The maximum payment limit of the medical insurance fund
The "maximum payment limit" of the overall pool fund, commonly known as the "ceiling line", refers to the amount of money paid in a year (January 1 to 12 The maximum amount of medical expenses paid by the unified fund within the month 31). At present, the maximum annual payment limit of the unified fund for urban employees and flexible employment personnel is 100,000 yuan, the maximum annual payment limit of the unified fund for basic medical insurance for adults and elderly residents is 80,000 yuan, and the maximum annual payment limit for the unified fund for basic medical insurance for school students and minor residents is 100,000 yuan. The payment limit is 125,000 yuan.
What is the medical insurance fund?
The medical insurance fund refers to the state's basic medical care for employees, which is raised by the medical insurance agency from units and individuals in accordance with relevant national regulations. Special fund for employee basic medical insurance. The basic medical insurance fund consists of two parts: social pooling fund and personal account, which are paid jointly by the employer and individual employees according to a fixed proportion.
Sources of medical insurance fund expenses
The basic medical insurance fund should be based on revenue and expenditure should be balanced. It is mainly composed of five parts: basic medical insurance premiums paid by the employer; basic medical insurance premiums paid by individual employees; interest on basic medical insurance premiums; late payment fees for basic medical insurance premiums; and other funds incorporated into the basic medical insurance fund according to law.
(1) Administrative agencies are arranged by finance at all levels.
(2) Public institutions provided by finance shall be arranged by finance at all levels based on financial subsidies and business income. Other public institutions shall be disbursed from the medical funds drawn from business income or operating income.
(3) Enterprises spend on employee welfare fees.
(4) The basic medical insurance premiums for laid-off employees of enterprises entering the re-employment service center, including employer contributions and individual contributions, will be calculated by the re-employment service center based on 60% of the average social salary of employees in the previous year in the coordinating area Pay the base amount.
(5) The medical insurance premiums for those who are employed, take long leave, do not enter the re-employment service center, and are on leave without pay shall be collected and paid by the original unit.
Through the introduction of this article, everyone knows about the maximum payment limit of medical insurance funds. This is a very important point for investors. Through such restrictions, medical insurance funds can be effectively restricted. , protect investors’ investment risks.