All insurance funds are managed separately, that is, each insurance has its own overall fund.
It is an important principle that the basic medical insurance combines social pooling with individual accounts. There are four specific provisions for the establishment and use of pooling funds and individual accounts:
1, which is to establish overall funds and personal accounts. Personal contributions are all included in personal accounts; The unit payment is included in the personal account according to about 30% of the overdue fine, and the rest is set up as a whole fund. The principal and interest of the banquet in the personal account are owned by the individual and can be carried forward and inherited;
2, that is, the overall fund and individual account should be clear about their respective payment scope and managed separately. Personal accounts are mainly used for minor illness or outpatient expenses, and pooling funds are mainly used for serious illness or hospitalization expenses. The purpose is to clarify their respective responsibilities, avoid the overdraft of individual accounts by pooling funds, and facilitate management;
3, is to develop the overall fund Qifubiaozhun and maximum payment limit. Qifubiaozhun is controlled in principle at about 10% of the average annual salary of local employees, and the maximum payment limit is controlled in principle at about 4 times of the average annual salary of local employees;
4. Medical expenses below the minimum threshold shall be paid from personal accounts or by individuals. Medical expenses above Qifubiaozhun and below the maximum payment limit are mainly paid from the overall fund, and individuals also have to bear a certain proportion.