(Summit No. 47 of the Government of 22 March 2014 to discuss the adoption of the Decree No. 252 of 1 April 2005 of the Government of the South Françoise People's Government of 1 April 2014)

Chapter I General

Article 1 provides for the establishment and improvement of the basic health insurance system for workers and guarantees basic medical care for workers, which, in line with the relevant provisions of the State and the province, develops this approach in the light of the actual provisions of this city.

Article II applies to activities such as the participation, service and supervision of the basic health insurance for workers in the city's administration.

Article 3 Basic health insurance for workers should uphold the principle of payment, balance of payments, a slight balance, a combination of equity and efficiency, rights and obligations, and the level of security is commensurate with the level of social development.

Article 4 The WCSS agencies are specifically responsible for the raising, management and treatment of the basic health insurance fund for the workers.

The executive heads of the social insurance administration in the current administrative area are responsible for the mobilization, management and treatment of the basic health insurance fund for workers.

Sectors such as finance, health, food medicine regulation, price, audit and civil affairs should be co-ordinated in the management of basic health insurance for workers, in accordance with their respective responsibilities.

Article 5

Chapter II

Article 6. Employers' basic health insurance fund income includes: basic health insurance payments paid by user units and workers, flexible employed persons, interest income, financial subsidy income, transfer of income, secondary income, lower-level income and other income.

Article 7.

The monthly salary of the employee is less than 60 per cent of the average monthly salary of the insured employee in the current city, and the unit and individuals are paid by the average monthly salary of the employee in the current city by 60 per cent.

Article 8. Flexible employed persons are based on the average monthly salary of the employed workers in the current city, which can be paid at a rate of 10 per cent and individual accounts, or the individual accounts are not established at a rate of 5.5 per cent.

Article 9. The owner's unit shall terminate, withdraw, disband and insolvency under the law and shall give priority to the payment of basic health insurance expenses in accordance with the relevant provisions of the State, the province.

Insolvency enterprises should pay a one-year health insurance fee for retirees in this unit, in accordance with the per capita medical fee for retired persons in the current city.

Article 10

(i) The portion raised in the year, in accordance with the interest rate of the bank's term deposits;

(ii) Removal of funds over the previous year, in accordance with the bank's three-month lump-sum interest rates;

(iii) Resistance funds deposited with the Social Security Finance Principal, which are not lower than the record rate of interest rates than the bank's three-year period.

Article 11. The Basic Health Insurance Fund for Employers is divided into the Integrated Fund and Personal Accounts Fund.

The Integrated Fund refers to the portion of the employee's basic health insurance fund income deducted into the personal accounts. Individual accounts include the contributions of the employee and the portion of the individual accounts transferred from the Fund's income. Individual accounts and their interest are owned by individuals.

Article 12. The personal accounts of the employee are classified according to the following provisions: 0.8 per cent of the monthly salary paid by the age of 35 years; 1 per cent of the salary paid by the age of 45 years over 35 years of age; and 1.5 per cent of the salary paid by the age of 45 years.

The monthly salary of the employee was higher than the average monthly salary of 30 per cent of the insured employee in the current city, and 50 per cent was transferred to the personal accounts.

The personal accounts of the flexibilities of employed persons are classified as follows: 2.8 per cent of the salary paid for a person under the age of 35 years, 3 per cent of the salary paid by him for 45 years of age and above, and 3.5 per cent of the salary paid for the month of 45 years.

The individual accounts of the retired person were transferred to the home in accordance with 4 per cent of his basic pension (the pension) for the month. Of this amount, the amount of $50 per month under the age of 60 was converted to a maximum of US$ 170 per cent, up to US$ 60 years of age, up to US$ 60 years of age, up to US$ 190, and the amount of €70 per month over the age of 80 years was transferred to a maximum of US$ 220 million, up to $220, and the accounts for less than 80 years of the age of 80 years of age, up to $220, or less than 90 years of age.

Article 13 The specific approach was developed by the Municipal Social Insurance Administration.

Chapter III

Article 14.

Inpatients in compliance with the basic health insurance requirements, medical treatment provisions and general referrals are subject to personal burdens and the cost of buying medicines at targeted retailers can be paid by personal accounts.

Article 15. The payment criteria referred to in this approach refer to the degree of medical expenses incurred by individuals during a medical year prior to the inpatientation of the sick and the general clinic.

Inpatient, patient and general-patient criteria are based on the average salary of the occupancy workers in this city, which is not higher than 6 per cent for the three-tier medical institutions, 4 per cent for secondary medical institutions and 3 per cent for other medical institutions.

Inpatient, patient and general-patient criteria are calculated separately. In a medical year, the second occupancy rate for the insured person was reduced by 20 per cent compared to the previous year, from the third inpatient period to no longer calculate the payment criteria; the patient set the rates for the sick and the general patriots were calculated separately and only once.

Article 16 states that the maximum payment limit is the maximum amount of medical expenses incurred by insured persons within a medical year. The maximum payment threshold for hospitalization and patient care provides for six times the average salary of the employee in the current city, and the maximum payment threshold for the general clinic is provided by the municipal social security administration.

Medical fees exceeding the maximum payment thresholds are resolved by a large amount of medical assistance, with a specific approach drawn up by the municipal social insurance administration.

Article 17 is a medical year from 1 January to 31 December each year.

The threshold for each medical year and the maximum payment threshold are published by the municipal social insurance administration.

Article 18 Inpatient and introductory medical expenses incurred by the insured person (non-consistency of retired persons) in the context of an integrated fund during a medical year, as set out below:

The standard of payment, with the following portions of H$100,000, has an integrated fund burden of 85 per cent and a personal burden of 15 per cent;

More than 2.10000 to the maximum payment threshold, the integrated fund affords 88 per cent and the individual burdens 12 per cent.

The proportion of the integrated fund burden of retirees has increased by three percentage points compared to the proportion of the above-mentioned payments, with a decrease of three percentage points for individuals. The proportion of pre-established workers in the integrated fund has increased by 5 percentage points compared to the proportion of retirees, with a decrease of 5 percentage points for individuals.

Integral hospitals, such as tier 3 (a) or higher-level specialist hospitals, agreed to be transferred to inpatient treatment in the field, in temporary care for emergencies in the field, off-site placement or long-term field personnel were transferred to other hospitals by targeted hospitals in the long-term reserve case, the proportion of the Fund's burden was reduced by 10 percentage points and the proportion of individuals was increased by 10 percentage points.

The general medical costs incurred by the insured person during a medical year are set up separately by the municipal social insurance administration.

Article 19

Article 20 enjoyed basic health insurance treatment for the second month of the payment of basic medical insurance expenses by the employee's unit.

Flexible workers enjoyed basic health insurance treatment for 7 months of continuing payment of basic health insurance fees. As a result of the work of the user unit, the basic health insurance payments had been paid for a period of six months and, within three months after the lifting, termination of the labour relationship or the receipt of the unemployment insurance pension had been completed, the basic health insurance treatment had been enjoyed in the last month of the payment.

Article 21 Minimum contributions for the treatment of workers' basic health insurance are limited to 30 years for men and 25 years for women.

Without the minimum payment period, the average monthly salary of the employee in the current city at the time of the retirement process should be based on the average monthly salary of the employee, a one-time replenishment of the basic health insurance expenses for the month of the difference and benefits of the basic health insurance for the employee since the month.

The number of years of actual contributions for the basic old-age insurance for the same employee was calculated at the same time as the number of years of payment for the basic old-age insurance for the first-clocked workers in January 2005.

Article 2, paragraph 2, pays the basic health insurance expenses of the employee, and since the second month of the payment, the Integrated Fund suspended the payment of its employees' medical expenses, and the balance of the individual accounts could continue. Removal of the treatment of workers has been restored since the last month of replenishment and lagging.

Flexible workers have been suspended for their medical expenses since the last month of the payment of basic health insurance payments to their employees. In the last six months of the continuing underpayment, self-sufficiency and lagging benefits were reinstated for the second month of the last month of the repayment period; in the second month of the repayment.

Medical costs incurred during the stay of the insured person are not covered by the Integrated Fund.

Article 23 pays for basic health insurance expenses to be paid by unemployed persons during the payment of unemployment insurance payments from the unemployment insurance fund and individuals are no longer paid.

Article 24 is determined by the judiciary or by the authorities concerned that the medical expenses incurred by the insured person for suicide, self-immoval or criminal injury, illness and illness are not covered by the Integrated Fund.

Chapter IV

Article 25. Basic health insurance is governed by targeted medical institutions and custom retail pharmacies.

The social security administration should determine the point of order from the eligible medical institutions and retail pharmacies, which are signed by the social insurance agencies with them, specifying the rights obligations of both parties. The specific approach was developed by the Municipal Social Insurance Administration.

Article 26 The insured person has an effective medical treatment of medical documents to the targeted medical institutions in the city, which may purchase medicines by a targeted medical institution or a medical clinic to purchase medicines at a targeted retail shop.

The application for medical treatment should be confirmed by the organization of the Social Insurance Agency and provided with medical certificates for the basic medical treatment.

Responsibilities for patients at risk can be treated for hospitalization near the non-scheduled medical facility in this city, but written reports should be submitted to the Social Insurance Agency within three working days from the date of hospitalization and should be transferred to targeted medical institutions for treatment. The Integrated Fund does not pay for unwarranted reports or emergency relief for patients identified as at risk.

Article 27: The person's unit or individual shall not have the following acts of fraud in the treatment of basic health insurance:

(i) Failing labour relations or taking advantage of personal data from others to participate in basic health insurance;

(ii) Acquisition for medical treatment by taking advantage, forfeiture or basic medical insurance-related vouchers in targeted medical institutions and at-point retail pharmacies;

(iii) Disaggregation of basic health insurance treatment by repetitive or falsified, altered, courier, reimbursable, voucher or supporting material;

(iv) Remove the personal basic medical insurance certificate to others, or perform the basic medical insurance cost settlement through a reimbursable transfer of medical certificates, a settlement card;

(v) Removal of medicines or medical materials derived from the basic health insurance fund;

(vi) Use of cash pools for personal accounts;

(vii) Other acts of fraud in the treatment of basic health insurance.

Article 28 Medical institutions and targeted retail pharmacies and their staff should strictly implement the directory of basic health insurance medicines, therapeutic projects, the scope of medical services facilities and payment standards.

Targeted medical institutions, customized retail pharmacies should provide reasonable and necessary medical and pharmaceutical services to the insured person. In order for the insured person to use medicines, materials or services outside the scope of the basic health insurance catalogue, prior consent shall be sought.

Article 29 does not include:

(i) In violation of the regular, technical operation of therapeutic treatment of diseases, there are excessive inspections beyond the necessary limitations of the treatment, drug use, treatment, etc., resulting in waste of medical resources and losses of the basic health insurance fund;

(ii) The use of the basic health insurance fund by defecating the hospitalization of the beds, falsely inpatients or by means of violation, such as counterfeiting, transgendering materials;

(iii) The use of the basic health insurance fund to cover medical costs for non-insecution workers themselves, or to make the basic health insurance settlement information system available to non-specified medical institutions or retail pharmacies;

(iv) The placement or referral of a patient who is not in accordance with the standards of access to a school or a referral facility, the number of hospitalizations or the intentional extension of the patient's hospitalization, resulting in the loss of the basic health insurance fund;

(v) The denial of medical services for the insured person without justification and the transfer of medical expenses incurred by the Integrated Fund for Basic Health Insurance to the individual insured person;

(vi) The medical costs incurred outside the coverage of the basic health insurance fund shall not be met by a combination of medicines, medical treatment projects, medical material or the payment of basic health insurance funds;

(vii) Use of cash pools for personal accounts of the insured person;

(viii) Other acts of fraud in accessing the basic health insurance fund or resulting in losses of the basic health insurance fund.

Chapter V Oversight management

Article 33 The Government of the city, the district (commune) has established the social oversight of the Basic Health Insurance Fund by the Government-related departments, representatives of user units, representatives of medical institutions, representatives of trade union organizations, and the basic health insurance fund, which is attended by experts.

Article 31 of the Basic Health Insurance Fund is included in the management of the financial exclusive household, with a dedicated section and no unit or person may be excluded and diverted.

The social security administration and the financial sector should strengthen the supervision of the basic health insurance fund. The audit department should conduct regular audits of the payments and management of the funds of the social insurance agencies.

Article 33 The Social Insurance Administration and the Office of the United Nations High Commissioner for Refugees should strengthen oversight inspections of targeted medical institutions, targeted retail pharmacies, which should be actively coordinated by inspection units and personnel, such as the provision of archives, medical material and data.

Article 34 quantifications should be made readily available to society for the publication of basic health insurance medicines prices, treatment projects, medical facilities.

The Social Insurance Administration should establish basic health insurance surveillance telephones and complaint kits to receive timely complaints from society.

Chapter VI Legal responsibility

Article XVI does not pay a medical insurance fee in full and on time, and is paid by the social insurance premium for the duration of payment or replenishment of the institution's liability and receive a five-year lag from the date of payment.

Article 37 does not pay the basic medical insurance fees as prescribed, during which the medical expenses incurred by the insured person are paid by the user's unit in accordance with the standards set out in the scheme; the impact of the insured person's calculation of the basic medical pay period has resulted in the loss of his or her loss, in part by the user's unit according to the standards set out in the scheme.

Article 338, in violation of article 27 of this approach by a person's unit or by a person, is transferred to the basic health insurance fund by a social security administrative order and is fined for more than five times the amount.

Article 39 of the final medical institution, the customary retail pharmacies, in violation of article 28 of the scheme, imposes economic losses on the insured person, which is liable by custom medical institutions, customized retail pharmacies.

Article 40 quantified medical institutions and targeted retail pharmacies violate the provisions of article 29 of the scheme, which does not pay for medical expenses incurred by social insurance agencies in respect of their violations, have been recovered and, as appropriate, subject to a suspension of the settlement or lifting of the agreement; fines are imposed by the social security administration for them more than five times more than five times; and in serious circumstances, the removal of the eligibility for entry points.

Article 40 of the Social Insurance Agency and its staff, in the collection, management, supervision of the Basic Medical Insurance Fund, have abuse of their functions,ys of negligence, provocative acts of private fraud, which are redirected by the Social Insurance Administration, administrative disposition of the competent person and the person directly responsible, and criminal responsibility is lawful.

Chapter VII

Article 42, paragraph 1, of the scheme refers to persons of flexible employment who are not employed in the workforce, non-time practitioners who do not participate in the basic health insurance for workers and other flexible employment personnel.

In accordance with the income and expenditure of the Basic Health Insurance Fund and the level of medical consumption, the municipality adjusts the unit, the employee, the flexible employment rate and the proportion of payments paid by the Integrated Fund.

In accordance with the level of economic and social development in the city, the social security administration adjusts the individual accounts to the provisions, the extent to which the individual accounts are paid, the criteria for the integrated financing of the general patriots, and the directory of the illnesses in a timely manner.

Article 44 The provisional scheme for basic health insurance for workers in the city of Zannan, published on 14 October 2002, was also repealed.