The reform of the economic security system for workers' outpatient service mainly includes four aspects:
First, the general outpatient expenses of medical insurance for employees should be guaranteed as a whole;
The second is to coordinate and promote the unification of the payment period of employees' medical insurance;
Third, standardize and expand the use of personal medical insurance accounts;
Fourth, improve the method and level of personal account of medical insurance.
According to incomplete statistics, including Beijing, Shanghai, Jiangsu, Shandong, Guangdong, Sichuan and other regions, the Measures for the Implementation of Basic Medical Insurance for Employees have been promulgated and implemented one after another.
Then, from June 5438+ 10, 2023, the retirees' personal medical insurance account was uniformly transferred to 3540 yuan. Is it true?/You don't say.
According to public information, in areas where the Measures for the Implementation of Economic Security for Employees' Basic Medical Insurance Outpatients have been issued, individual accounts for employees' medical insurance are gradually being coordinated at the provincial level, and the standards for individual medical insurance accounts are gradually unified.
According to the "Measures for the Implementation of Economic Security for Employees' Basic Medical Insurance Outpatients" issued by various regions, the amount of individual medical insurance accounts for retired employees in most regions is determined on the basis of the average level of basic pensions in the year when the reform policy was formulated and implemented, and the inclusion ratio is generally between 2% and 3%.
Recently, many retirees reported that starting from June 5438+ 10, 2023, retirees' personal medical insurance accounts were transferred to 3540 yuan at one time. Is there a uniform standard for the distribution of individual medical insurance accounts? Is it true?/You don't say. /You don't say.
It has been verified that some areas, including Ningbo City, Zhejiang Province, do allocate funds from employees' personal medical insurance accounts on an annual basis, including not only retired employees, but also on-the-job employees' personal medical insurance accounts.
Among them, Ningbo City, Zhejiang Province set the annual basic medical insurance for employees as 202 1 to 1 to February, and set the annual transition period of employee medical insurance in 2020 as 1 in May 2020.
For example, in May 2020 1, based on the base corresponding to the payment in April 2020, the employee's account in 2020 will be pre-allocated for 8 months at one time.
In 2020, the standard for monthly account transfer of retirees in the current year is 20 19, with an increase of 10 yuan, with a one-time advance of 8 months.
In 2020, the personal account standard of medical insurance for retirees is: retirees under the age of 70 will be included in 250 yuan every month, with a total of 2,000 yuan in 8 months; Retirees aged 70 and above are paid 275 yuan per month, totaling 2,200 yuan for 8 months.
Starting from 2002 1 year, the employee's current account of 12 months will be pre-allocated on a daily basis, and the pre-allocated amount will be calculated according to the inclusion ratio determined by the base, personnel category and age group corresponding to the payment in the last month of last year, and the individual account of retirees will be allocated according to the quota stipulated by the policy.
Among them, the personal account standard of medical insurance for retirees in 2022 is: retirees under the age of 70 are included in 270 yuan every month, and 270× 12=3240 yuan for the whole year; Retirees aged 70 and above will be paid a lump sum of 295 yuan per month and 295×12 = 3,540 yuan throughout the year.
According to public information, Zhejiang Province has not issued the relevant policies of the Measures for the Implementation of Employees' Basic Medical Insurance. In other words, Zhejiang Province has not issued new accounting methods and standards for employees' personal medical insurance accounts.
Therefore, if the above policies continue to be implemented in 2023, retirees in Ningbo, Zhejiang Province will receive the personal account funds of medical insurance for the whole year of 2023 on June 5438+ 10/day. The standard is: retirees under the age of 70 are included in 280 yuan every month, and the annual lump sum is 280× 12=3360 yuan; Retirees aged 70 or above are paid RMB 305 per month and RMB 305× 12=3660 in one lump sum throughout the year.
Based on the above situation, it is unreasonable to transfer 3540 yuan into the personal account of retirees' medical insurance in June 2023 from 5438+ 10. This is only a policy in some areas, not a unified standard in the whole country.
Compared with the areas where the implementation measures of outpatient medical insurance for employees have been announced, the amount of individual medical insurance accounts for retired employees in Ningbo, Zhejiang Province is quite high.
For example, in Shanghai, it is stipulated that the individual accounts of retirees should be transferred from the overall fund according to the quota, which will be implemented on July, 2023 1. The standard is 1680 yuan/year for retirees under 74 years old and 1890 yuan/year for retirees over 75 years old.
According to Beijing regulations, the individual accounts of retirees are allocated by the overall fund according to the quota. Among them, the individual account of retirees under 70 years old is allocated 100 yuan every month, totaling 1200 yuan for the whole year; For retirees aged 70 and above, the monthly personal medical insurance account will be transferred to 1 10 yuan, with a total of 1320 yuan for the whole year.
It should be noted that the reform of outpatient medical insurance system aims to bring outpatient expenses into the payment scope of employee medical insurance pooling fund, reform employee medical insurance personal account, establish and improve outpatient medical insurance system, improve the utilization efficiency of medical insurance fund, gradually reduce the medical expenses burden of insured personnel, and realize a fairer and more sustainable system.
20021statistical bulletin on the development of human resources and social security shows that by the end of 20021.7 million people had retired in China, and 0.31.57 million people had retired.
According to the statistical bulletin on the development of national medical insurance in 20021year, the current balance of individual accounts of basic medical insurance for employees in China was billion yuan, and the accumulated balance of individual accounts was billion yuan.
According to the above situation, if the standard of personal medical insurance accounts for retirees is raised and uniformly implemented at RMB 3,540, the total personal medical insurance accounts for retirees in the whole year will be about 13 1.57 million × 1 10,000 yuan = 465.8 billion yuan, which has exceeded the current balance of personal medical insurance accounts for employees in China in 2002 1 year, only.
Raising the standard of retirees' medical insurance personal accounts will lead to an increase in medical insurance fund expenditure and even affect the medical insurance benefits of on-the-job insured persons.
Therefore, it is obviously impossible to uniformly raise the criteria for the inclusion of retired employees' personal medical insurance accounts and uniformly include 3,540 yuan into retirees' personal medical insurance accounts.