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Chapter 5 of Dongying City’s Urban Employee Medical Insurance Regulations: Management of Medical Insurance Funds

Article 15: Basic medical insurance funds, large-amount medical insurance funds, and civil servant medical subsidy funds must be separately accounted for, managed specifically, and accounted for separately.

Article 16 Basic medical insurance premiums are disbursed according to the following channels: (1) "Social security fees" expenditures listed as "recurrent expenditures" by party and government agencies and mass organizations; (2) "Social security fees" listed as "public expenditures" by public institutions

"Social Security Fees" expenditures (employees who are engaged in business activities full-time are listed as "Social Security Fees" expenditures in "Funding Expenditures"); (3) Enterprise employees are listed as "Welfare Fees Payable", and enterprise retirees are listed as "Labor Insurance Premiums"

; (4) Private non-enterprise units shall list expenses from their income.

Article 17 The basic medical insurance fund consists of overall funds and personal account funds.

(1) Sources of personal account funds include: 1. Basic medical insurance premiums paid by individual employees are all transferred to the personal account; 2. Part of the basic medical insurance premiums paid by the employer are transferred to the personal account.

Based on the wages paid by the employees themselves, those under 45 years old (including 45 years old) are included at 1%; those over 45 years old are included at 2.5%.

Retirees use their monthly pension as the base and are allocated 6%.

(2) Coordination fund.

After the basic medical insurance premiums paid by the employer are transferred to personal accounts, the remainder is the basic medical overall fund, which is centrally managed by the medical insurance agency.

Article 18: Large-amount medical insurance funds are centrally managed by medical insurance agencies at the same level.

Article 19: Medical subsidy funds for civil servants shall be credited to individual accounts at the rate of 2% of personal contribution wages (retirees’ pensions), and the remainder shall be included in the civil servant subsidy overall fund, which shall be centrally managed by the medical insurance agency.

Article 20: Medical insurance agencies shall uniformly establish personal accounts for insured employees and issue social security cards.

Article 21 The principal and interest in the personal account of an insured employee belong to him or her and can only be used to pay for his or her outpatient medical expenses and inpatient medical expenses at his own expense.

The balance of a personal account is transferred as the person changes his job and can be carried forward for use and inherited in accordance with the law.

Article 22: The bank interest calculation method for the basic medical insurance fund: the part raised in the current year is calculated at the interest rate of current deposits; the principal and interest of the fund carried forward from the previous year is calculated at the interest rate of bank deposits with a three-month period;

Precipitated funds deposited into the medical insurance financial account will be charged interest based on the three-year zero-sum savings deposit interest rate, which is not lower than the interest rate level of this grade.

Article 23 Basic medical insurance implements municipal-level overall planning, hierarchical management, plan (budget) control, and proportional adjustment management methods, and is incorporated into the medical insurance fund special account of the same level of finance. It implements two-line management of revenue and expenditure, and special funds are earmarked.

, no unit or individual is allowed to appropriate or misappropriate it.

Article 24: The total revenue and expenditure of basic medical insurance funds in each county and district shall be controlled by plans.

Every year, the municipal human resources and social security department, together with the municipal finance department, issues basic medical insurance fund collection plans and medical expense expenditure plans to all counties and districts.

Article 25: Establish a basic medical insurance overall fund adjustment system.

Each county or district withdraws an adjustment fund based on 15% of the current year's basic medical insurance fund collection plan.

When the fund collection plan is completed in the current year and the medical insurance co-ordination fund is unable to meet the expenditure, the municipal basic medical insurance adjustment fund will be used to subsidize the payment.

*** The same responsibility shall be borne by the government; if the fund collection plan is not completed in the current year and the medical insurance co-ordination fund is unable to meet the expenditure, it shall be made up by the local rolling balance over the years. If the shortage is not made up, the financial department at the same level shall be responsible for making up the amount.

The rolling balance of the basic medical insurance pooling fund over the years is an integral part of the municipal pooling fund.

The accumulated balances of each county and district over the years are temporarily retained in the county and district, and are jointly managed by the city and county levels. They are used to "make up for the deficit with abundance" and to seek a balance among themselves. They will be allocated in a timely manner based on the payment capabilities of the city and county basic medical insurance funds.

It is turned over to the municipal financial account and used by the municipal medical management agency as a whole.

Article 26: On the basis of participating in basic medical insurance and large-amount medical insurance, qualified enterprises (including public institutions without financial appropriation) can establish enterprise supplementary medical insurance.

Article 27: Improve the supervision mechanism of medical insurance funds.

The human resources and social security departments and the financial department shall strengthen the supervision and management of medical insurance funds; the audit department shall regularly audit the fund income and expenditure and management of medical insurance agencies; the establishment shall be composed of representatives of relevant government departments, representatives of employers,

The medical insurance fund supervision organization, in which representatives of medical institutions, trade union representatives and relevant experts participate, implements a fund overexpenditure early warning reporting system to strengthen social supervision of medical insurance funds.

Article 28 The employer shall regularly announce the payment status of medical insurance premiums and accept supervision by employees; employees have the right to inquire and understand the status of personal account funds and the collection, use and management of medical insurance premiums.