Eight points for the five social insurances and one housing fund is the individual payment ratio.
After the reform, the basic pension for employees of government agencies and institutions will consist of two parts: basic pension and personal account pension.
According to the decision, in terms of basic pension insurance, the unit shall pay 20% of the total salary; individuals shall pay 8% of the personal salary. The part of the personal salary higher than 3 times the average salary of local employees will not be included in the payment base, and the part lower than the average salary 60%
% pay based on 60%, that is, "300% cap and 60% bottom".
The specific situation is as follows: 1. What does the 8% personal contribution ratio mean? According to the document released yesterday, this pension reform involves all units managed according to the Civil Service Law, agencies (units) managed with reference to the Civil Service Law, public institutions and their establishments.
Nearly 40 million "in-system personnel" will switch from fiscal support to pension contributions, and from workplace pension to social pension.
After the reform, the basic pension for employees of government agencies and institutions will consist of two parts: basic pension and personal account pension.
According to the decision, in terms of basic pension insurance, the unit shall pay 20% of the total salary; individuals shall pay 8% of the personal salary. The part of the personal salary higher than 3 times the average salary of local employees will not be included in the payment base, and the part lower than the average salary 60%
% pay based on 60%, that is, "300% cap and 60% bottom".
Individual payment ratio 2. The individual medical insurance payment ratio remains unchanged 1. The scope of application is expanded. According to the relevant provisions of the Social Insurance Law, the "Measures" will apply to enterprises, institutions, state agencies, social groups, and private non-profit organizations within the Shanghai administrative area.
Enterprise units and individual industrial and commercial households with employees, the "enterprise" is not limited to "urban enterprises", in fact, all enterprises and their employees in Shanghai are included in the employee basic medical insurance system, and the expanded scope of application involves those who participated in the small town comprehensive insurance
Shanghai suburban employers and their employees, foreign employees who originally participated in comprehensive insurance, and individual industrial and commercial households with employees and their helpers.
2. Some payment ratios have been adjusted. The proportion of employers paying basic medical insurance premiums according to the payment base has been adjusted from 10% to 9%. However, the proportion of employers paying local additional medical insurance premiums is still 2%, and the proportion of individual employees paying 2% is still 2%.
The payment ratio will not be adjusted.
3. Improved outpatient and emergency medical benefits. Shanghai adjusted and improved outpatient and emergency medical insurance benefits. 1. Simplified the classification of people, changed the original classification standard of birth date, and divided the people into working people under 45 years old, 45 years old to retirement, and retired people.
to 70 years of age and above; 2. Appropriately widen the proportion of self-payment of hospitals at different levels, and appropriately increase the proportion of medical insurance fund payment for different groups of people in hospitals at different levels; 3. Ensure the smooth connection between the new and old methods and ensure the safety of all insured persons
Outpatient benefits will not decrease, and the benefits for "retired seniors" will remain unchanged. For those who were born before December 31, 1955 and started working before December 31, 2000, a transitional approach will be adopted to ensure higher benefits.
4. Clarify the adjustment principles and procedures for relevant standards and proportions. The basic medical insurance system involves many standards and proportions, such as outpatient and emergency self-payment standards, overall fund minimum payment standards, payment ratios of the overall fund and additional funds, and the maximum overall fund
Payment limits.
This time, in addition to relatively definite definitions of these standards and proportions, the principles that should be followed in the adjustment have been clarified, that is, the level of basic medical insurance should be consistent with Shanghai's economic and social development level, and the basic medical insurance benefits should be kept reasonable.
Gradient and improve the efficiency of use of medical resources; the adjustment procedures are clarified, that is, the specific adjustment plan will be studied and demonstrated by the Municipal Human Resources and Social Security Bureau in conjunction with relevant departments, and will be announced and implemented after being submitted to the Municipal People's Government for approval.
5. Expanded the scope of outpatient serious diseases. Since the implementation of the Shanghai Employee Basic Medical Insurance System, the scope of outpatient serious diseases has been expanded, mainly involving the treatment of malignant tumors and some mental illnesses.
From the perspective of strict fund payment projects and legal administration by medical insurance management departments, the above-mentioned expanded and implemented scope needs to be clarified and fixed.
The "Measures" will expand the treatment methods for malignant tumors included in the scope of outpatient serious diseases from the original chemotherapy and radiotherapy to endocrine-specific treatment, isotope therapy, interventional treatment and traditional Chinese medicine treatment, as well as some psychiatric diseases such as schizophrenia and moderate to severe depression.
, mania, obsessive-compulsive disorder, mental retardation associated with mental disorders, epilepsy associated with mental disorders, and paranoid psychosis, thus ensuring the medical needs of these insured persons.
6. Improved the method of using personal account funds. In order to guide insured persons to actively save personal account funds, the method of using personal account funds has been improved, that is, insured persons use up their personal account funds for the current year (instead of using up their personal account funds over the years as originally stipulated).
After that, the "self-confidence segment" is entered, and the personal account funds over the years can be used to pay for the personal self-confidence portion of the personal self-confidence segment and the first payment segment.
At the same time, the expenses incurred by current employees and retirees in dispensing prescriptions at designated retail pharmacies can also be paid by the balance of personal medical accounts over the years.