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  #1  
Old February 28th, 2011, 15:28
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Default [Ask] Beda Askes dan Jamsostek

Halo Bro Sekalian,

Saya mau tanya, perusahaan tempat saya bekerja ini berbentuk perusahaan peorangan atau UD. Saya ingin memasukan staff di tempat saya untuk asuransi, yang ingin saya tanya itu :

1. Apakah perusahaan perorangan bisa mendaftarkan karyawan ke askes atau jamsostek
2. Apakah beda jamsostek dengan askes (lebih bagus mana ya)
3. untuk biaya asuransi pegawai biasa diambil dari gaji atau memang subsidi dari perusahaan.

Terima Kasih
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  #2  
Old February 28th, 2011, 17:09
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Default Re: [Ask] Beda Askes dan Jamsostek

CMIIW, Askes itu hanya untuk pegawai negeri.
Kalau perusahaan swasta biasa di Jamsostek.

Untuk jamsostek ada 4 komponen :

1. Jaminan Hari Tua (JHT = dana pensiun)
Iuran sebesar 2% dari upah bulanan dibayarkan oleh karyawan dan 3.7% dari upah bulanan dibayarkan oleh perusahaan.
Dana ini dapat dikelola oleh Jamsostek, saldonya dilaporkan setiap akhir tahun.

2. Jaminan Kecelakaan Kerja (JKK):
Iuran sebesar 0.24% dari upah bulanan dibayarkan oleh perusahaan

3. Jaminan Pemeliharaan Kesehatan (JPK) :
Iuran sebesar 3% (untuk karyawan belum menikah) atau 6% (untuk karyawan sudah menikah) dari upah bulanan dibayarkan oleh perusahaan.
Maksimum iuran Rp 30.000 untuk karyawan belum menikah dan Rp 60.000 untuk karyawan sudah menikah
Untuk karyawan yang sudah menikah JPK ini berlaku bagi istri/suami dan maksimal 3 anak.

4. Jaminan Kematian (JKM) :
Iuran sebesar 0.3% dari upah bulanan dibayarkan oleh perusahaan

JPK itu opsional, jadi bisa hanya ambil JKK, JKM, dan JHT saja jika perusahaan mempunyai sistem jaminan pemeliharaan kesehatan sendiri, karena untuk JPK itu klaimnya tingkat pertama harus di Puskesmas.
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  #3  
Old February 28th, 2011, 17:41
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Default Re: [Ask] Beda Askes dan Jamsostek

@jack11, terima kasih atas infonya.

Satu lagi bro, apakah perusahaan perorangan (UD) bisa ikut jamsostek ? Atau hanya untuk perusahaan besar aja.

Thanks
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  #4  
Old February 28th, 2011, 18:11
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Default Re: [Ask] Beda Askes dan Jamsostek

Perusahaan perorangan bisa kok jadi anggota jamsostek, tinggal cek saja lokasi kantor masuk ke kanwil jamsostek mana untuk pendaftaran.

Jangankan perusahaan perorangan, tenaga kerja freelance juga bisa sama-sama membentuk wadah untuk mendaftarkan anggotanya jadi anggota jamsostek.
Waktu sosialisasi dari kanwil contohnya adalah para tukang bakso di kecamatan tertentu bisa saja membentuk wadah lalu mendaftarkan anggotanya ke jamsostek.
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  #5  
Old February 28th, 2011, 19:51
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Default Re: [Ask] Beda Askes dan Jamsostek

Gila euy..... ngga nyangka yah,koko Jack11 jago banget dalam hal ini. Ngga cuma jago di ranjang......(Kata si itu tuhhhh.......)
Upppssss..........kelepasan iq,kabur ahhhh..........
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  #6  
Old February 28th, 2011, 21:35
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Default Re: [Ask] Beda Askes dan Jamsostek

meralat sedikit informasi dari Bro Jack11 (sorry, no offence), ASKES juga boleh dipakai diperusahaan swasta, tp layanan ASKES hanya terbatas pada asuransi kesehatan saja, sedangkan jamsostek lbh lengkap seperti yg disebutkan oleh Bro Jack11.
Menurut peraturan depnaker, kalau ga salah suatu perusahaan sdh diwajibkan utk mendaftarkan jamsostek jika memiliki karyawan minimal 10 ke atas ( tapi kalau ketahuan lho )....

Salam
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  #7  
Old February 28th, 2011, 22:28
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Default Re: [Ask] Beda Askes dan Jamsostek

sptnya askes, claim-nya dalam hal biaya rawat dan pengobatan .. lebih besar dari jamsostek.
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Old March 1st, 2011, 00:18
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Default Re: [Ask] Beda Askes dan Jamsostek

Bro Astro1975, Askes untuk badan usaha swasta (askes komersial) bukannya sekarang sudah dialihkan ke anak perusahaannya, PT Asuransi Jiwa Inhealth Indonesia?
Soalnya tahun lalu sempat jajaki pindah dari jamsostek ke askes, dibilangnya askes sudah tidak melayani swasta, disuruh kontak ke Inhealth. Klien lama askes komersial juga katanya secara bertahap dipindah ke Inhealth.

Memang benar kata Bro Moori, kalau di jamsostek semua sama rata, pengobatan tahap 1 harus via puskesmas dulu baru dirujuk ke rumah sakit kalau dinilai perlu.
Kalau inhealth kalau ngga salah (seperti askes komersial dulu) bisa pilih level service berdasarkan level karyawan, jadi bisa langsung ke RS.
Tapi preminya tentu saja beda nilainya.

Last edited by jack11 : March 1st, 2011 at 00:23.
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  #9  
Old March 1st, 2011, 08:14
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Default Re: [Ask] Beda Askes dan Jamsostek

Makasi atas informasinya, bro Jack11, kalau mengenai skrg sdh dipindahkan ke anak perusahaannya, nubie kurang tau, secara nubie sdh tidak bergelut di bidang itu saat ini sejak pindah ke jkt. Kalau begitu beneran ya ASKES skrg hanya utk pegawai negeri doank ?

Untuk pelayanan kesehatan di askes, setau nubie jauh lebih bagus dibandingkan jamsostek, demikian juga claimnya, misalnya dulu polda nubie sewaktu bersalin, nubie pake dana sendiri, alasannya krn dokter yg nubie pake tidak terdaftar sbg dokter askes, setelah itu biaya persalinan nubie claim ke askes dibayarkan sktr 60-70%, sedangkan kalau di jamsostek, standard kelahiran normal cuma 300-400rb (ga tau kalau saat ini)
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Old March 1st, 2011, 09:04
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Default Re: [Ask] Beda Askes dan Jamsostek

Quote:
Originally Posted by jack11 View Post
Bro Astro1975, Askes untuk badan usaha swasta (askes komersial) bukannya sekarang sudah dialihkan ke anak perusahaannya, PT Asuransi Jiwa Inhealth Indonesia?
Betul Bro, unit Komersial Askes udh ditutup dari tahun kemaren, so sepertinya memang untuk pegawai swasta ditangani Inhealth..
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Old March 1st, 2011, 09:25
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Default Re: [Ask] Beda Askes dan Jamsostek

CMIIW ... kalo gak salah persyaratan jamsostek minimal harus ada 10 karyawan deh
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  #12  
Old March 1st, 2011, 10:31
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Default Re: [Ask] Beda Askes dan Jamsostek

kalo mao asuransi kesehatan perusahaan yang lebih bagus coba cek ACA sama Manulife.
Gua sih menyarankan manulife secara syarat untuk dapat jaminan askes dengan kartu lebih mudah, kalo ga salah minimal 25 pegawai.
Sedangkan CAR ada minimum premi yang harus dicapai untuk diberikan kartu langsung.

Keuntungan adanya kartu adalah pada saat cek in di rumah sakit bisa langsung masuk tanpa harus siapin jaminan dll.
Pembayaran rumah sakit yang ditanggung juga langsung dipotong pada saat pembayaran (tidak sistem claim) atau ada yang di cover seluruhnya dahulu oleh perusahaan asuransi.

Ada beberapa perusahaan asuransi yang juga memberikan cash back bila klaim sedikit atau tidak ada claim ke perusahaan.
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  #13  
Old March 1st, 2011, 12:17
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Default Re: [Ask] Beda Askes dan Jamsostek

Mau share juga pengalaman diperusahaan tempat gw kerja, sudah lebih dari 10 tahun kita memakai jasa perusahaan asuransi CAR untuk pelayanan kesehatan nya, yang kantornya di Kompleks Duta Merlin, Jl. Gajah Mada, Jakarta Pusat.
Sejauh ini perusahaan gw cukup puas dengan pelayanannya, waktu sebelum pakai CAR sempat juga mau pilih Manulife, tapi waktu itu Manulife untuk seluruh claim, baik in-patient (rawat inap) maupun outpatient (rawat jalan), menggunakan sistim reimbursement, terutama untuk in-patient agak repot juga karena kita harus menaruh jaminan di RS tsb.
Sedangkan CAR untuk in-patient menanggung semua biaya yang dikeluarkan, yang nantinya kalau seluruh perawatan sudah selesai, baru diperhitungkan dengan kita, apabila kita menghabiskan biaya lebih dari plafond kita, maka selisihnya akan ditagihkan kepada kita.
Memang di CAR ada minimumnya, kalo ga salah 25 orang.
Kitapun dapat memilih premi rawat jalan maupun rawat inap yang kita inginkan, misalnya rawat jalan Rp.100.000/kunjungan, rawat inap Rp.500.000/hari.
Jasa yang didapatkan selain biaya konsultasi dokter sebesar Rp.100.000 juga obat2an dan biaya lab yang plafondnya akumulatif untuk setahun.
Biaya2 ini claimnya diajukan kepada CAR, dan sesudah mereka menganalisanya, biasanya claim keluar kira2 2 minggu sesudah kita mengajukan.
Untuk detailnya bisa menanyakan ke kantor CAR, btw asuransi jenis ini namanya Asuransi Prevensia.
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Old March 4th, 2011, 09:36
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Default Re: [Ask] Beda Askes dan Jamsostek

Oh ... CAR lumayan oce yach....
Lumayan buat referensi nih...

Sekarang ini sih, sebagian pegawai gua, di asuransikan di Avrist , ex AiA indonesia.
So far sih, semua claim tidak bermasalah n lancar2 aza.
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Old May 14th, 2011, 19:21
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Default Re: [Ask] Beda Askes dan Jamsostek

hanya utk informasi aja:

sebaiknya kalo masih bisa berobat/masuk rs bila kita ga kenal deket dg dokternya lebih baik menggunakan fasilitas tanpa kartu.
memang fasilitas dg pake kartu itu lebih mudah ga pake dp, bisa lgsg dirawat dsb.
peristiwa itu terjadi beberapa kali di gw sendiri, polda gw, temen deket, supplier obat yg gw ga ragukan kredibilitasnya.

modus operandinya:
1. disuruh periksa yg ga sesuai dg keluhan yg ada. (tiap ari disuruh rontgen, sakit db disuruh ct-scan dsb)
2. ditambahin obat/vitamin yg sebenernya ga dibutuhkan. vitamin msh gpp krn gampang dibuang ama badan kalo kelebihan, tp kalo obat bisa ngerusak ginjal ato imun badan. (obat normalnya 3 macem jd 5 macem, ada antibiotik yg ga dianjurkan malah dipake 3x sehari)

semua itu asalnya dari komisi. yap bener uud (ujung2nya duit), krn banyak dokter tuh dapet komisi dari setiap obat yg dikasih plus penggunaan alat2 rs.
so bila dokternya nakal, dia bs kepikir mumpung pasiennya ga bayar sendiri ini.
please bro/sis bm pertimbangin antara kemudahan dan efek samping yg ada.
jg banyak rs yg orientasinya duit, so kalo dorkternya ga menyarankan, tetep aja penggunaan alat2 dimasukkan sbg perawatan standard.

kejadian ini akibatnya:
1. plafon berobat bisa kelebihan so akan dibebankan langsung ke pasien (udah jatoh ketimpa tangga), atau ke perusahaan baik langsung ato next premi (premi jd mahal).
2. standard premi di perusahaan akan dihitung ulang, ujung2nya perusahaan akan kebebanan premi yg ga wajar. ini akan berimbas ke perusahaan kalo perusahaan yg bayarin premi ato ke pegawai kalo pegawai yg bayar sebagian dipotong dari gaji.
3. catatan medis yg jelek kalo akan memakai jasa asuransi dikemudian hari.
4. kerugian fisik yg mungkin ga dirasakan saat ini tp bisa aja ada masalah dikemudian hari.

sori bgt oot neh...

balik ke topik...

btw beda mendasar jamsostek ama askes itu kalo jamsostek lebih kearah rencana masa depan (kalo di swasta ada dplk plus) kalo askes hanya utk berobat aja.

tipe2 askes ada 2 macam:
1. rawat inap dan teman2nya. (standard health insurance)
-1.a. personal
-1.b. kumpulan
2. asuransi kesehatan karena kecelakaan (pa/personal accident-c) yg hanya bisa diambil secara kumpulan.

cara jual askes:
1. polis pribadi
-1.a. polis terpisah (biasanya pas klaim haru pake bon asli)
-1.b. bagian dari polis lainnya (biasanya pas klaim bs pake bon kopi).
2. polis kumpulan (selalu pake bon asli)
satu hal yg harus diingat bener2, askes itu secara legal statement adalah asuransi tahunan walaupun agen asuransi sering ga ngomong atau ngomongnya beda. (bagi yg punya polis boleh dibaca deh, ada tertulis di sana)
jd tidak ada keharusan dari perusahaan asuransi untuk terus memperpanjang askes bila dia tahu bakal ada klaim2 besar di masa datang. (ini ga tertulis, tp sudah ditegaskan di atas yaitu asuransi tahunan)

tipe proteksi:
1. rawat inap (opsi: bisa tambah maternity)
-1.a. kamar, dr, bedah, dst
-1.b. kamar plus bedah saja
2. rawat inap plus rawat jalan (opsi: maternity, rawat gigi, kacamata)
di sini banyak kerancuan yg sering dipake agen utk misleading:
1. mengatakan ada rawat jalan padahal rawat jalan yg ada harus sebab khusus: bedah tanpa rawat inap, rawat jalan akibat kecalakaan, rawat jalan pre/post rawat inap.
2. lengkap padahal hanya rawat inap saja.
3. proteksi tinggi padahal hanya biaya kamar yg oke, bedah/dokter imut2 banget.
pokoknya yg penting jgn beli kucing dalam karung deh.

plafon askes;
1. per kunjungan/per rawat inap saja.
2. per kunjungan/per rawat inap plus plafon tahunan
3. plafon tahunan saja.
di sini jg bro/sis harus waspada, sering kali premi rendah tapi syarat plafonnya banyak bener.
oh ya, sebenernya bro/sis bisa tawar2an utk plafon ini kalo bro/sis pakenya kumpulan.
krn di asuransi kumpulan tidak ada paket standardnya, bisa diatur termasuk gedenya plafon tiap2 bagian mis kamar mau brp, dokter mau brp, bedah brp dst. 'n so pasti ujung2nya di premi yg harus dibayarkan.

kalo jamsostek itu yg pasti adalah jht, jkk, jkm, yg dalam asuransi swasta dijual pake nama dplk (dana pensiun lembaga keuangan) plus (opsi: ekstra untuk meninggal, kecelakaan hingga cacat/meninggal, ketidak mampuan utk bekerja, sakit kritis)
jg bisa ditambah jpk yg bisa diganti langsung dengan askes.
bedanya swasta dg pemerintah adalah tipe pengelolaan uang yg ada, selebinya 11-12 lah.

summary gampangnya jamsostek agak2 mirip unitlink/endowment kalo askes ya seperti namanya asuransi kesehatan.
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  #16  
Old May 14th, 2011, 22:40
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Default Re: [Ask] Beda Askes dan Jamsostek

@eastgarou,

Thanks bro atas sharing informasinya
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  #17  
Old May 15th, 2011, 18:49
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Default Re: [Ask] Beda Askes dan Jamsostek

@shiratori: gw ga tau persis maksudnya 'in health'. tp mestinya seh askes ya.

btw bro/sis gw barusan ditawarin askes dari salah satu broker.
perusahaan asuransinya seh gede tp ga ada cabang di indo, jd masuk indo secara gelap lewat broker aja (polis tetep dr luar).
sistemnya bayar berapa tahun tp proteksinya seumur hidup sekian, mau diklaim lewat rawat apapun terserah, trus masuknya ga perlu cek-up ini itu.
sound so good, tp koq rasanya ada yg ngeganjel di ati.

1. asuransi tuh maennya hukum bilangan besar, alias kata gampangnya tuh pake statistik.
jd dia tuh dah tau perkiraan dalam tiap2 milyar premi bakalan ilang berapa buat bayar klaimnya. misal 'si a' sesuai profile dia ada kemungkinan 2%, 'si b' kemungkinannya 2,2%, 'si c' 1.9% dsb. jd mereka punya bates min-max kemungkinan, plus statistik internal sendiri. nah nilai2 ini mrk jg akan asuransiin lagi ke reasuransi biar aman, makanya selalu ada klausul negara dlm keadaan perang, krn statistiknya bs bubar jalan trus bakalan hanya dibayar sebagian dulu dan trus setelah damai akan diitung ulang resikonya so pasti duit klaim ga akan dapet penuh.
di sini ada yg 'feel fishy', krn reas hanya mau terima kalo tidak terlalu berbeda ama statistik mereka (reas jg pake statistik lagi), misal perusahaan asuransi negara 'a' disesuaikan ama statistik negara 'a' ga boleh njomplang. jd statistik resiko gw di indo so pasti akan beda kalo gw di singapore ato gw di irak, nah ini yg ga beres.
kalo perusahaannya ambil klien di indo, tp reas lewat negara lain, yah semoga aja statistiknya ga ngebundet, krn kalo problem sapa yg bakal bayar? buat nasabah pasti bilang ya perusahaannyalah yg bayar, tp di perusahaan akan ribut pake sistem statistik resiko mana buat ngitung bayarnya?
2. asuransi selalu berjalan sesuai koridor hukum, hukum negara pastinya. nah kalo ada sengketa, gw di indo perusahaannya di luar, mo pake hukum mana? gw rakyat indo, perusahannya badan hukum luar. apa kalo gw gugat di indo mereka bakalan mau aja nurutin. apa iya harus pake arbitrase luar yg bujug mahalnya itu. remember manohara case, di indo sapa yg menang, di malay sapa yg menang, trus ujung2nya ga ngaruh apa2 tuh. toh manohara ga terikat ama hukum malay, si pangeran ga terikat ama hukum indo.

jd dalam pikirin gw summarynya gini, 'kira2 kalo klaimnya normal2 aja trus masih dalam range statistik si perusahaan seh pastinya dibayar, kalo dah meleset ya urus masing2 aja'.

gw tanyain deh ke agennya eh jawabnya cuma ah, uh aja kaga puguh... buset... dalam pikiran gw jd buruk aja, 'elu mo ambil duit tp ga tau masalah, kalo kejadian emang elu mau ngapain? belain jelas ga bisa, ngabur pastinya yg elu bisa', ya akhirnya gw tolak aja, abis ga masuk nalar (maunya 'shifting risk' tapi 'take another risk' kan aneh).

bos moderator, kalo gw ngejelasin gini rasanya masuk oot yah..
so gw serahin ke bos aja deh gimana baeknya, mau tetep disini ato thread baru. (btw, ini termasuk 'shifting risk' loh)
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  #18  
Old May 18th, 2011, 10:05
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Default Re: [Ask] Beda Askes dan Jamsostek

bro...nanya dong kalo buat tarik jamsostek pake surat apa aja ya? soalnya ane dulu kerja kena potong jamsostek dan sekrang dah gak kerja lagi..katanya bisa diambil..tp pake apa ya? thx sebelumnya
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Old May 18th, 2011, 10:25
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Default Re: [Ask] Beda Askes dan Jamsostek

Quote:
Originally Posted by delta man View Post
bro...nanya dong kalo buat tarik jamsostek pake surat apa aja ya? soalnya ane dulu kerja kena potong jamsostek dan sekrang dah gak kerja lagi..katanya bisa diambil..tp pake apa ya? thx sebelumnya
Bro kalo mau ambil JHT nya Jamsostek cukup membawa:

1. Surat keterangan berhenti (verklaring) dari perusahaan.
2. Kartu sebagai peserta Jamsostek.

Bawa kekantor Jamsostek, isi form aplikasi, lampirkan dokumen2 tsb. diatas.
Semoga bisa membantu bro.
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  #20  
Old May 18th, 2011, 11:21
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Default Re: [Ask] Beda Askes dan Jamsostek

Quote:
Originally Posted by toni610 View Post
Bro kalo mau ambil JHT nya Jamsostek cukup membawa:

1. Surat keterangan berhenti (verklaring) dari perusahaan.
2. Kartu sebagai peserta Jamsostek.
Nambahin, kalau belum sampai umur 55, kalau ngga salah ingat 5 tahun setelah jadi anggota jamsostek baru bisa ambil JHT.
Jadi kalau belum 5 tahun sejak masuk jamsostek harus tunggu dulu sampai genap 5 tahun sejak tanggal masuk.
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