(1) Urban enterprises and their employees;
(two) the basic medical insurance relationship of state organs, institutions, social organizations and their employees in this Municipality;
(3) Private non-enterprise units and their employees;
(4) Urban individual industrial and commercial households with employees in this Municipality and their employees. Third maternity insurance fund and the basic medical insurance fund have the same level of overall planning, which is implemented at the city and county levels and gradually transferred to the whole city.
Maternity insurance funds shall be raised, used and managed in a unified way. Article 4 Maternity insurance for employees shall be managed by agreement between designated medical institutions and designated family planning technical service institutions (hereinafter referred to as designated maternity insurance service institutions). Article 5 The municipal and county administrative departments of labor and social security shall be in charge of maternity insurance within their respective administrative areas, and their maternity insurance agencies (hereinafter referred to as agencies) shall specifically undertake maternity insurance business.
Finance, local tax, population and family planning, health, food and drug supervision, price and other relevant departments shall, within the scope of their respective duties, assist in the work related to maternity insurance. Chapter II Maternity Insurance Fund Article 6 Maternity insurance funds shall be raised according to the principle of fixed income by expenditure and balance of income and expenditure, and shall be included in the financial special account, and shall be managed by two lines of income and expenditure. Article 7 The maternity insurance fund consists of the following items:
(1) Maternity insurance premium paid by the employer;
(two) the interest of maternity insurance fund;
(3) Failing to pay maternity insurance premiums;
(four) other funds incorporated into the maternity insurance fund according to law. Eighth maternity insurance fund for the following expenses:
(1) Maternity allowance;
(2) Maternity medical expenses;
(3) Medical expenses for family planning operation;
(four) the medical expenses of maternity complications and current complications of family planning operation during maternity leave;
(five) medical expenses for complications in the current period of childbirth;
(six) the maternity care leave subsidy enjoyed by the insured male workers whose spouses are agricultural registered permanent residence and have not participated in maternity insurance;
(seven) other related expenses that should be paid by the maternity insurance fund as stipulated by laws, regulations and rules. Ninth maternity insurance fund shall not pay the following fees:
(a) related expenses incurred in violation of national, provincial and municipal family planning regulations;
(two) related expenses due to medical accidents;
(three) the cost of artificial assisted reproduction before delivery;
(four) involving the baby's medical care, nursing, health care and other expenses;
(five) related expenses incurred during going abroad, going to Hong Kong, Macao and Taiwan;
(6) Expenses during the execution of the judgment;
(seven) the implementation of cesarean section without clinical indications, exceeding the standard of maternity medical expenses paid by natural delivery. Article 10 An uninsured employer shall, within 30 days from the date of implementation of these Measures, go through the registration formalities of maternity insurance with the local tax authorities and social insurance agencies. After the implementation of these measures, the newly established employer shall go through the insurance registration formalities within 30 days from the date of establishment.
Where the employing unit terminates in accordance with the law or the registered items such as its name, domicile and legal representative are changed, it shall go through the formalities of cancellation or change of registration with the local tax authorities and social insurance agencies within 30 days after the termination or change. Eleventh state organs, fully funded institutions payment rate of 0.4%; The enterprise contribution rate is 0.8%; Other employers can choose one of the above rates.
When the enterprise maternity insurance rate needs to be adjusted, the municipal labor and social security administrative department shall put forward opinions jointly with the municipal finance department and report them to the Municipal People's government for approval. Twelfth the employer's payment base is determined according to the total wages of all employees in the previous year. The unit payment base shall not be lower than the sum of the individual payment bases of basic medical insurance (or basic old-age insurance) paid by all insured employees in the current period. Article 13 The employing unit shall pay the maternity insurance premium in full monthly, and the maternity insurance premium shall not be reduced or exempted.
Workers (employees) do not pay maternity insurance premiums. Chapter III Maternity Insurance Benefits Article 14 To enjoy maternity insurance benefits, insured employees shall meet the following conditions:
(a) the employer in accordance with the provisions of the first paragraph of Article 10 of these measures, timely insurance, continuous payment, insured workers from the next month to fulfill the obligation of full payment to enjoy maternity insurance benefits.
(two) the birth of the insured workers or the implementation of family planning operations are in compliance with laws and regulations.
(three) the insured workers in maternity insurance designated service institutions or the implementation of family planning surgery.
If the employer fails to apply for insurance registration according to the provisions of the first paragraph of Article 10 of these Measures, it is necessary to pay maternity insurance premiums and late fees in full within the registration period as stipulated in these Measures, and its insured employees will enjoy maternity insurance benefits from the next month of payment. During the overdue period, the relevant expenses and benefits of maternity and family planning operations shall be borne by the employer in accordance with the standards stipulated in these Measures.
If the employer interrupts the payment, it is necessary to fully repay the maternity insurance premium and late payment fee during the interruption of payment, and its insured employees will enjoy maternity insurance benefits from the month after the resumption of payment. During the interruption of payment, the expenses and benefits related to the birth of the insured workers and the implementation of family planning operations shall be borne by the employer in accordance with the standards stipulated in these Measures.