chapter I general provisions article 1 these measures are formulated in accordance with the social insurance law of the people's Republic of China, the regulations of the State Council on the supervision and administration of the use of medical insurance funds and other relevant provisions, in combination with the actual situation of this municipality, in order to standardize the basic medical insurance relationship and protect the legitimate rights and interests of the insured. Article 2 These Measures shall apply to the collection and treatment of expenses for basic medical insurance for employees (hereinafter referred to as employee medical insurance), maternity insurance for employees, basic medical insurance for urban and rural residents (hereinafter referred to as resident medical insurance) and serious illness insurance within the administrative area of this Municipality, as well as medical settlement, medical services, public management services and fund management. Article 3 The basic medical insurance work adheres to the principle of covering the whole people, coordinating urban and rural areas, clearly defining rights and responsibilities, ensuring moderate and sustainable development, following the principle of giving consideration to fairness and efficiency, unifying rights and obligations, and adapting the level of protection to the level of economic and social development. In accordance with the requirements of fixed income and expenditure, balancing income and expenditure, and having a slight balance, the use efficiency of the medical insurance fund will be improved, the basic medical needs of the insured will be guaranteed, the medical and health resources will be rationally utilized, and the bottom line of protection will be established. Article 4 The basic medical insurance shall be subject to municipal overall planning, hierarchical management, responsibility * * *, and the city's unified financing policy, treatment guarantee policy, agreement management, fund management, handling services and information system. Fifth city, county (city) District People's government should strengthen the leadership of the basic medical insurance, medical security into the national economic and social development plan.
the administrative committees of high-tech industrial development zone, economic and technological development zone and Xinzhan high-tech industrial development zone shall do a good job in basic medical insurance in accordance with regulations.
township people's governments, sub-district offices and community (village) residents' committees should do a good job in the publicity and mobilization of residents' medical insurance, insurance registration and payment as required. Article 6 The administrative department of medical security is responsible for the management of basic medical insurance, and its affiliated medical security agencies and regulatory agencies are responsible for the specific implementation; The tax department is responsible for the collection and management of basic medical insurance premiums.
The departments of development and reform, education, public security, civil affairs, finance, human resources and social security, health and wellness, agriculture and rural areas, retired military affairs, rural revitalization, auditing, market supervision and management, data resource management, and the Disabled Persons' Federation are responsible for the work related to basic medical insurance within their respective responsibilities. Chapter ii medical insurance for employees article 7 the following units and personnel shall participate in medical insurance for employees:
(1) state organs, institutions, social organizations, enterprises, private non-enterprises and individual industrial and commercial households with employees (hereinafter referred to as employers) and their employees;
(2) other units and personnel that should participate in employee medical insurance as stipulated by the state and province. Article 8 Individual industrial and commercial households without employees, part-time employees who have not participated in employee medical insurance in the employing unit and other flexible employees (hereinafter referred to as flexible employees) may participate in employee medical insurance. Article 9 The employing unit shall go through the formalities of registration, alteration, cancellation and payment base declaration of medical insurance for employees according to law.
The employer and the insured shall pay the employee's medical insurance fee on a monthly basis in accordance with the following provisions:
(1) The employee's average monthly salary of the previous year is taken as the base of personal payment for the period from January 1 to December 31 of that year, which is withheld and remitted by the employer at the rate of 2%.
the employer takes the sum of the payment bases of all employees participating in the insurance as the unit payment base, and the state organs and institutions pay according to the proportion of 6.2% and other employers pay according to the proportion of 6.4%.
if the employer adds or reduces the insured, the payment base of the unit and individual employees shall be adjusted and determined according to the actual salary; If a newly established unit is insured, the payment base of the unit and individual employees shall be determined according to the actual salary.
if the individual payment base of employees is lower than 6% of the monthly average wage of employees in full-caliber urban units in the province last year (hereinafter referred to as the provincial average wage), it shall be calculated according to 6%; If it exceeds 3%, it shall be calculated as 3%.
(2) flexible employees shall pay 6% of the provincial average salary as the payment base and pay according to the proportion of 6%.
(3) During the period when the unemployed receive unemployment insurance benefits, the unemployment insurance fund shall pay the medical insurance premiums of the employees according to the regulations. Article 1 The municipal medical security administrative department shall, jointly with the financial department, put forward an adjustment plan for the proportion of employees' medical insurance contributions in a timely manner according to the national and provincial regulations and the economic and social development of this Municipality and the operation of employees' medical insurance funds, and report it to the Municipal People's Government for approval. Article 11 When the insured reaches the statutory retirement age, if the accumulated payment period is over 25 years for men and 2 years for women, and the actual payment period is over 15 years (including the actual payment period for participating in medical insurance in the army), the employee's medical insurance fee will no longer be paid, and he will enjoy medical insurance benefits in accordance with the regulations; If the above-mentioned payment period is not reached, the average salary of the province in the previous year will be used as the base when the payment is made, and the one-time payment will be made to the specified period according to the proportion of 6%, and the medical insurance premiums for employees who have been paid back will be all included in the overall fund. Among them, if the payment period is insufficient due to the employer's reasons, the employer shall be responsible for filling it up; If it is not caused by the employer, the individual shall be responsible for filling it up.
the payment period of employees' medical insurance includes the actual payment period and the deemed payment period, and the length of service recognized by the state before December 1, 22 (the establishment of the basic medical insurance system in this city) is regarded as the payment period of employees' medical insurance. The actual payment period and the deemed payment period are not calculated repeatedly. If the employee's medical insurance is interrupted, the actual payment period before and after the interruption is calculated cumulatively.
before the implementation of these measures, those who have retired in this city and received the basic pension on a monthly basis are not included in the employee medical insurance, and individuals can voluntarily pay the employee medical insurance premium in one lump sum according to the payment standard stipulated in the first paragraph of this article and enjoy the employee medical insurance benefits.