--- title: "GVFMC and CSHI: How the Healthcare Financing Systems Differ" country: KZ lang: en author: Сапа Т.И. (https://buhgpt.kz/authors/sapa-ti) date: 2026-10-13 canonical: https://buhgpt.kz/suraqtar/gobmp-i-osms-chem-otlichayutsya-sistemy-finansirovaniya-m-en source: BuhGPT --- # GVFMC and CSHI: How the Healthcare Financing Systems Differ > **TL;DR:** GVFMC and CSHI are separate healthcare financing frameworks in Kazakhstan. GVFMC means the guaranteed volume of free medical care, while CSHI means compulsory social health insurance. The Tax Code also distinguishes the provision of GVFMC, the payment of state contributions to --- GVFMC and CSHI are separate healthcare financing frameworks in Kazakhstan. GVFMC means the guaranteed volume of free medical care, while CSHI means compulsory social health insurance. The Tax Code also distinguishes the provision of GVFMC, the payment of state contributions to CSHI, and the provision of medical care under the CSHI system as separate types of material benefit that are not recognized as an individual's income (Article 367 of the Tax Code of the Republic of Kazakhstan). For an accountant, it is important in practice to correctly distinguish between medical care and CSHI settlements. CSHI employer contributions and individual contributions are accounted for in accordance with the legislation on compulsory social health insurance. The cited provisions of the Tax Code of the Republic of Kazakhstan do not establish a separate deduction from an employee's income called “GVFMC.” CSHI and GVFMC: What Is the Difference for an Accountant? GVFMC is the guaranteed volume of medical care provided from budget funds. The material benefit received by an individual when such care is provided is not treated as their income. A similar tax treatment applies to medical care provided under the CSHI system and to state contributions to CSHI paid in accordance with the legislation on compulsory social health insurance (Article 367 of the Tax Code of the Republic of Kazakhstan). Consequently, a person's receipt of medical care should not be confused with the payment of income to that person by an employer. When calculating payroll, an accountant deals not with the cost of medical services provided to an employee but with the CSHI employer contributions and individual contributions prescribed by law. For accounting purposes, CSHI payments must be separated according to their economic substance: - employer contributions are accounted for as payments related to the employer's obligations; - individual contributions are accounted for separately from employer contributions; - state contributions to CSHI are not recognized as an individual's income (Article 367 of the Tax Code of the Republic of Kazakhstan); - the services of the Social Health Insurance Fund involving the accumulation of employer and individual contributions, the procurement of medical services, and the performance of other functions established by law are exempt from VAT (Article 477 of the Tax Code of the Republic of Kazakhstan). The VAT exemption for the Fund's services characterizes the tax treatment of the Fund's own transactions. It does not replace the rules governing the calculation of employer and individual contributions by an employer and does not determine the scope of medical care available to a particular person. Thus, the question of what medical care a person receives under GVFMC or CSHI must be separated from the calculation question: what status the income recipient has, whether the payment is subject to the calculation of the relevant charges, and who is responsible for fulfilling the corresponding obligation. How to Report CSHI in Form 200.00 When preparing Form 200.00, information relating to CSHI should be separated from figures for other mandatory payments. The accountant must ensure that the declaration is consistent with payroll calculations and accounting registers for each month of the reporting period. It is advisable to verify the figures in the following sequence: - identify the income recipient and the basis for the payment; - separate payments to employees from remuneration paid to individuals under civil law contracts; - distinguish between the amounts of employer contributions and individual contributions; - compare the monthly payroll data with the CSHI registers; - verify that the quarterly total corresponds to the sum of the figures for the months included in the quarter; - prevent CSHI payments from being combined with social tax and social contributions. This internal verification procedure makes it possible to trace the origin of each figure in the declaration. If the total amount consists of several categories of payments, it is advisable to retain a breakdown in the register by individual, month, and type of payment. Particular attention is required for payments under civil law contracts. They cannot automatically be processed using the same settings as employee salaries: the individual's status, the nature of the payment, and the tax agent's obligation regarding the relevant payment must first be determined. The general information in the declaration and the CSHI figures must relate to the same taxpayer and the same reporting period. Before submitting the form, it is useful to compare the Individual Identification Number or Business Identification Number, the reporting quarter, the type of declaration, and the amounts from the accounting system with the prepared tax return. The Tax Code separately regulates the tax status of medical care for an individual. The provision of GVFMC and medical care under the CSHI system, as well as the payment of CSHI contributions by the state, are not recognized as an individual's income (Article 367 of the Tax Code of the Republic of Kazakhstan). Therefore, these types of state support should not be included in an employee's taxable income as a payment from the employer. CSHI, GVFMC, and Orders: What to Check in 2026 When searching for “CSHI GVFMC order,” it is important first to determine the subject matter regulated by the document. One regulatory legal act may establish the procedure for calculating and transferring payments, another may establish the rules for providing medical care, and a third may establish the procedure for preparing reports. It is incorrect to use an order number without considering its subject matter and current version. For payroll calculations, an accountant needs the provisions governing payers, the calculation base, rates, limits, exemptions, and the procedure for transferring employer and individual contributions. When completing Form 200.00, the current procedure for preparing tax reports for the relevant reporting period also applies. The Tax Code confirms the distinction between GVFMC and CSHI for the taxation of individuals' income: it separately identifies the provision of the guaranteed volume of free medical care, the payment of CSHI contributions by the state, and the provision of medical care under the CSHI system (Article 367 of the Tax Code of the Republic of Kazakhstan). The nature of the services provided is also relevant to healthcare organizations. A legal entity may be recognized as an organization operating in the social sphere if it meets the conditions established by the Tax Code of the Republic of Kazakhstan concerning the types of activities and the proportion of corresponding income. Social-sphere activities include the provision of medical services by a healthcare entity licensed to perform medical activities (Article 15 of the Tax Code of the Republic of Kazakhstan). The mere fact that medical services are provided does not establish compliance with all the conditions prescribed for a social-sphere organization. To apply this status, the full set of requirements under Article 15 of the Tax Code of the Republic of Kazakhstan must be considered, including the prescribed proportion of income from the relevant activity. Separately, the Tax Code of the Republic of Kazakhstan exempts from VAT the services of the Social Health Insurance Fund involving the accumulation of employer and individual contributions, the procurement of services from healthcare entities, and the performance of other functions defined by the laws of the Republic of Kazakhstan (Article 477 of the Tax Code of the Republic of Kazakhstan). This provision applies specifically to the listed services of the Fund. What an Accountant Should Do in Practice A working review can be organized as follows: - Determine the status of the income recipient and the documentary basis for the payment. - Establish the type of payment and the period to which it relates. - Determine the employer's obligation regarding employer contributions and the obligation to calculate, withhold, and transfer individual contributions. - Separate the amounts attributable to the employer from those attributable to the individual. - Compare the calculation with the version of the CSHI legislation in effect on the payment date. - Verify the monthly reporting of the figures in the accounting registers and Form 200.00. - Compare the quarterly totals with the sum of the data for the three months. - Retain a breakdown of the calculation by individual and type of payment. If an organization works with individuals under civil law contracts, such payments should be analyzed separately. The existence of a contract does not in itself replace verification of the recipient's status, the nature of the remuneration, and the obligations of the person paying the income. If the organization itself provides medical services and applies the provisions governing social-sphere activities, the accountant must monitor the existence of a license to perform medical activities, the composition of income, and compliance with the proportion of income prescribed by Article 15 of the Tax Code of the Republic of Kazakhstan. The review should be performed at the end of the relevant tax period based on accounting data. The cost of GVFMC, medical care under the CSHI system, and state contributions to CSHI is not included in an individual's income because such material benefits are expressly classified as types of benefit that do not constitute income (Article 367 of the Tax Code of the Republic of Kazakhstan). This rule should be applied specifically to the types of care and benefits listed in the article. Frequently Asked Questions Are GVFMC and CSHI the same thing? — No. The Tax Code of the Republic of Kazakhstan separately identifies the provision of GVFMC, the payment of CSHI contributions by the state, and the provision of medical care under the CSHI system (Article 367 of the Tax Code of the Republic of Kazakhstan). Must a separate GVFMC payment be withheld from salary? — No, the cited provisions of the Tax Code of the Republic of Kazakhstan do not establish a separate payroll deduction under that name. When making settlements with employees, the employer and individual contributions to CSHI prescribed by law must be distinguished. Is the cost of medical care an individual's income? — The provision of GVFMC and medical care under the CSHI system is not recognized as an individual's income. State contributions to CSHI paid in accordance with the CSHI legislation are also not treated as income (Article 367 of the Tax Code of the Republic of Kazakhstan). How should CSHI data in Form 200.00 be verified? — The figures in the form should be compared with the monthly calculations, employer contributions and individual contributions should be checked separately, and the quarterly total should then be reconciled with the data for the three months. How should payments to individuals under civil law contracts be accounted for? — They should be analyzed separately, taking into account the recipient's status, the nature of the payment, and the tax agent's obligations. Such payments cannot automatically be treated as an employee's salary. Are the Fund's services exempt from VAT? — Yes. The services of the Social Health Insurance Fund involving the accumulation of employer and individual contributions, the procurement of medical services, and the performance of other functions defined by the laws of the Republic of Kazakhstan are exempt from VAT (Article 477 of the Tax Code of the Republic of Kazakhstan). When is a medical organization classified as a social-sphere organization? — To qualify, a legal entity must meet the full set of conditions under Article 15 of the Tax Code of the Republic of Kazakhstan. In particular, medical services must be provided by a healthcare entity licensed to perform medical activities, and the proportion of corresponding income must meet the prescribed criterion (Article 15 of the Tax Code of the Republic of Kazakhstan). Which document should be used to calculate CSHI payments? — The CSHI legislation in effect on the calculation date and governing the relevant type of payment must be applied; when preparing Form 200.00, the current procedure for completing tax reports for the reporting period must also be followed. Sources - Tax Code of the Republic of Kazakhstan: Article 367 on material benefits that do not constitute an individual's income - Tax Code of the Republic of Kazakhstan: Article 477 on the VAT exemption for financial transactions - Tax Code of the Republic of Kazakhstan: Article 15 on organizations operating in the social sphere --- _BuhGPT — ИИ-помощник для бухгалтеров Казахстана: https://buhgpt.kz_