1, personal medical insurance coverage adjustment
① The coverage of the medical insurance system for urban and rural residents includes the existing medical insurance for urban residents and the new rural cooperative medical system, that is, it covers all urban and rural residents except the countries where employees' basic medical insurance should be insured.
② Migrant workers and flexible employees shall participate in basic medical insurance for employees according to law. If you have difficulties, you can participate in medical insurance for urban and rural residents in accordance with local regulations.
2. How to raise funds for personal medical insurance?
(1) Insist on multi-channel porcelain cultivation, continue to implement the method of combining individual micro-fees with government subsidies, and encourage collectives, units or other social and economic organizations to give support or funding.
(2) Reasonably divide the US-funded responsibilities of the government and individuals. At the same time as the local government subsidizes the standards, the proportion of personal micro-fees should be appropriately increased.
3, personal medical insurance financing standards.
(1) All localities should make overall consideration of the needs of urban and rural residents for medical insurance and serious illness check-ups, balance funds on schedule, and reasonably set the standards for American investment in urban and rural integration.
② In areas where there is a big gap between the existing medical insurance for urban residents and the individual payment standard of the new rural cooperative medical system, we can adopt the method of differential micro-fee. It takes 2-3 years to gradually transition.
③ After the integration, the actual per capita fund-raising and individual contributions are not lower than the current level.
4. Personal medical insurance.
(a) follow the principle of moderate security and balance of payments, coordinate urban and rural security benefits, and gradually unify and guarantee the payment standards of Tianjin and Hunan.
② The medical insurance fund for urban and rural residents is mainly used to pay the medical expenses incurred by the insured in any hospital and clinic.
③ Stabilize the level of hospitalization security, and keep the proportion of hospitalization expenses in the policy scope at about 75%.
⑤ Gradually narrow the gap between the payment ratio within the policy scope and the actual payment ratio.
5. When will the new personal medical insurance be implemented?
All provinces, autonomous regions and municipalities should plan and deploy medical insurance for urban and rural residents before the end of June. A clear timetable. A road map to ensure the implementation of various policies and measures.
(3) The overall planning areas should issue specific implementation plans before the end of 65438+February.
The proportion and base of medical insurance payment for employees in Shenyang;
1. The basic medical insurance premium shall be paid by both the employer and the employee. According to the sum of the payment ratio of the employer's participation in the basic medical insurance and maternity insurance for employees, it is determined that the employer will pay 8% of the total wages of employees in the previous year. 6% payment; On-the-job employees pay 2% of the salary income of the previous year.
2. The total wages of employees above the annual level of the employing unit shall be the payment base, and the total wages of newly established employing units above one month shall be the payment base; If the per capita payment wage of the employer is lower than the average full-caliber wage of the whole city in the previous year or the total wage cannot be determined, the average full-caliber wage of the whole city in the previous year shall be paid as the base.
3. On-the-job employees take their salary income of the previous year as the payment base. The monthly salary of new employees is the base of payment. The wage income of employees is higher than 300% of the city's full-caliber average wage in the previous year, and 300% of the city's full-caliber average wage in the previous year is the payment base; If the wage income of employees is lower than 60% of the city's full-caliber average wage in the previous year, 60% of the city's full-caliber average wage in the previous year is the payment base. The basic medical insurance premiums paid by individual employees on the job shall be withheld and remitted by the employer from their wages.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis: Article 23 of the Social Insurance Law of People's Republic of China (PRC).
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.