Health Insurance Law, Everyone in the world is looking for safety, and one of the most important sources of safety is that treatment is available, which happens when a person has health insurance, as it gives individuals the right to treatment and receive all the necessary medical services in the best clinics and hospitals and the work of comprehensive medical examinations that he needs, and this is what made the Egyptian government seek to provide an integrated system that works to protect the public health of citizens, therefore, it issued the Comprehensive Health Insurance Law No. 2 of 2018, which aims to Providing a safe and healthy life for each individual at the lowest costs, which helps the citizen avoid facing large spending on health, which leads to improving the lives of citizens.

The law contains many provisions that oblige companies and institutions in the private sector, public entities and the public business sector to apply them in order to achieve health and social security for every citizen employee.

and among the most prominent of these items are the following:

(1) The company pledges to promptly notify the General Authority for Comprehensive Health Insurance when an insured individual is injured at work or on the related occasion. This should be done following specified procedures and timelines, using the prescribed forms. The service for the injured individual will not be terminated for any reason without ensuring the ongoing treatment for the sustained injury.

(2) The company is obligated to refer the injured employee to the designated treatment facility to complete their medical care. This commitment applies even if the employee is seconded, assigned, or on a work-related assignment abroad, and their secondment or assignment period has ended, but they still require medical treatment.

(3) The employer is obligated to pay the cost of the service provided by the entity responsible for determining individuals exposed to occupational diseases. This cost is determined by the General Authority for Comprehensive Health Insurance for each insured individual undergoing examination. The payment must be made within ten days from the date of the request.

(4) Employers subject to social insurance laws are required to contribute their share towards the employees’ subscriptions at a rate of (4%) monthly of the subscription salary for the insured employee, at least fifty pounds per month. This contribution covers health insurance, treatment, and work-related injuries services.

(5) The employer is committed to paying the due contributions to the National Social Insurance Authority monthly. This includes both the employer’s share and the portion deducted from the insured employee’s salary to cover their contributions. Payments should be made on the scheduled dates for social insurance contributions.

(6) All relevant public and private entities are committed to implementing the provisions of this law by providing the General Authority for Comprehensive Health Insurance with necessary data about individuals subject to its provisions, including their geographic distribution, ages, professions, and any other information required directly for its activities.

(7) The employer is obligated to inform the General Authority for Comprehensive Health Insurance of the enrollment of all their employees or some of them who have not previously subscribed, allowing the submission application in facing the authority.

The Comprehensive Health Insurance Law includes important obligations that must be followed, there are also strict penalties for anyone who violates these obligations and circumvents obtaining the service, and these penalties stipulate the following:

  1. In the case of non-subscription or failure to pay, individuals are required to settle overdue contributions in a lump sum or through installment payments, as determined by the General Authority for Comprehensive Health Insurance. This condition does not apply if the employer fails to remit the contributions to the authority.
  2. If the employer in the private sector or the designated employee in public entities and public business sectors fails to enroll in the General Authority for Comprehensive Health Insurance for any of the workers subject to this law or does not enroll based on their actual wages, they shall be punished with imprisonment for a term not exceeding one year and a fine of no less than five thousand pounds and not exceeding fifty thousand pounds, or with either of these penalties.
  3. If the insured individuals bear any amounts contrary to the provisions of this law, the employer or the designated employee in public entities and public business sectors shall be punished with the same aforementioned penalties, and the court may, on its own initiative, order them to reimburse the insured individuals the value of the amounts they bore.
  4. In case of delayed payment of contributions beyond the specified deadlines, the obligated party must pay an additional annual amount for the duration of the delay from the due date until the end of the payment month. The additional amount is calculated according to the rules set forth in this law.
  5. If an individual provides false information or refuses to provide the required data as specified in this law, resulting in the wrongful receipt of funds from the authority, they shall be punished with imprisonment for a period of not less than six months and a fine of not less than two thousand pounds and not exceeding ten thousand pounds, or with either of these penalties.
  6. Preventing the Individuals of the authority who have the status of the judicial seizure’ entry to the workplace or denying access to necessary documents under this law, intentionally providing false information, or failing to meet obligations face imprisonment for a minimum of six months, a fine ranging from twenty thousand to one hundred thousand pounds, or both penalties.
  7. If there is a deliberate submission of false claims or claims for services not provided, or allowing non-subscribers to the system to obtain services without legitimate cause, every healthcare service provider, beneficiary, or employee of the General Authority for Comprehensive Health Insurance shall be punished with imprisonment for a period of not less than one year, a fine of not less than one hundred thousand pounds, and not exceeding two hundred thousand pounds, or with either of these penalties.

For more information, contact the “Consortio Law Firm” special team now through the phone number 002 01028806061 or via WhatsApp or email Info@consortiolawfirm.com.