Medical insurance agencies shall, in accordance with these measures, do a good job in the collection, use and operation of medical insurance funds.
The agreed medical institution shall actively cooperate with the medical insurance fund management department and the medical insurance agency to manage and use the medical insurance fund. Article 4 Medical insurance premiums paid by units and employees shall be paid by units to medical insurance agencies before 10 every month. Article 5 After receiving the medical insurance fund, the medical insurance agency shall deposit it into the "financial special account" opened by the financial department in the bank before 15 every month, and the financial department shall examine and allocate the medical insurance expenses according to the appropriation plan proposed by the medical insurance agency. Sixth medical insurance fund disbursement channels:
(a) state organs (including organizations), institutions that implement full budget management and hospitals owned by the whole people that implement differential budget management shall be paid by the budgetary funds of each unit; Other institutions that implement differential budget management and self-supporting budget management shall be paid by the medical fund extracted by the unit; On-the-job employees of enterprises shall be paid out of welfare funds, retired and resigned personnel (hereinafter referred to as retirees) shall be paid out of labor insurance premiums in enterprise management fees, and the part paid by individuals shall be deducted from my salary.
(II) In violation of relevant regulations, late payment fees or fines paid by state organs and institutions with full funding and self-supporting budget management in balance allocation shall be charged to the special fund. Enterprises are charged in non-operating expenses.
(three) the personnel who leave without pay shall be borne by the individual or the employing unit, and shall be collected and remitted by the unit that retains the public office. Those who go abroad without pay are only allowed to use the funds deposited in their personal accounts, and the overruns will not be covered. Article 7 When a bankrupt enterprise liquidates its property, it shall first pay off the unpaid medical insurance premium and pay the medical expenses for 65,438+00 years, which is enough to pay the actual per capita medical expenses of retirees in the previous year. Article 8 If a unit with financial difficulties is really unable to pay medical insurance premiums, it shall apply to the medical insurance agency within the prescribed payment period, and may go through the formalities of deferred payment with the consent of the medical insurance agency and the approval of its competent department. The maximum extension period is three months.
If the insured unit fails to pay the medical insurance premium for one month without reason or fails to pay it after three months of approval, the medical insurance agency will stop its employees from using the social pooling medical fund to pay the medical expenses. Ninth medical insurance funds must be included in the financial budget management, special account storage, special account records, earmarked for the following expenses:
(1) Basic medical expenses;
(two) the management service fee extracted by the medical insurance agency according to a certain proportion of the medical insurance premium. Expenditure items of management service fee: personnel fee, official fee, business fee, publicity fee, equipment purchase fee, housing infrastructure repair fee and other expenses related to medical insurance (specific measures for management service fee shall be formulated separately).
(three) other expenses related to medical insurance paid with the approval of the municipal government. Article 10 All employees participating in medical insurance shall establish personal medical accounts (IC cards).
Personal medical account funds are transferred to IC cards, and employees use IC cards for settlement when they seek medical treatment in medical institutions that implement computer networking management. If you seek medical treatment in an agreed hospital without computer management, the medical expenses shall be paid in advance by the individual workers temporarily. Article 11 Employees' IC cards shall be properly kept and shall not be altered or damaged. Lost, should immediately report the loss to the medical insurance agency, go through the formalities, and all losses before reporting the loss shall be borne by the employee himself. Article 12 The balance of individual medical accounts shall be settled once a year, and the interest shall be calculated according to the deposit rate of residents for the same period. After approval, it will be included in the personal medical account and carried forward. Thirteenth after the death of employees, personal medical account balance in accordance with the provisions of the "People's Republic of China (PRC) Inheritance Law" inheritance. If the legal heir has a job, it can be transferred to the personal medical account of the legal heir. If there is no job, the balance and interest (until the settlement date) will be settled by the medical insurance agency in one lump sum and sent to the legal heir. Fourteenth employees in the scope of insurance work changes, with the relevant documents to the medical insurance agencies for personal medical account transfer procedures. If there are unpaid medical insurance premiums, the unpaid part shall be paid first, and then the individual medical account transfer procedures shall be handled.
Workers transferred to other provinces and cities, the personal medical account fund balance can be transferred to the transferred medical insurance institutions, if the transferred areas have not implemented social pooling of medical insurance, the personal medical account fund balance and interest can be settled to me in one lump sum. Fifteenth employees and insured units due to the dissolution or termination of labor relations and other reasons to suspend the payment of medical insurance premiums, the unit shall promptly notify the medical insurance agencies, the funds in the employee's personal medical account can continue to be used. After the funds are used up, the IC card will be suspended and kept by myself, and can continue to play its role after re-employment.