Voluntary health insurance (DMS) is one of the most sought-after elements of an employee benefits package. The employer pays for the policy, and the employee receives medical care at good clinics without long waits. For a company it is a way to retain specialists and reduce the time people spend looking for a doctor and getting treatment.

DMS and OMS: the difference

Compulsory health insurance (OMS) is governed by Federal Law No. 326-FZ and entitles people to free care within the state guarantee programme. DMS does not replace OMS but complements it: the programme is designed by the insurance company together with the client, care is provided by clinics listed in the contract, and the scope of services, service quality and appointment times are usually more comfortable.

What DMS programmes include

Insurers name their programmes differently, so Polis Re recommends looking not at the name but at the content: which services, at which clinics and within which limits.

Basic programme

  • outpatient care: appointments with a general practitioner and specialists, diagnostics and tests prescribed by a doctor;
  • the insurer's 24/7 dispatch service;
  • telemedicine consultations.

Standard programme

  • everything in the basic programme;
  • emergency and planned hospitalisation;
  • emergency medical care (ambulance);
  • home visits for acute illness;
  • dentistry within a set limit.

Extended programme

  • everything in the standard programme, with a wider list of clinics, including leading private medical centres;
  • rehabilitation after inpatient treatment;
  • pregnancy care (if included in the contract);
  • a personal doctor-curator who coordinates treatment.

Additional options

  • an annual preventive check-up with tests and examinations;
  • vaccinations, including against flu;
  • extended dentistry;
  • prescribed medicines within a limit;
  • programmes for employees' children and relatives at a corporate rate;
  • travel medical insurance for business trips abroad.

What to check in the contract

  • List of clinics — are there medical facilities convenient for employees near the office and home, including in the regions?
  • Exclusions — chronic diseases, exacerbations, oncology and certain types of treatment are often excluded or limited.
  • Limits — for dentistry, medicines and inpatient care.
  • Booking procedure — via the insurer's call centre, an app or directly at the clinic; how quickly guarantee letters are approved.
  • Changing the list of insured persons — how to add new employees and remove those who have left, and how the premium is recalculated.

How an employee uses the policy

  1. They contact the insurer's 24/7 call centre by phone, through the mobile app or via chat.
  2. The insurer selects a clinic from the programme and books an appointment or sends the clinic a guarantee letter.
  3. The employee receives care and pays nothing at the clinic for services covered by the programme — the insurance company pays the bill.
  4. If a service is not covered, the clinic warns about it in advance, and the employee decides whether to pay for it themselves.

Tax rules for employers

The Tax Code of the Russian Federation supports employee DMS. An employer's DMS expenses are deductible for corporate profit tax up to 6% of payroll costs, provided the contract is concluded for at least one year with a licensed insurer (Article 255 of the Tax Code). Social insurance contributions are not charged on payments under such contracts (Article 422), and employer contributions under DMS are exempt from employees' personal income tax (Article 213). Check the details of application with your accountant.

How to choose a programme

  1. Define the budget per employee and your goals: retaining key specialists, a mass benefits package or a combination of levels.
  2. Map out offices and where employees live — the list of clinics depends on it.
  3. Request offers from several insurers on identical terms so that you compare like with like.
  4. Compare not only price but also exclusions, limits and the quality of the insurer's service.

Learn more about corporate policies in the Employee health insurance section and about individual cover in the Voluntary health insurance section. You can add employee accident insurance to your benefits package. To get a quote, submit a request — Polis Re specialists will prepare a comparison of offers.