The maximum payment limit is the maximum amount that the overall fund can pay. In principle, it should be controlled at about 4 times of the average annual salary of local employees. Not all medical expenses above Qifubiaozhun and below the maximum payment limit shall be borne by the overall fund, and individuals shall also bear part of them.
1. What are the standards of the State Administrative Compensation Law?
The national administrative compensation standard is: the daily compensation is calculated according to the average daily salary of employees in the previous year. If physical injury is caused, medical expenses and nursing expenses shall be paid, and the income reduced due to missed work shall be compensated. The compensation for daily income reduction is calculated according to the average daily salary of employees in the previous year, and the maximum is five times the average annual salary of employees in the previous year.
What is the contribution ratio of the second and third types of industrial injury insurance?
The payment ratio of industrial injury insurance has the following three categories:
1, one is an industry with less risk;
2. The second category is medium-risk industries;
3. The third category is the risk industry.
The three types of industries are divided into three types of industries, and the contribution rates of industrial injury insurance are different. According to the industrial and commercial registration and main production and operation of the employer, the social insurance agency determines the industry risk category of each employer. In principle, the average contribution rate of industrial injury insurance in enterprises should be controlled at the total wages on the job 1. 0% The benchmark rate of the three industries is 0.0% of the total wages of the employees of the employing unit. 5%、 1。 0%、2。 About 0%.
Third, why is flexible employment medical insurance so high?
The high payment of flexible employment medical insurance is calculated according to different payment bases and different insured objects. The main difference between flexible employment medical insurance and employee medical insurance is: 1, and the payment base is different. The payment base of flexible employees participating in medical insurance is generally 60% of the average annual salary of local employees in the previous year; The payment base for employees to participate in medical insurance is the total monthly salary of employees; 2, the insured object is different, the insured object of flexible employees is part-time employees and other flexible employees who have not participated in the basic medical insurance for employees of the employer; Individual industrial and commercial households without employees within the employment age range; The insured objects of employee medical insurance are urban on-the-job employees and retired employees; 3. Different payment methods. The medical insurance for flexible employees shall be paid in full by the flexible employees themselves according to a certain base and proportion, and may be paid monthly or annually. Employee medical insurance is paid by both the unit and the employee, and is generally paid monthly; 4. Flexible employees have two different payment ratios. According to local standards, such as Shenyang standard, you can choose the ratio of 10% or 6. The proportion of 8%. The proportion of employees' medical insurance contributions is about 6% for the unit and about 2% for the individual employees; 5. Fund accounts are divided in different ways. Both medical insurance for flexible employees and medical insurance for employees have personal accounts, and all the basic medical insurance premiums paid by employees are included in the personal accounts. The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish the overall fund, and the other part is included in the personal account.
I hope the above content can help you. If in doubt, please consult a professional lawyer.
Legal basis:
Article 2 of People's Republic of China (PRC) Social Insurance Law
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.