1. The medical insurance pooling fund refers to the remaining portion of the medical insurance premiums paid by all employers in the pooling area for their employees after deducting them and transferring them to individual accounts.

2. The overall planning fund includes: the remainder after deducting the total payment of all insured units in the overall planning area and crediting it to individual accounts; financial subsidies; social donations; bank interest; late payment fees, etc.

3. The medical insurance pooling fund belongs to all insured persons and is stored and used exclusively for special purposes. No unit or individual may misappropriate it.

4. The overall fund is mainly used for: medical expenses such as hospitalization of insured persons, emergency rescue in non-designated hospitals, off-site transfer (hospital), off-site placement, special disease outpatient services, etc.

5. Pooling funds and personal accounts 1. Basic medical insurance combines social pooling and personal accounts. The basic medical insurance fund consists of pooling funds and personal accounts.

All basic medical insurance premiums paid by individual employees will be charged to their personal accounts.

The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish a unified fund, and the other part is transferred to the personal account.

About 30% of the employer's payment is transferred into the employee's account. The specific proportion is determined by the coordinating region based on factors such as the payment scope of the individual account and the age of the employee.

The overall fund and personal accounts must delineate their respective payment scopes and account for them separately, and cannot squeeze each other out.

2. Determine the minimum payment standard and maximum payment limit of the overall pool fund.

In principle, the minimum payment standard is controlled at about 10% of the average annual salary of local employees, and the maximum payment limit is in principle controlled at about 4 times the average annual salary of local employees.

Medical expenses below the minimum payment standard shall be paid from a personal account or paid by the individual out of pocket.

Medical expenses above the minimum payment standard and below the maximum payment limit are mainly paid from the overall fund, and individuals also have to bear a certain proportion.

Medical expenses exceeding the maximum limit can be settled through commercial insurance and other channels.

The specific minimum payment standard and maximum payment limit of the overall planning fund, as well as the proportion of personal burden of medical expenses above the minimum payment standard and below the maximum payment limit, are determined by the coordinating region based on the principle of determining expenditure based on revenue and balancing revenue and expenditure.