I. Main Work Progress

(1) Progress of Three Risks Expansion.

(two) the income and expenditure of the three insurance funds

Second, the main practices

(1) Actively promote capacity expansion.

In order to do a good job in expansion, we made an expansion work plan at the beginning of the year, and decomposed the expansion task into people. According to the plan, we classified the expansion work of retirees, flexible employees, normal production enterprises and private enterprises in difficult enterprises, so as to achieve half the time and half the task.

2, strengthen publicity and services, do a good job in the insurance and renewal of flexible employment. In order to do a good job in the insurance and renewal of insurance for flexible employees, first, strengthen publicity, widely publicize policies through newspapers, television, radio and other media, issue notices many times, post and distribute leaflets through service windows such as laid-off re-employment service centers, neighborhood offices and community service stations, and send policies to flexible employees; The second is to carry out convenience service, optimize the operation process internally, provide one-stop service, open the window of insurance procedures, and operate with banks in two directions to reduce the working hours of flexible employees. At present, the number of flexible employees directly under the municipal government has reached 3 1 10,000.

3. Do a good job in unit insurance. First, do a good job in expanding the scope of normal production and operation enterprises and financial institutions that have not yet been insured. In the first half of the year, 27 18 people from 82 units including Agricultural Bank participated in medical insurance. Second, we should increase the expansion of private enterprises and private enterprises. Through the social insurance bureau, fund settlement center and other relevant units, we can timely grasp the situation of private enterprises and private enterprises that have newly applied for social insurance, publicize policies at home and work patiently. In the first half of this year, 988 employees of 47 enterprises, including Sheng Mao Special Steel, were included in the overall coverage of medical insurance.

(B) improve medical management

1, improve the protocol management. Protocol management is the basis of medical management. At the beginning of each year, the medical insurance service agreement should be revised and improved according to the implementation of the previous year's agreement. This year, three improvements have been made: first, medical violations have been clarified, and the punishment clauses have been refined accordingly; Second, the actual medical expenses of agreed diseases were calculated in detail, and some unreasonable settlement bases of agreed diseases were adjusted; Third, according to the affordability of the fund and the actual development of medical technology, some new medical technologies have been appropriately added into the settlement scope of the medical insurance pooling fund.

2 do a good job in the annual assessment of the "two fixed" institutions. In the first half of the year, together with health, drug administration, price and other relevant departments, we made an assessment of the implementation of medical insurance policies and regulations by designated medical institutions and pharmacies in the city in 2006. Generally speaking, the "two fixed" institutions have further deepened their understanding of medical insurance policies and regulations and implemented them well. However, there are also a few units that do not have a deep understanding, are lax in implementation, and even deliberately violate the rules and make profits. These units have been rectified within a time limit.

3. Improve capital analysis and strengthen supervision in a targeted manner. In the first half of this year, we made a detailed analysis of the operation of the medical insurance fund from June 5438 to April in the form of chart analysis for the first time. Through analysis, we found out the key problems in the operation of the fund and their reasons, such as the excessive growth of contracted diseases, which are targeted at us.

It provides a basis for taking measures to strengthen supervision.

(3) Strengthen the prevention of work-related injuries

In the practice of industrial injury insurance, we gradually realize that the operation mode of industrial injury insurance, which used to focus on industrial injury treatment and compensation, can no longer meet the requirements of the development of the situation, and should gradually transition to the mode of paying equal attention to prevention, treatment and compensation. To this end, in the first half of the year, we intensified the prevention of work-related injuries. The first is to strengthen publicity. We set up columns in newspapers and radio stations to publicize work-related injury insurance and work-related injury prevention knowledge on a regular basis; On the occasion of the third anniversary of the promulgation of the Regulations on Work-related Injury Insurance and during the publicity month of work safety, two voluntary consultation activities were organized, a publicity column 14 was made and more than 5,000 publicity materials were distributed. The second is to implement floating rates. In the first half of the year, the contribution rate of the industrial injury insurance fund and the incidence rate of industrial accidents (occupational diseases) of the insured units in the previous year were counted, and it is planned to start floating the contribution rate of the insured units in the second half of the year, with the excellent falling and the poor rising, so as to encourage the insured units to strengthen industrial injury prevention and reduce industrial accidents. The third is to formulate incentives. In the first half of the year, the "Measures for Incentives for Work Safety and Work Injury Prevention" was drafted, which will reward units and related individuals who have done a good job in work safety according to the contribution rate of work injury insurance funds of insured units and the incidence of work-related accidents, and will be formally promulgated and implemented in the second half of the year.

(4) increase publicity.

In order to popularize medical insurance knowledge and promote the correct implementation of medical insurance policies and regulations, we have continuously increased publicity. First, expand the medical insurance column page opened by Dongchu Evening News, increase the column setting, and publicize the medical insurance policy to the insured in a more flexible way; The second is to cooperate with Yan 'an Road community, set up a medical insurance publicity column in the community, and carry out community medical insurance publicity pilot; The third is to publicize the new medical insurance policies and latest trends to the insured through major media in a timely manner; The fourth is to go deep into designated medical institutions and explain the new annual medical and industrial injury insurance service agreement and medical insurance policy to front-line medical staff; Fifth, the compilation of medical insurance documents for urban workers in Huangshi City was edited and printed, so as to facilitate all insured units and personnel to fully understand the medical insurance policies of our city.

(5) Strengthen theoretical and professional study.

In the first half of the year, according to the spirit and unified arrangements of the Party organizations at higher levels, our bureau earnestly organized the study and implementation of party constitution and the "one law, one regulation" activities, strengthened theoretical and professional study, and achieved certain results. First, thoroughly study and implement party constitution, and combine the study and implementation of party constitution with the maintenance of the party's advanced construction and medical insurance work; Second, study and apply Deng Xiaoping Theory, study and practice Theory of Three Represents, and study and implement Scientific Outlook on Development; The third is to study the spirit of the 16th National Congress of the Communist Party of China and the Third, Fourth and Fifth Plenary Sessions of the 16th National Congress; The fourth is to study the Law of People's Republic of China (PRC) on Public Security Administration Punishment and the Regulations of Hubei Province on Letters and Visits; The fifth is to learn medical insurance business knowledge, medical insurance policy and theory knowledge and computer application knowledge. Through study, the staff of our bureau have strengthened their lofty ideals and beliefs, strengthened their sense of serving the people, improved the professional level of medical insurance theory, and promoted the all-round progress of all work.

Third, the main problems

(1) The proportion of contracted disease expenses to total expenses has increased too fast, resulting in a rapid increase in per capita overall payment expenses.

(B) The phenomenon of flexible employees losing their insurance is more serious.

Among 3 1 10,000 flexible employees in our city, nearly 3,000 people lost their insurance coverage because they did not renew their insurance coverage, and nearly 1 10,000 people have reached the payment period but have not renewed their insurance coverage. It is understood that there are two main reasons for this part of the staff to break the insurance. First, because of going out to work, busy work, lack of concentration, good health and other reasons, I forgot to renew my insurance payment on time; Second, because of economic difficulties, the annual medical insurance cost of 1034 yuan is unbearable, and I intend to renew my insurance and cannot afford it.

Four. Work plan for the second half of the year

(a) seriously investigate and properly solve the problem of medical security for retirees in difficult enterprises.

In order to conscientiously implement the spirit of the provincial and municipal documents on solving the problem of retirees from difficult enterprises participating in medical insurance and properly solve the problem of medical security for retirees from difficult enterprises, according to the arrangement of the municipal government, in July, we will conduct a thorough investigation on the basic medical insurance for retirees from difficult enterprises in our city in conjunction with the relevant departments such as finance, economic commission and SASAC. After the investigation is completed, we will study and formulate the insurance measures for retirees from difficult enterprises in our city according to the specific conditions, and take practical measures to bring retirees from difficult enterprises into medical insurance as a whole.

(2) Accelerate the expansion of industrial injury and maternity insurance.

The expansion of industrial injury insurance, first, do a good job of migrant workers to participate in industrial injury insurance; Second, actively promote high-risk industries to participate in industrial injury insurance; The third is to implement insurance work in large state-owned enterprises such as yellow enterprises; The fourth is to do a good job in enterprise insurance.

Expand maternity insurance, focusing on maternity insurance for large enterprises such as nonferrous metals and metallurgy; Explore ways for special groups such as flexible employees to participate in maternity insurance.

(C) innovative management tools to strengthen medical management

First, speed up the real-time transmission of medical insurance information in designated medical institutions, and strive to realize real-time transmission and real-time monitoring of major designated medical institutions in the second half of the year; Second, improve the capital operation analysis system, hold regular capital operation analysis meetings every month to keep abreast of the situation and conduct targeted management; The third is to publicize the medical insurance information of designated medical institutions on a trial basis and report the medical expenses of the same disease in each designated medical institution in the media.

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