Employees' medical mutual insurance is generally undertaken by independent organizations such as trade unions, and employees participate voluntarily. When the medical expenses borne by individuals exceed a certain amount, they can receive a certain amount of mutual insurance plan from the employee medical mutual insurance fund formed by payment. The undertaking of workers' mutual medical insurance agencies should not be for profit.
supplement of relevant knowledge
first, what are the characteristics of medical mutual assistance for employees?
1. Low investment, once a year, and each employee pays 4 yuan.
2. High subsidy, in line with the provisions of the measures, with a maximum mutual aid payment of 3, yuan.
3. A variety of diseases, subsidies for 11 major diseases and general hospitalization diseases; Subsidies are also given to those who suffer from specific diseases and seek medical treatment in outpatient clinics.
4. The procedures are simple and standardized, and the participation and payment are handled by the unit trade union for the convenience of employees.
5. Pay quickly, notify the agency of the approval conclusion within 2 days, and distribute the subsidy in place.
6. Work wholeheartedly for employees, not for profit.
2. What are the differences between employee medical mutual assistance and social basic medical insurance and commercial medical insurance?
Social basic medical insurance is guaranteed by national laws and regulations, and is enforced. It aims at maintaining social stability and implements administrative management. Commercial medical insurance is the commercial behavior of insurance enterprises, and the principle of enterprise management and equivalent exchange is implemented.
however, the medical mutual assistance activities for employees with major diseases are not for profit, but for mutual assistance and cooperation through trade union organizations to mobilize employees to participate voluntarily, and democratic decision-making, democratic management and democratic supervision are implemented to help solve the special difficulties of participating employees. Before joining the WTO, there is no need for physical examination. For poor workers who have no ability to pay fees, the trade union can provide assistance to the workers through the "send warm" and other channels, and the conditions can also be paid by the unit.
3. What is the reimbursement rate of employee mutual medical care?
due to the different regulations in different regions, the reimbursement ratio is different. for example, in Zhuzhou city, Hunan province, if the total amount of medical expenses incurred in a year is between 6, yuan and 18, yuan, then 94% of the medical expenses can be reimbursed by the employees' mutual medical care, and individuals only need to bear 6% of the medical expenses.