Requirements for Filling in the Application Form for Maternity Insurance Benefits for Employees
1. Name
2. Social security number: ID number
3. Personal code: social security 8-digit code
4. Work unit
5. Company code: Ask the person responsible for paying social security.
6. Name of spouse
7. Spouse ID number
8. domicile (please refer to the household registration book for your spouse)
9. Birth certificate number (the number on the birth certificate)
10. Only-child card number (the number on the only-child card) "Fill in this item if you have a card"
1 1. Delivery time (the birth time of the child)
12. Newborn birth certificate number (number on hospital birth medical certificate)
13. Maternity hospital (hospital where children are born)
14. Delivery situation (caesarean section is dystocia)
15. Does the spouse have a work unit and enjoy maternity-related treatment (stamped by the labor and social security department where the spouse is registered)
16. Certificate of male employee unit (official seal of male employee unit)
1, declared in duplicate, one for financial and maternity insurance;
2. Application materials for applying for maternity treatment: hospitalization receipt, medical certificate, expense details, original and photocopy of baby's birth certificate, marriage certificate, original and photocopy of second child's birth certificate, and copy of medical record and grade certificate of the hospital where the child was born in another place.
3. Application materials for applying for family planning treatment: hospitalization receipt, diagnosis certificate, outpatient medical manual, original and photocopy of marriage certificate for induced abortion workers, and photocopy of retirement approval form for retirees.
4, by the enterprise maternity insurance agencies unified management.
Relevant provisions on employees' application for maternity insurance benefits
Maternity insurance (embedded in basic medical insurance) requires continuous payment 1 year or more (i.e. observation period).
2. According to the detailed rules for the implementation of maternity insurance measures, the reimbursement situation is as follows:
I. Eligible for reimbursement
(a) in line with the family planning policy, marriage law and other laws and regulations;
(2) Persons who participate in maternity insurance for the first time have been pregnant for 12 months without interruption since the month of handling. Those who have participated in maternity insurance will be given birth after continuous payment 12 months (excluding supplementary payment).
(three) before the implementation of fertility and abortion, the birth index approved by the family planning department should be held.
B, the guarantee is
Eighth female workers maternity medical expenses according to the following standards:
1. 3,000 yuan for cesarean section or cesarean section abortion after 7 months of pregnancy;
2. 2,000 yuan for delivery or abortion after 7 months of pregnancy;
3. 1 1,000 yuan for delivery or abortion after being pregnant for more than 3 months but less than 7 months;
4. 300 yuan who miscarried within 3 months of pregnancy;
5. Multiple births increase 400 yuan for each additional baby.
Article 9 Male employees who have participated in maternity insurance have paid maternity insurance premium for 12 months continuously, and their spouses belong to non-urban population and unemployed people in cities and towns who have not participated in maternity insurance, or have participated in maternity insurance but paid less than 12 months (excluding overdue payment), and enjoy a one-time maternity medical subsidy of 50% of female employees' maternity medical expenses according to Article 8 of the Measures. The subsidy standards are as follows:
1. Cesarean section or cesarean section abortion after 7 months of pregnancy 1500 yuan;
2. Delivery or abortion after 7 months of pregnancy 1000 yuan;
3.500 yuan, pregnant for 3 months but less than 7 months, having given birth or aborted;
4. Abortion within 3 months of pregnancy 150 yuan;
5. Multiple births increase 200 yuan for each additional baby.
Both husband and wife participated in maternity insurance. If the woman meets the conditions for enjoying maternity insurance benefits, she will enjoy it, and the man will no longer enjoy maternity medical expenses subsidies. The man enjoys maternity medical expenses subsidies, and his spouse has enjoyed maternity insurance benefits according to other policies and regulations, but has not reached the maternity medical expenses subsidy standards stipulated in these rules, and the difference is made up by the maternity insurance fund; Has reached the subsidy standard stipulated in these rules, the maternity insurance fund will no longer pay.
Tenth family planning operation fee price standards in accordance with the relevant provisions of the provincial and municipal price departments. Namely: intrauterine device 45 yuan; Take out the intrauterine device 46 yuan; Drug abortion 1.27 yuan (curettage due to incomplete drug abortion increases 47 yuan); 85 yuan of induced abortion (Jia Zeng 12 yuan); Induced labor in the second trimester is 366 yuan [50 yuan will be increased if induced labor is more than seven months (including seven months)]; Vasectomy 150 yuan; Tubal ligation 5 10 yuan; Vasectomy 370 yuan; Tubal anastomosis, 400 yuan.
Eleventh maternity medical expenses, family planning surgery fees, maternity medical expenses subsidies and gradually adjusted with the adjustment of the price department of this Municipality. The specific adjustment plan is proposed by the municipal labor security administrative department in conjunction with the municipal finance department and implemented after being approved by the municipal government.
Article 12 When the insured gives birth or carries out family planning operation, the hospitalization medical expenses caused by cholestasis of pregnancy, postpartum hemorrhage, uterine rupture, amniotic fluid embolism and complications of family planning operation shall be included in the scope of payment of maternity insurance fund.
Measures for reimbursement of hospitalization medical expenses for complications of birth and family planning operations shall be implemented in accordance with the provisions of basic medical insurance. The insured person meets the one-time hospitalization medical expenses stipulated in the basic medical insurance, and the amount is above the Qifubiaozhun of the basic medical insurance pooling fund and below the maximum payment limit. After the individual pays part of the special expenses first, the maternity insurance fund will pay in proportion. The part below Qifubiaozhun and the part exceeding the maximum payment limit of basic medical insurance will not be reimbursed. Qifubiaozhun and maximum payment limit of hospitalization medical expenses and special expenses paid by individuals in advance for complications of birth and family planning operations shall be implemented in accordance with the provisions of basic medical insurance.
Maternity allowance: The maternity allowance shall be calculated according to different situations after dividing the total wages paid by maternity insurance for female employees 12 months before delivery by 365 days:
A. 90 days for delivery or abortion after 7 months of pregnancy;
B. If the pregnancy is more than 3 months but less than 7 months, it shall be multiplied by 42 days;
C. If the pregnancy is less than 3 months, multiply by 14 days;
D. cesarean section increased by 15 days;
E 15 days for each additional baby born in multiple births.
C. Information required for reimbursement
Thirteenth when applying for maternity insurance benefits, the original and photocopy of the following documents shall be provided:
(a) female workers who enjoy maternity allowance must provide maternity medical expenses:
1. Employees insured by the company: Chengdu maternity insurance benefits approval form in duplicate, labor contract, ID card, medical service bills produced or supervised by the financial department, discharge certificate, birth certificate or other medical certificates, marriage certificate, filled in and stamped with the official seal of the company.
2. Individual insured: fill in the Approval Form for Maternity Insurance Benefits in Chengdu in duplicate, valid unemployment certificate, ID card, medical service bill produced or supervised by the financial department, discharge certificate, birth index, baby birth certificate or other medical certificates, marriage certificate and personal settlement passbook.
(two) male workers who enjoy maternity medical expenses subsidies must provide:
1. Employees insured by the company: Chengdu maternity insurance treatment approval form in duplicate, labor contract, ID card, medical service bill supervised or supervised by the financial department, discharge certificate, birth index, baby birth certificate or related medical certificate, marriage certificate, spouse's household registration certificate, spouse's social insurance relationship certificate and spouse's unemployment certificate.
2. Individual insured: fill in the Approval Form for Maternity Insurance Benefits in Chengdu in duplicate, valid unemployment certificate, ID card, medical service bill produced or supervised by the financial department, discharge certificate, birth index, baby birth certificate or related medical certificate, marriage certificate, spouse's household registration certificate, spouse's social insurance relationship certificate, spouse's unemployment certificate and personal settlement passbook.
(three) to apply for family planning surgery fees must be provided:
1. Employees insured by the company: Chengdu maternity insurance benefits approval form in duplicate, operation expense bill, illness certificate, labor contract, ID card and marriage certificate, filled in and stamped with the official seal of the company.
2. Personal insurance: fill in the Approval Form for Maternity Insurance Benefits in Chengdu in duplicate, valid unemployment certificate, bill of operation expenses, disease certificate, ID card, marriage certificate and personal settlement passbook.
(four) reimbursement of complications of birth and family planning surgery hospitalization expenses should provide:
1. Employees insured by the company: the Approval Form for Hospitalization Expenses of Birth and Family Planning Complications in Chengdu, which is filled in and stamped with the official seal of the company, and the medical service charge bill, hospitalization expenses list, compound prescription, company certificate, discharge certificate, marriage certificate, social insurance card and ID card supervised or supervised by the financial department.
2. Individual insured persons: fill out the Approval Form for Hospitalization Medical Expenses for Complications of Birth and Family Planning in Chengdu in duplicate, the bill of medical service charges, the list of hospitalization expenses, multiple prescriptions, discharge certificates, marriage certificates, social insurance cards, identity cards and personal settlement passbook supervised or supervised by the financial department.
3. To declare the cost of vasectomy and tubal anastomosis, in addition to the above certificates, relevant certificates from the Family Planning Commission are required.
If the insured entrusts others to handle the matter, it must also provide the power of attorney of the principal and the identity card of the principal.
(five) other information provided by the provincial and municipal social insurance agencies.
Fourteenth maternity insurance fund will not pay the scope:
(1) Expenses incurred in giving birth or terminating pregnancy abroad and in Hong Kong, Macao and Taiwan;
(2) Expenses exceeding the standards stipulated in the Measures and these Rules;
(three) the cost of childbirth or family planning surgery after retirement or receiving the basic pension;
(four) the cost of artificial assisted reproduction before delivery;
(5) Having enjoyed maternity insurance benefits outside the overall planning area of this Municipality; I hope it helps you!