1, the proportion of payment by employers and individuals.

(1) Employer: the contribution ratio is 7.5% of the total wages of employees;

② Employee: The payment ratio is 2% of my salary.

2 units and employees' individual payment base

(1) The employer's total monthly average salary of employees for more than one year is the payment base, and individual employees' monthly average salary income for the previous year is the payment base.

② If the monthly payment base of units and employees is lower than 60% of the average monthly salary of employees in the previous year, 60% of the average monthly salary of employees shall be the payment base; More than 300% of the average monthly salary of employees is not included in the payment base.

3. The proportion of the basic medical insurance premium paid by the employer included in the personal account.

The State Council stipulates that the medical insurance premium paid by the employer is divided into two parts, one of which is used to establish a unified fund; Part of it is transferred to personal account. The proportion of individual accounts is generally about 30% of the employer's contribution, and the specific proportion is determined by the overall planning area according to the payment scope of individual accounts and the age of employees.

4. If the employer and the insured employees fail to pay or default the basic medical insurance premium, the personal account shall be handled.

Employers and insured employees shall earnestly fulfill their payment obligations. When the medical insurance premium is unpaid or in arrears, the funds in the employee's personal account will stop being transferred. Personal account balance can continue to be used.

New policy of personal medical insurance

1. Adjustment of population covered by individual medical insurance

① The coverage of the medical insurance system for urban and rural residents includes all the insured (co-insured) personnel of the existing medical insurance for urban residents and the new rural cooperative medical system, that is, all urban and rural residents except those who should be insured in the basic medical insurance for employees.

② Migrant workers and flexible employees shall participate in the basic medical insurance for employees according to law, and those who have difficulties may participate in the medical insurance for urban and rural residents according to local regulations.

2. How to raise funds for personal medical insurance?

Adhere to multi-channel financing, continue to combine individual contributions with government subsidies, and encourage collectives, units or other social and economic organizations to give support or funding.

(2) Reasonably divide the financing responsibilities of the government and individuals, and appropriately increase the proportion of individual contributions while raising the government subsidy standard.

3. Determination of financing standard of individual medical insurance

All localities should consider the needs of urban and rural residents for medical insurance and serious illness insurance as a whole, and reasonably determine the unified financing standards for urban and rural areas in accordance with the principle of fund balance.

② In areas where there is a big gap between the existing urban residents' medical insurance and the individual payment standard of the new rural cooperative medical system, the difference payment method can be adopted, and it will take 2-3 years to gradually transition.

③ After the integration, the actual per capita fund-raising and individual contributions are not lower than the current level.

4. Individual medical insurance benefits

(1) Follow the principles of moderate security and balance of payments, balance the interests of urban and rural security, and gradually unify the scope of security and payment standards.

The medical insurance fund for urban and rural residents is mainly used to pay the hospitalization and outpatient medical expenses incurred by the insured.

③ Stabilize the level of hospitalization security, and keep the proportion of hospitalization expenses in the policy scope at about 75%.

(4) To further improve outpatient co-ordination and gradually improve the level of outpatient support.

⑤ Gradually narrow the gap between the payment ratio within the policy scope and the actual payment ratio.

5. When will the new personal medical insurance be implemented?

All provinces (autonomous regions and municipalities) should make plans and arrangements for the integration of medical insurance for urban and rural residents before the end of June, clarify the timetable and road map, and ensure that all policies and measures are put in place.

(2) The overall planning areas should issue specific implementation plans before the end of 65438+February.

Related reading

"Three Stresses" in Medical Insurance for Urban Residents in Yolanda Town, Guazhou

September 6 th Recently, Yolanda Town vigorously carried out the collection and payment of medical insurance for urban residents, and paid close attention to the implementation of the work from three aspects.

The first is to grasp publicity. Towns and communities have publicized, mobilized and deployed policies related to residents' medical insurance. * * * Hanging banners 12, scrolling 56 banners on the electronic screen, posting 98 copies of publicity materials 1000 in the community, and distributing more than one copy of publicity materials1000. Through various forms such as door-to-door explanation, people can better understand the significance, benefits and welfare of residents' medical insurance, which is a household name. The second is hard work. In order to ensure that the medical insurance policy benefits the majority of residents and that the medical insurance policy is not omitted, community propagandists fully carry forward the spirit of hard struggle of "5+2" and "white plus black", mobilize at home, visit the permanent and floating population in the jurisdiction, and collect services for new insured and renewed residents at home to ensure that the majority of residents have medical insurance and medical care. The third is to grasp responsibility. The town government set up a leading group for basic medical insurance for urban residents, with the deputy mayor as the leader and the directors of the town social security office and community neighborhood committees as members. The division of responsibilities was clarified, the task indicators were issued, the work progress was grasped on time, and the responsibility mechanism of "weekly assessment" and "weekly notification" was implemented.

Through three measures, at present, the medical insurance for urban residents in Yolanda is progressing steadily and smoothly.

;