The district and county administrative departments of labor security shall be responsible for maternity insurance within their respective administrative areas.
The social insurance agencies set up by the municipal, district and county administrative departments of labor security specifically undertake maternity insurance affairs. Fourth financial and auditing departments shall supervise the income and expenditure and management of maternity insurance funds according to law.
Health, drug supervision, price control, family planning and other departments shall, within the scope of their respective duties, assist the administrative departments of labor and social security to do a good job in maternity insurance. Chapter II Maternity Insurance Fund Article 5 Maternity insurance funds shall be raised in a unified way according to the principle of fixed income by expenditure and balance of income and expenditure, and shall be included in the financial special account, and shall be managed by two lines of income and expenditure. Article 6 The maternity insurance fund consists of the following items:
(a) maternity insurance premiums paid by enterprises;
(2) Fund interest;
(3) late fees;
(four) other funds incorporated into the maternity insurance fund according to law. Seventh maternity insurance premiums paid by enterprises on a monthly basis. Self-employed workers do not pay maternity insurance premiums.
Enterprises pay maternity insurance premiums at 0.8% of the total payment base. The total payment base of an enterprise is the sum of the eligible employee payment bases of the enterprise.
The employee payment base is calculated according to the average monthly salary of the previous year; If it is lower than 60% of the average monthly salary of employees in this Municipality in the previous year, it shall be calculated according to 60% of the average monthly salary of employees in this Municipality in the previous year; If it is more than 3 times the average monthly salary of employees in this Municipality in the previous year, it shall be calculated according to 3 times the average monthly salary of employees in this Municipality in the previous year; If it is impossible to determine my average monthly salary in the previous year, it shall be calculated according to the average monthly salary of employees in this city in the previous year. Eighth maternity insurance premium payment standards need to be adjusted, the municipal labor and social security administrative department in conjunction with the municipal finance department put forward an adjustment plan, approved by the Municipal People's government and promulgated for implementation. Ninth maternity insurance premiums paid by enterprises shall be withheld and remitted by social insurance agencies on a monthly basis through the settlement method of "entrusting banks to collect (no payment period)".
Social insurance agencies shall establish payment records for enterprises and employees. Article 10 The collection and payment of maternity insurance premiums shall be carried out in accordance with the Provisional Regulations on the Collection and Payment of Social Insurance Fees in the State Council and the Provisions on the Collection and Payment of Social Insurance Fees in Beijing. Chapter III Maternity Insurance Benefits Article 11 Employees who enjoy maternity insurance benefits shall comply with the relevant provisions of the state and this Municipality on family planning. Twelfth maternity insurance fund payment scope includes:
(1) Maternity allowance;
(2) Maternity medical expenses;
(3) Medical expenses for family planning operation;
(four) other expenses stipulated by the state and this Municipality. Thirteenth maternity insurance fund payment standards need to be adjusted, by the municipal labor and social security administrative department in conjunction with the municipal finance department to propose an adjustment plan, announced after the approval of the Municipal People's government. Fourteenth normal maternity leave for female employees is 90 days; The number of dystocia increased 15 days, multiple births increased 1 baby increased 15 days, and late childbirth increased by 30 days.
Maternity leave is 15 to 30 days for female employees who are less than 4 months pregnant and have an abortion, and 42 days for female employees who are more than 4 months pregnant. Fifteenth maternity allowance shall be calculated according to the payment base of the month when female employees give birth divided by 30 and multiplied by the number of days of maternity leave.
Maternity allowance is the salary of female employees during maternity leave. If the maternity allowance is lower than my salary standard, the difference will be made up by the enterprise. Article 16 Maternity medical expenses include medical examination expenses, delivery expenses, operation expenses, hospitalization expenses and medicine expenses incurred by female employees due to pregnancy and childbirth.
The medical expenses of family planning operation include the medical expenses incurred by workers in placing (taking out) IUD, abortion, induced labor, sterilization and recanalization due to family planning.
If the medical expenses for fertility and family planning operations meet the requirements of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities in this Municipality, they shall be paid by the maternity insurance fund. Seventeenth maternity insurance fund to pay for maternity and family planning surgery medical expenses settlement measures, formulated by the municipal administrative department of labor and social security. Article 18 Workers who give birth and carry out family planning operations shall seek medical treatment in designated medical institutions of basic medical insurance (hereinafter referred to as designated medical institutions) qualified for midwifery and family planning operations in accordance with the medical regulations of this Municipality.
Workers should show the Beijing Medical Insurance Manual when seeking medical treatment; Need to be hospitalized, at the same time to show the "Beijing maternity service certificate" when handling the hospitalization procedures, a copy of which is retained by the designated medical institutions. Nineteenth the following maternity and family planning surgery medical expenses maternity insurance fund will not be paid:
(a) does not meet the provisions of the state or the city's family planning;
(two) does not meet the provisions of the basic medical insurance in this Municipality;
(three) does not conform to the provisions of the city's basic medical insurance drug list, diagnosis and treatment projects and medical service facilities;
(4) Medical expenses incurred abroad or in Hongkong, Macao Special Administrative Region and Taiwan Province Province;
(five) medical expenses due to medical accidents;
(six) the cost of treatment of reproductive complications;
(seven) according to the provisions of the state or the city should be borne by individuals.