Background

Badan Penyelenggara Jaminan Sosial (BPJS), is an legal organization formed to administer social
security programs implemented since the 1st january 2014. BPJS consists of BPJS kesehatan (General
health) and BPJS Ketenagakerjaan (Worker Health). BPJS was formed to provide health insurance,
which guarantees to every participants to get healthcare and security in order to fulfill basic health
care and health needs, and are given to every person who has paid their dues or dues paid by the
government. Every population of Indonesia are required to join BPJS including foreigners who have
worked at least six months in Indonesia and has paid his dues.

Various aspects related with BPJS, are based on Undang-undang Republik Indonesia Nomor 24
Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial.

Vision

Realization of Health Insurance (JKN-KIS) quality and sustainable for the entire population of
Indonesia in 2019 based on mutual cooperation with justice through BPJS reliable, superior and
reliable system.

Mission

1. Improving the quality of services to participants, health care providers and other
stakeholders through effective and efficient system..
2. Expanding the membership JKN-KIS that covers all Indonesia no later than January 1, 2019
through increased partnerships with all stakeholders and encourage public participation and
to improve responsibility of members.
3. Maintain KIS-JKN program by optimizing insurance dues, payment systems and financial
management of health facilities in a transparent and accountable manner.
4. Strengthen policy and program implementation JKN-KIS through increased inter-institutional
cooperation, partnerships, coordination and communication with all stakeholders.
5. Strengthening the capacity and governance of the organization, supported by professional
human resources, research, planning and evaluation, and business process management and
risk management that is effective and efficient as well as reliable infrastructure and
information technology.

Jaminan Kesehatan Nasional refers to the principles of the Sistem Jaminan Sosial Nasional (SJSN)
which are:
 1. The principle of Gotong Royong (mutual cooperation)

Gotong royong has been one of the principles in Indonesian social life, and also one of our
culture. In SJSN, the principle of mutual cooperation means that the participants who are a
ble to help people who are less able, healthy participants help the sick or high risk, and the
healthy volunteers help the sick.

2. The principle of non-profit

Management of funds by BPJS is a non-profit and not for profit. But the main purpose is to
meet the maximum interests of the participants. The funds collected from the people is a
trust fund, so the investment results, will be utilized as much as possible for the benefit of
the people.

3. The principle of portability

The principle of portability aims to provide continuous security to participants, even if they
change jobs or residence in the territory of Indonesia.

4. The principle of participation is mandatory

The principle of mandatory membership is intended to allow all the people become
participants. Although participation is mandatory for all citizens, its application remains
adjusted to the economic capacity of the people and the government.

5. The principle of trust fund

Funds collected from participants contributions are funds entrusted to the organization to
be managed in order to maximize the funds for population welfare.

6. The principle of the management of the Social Security Fund

Funds that have been collected used entirely for program development and for the benefit
of the population.

Legal foundation of BPJS are based on :

1) Undang-Undang Republik Indonesia Nomor 40 Tahun 2004 tentang Sistem Jaminan Sosial
Nasional (Lembaran Negara Republik Indonesia Tahun 2004 Nomor 150, Tambahan
Lembaran Negara Republik Indonesia Nomor 4456)
2) Undang-Undang Republik Indonesia Nomor 14 Tahun 2008 tentang Keterbukaan Informasi
Publik (Lembaran Negara Republik Indonesia Tahun 2004 Nomor 61, Tambahan Lembaran
Negara Republik Indonesia Nomor 4846)
3) Undang-Undang Republik Indonesia Nomor 24 Tahun 2011 tentang Badan Penyelenggara
Jaminan Sosial (Lembaran Negara Republik Indonesia Tahun 2011 Nomor 116, Tambahan
Lembaran Negara Republik Indonesia Nomor 5256);4. Peraturan Pemerintah Nomor 85
Tahun 2013 tentang Tata Cara Hubungan Antar Lembaga Badan Penyelenggara Jaminan
Sosial (Lembaran Negara Republik Indonesia Tahun 2013 Nomor 230 Tambahan Lembaran
Negara Nomor 5473)
4) Peraturan pemerintah Nomor 85 tahun 2013 tetntang Tata cara hubungan antar lembaga
badan penyelenggara jaminan sosial (lembaran negara Republik Indonesia tahun 2013
nomor 230 tambahan lembaran negara nomor 5473)
5) Peraturan Pemerintah Nomor 87 tahun 2013 tentang pengelolaan aset jaminan sosial
kesehatan (lembaran Negara Republik Indonesia tahun 2013 nomor 239 tambahan lembaran
negara nomor 5482)
6) Peraturan Pemerintah Nomor 88 tahun 2013 tentang Tata cara pengenaan sanksi
administratif bagi anggota dewan pengawas dan anggota direksi badan penyelenggara
jaminan sosial (lembaran negara Republik Indonesia tahun 2013 nomor 240 tambahan
lembaran negara nomor 5483)
7) Peraturan dewan pengawas BPJS Kesehatan nomor per-01/Dewas.BPJS-Kesehatan/2014
tentang tata cara pelaksanaan fungsi, tugas dan wewenang dewan pengawas BPJS
kesehatan.
8) Peraturan dewan pengawas BPJS Kesehatan nomor per-02/Dewas.BPJS-Kesehatan/2014
tentang organ pendukung dewan pengawas bpjs kesehatan.
9) Peraturan dewan pengawas BPJS Kesehatan nomor per-03/Dewas.BPJS-Kesehatan/2014
tentang piagam komite audit BPJS Kesehatan.
10) Peraturan dewan pengawas BPJS Kesehatan nomor per-04/Dewas.BPJS-Kesehatan/2014
tentang piagam komite audit BPJS kesehatan.
11) Peraturan Direksi BPJS Kesehatan nomor 15 tahun 2014 tentang struktur organisasi BPJS
Kesehatan tahun 2014.
 12) Peraturan direksi BPJS Kesehatan nomor 0121 tahun 2014 tentang pedoman internal dan
rencana pengembangan manajemen aktuaria BPJS Kesehatan
13) Keputusan direksi BPJS Kesehatan Nomor 63 tahun 2014 tentang pembagian tugas dan
wewenang anggota direksi.

Citated and Translated From :

Kementerian Kesehatan RI. Buku Saku FAQ (frequently asked questions). Jakarta:
Kementrian kesehatan RI; 2013.
Thabrany H. Badan Penyelenggaran Jaminan Kesehatan Nasional: sebuah policy paper dalam
analisis kesesuaian tujuan dan struktur BPJS. Jakarta; 2009.
Kementrian kesehatan RI. Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional (JKN) dan
Sistem Jaminan Sosial Nasional. Jakarta; 2011.