive:

• treatment (in hospital or outpatient);
• diagnostics, examinations, test results;
• consultations of narrow specialists; ambulance;
• dental procedures (if they are included in the policy);
• additional services (acquisition of medicines, preventive, rehabilitation measures).

The cost of the VHI policy is calculated individually and depends on the personal data and medical indications of the insured, as well as on the chosen insurance program. Insurance can be individual and collective, depending on the set of services, there are basic, extended, full insurance and Special offers SC.

Differences between VHI and CHI

Despite the fact that both types of insurance provide medical care, CHI (minimum necessary medical care) differs from VHI (additional services and services) quite strongly in a number of points listed in the table below:

VHI	CHI
Voluntary insurance	Compulsory for all citizens of the Russian Federation
Source of financing - personal funds of a person	Financing is provided by the state
Conditions are determined by the insurance company	Insurance conditions are the same for everyone and are determined by the state
Possibility to choose a wide range of medical services and medical institutions	Includes a minimum set of medical services. Treatment is carried out in health care facilities (medical and preventive institutions) at the place of residence. Emergency care is provided throughout Russia.
High quality medical services	Poor quality of medical services

In order to insure under the VHI program, the insured must independently contact the insurer. visiting the office of the company or inviting insurance agent to yourself, while in compulsory medical insurance the service is provided automatically to all citizens of the Russian Federation.

The main subjects of the VHI system

The main subjects of VHI are:

• The insured - concludes an agreement and buys a VHI policy. As a rule, any capable person can be the insured, entity or charitable foundation;
• The insured person is a person using the services of the VHI policy (the insured himself or another individual in respect of which the contract was concluded). It can be any citizen of the Russian Federation, as well as a foreign citizen;
• Insurance company (insurer) - an organization that has a license for this type of activity;
• Medical organizations - healthcare facilities that provide medical services and have a license for this activity. They enter into agreements with insurance companies.

Relations between the main subjects of the VHI system are officially enshrined in several legislative acts, and are presented in the following diagram:

A Brief History of the Development of VHI in Russia

Voluntary medical insurance in Russia appeared in 1991 after the adoption of the law "On health insurance of citizens in the RSFSR". Model voluntary insurance 1991-1993 was characterized by low efficiency. Thus, a person insured under a VHI contract was attached to a certain medical organization, and in the event of an insured event, payments often turned out to be lower than insurance premiums. The funds that remained after that were returned. This model was beneficial for employers who hide the salaries of employees from the tax authorities.

In 1993-1994, the attitude towards insurance changed, the requirements for insurers increased. New types of VHI programs are emerging. Insurance compensation already exceed the original insurance premiums.

Since 1995, the VHI system has undergone significant changes. First, it was forbidden to return unspent cash(although there is a VHI deposit agreement that allows you to transfer funds to the next insurance period). This prevented employers from evading taxes. Secondly, the legislation in relation to insurers has become tougher, within the framework of VMI, organizations began to offer a large number of programs and various lists of services, a personal approach to the client has appeared.

How is VHI funded?

VHI is financed from the insured's (person or organization's) own funds, paid as insurance premiums. The amount of payments is determined by the contract concluded with the insurance company.

The insurer from the formed insurance fund pays medical institutions for actually rendered medical services under the VHI program. Insurance organizations may also have additional funding channels, use their own funds and interest on received and invested insurance premiums. Thus, the funds come to the insurer from various sources. Then they are accumulated in a bank account and spent according to the estimate of a specific VHI policy.

Today, the VHI system is actively developing. In connection with the onset of the economic crisis and a decrease in the purchasing power of the population, new programs and truncated policies are being developed. basis modern system Voluntary medical insurance consists of: taking care of people's health, an individual approach to each person, increasing the liability of insurance and medical organizations, improving the quality of medical services, legislative regulation of all processes.

How does the VHI system work in Russia today?

Today VHI policies most often bought by employers for their employees. Individual insurance under the VHI system is much less widespread, mainly due to very high tariffs.

To apply for a policy, the applicant only needs to come with a passport to the insurance company, fill out an application and conclude a VHI agreement. In some cases, a medical examination or questionnaire may be required.

In the event of an insured event, you should call the insurance company. She will send a medical team to the patient or provide other assistance in obtaining assistance, in emergency situations it is allowed to call the city ambulance at number 112. After hospitalization, you need to tell your agent the hospital number so that the insurer pays the costs and improves the conditions for the patient's accommodation. The usual receipt of medical assistance under VHI looks like this:

• Visiting a doctor and obtaining a referral for the necessary examinations or procedures;
• Appeal to a personal manager in an insurance company with a referral from a doctor;
• Joint choice of a medical institution and the time of procedures;
• Implementation of therapeutic measures.

Under these conditions, all costs are borne by the insurance company. They are limited by the amount of the sum insured, determined by the VHI agreement, and the list of services included in a particular policy.

In the article, we will not only talk about how to properly draw up and record a voluntary medical insurance contract (VHI) for employees, but also pay attention to what mistakes can lead to very sad financial consequences.

General issues of taxation of operations under VHI agreements are regulated by the Tax Code of the Russian Federation. Special cases are explained by the relevant letters of the Ministry of Finance of Russia. Judicial practice in cases related to the taxation of VHI agreements is extremely contradictory and reflects purely special cases, so it makes no sense to be guided by it in this matter.

This is also true for tax accounting such contracts - errors in taxation and accounting are fraught with significant losses for the enterprise, and competent accounting and use of the benefits provided by law will make it possible to derive certain benefits when concluding these contracts.

Consider the features of taxation and registration of VHI agreements, which organizations should know when planning, budgeting and developing VMI programs.

income tax

According to Art. 253 of the Tax Code of the Russian Federation, labor costs are included in expenses that reduce taxable income. But at the same time, please note that, in accordance with sub. 16 art. 255 of the Tax Code of the Russian Federation:

• contributions under voluntary personal insurance contracts, which provide for the payment by insurers of medical expenses of insured employees, are included in expenses in an amount not exceeding 6% of the amount of labor costs;
• labor costs include the amounts of payments (contributions) under contracts of voluntary personal insurance of employees concluded for a period of at least one year, providing for payment by insurers of medical expenses of insured employees.

That is, according to sub. 16 art. 255 of the Tax Code of the Russian Federation, labor costs for the purpose of calculating income tax include the amounts of insurance premiums for VHI paid by the employer for employees, in an amount not exceeding 6% of the total amount of labor costs, calculated taking into account Art. 255 of the Tax Code of the Russian Federation. By the way, this rule does not apply to persons who are not on the staff of the insured (letter of the Ministry of Finance of the Russian Federation dated 09.03.2011 No. 03-03-06 / 1/130).

At the same time, the above costs can be taken into account as expenses for the purposes of taxation of profits of organizations. as in the case of payment by the insurer of medical expenses to a medical institution providing medical services to insured employees of the employing organization (insurant organization), and directly insured employees of the employing organization when providing the relevant primary documents on payment of medical expenses by them, provided for by the VMI program (letter of the Ministry of Finance of the Russian Federation dated January 13, 2009 No. 03-03-06 / 1/2).

Note

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The number of insured persons in relation to the total number of employees of the organization, as well as the difference in the insurance programs of individual employees, does not matter for income tax purposes. If the organization has 1000 people, you can insure only 10 or choose different programs for different categories of employees (letter of the Ministry of Finance of the Russian Federation dated 10.05.2011 No. 03-03-06 / 1/284).

The only restriction is that it should not contradict the collective agreement and fall under the formal signs of discrimination specified in Art. 3 of the Labor Code of the Russian Federation. For example, if you have two cleaners with the same functions, and you only insured one, this must be somehow convincingly justified. Moreover, in writing and with reference to the functionality or business qualities (for example, an annual policy in the form of bonuses to individual employees or compensation for increased responsibility, scope of work, etc.). Otherwise, the “offended” cleaning lady has the right to apply to the court “with an application for the restoration of violated rights, compensation for material damage and compensation for non-pecuniary damage” (Article 3 of the Labor Code of the Russian Federation). In practice, if the positions and functions are different, there are no questions.

And we also want to remind you that attribution of insurance premiums under the VHI agreement to expenses that reduce the taxable base for income tax is only possible under the following conditions:

1. the insurer must have an appropriate license to carry out activities in the field of voluntary medical insurance in the Russian Federation, valid for a period not less than the expected term of the contract. The absence of such a license does not give the right to include payments under the contract in expenses. It does not matter whether the insured person is being treated in Russia or abroad, the main thing is that the insurer itself has a license valid on the territory of the Russian Federation (letter of the Ministry of Finance of the Russian Federation dated 05.07.2007 No. 03-03-06/3/10);
2. the VHI contract must be concluded for a period of at least one year (note: this applies to the contract itself, and not to the insurance period of each employee). Therefore, when concluding a VHI contract, it must be borne in mind that the replacement (exclusion or addition of insured persons) does not change the term of the contract itself.

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In some standard contracts VHI has the clause “The contract in relation to the Insured withdrawn from insurance is considered terminated from the date specified in the application, unless otherwise established by an additional agreement of the Parties. At the same time, the number of the Insured under the Contract is decreasing”.

According to this wording, income tax must be recalculated and additionally assessed in terms of a person withdrawn from insurance if he was insured for a period of less than a year.

It would be more correct from the point of view of tax accounting to write: “The obligation of the Insurer in relation to the Insured withdrawn from insurance is considered terminated from the date specified in the application, unless otherwise provided by an additional agreement of the Parties. At the same time, the number of the Insured under the Contract is decreasing”.

It is also useful to prescribe in the contract a mechanism for replacing one insured person with another. From a tax point of view, this is less risky than returning part of the insurance premium.

Keep in mind that the amounts of insurance premiums paid by the employer under VHI agreements for members of employees' families are not taken into account for income tax purposes. This conclusion follows from par. 5 p. 16 Art. 255 and paragraph 6 of Art. 270 of the Tax Code of the Russian Federation. The above is also confirmed by the capital tax authorities in the letter of the Federal Tax Service of Russia for Moscow dated August 22, 2008 No. 21-11 / [email protected]

And further important point: if you want to change the insurer on your own initiative , it is better to do this after a year has passed since the start of the contract that “does not suit you”. Otherwise (upon termination of the VHI agreement up to a year and the conclusion of an agreement with another insurer), the taxable base will have to be recalculated - the expenses attributed to the reduction of the tax base for income tax must be restored as income, since the conditions established by para. 5 p. 16 Art. 255 of the Tax Code of the Russian Federation (letter of the Ministry of Finance of the Russian Federation dated 07.06.2011 No. 03-03-06/1/327). But you can take into account the costs of a new contract only in the relevant period (when it is valid) and only if it is also concluded for a period of at least a year. This applies not only to income tax, but also to other taxes. Tax incentives do not apply to VHI contracts for a period of less than a year.

Changes in the composition of the insured, the VHI program and the amount of insurance premiums within the framework of the current agreement does not entail changes in taxation. According to the letters of the Ministry of Finance of Russia dated December 18, 2006 No. 03-03-04 / 2/260, dated November 9, 2006 No. 03-03-04 / 1/747, as well as the Federal Tax Service of Russia for Moscow dated January 30, 2009 No. 19-12 /007403, dated 10.10.2007 No. 20-12/096637, if changes were made to the list of insured persons related to the hiring and dismissal of employees without changing the essential terms of the contract (term, number of insured persons, etc.), then insurance premiums under such contracts are also accepted as a reduction in the taxable base for income tax.

In accordance with the explanations set out in the letter of the Ministry of Finance of Russia dated January 29, 2010 No. 03-03-06 / 2/11, in the event of the conclusion of an additional agreement to the main contract, the terms of which provide for inclusion in the main contract of new employees of the employing organization , expenses in the form of additional amounts of payments (contributions) under the contract of voluntary personal insurance of employees are also taken into account as part of labor costs for the purpose of taxing the profits of organizations, provided that all essential conditions are met by the additional agreement (term, number of insured persons, etc.). ) contracts of voluntary personal insurance of employees and the amount "fits" in 6%.

In addition, if the obligations under the contract of voluntary personal insurance of employees of the organization the insurer transfers to another insurer (insurers) without terminating the contract (by replacing persons in the obligation), the policyholder may continue to include the amount of contributions under such an insurance contract as an expense for income tax purposes. A similar approach is also legitimate in a situation where the transfer of obligations under a contract of voluntary personal insurance of employees occurs not on a voluntary basis, but on the grounds provided for in Art. 57 and 58 of the Civil Code of the Russian Federation (in connection with the reorganization) (letter of the Ministry of Finance of the Russian Federation dated November 11, 2011 No. 03-03-06 / 3/12).

Features of the accounting procedure: if the terms of the insurance contract provide for the payment of an insurance premium in a single payment, under contracts concluded for a period of more than one reporting period, expenses are recognized evenly over the term of the contract in proportion to the number of calendar days of the contract in the reporting period (clause 6 of Art. 272 of the Tax Code of the Russian Federation). At the same time, the amount of the insurance premium actually paid, attributable to the days of the contract, for the corresponding reporting ( tax periods) cannot exceed the limit level.

personal income tax

Insurance premiums under VHI agreements are not subject to personal income tax (both for the employee himself and for members of his family who are not in labor relations with the enterprise), this follows from the norms of clause 3 of Art. 213 of the Tax Code of the Russian Federation. The specified insurance premiums are not subject to personal income tax even if they are paid in favor of family members of employees (letters of the Ministry of Finance of the Russian Federation dated 03.07.2008 No. 03-04-06-01 / 185, dated 26.12.2008 No. /388, Federal Tax Service of Russia for Moscow dated July 1, 2010 No. 20-14/3/068886).

According to sub. 3 p. 1 art. 213 of the Tax Code of the Russian Federation, when determining the tax base, income received in the form of insurance payments in connection with the occurrence of relevant insured events ... under agreements providing for the reimbursement of medical expenses (with the exception of payment for sanatorium and resort vouchers) is not taken into account. The norm applies to insurance of any persons.

Payments made by the employer in favor of employees in the form of providing them with dietary nutrition provided for by the voluntary medical insurance program, if the employees have the relevant diseases, are not subject to personal income tax.

A natural question arises: what to do with spa treatment? Unfortunately, the analysis of clarifications on this issue does not make it possible to unambiguously answer it. There is a so-called "tax risk". Apparently, when including this clause, the legislator had something important in mind, but the clause is worded in such a way that it is unequivocally impossible to understand it.

One side, insurance payments under voluntary medical insurance agreements concluded by organizations in favor of their employees, they are subject to personal income tax in terms of payment for sanatorium and resort vouchers, since this is directly provided for by current legislation. On the other hand, who exactly is a tax agent in this case - an employer organization or an insurance company, is not clearly defined by the current legislation, and judicial practice on this issue is contradictory.

Arbitrage practice

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Judicial practice sometimes develops not in favor of the taxpayer (see, for example, the decisions of the Federal Antimonopoly Service of the West Siberian District dated January 15, 2010 in case No. A27-6748 / 2009, dated December 18, 2009 in case No. A27-6555 / 2009, district of July 16, 2010 in case No. A56-24057 / 2008).

At the same time, the decision of the Federal Antimonopoly Service of the Urals District dated March 12, 2008 No. F09-1326 / 08-C3 in case No. A60-11974 / 07 states that such payments of personal income tax are not subject to personal income tax in the case when employees of the organization underwent rehabilitation and rehabilitation treatment in a sanatorium - spa establishments.

At the same time, in judicial practice there is no single approach to the question of which organization (employer-insured or insurer) should withhold personal income tax from this insurance payment.

For example, in the decisions of the Federal Antimonopoly Service of the West Siberian District dated January 15, 2010 in case No. A27-6748 / 2009, dated December 18, 2009 in case No. A27-5584 / 2009 and in case No. A27-6555 / 2009, it is indicated that personal income tax should be withheld employer, and in the decisions of the Federal Antimonopoly Service of the North-Western District dated July 16, 2010 in case No. A56-24057 / 2008, dated July 2, 2009 in case No. A56-24057 / 2008 - that the insurance company (insurer) must withhold personal income tax.

Thus, there is a risk of being held liable in case of non-withholding and non-listing in personal income tax budget for the employing organization in this situation. But at the same time, according to paragraph 1 of Art. 226 of the Tax Code of the Russian Federation, in this case, the tax agent may not be the employer, but the insurance organization that makes payments. It must calculate, withhold, and transfer personal income tax or inform the inspectors about the impossibility of withholding (clause 5 of article 226 of the Tax Code of the Russian Federation, determination of the Supreme Arbitration Court of the Russian Federation of November 10, 2010 No. VAS-14352/10).

Therefore, in order to avoid unnecessary problems, it is better to stipulate in advance in the VHI contract that the personal income tax from the specified amount is calculated and paid by the insurer when providing spa services. True, he will have to compensate for this amount in the cost of the contract.

Another important nuance: what to do with personal income tax, if the VHI agreement provides that Does the employee receive insurance compensation in monetary terms?

There are two options. If the insured, according to the terms of the VHI contract, receives a sum of money simply as a payment upon the occurrence of an insured event at pre-agreed rates, then his taxable income includes the amount of the insurance premium and is subject to personal income tax at a rate of 13%. Moreover, according to Art. 223 of the Tax Code of the Russian Federation, this should be done in the case when the employee has received income, i.e. on the day of payment insurance compensation.

At the same time, the amount of insurance compensation itself does not need to be taxed with personal income tax: according to Art. 213 of the Tax Code of the Russian Federation, the tax base does not include amounts that are paid after an insured event has occurred.

The second option is if the employee receives sum insured as compensation for already incurred costs of treatment. For example, in another region where the insured does not have contracts with medical organizations or in another medical institution (in the absence of the opportunity to receive such assistance in the medical institution of the insurer). When providing the relevant primary documents on payment of medical expenses by them, provided for by the VMI program, and in the amount indicated in these documents, the personal income tax contribution is not subject to personal income tax (letter of the Ministry of Finance of the Russian Federation dated July 17, 2008 No. 03-04-06-01 / 216).

Documented expenses for the purpose of substantiating VHI expenses for the insured are understood to mean expenses confirmed by documents drawn up in accordance with the legislation of the Russian Federation, or documents drawn up in accordance with business practices applied in a foreign state in whose territory the corresponding expenses were made, and ( or) documents indirectly confirming the expenses incurred (including a customs declaration, a business trip order, travel documents, a report on the work performed in accordance with the contract) (letter of the Ministry of Finance of the Russian Federation of August 22, 2011 No. 03-03-06/1/507) .

Note

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The form and procedure for insurance payments to the insured person are determined on the basis of a specific VHI agreement.

Insurance premiums

Insurance premiums for compulsory social insurance, including insurance premiums against accidents at work and occupational diseases, contributions and payments under VHI are also not taxed. Exemption from taxation of insurance premiums is provided for in paragraph 5 of part 1 of Art. 9 of the Federal Law of July 24, 2009 No. 212-FZ “On insurance premiums in Pension Fund Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund, sub. 5 p. 1 art. 20.2 of the Federal Law of July 24, 1998 No. 125-FZ "On the mandatory social insurance from accidents at work and occupational diseases.

However, this exemption does not apply to cases where VHI agreements are concluded for a period of less than a year, accruals under the agreement will be subject to insurance premiums, including insurance premiums against accidents at work and occupational diseases (letter of the Ministry of Finance of the Russian Federation dated July 17, 2008 No. 03-04 -06-01/216).

The specified norm applies to employees, but there are no labor relations between the organization and family members of employees, therefore, when transferring an insurance premium for them under voluntary health insurance agreements, the object of taxation with insurance premiums, including contributions for insurance against accidents at work and occupational diseases, does not arise (Part 1 of Art. 1 article 7 of the Federal Law No. 212-FZ, paragraph 1 article 20.1 of the Federal Law No. 125-FZ).

value added tax

This tax is the easiest. Insurance premiums(contributions) and insurance payments exempt from value added tax by virtue of a direct indication of the law (subclause 7, clause 3, article 149 of the Tax Code of the Russian Federation).

Simplified taxation system

The position of the specialists of the Ministry of Finance of Russia on the issue of accounting for taxation purposes when applying the “simplified system”, the organization’s expenses for voluntary medical insurance of its employees is reflected in letters dated 01/30/2012 No. 03-11-06/2/14 and dated 09/27/2011 No. -06/2/133.

In accordance with sub. 6 p. 1 art. 346.16 of the Tax Code of the Russian Federation, enterprises and individual entrepreneurs employees working under the simplified system of taxation "income minus expenses" have the right to take into account the costs of voluntary medical insurance of their employees as part of their expenses. At the same time, a voluntary agreement CHI insurance must be concluded for at least one year.

Despite the fact that such costs are not directly named in the closed list of expenses “permitted” under the simplified taxation system (Article 346.16 of the Tax Code of the Russian Federation), the taxpayer can take them into account as expenses on the basis of subpara. 6 p. 1 art. 346.16 of the Tax Code of the Russian Federation as labor costs, and the composition of labor costs, in turn, is determined in accordance with Art. 255 of the Tax Code of the Russian Federation (clause 2 of article 346.16 of the Tax Code of the Russian Federation). At the same time, contributions under such contracts are included in expenses in the amount not exceeding 6% of the amount of labor costs.

However, it should be noted that there is another approach to solving this issue. This approach is demonstrated by individual specialists of regulatory authorities in private explanations and in practice during tax audits. Its essence is as follows. Subparagraph 7 of paragraph 1 of Art. 346.16 of the Tax Code of the Russian Federation allows to include only expenses for all types of compulsory insurance employees, property and liability. This rule is special in relation to the general rule of Art. 255 of the Tax Code of the Russian Federation. Therefore, taxpayers applying the simplified system with the object of taxation "income minus expenses" are not entitled to include as expenses when calculating the single tax the amount of contributions under voluntary personal insurance contracts for employees.

Thus, it must be borne in mind that when accounting for contributions under voluntary medical insurance contracts for employees concluded for one year, as part of the costs when calculating the tax paid in connection with the application of the “simplification”, claims from the inspection authorities are possible. Moreover, due to the absence of the existing judicial practice on this issue, it is difficult to predict what position the court will take in the event of a possible trial.

High salary and career prospects are great. However, good specialists are also interested in the social package: is there official transport and corporate communications, does the company conduct trainings at its own expense, and most importantly, is voluntary medical insurance for employees provided?

VHI for employees: what is it and why is it needed?

In short, VHI is an opportunity to be treated in good clinics by qualified doctors at the expense of the insurance company. By compulsory medical insurance policy a person receives an appointment for a week and an hour of waiting in line, and in the office he is met by a tired and dissatisfied doctor. VHI is another matter: attentive doctors, individual approach and appointment at any convenient time.

The minimum voluntary insurance costs 20-30 thousand rubles a year, so employees can rarely afford it. They will be grateful to the employer who will take care of their health. The employer also wins: the company raises its status in the eyes of staff, customers and partners.

Registration of medical insurance for employees

Only large companies or small but very profitable companies with a minimum staff can afford corporate VMI insurance. It is not worth counting on insurance for employment in a modest shop. New employees rarely receive insurance immediately: the employer acquires insurance for them after some time (standard - after 3, 6 or 12 months from the date of admission to the state).

Validity insurance contract is 1 year. A shorter period is unfavorable for the employer - only with annual insurance, the income tax base decreases. Insurance companies also set 1 year as the standard term. After this period, the insurance can be extended.

Services corporate VHI provided by many major insurers: Sberbank, Alfa Insurance, VTB and others. All these organizations give a good discount to corporative clients. A policy for an employee costs 1.5, and sometimes 2 times less than a regular medical insurance for a private person.

Benefits of VHI for employees

Let's imagine a newcomer who got a job in a company in one of the "ordinary" positions and honestly worked out the allotted time before receiving VMI. Will he be able to count on the maximum insurance package, which includes treatment for exotic diseases in the best clinic in the city? It is unlikely that an employer will buy such insurance except for top managers. But the standard program also provides for many "delicious" services:

• comprehensive medical examination;
• reception and consultations with generalists and some (not all) narrow specialists;
• doctor's home visit;
• a number of medical, diagnostic, preventive and rehabilitation procedures;
• decor sick leave and other medical acts;
• dental services (not always).

Experienced workers who confidently walk up the career ladder are encouraged by management to switch to extended VHI program . It may include:

• commercial ambulance;
• maintenance and treatment in a hospital;
• treatment at the dentist (already guaranteed);
• treatment and rehabilitation in sanatoriums, specialized medical centers;
• reimbursement for certain medicines;
• medical services for family members and relatives of the insured employee.

The most expensive versions of insurance stipulate payments in the event of temporary disability, disability and even death. The cost of such policies can reach 200-300 thousand rubles.

The insurer often provides discounts for other insurance products to employees with corporate VHI.

Benefits for employers

VHI included in the social package is a powerful competitive advantage.

• The prestige of the company and the level of employee loyalty are increasing. Corporate insurance is a sign that the company is doing well, and management listens to the needs and needs of its employees.
• More qualified and experienced candidates respond to vacancies. The availability of VHI for applicants sometimes becomes a factor that outweighs even high salary- you can save a lot of money on medical care under insurance.
• The employer uses tax incentives. The amount of insurance premiums is not subject to the unified social tax, and when calculating the taxable base of an employee, the income that he receives as an insurance payment is not taken into account. This reduces the financial burden on the employer when paying insurance premiums for employees.

By spending part of the profits on insurance premiums, the company is investing in the future. It is pleasant for employees to feel not as cheap labor, but as qualified specialists, the value of which is well known to the company's managers. This creates the foundation for productive work. People are more willing to work and more responsibly approach their duties.

Is there a trick here?

Beneficial for both parties. High level of employee motivation, reduced staff turnover, tax benefits, high-quality and free health care– good arguments in favor of VHI. However, employee insurance does not always go smoothly. Some employers choose the cheapest VHI options from dubious insurance companies in order to cut costs. As a result, the quality of medical services suffers - "profitable" insurers cooperate with mediocre clinics and hospitals. Sometimes insurance companies even deceive policyholders by replacing contracted services with cheaper ones.

This problem is easily solved - the employer must carefully check the insurers or cooperate only with large and reputable organizations. They value their reputation and always work professionally.

It is believed that they attract middle-aged and elderly employees, while young people are less interested in them. Wrong opinion! Ambitious and responsible young people understand that it is impossible to save on health. Starting a career in a reputable company with corporate insurance is what millions of talented guys dream of.

In a word, corporate voluntary medical insurance has much more pluses than minuses, and today, during the economic downturn, this is especially noticeable.