1, maternity allowance. According to relevant laws and regulations, maternity allowance is calculated and paid according to the average monthly salary of the employer in the previous year. Maternity allowance = the average monthly salary of the unit in the previous year divided by 30 days multiplied by the number of maternity leave days;
2. The average monthly salary of the employer in the previous year. The average monthly salary of the employer in the previous year is determined according to the sum of the average monthly salary of the insured employees in the previous year declared by the employer to the medical insurance agency divided by the number of employees at the end of 12. If the employer has the average monthly salary of employees in the previous year, the maternity allowance shall be calculated according to the average monthly salary of employees in this year;
Step 3 apply for maternity allowance
(1) The employer shall apply to the local medical insurance agency for maternity allowance and submit relevant materials;
(2) Female employees who meet the requirements of the employer's continuous payment of basic medical and maternity insurance premiums for employees for 6 months and meet the policy of giving birth or terminating pregnancy shall enjoy maternity insurance benefits in accordance with regulations;
(three) if the employer fails to pay the basic medical and maternity insurance premiums for employees, the maternity insurance benefits for employees will be stopped from the next month. If the arrears are less than 6 months, the amount owed and the overdue fine shall be paid in full and reissued according to the regulations.
4. Pay maternity allowance. After receiving the application from the employer, the medical insurance agency shall, if it meets the payment conditions, pay the maternity allowance to the employer monthly within 30 days from the date of receiving the application; If it does not meet the payment conditions, it shall make a written decision not to pay within 30 days and explain the reasons.
5 maternity medical expenses reimbursement is as follows:
(1) The medical expenses of maternity insurance (prenatal check-up, family planning medical expenses, genetic testing expenses for genetic diseases, medical expenses for childbirth and complications) shall be settled online. In line with the policy, according to the amount of maternity insurance settlement. Over the limit, can be settled by the employee's basic medical insurance personal account;
(2) The maternity medical expenses that have not been settled online in different places shall be paid in advance by the insured and reimbursed manually afterwards. The application materials for artificial reimbursement of maternity medical expenses and maternity allowance shall be submitted by the employer to the local medical insurance agency.
6, maternity insurance benefits supervision:
(1) The administrative departments of medical security in all districts and counties should strengthen the supervision over the use of maternity insurance funds, intensify the crackdown on employers and individuals who defraud maternity insurance funds by means of fictitious labor relations, affiliated insurance, surprise insurance, forged application materials, etc., and seriously investigate and deal with all kinds of illegal acts;
(2) The handling institution shall establish and improve the internal control mechanism, scientifically allocate posts and responsibilities, strengthen the mutual restriction and supervision between business posts and financial posts, and strictly perform the procedures of preliminary examination, review and approval of treatment settlement and payment.
7. others. The employing unit shall truthfully declare the insured and pay the wages to the local medical insurance agency according to the regulations. The process of applying for payment of maternity insurance benefits shall be formulated separately by the Municipal Medical Insurance Center.
legal ground
Article 55 of People's Republic of China (PRC) Social Insurance Law
Maternity medical expenses include the following contents:
(1) Maternity medical expenses;
(two) family planning medical expenses;
(3) Other project expenses stipulated by laws and regulations.
Fifty-sixth employees in any of the following circumstances, can enjoy maternity allowance in accordance with state regulations:
(1) Female employees enjoy maternity leave;
(2) Enjoy family planning operation leave;
(3) Other circumstances stipulated by laws and regulations.
Maternity allowance is calculated and paid according to the average monthly salary of employees in the previous year of the employer.