Maternity Insurance For Urban Workers In Tibet Approach

Original Language Title: 西藏自治区城镇职工生育保险办法

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(December 31, 2006 the people's Government of Tibet Autonomous Region, the 31st Executive session on January 8, 2007, the people's Government of Tibet Autonomous Region promulgated as of March 1, 2007, 76th) Chapter I General provisions article I in order to maintain the legitimate rights and interests of women workers, protection of urban workers maternity and family planning need basic living and medical care during the operation, in accordance with the People's Republic of China Labour Code, the People's Republic of China Law on protection of women's rights, the State Council
    Regulations concerning the labor protection of female staff and the Ministry of labour of the trial measures for the maternity insurance for enterprise employees, such as laws, regulations, rules, combined with practical, these measures are formulated.
    Second approach applies to the autonomous town within the administrative area of various types of enterprises (including received from or managed institution, the same below), State organs, institutions, social organizations, private non-enterprise units (hereinafter employer) and formed labour relations, workers who have permanent residency in my area.
    Employees of individual businesses and their employees to participate in maternity insurance for urban employees specific steps and approaches to local (City) area (the Government).
    Third State administrative departments of labor security in conjunction with the departments concerned to develop rules; guidance, coordination, supervision and district maternity insurance for urban employees work study and solve problems arising in the work in a timely manner.
    (City) labor and social security administrations responsible for the administration of maternity insurance for urban employees work advocacy training for maternity insurance in the appraisal, adjudication of the dispute. State and prefectural (City), administrative departments of labor security social insurance agency (hereinafter referred to as the Agency) host the maternity insurance fund collection, management and payment services; responsible for designated eligible for maternity insurance medical institutions signed an agreement to establish maternity insurance fund budget system, accounting and internal audit systems, compiling related statistics.
    Career requirements for agencies, included in the budget arrangement in full, by the financial allocation shall not be extracted from the maternity insurance fund.
    Health, population and family planning at all levels, financial, audit and other administrative departments, as well as trade unions, women's federations and other organizations, according to their respective duties, in collaboration with maternity insurance for urban employees work.
    Fourth maternity insurance shall practise, and prefectural (City) level and manpower. Autonomous regions district straight, and in the straight employing units (containing presence Lhasa the County employing units) and workers, and in autonomous regions business administration sector registration registered of town various enterprise and workers, participate in autonomous regions of birth insurance; around (City), and the County (city, and district), and Xiang (town), and subdistrict offices employing units and workers, and in around (City), and the County (city, and district) business administration sector registration registered of town various enterprise and workers, participate in around (City) of birth insurance
    And State and local (municipal) accredited employers and their workers in the field, attend local maternity insurance. Fifth chapter maternity insurance fund maternity insurance fund in accordance with the "fixed income, balanced" principle to raise, the implementation of State and prefectural (City) at different levels. Town organizations and private non-enterprise units at 0.5% of the workers ' wages to pay maternity insurance, State organs and fiscal transfers and institutions (including balance allocation units, the same below), social group at 0.4% of the workers ' wages to pay maternity insurance.
    Individual employees pay kids participating in the maternity insurance premiums.
    Employee payroll project identification in accordance with national statistical offices.
    Article sixth childbirth insurance payment adjustment of standards and other related policies, drawn up by the administrative departments of labor security in conjunction with the Finance Department of the autonomous region, and autonomous region people's Government for approval.
    Article seventh maternity insurance fund constituted by the following funds: (a) the employer pay maternity insurance fee; (b) interest on maternity insurance fund (iii) maternity insurance fees; (iv) other funds included maternity insurance fund by law. Eighth an employer shall provide the integrated (City) maternity insurance registration agencies, payment declarations and pay maternity insurance premiums in full and on time each month.
    Maternity insurance shall not be relief.
    State organs and institutions pay full financial allocations, such as maternity insurance, budget arrangements balance balance of funding institutions in the financial budget of the grant funds and own funds in Liechtenstein; the town of childbearing insurance premium paid by enterprises and private non-enterprise units, from welfare and labor insurance charges were charged.
    The employer due to closure of business, revocation, declares bankruptcy, terminate, or change, shall be registered to the Agency for cancellation or change, and shall be debts due to payment of the maternity insurance.
    Nineth maternity insurance fund revenue through agencies in the commercial bank "set up by maternity insurance fund income" over to the financial sector in the establishment of commercial banks "maternity insurance fund account" store, the two lines of income and expenditure management, storage, earmarking accounts, no unit or individual is allowed to occupy, use.
    Maternity insurance fund, excluding taxes and fees.
    Article tenth maternity insurance fund for the following expenditures: (a) childbirth allowance of women workers during maternity leave (ii) female worker due to planned maternity medical costs, (iii) staff implement contraception, sterilization, medical costs of termination of pregnancy.
    11th labor and social security, finance, auditing and other administrative departments within the scope of their respective duties, the law on maternity insurance fund revenue and expenditure monitoring and management.
    Chapter III maternity insurance benefits article 12th workers enjoyed maternity insurance benefits, shall also meet the following conditions: (a) birth or family planning operation in compliance with national and State policy, (ii) maternity insurance participation of employers in accordance with this approach, to meet their financial obligations, and cumulative 3 month payment. 13th female workers of enterprises and private non-enterprise units in maternity and pregnancy termination during maternity leave, you can pay to enjoy maternity benefits (determined by the units based on the actual situation), the maternity allowance in accordance with my fertility (or miscarriage) one month before the childbirth insurance contribution wage base divided by 30 days, multiplied by the days, a one-time full from a maternity insurance fund.
    Month maternity allowance higher than the overall monthly average wage of fully employed staff 300% of, 300% is counted as below 60% of the overall monthly average wage of fully employed staff and 60% calculation.
    14th state agencies and funding institutions and the social organizations of women workers ', in accordance with the regulations from the maternity insurance fund reimbursement for planned growth in medical costs and implementation of birth control, birth, termination of pregnancy for medical expenses, wages during maternity leave and payment according to the relevant provisions of the State. 15th enterprise and private non-enterprise units birth childbirth for 120 days maternity benefits (pre-natal leave of 15 days).
    Has following case of, also can increased enjoy birth allowance days: (a) dystocia of, increased 15 days; (ii) more cell tire birth of, each more birth a tire, increased 15 days; (three) first tire for late of (late age by autonomous regions population family planning policy provides of age standard implementation), increased 30 days; while meet Qian paragraph two species above case of, enjoy birth allowance of days cumulative calculation. Recipients of the one-child certificates during maternity leave, maximum of 360 days of maternity benefits, including: first 180 days, enjoy maternity benefits of 100%, 180 days, and 65% of the maternity allowance.
    Actually enjoy maternity benefits to unit the number of days of maternity leave days shall prevail.
    16th article enterprise and private non-enterprises female workers pregnancy 2 months following terminated pregnancy of (containing natural abortion, and abortion, with), enjoy 15 days birth allowance (which patient ectopic pregnancy of, increased 15 days); pregnancy 2 months above 4 months following terminated pregnancy of, enjoy 30 days birth allowance; pregnancy 4 months (containing 4 months) above terminated pregnancy of, enjoy 50 days birth allowance; pregnancy 4 months above terminated pregnancy while implementation tubal ligation surgery of, enjoy 65 days birth allowance.
    Article 17th after taking maternity insurance enterprises of women workers ' unemployment, unemployment benefit of birth meets the policy requirements for the period, from paid maternity insurance fund one-time childbirth benefit, the standard for overall regional annual per capita growth of medical costs.
    Spouses of male employees without work, but in line with national and State family planning policy, maternity or family planning surgical incurred medical costs, by co-ordinating regional annual per capita growth 50% in medical expenses, pay the one-time childbirth allowance from the maternity insurance fund.
    Overall regional annual per capita growth of medical costs, means and manpower per capita growth of reproductive insurance in accordance with the regulations of the Fund to pay medical costs.
    18th article workers implementation family planning surgery occurred of following medical costs, from birth Insurance Fund in the paid: (a) birth or terminated pregnancy by required of prenatal diagnosis and check fee, and treatment fee, and test fee, and delivered fee, and surgery fee, and hospital fee and medicine; (ii) in birth age within implementation lost eggs (fine) tube ligation surgery of costs; (three) meet national and autonomous regions birth policy again birth out Palace within birth control device or implementation complex pass surgery of costs;
    (D) implementation of lost eggs (HDC) tube ligation after pregnancy or pregnancy after intrauterine device costs of taking remedial measures, (e) after giving birth, termination of pregnancy, sterilization, placing or removing the IUD and the implementation of complex general surgery complications of medical expenses. 19th the employer in women workers during maternity leave during and after maternity insurance shall not be interrupted.
    If interrupt occurs, the employer bear the corresponding legal responsibility. 20th article has following case one of of, shall not from birth Insurance Fund in the paid medical: (a) workers birth or implementation family planning surgery during, for medical accident occurred of costs; (ii) embryos transplant of medical costs; (three) violation national and autonomous regions family planning provides birth of costs; (four) in non-Sentinel medical institutions birth of costs; (five) maternity leave expires Hou needed continues to treatment of costs and maternity leave during treatment other disease of medical costs; (six) for crime, and drug, and suicide, and Medical pregnancy termination costs caused by self-harm;

    (VII) maternity hospital baby other than medical, nursing, health care and other costs incurred.
    21st article workers received birth allowance, and claims medical with, should to and manpower area handling institutions handle procedures, and submitted following proved: (a) female workers birth of, submitted local family planning sector issued of belongs to plans within birth of proved (zhunsheng Zheng, and child card,); (ii) couples both ID (couples both is not same and manpower area of, also must provides both has participate in birth insurance or not belongs to parameter insurance range of proved material); (Three) Sentinel medical institutions issued of birth medical proved material (was born card, and baby death proved, and terminated pregnancy medical proved, and experts identification for birth caused other disease of proved, and birth control proved, and related medical with documents, original material); (four) is unemployment personnel of, also needed submitted employment service management sector audit effective of unemployment insurance received card; (five) male workers of spouse no work units of,
    Men his unit and his or her spouse are required where the villagers ' committees or neighborhood committees no work unit certificates and marriage certificates issued; (f) entrusted with the claim on his behalf, should also be submitted to apply for a letter of power of Attorney and client IDs. 22nd maternity benefits, medical expenses and one-time childbirth allowance by the employer, or any of his clients apply to the Agency.
    Male spouses of employees without work and to meet the requirements of receiving maternity benefits, by the man unit handling related materials and documents to co-ordinate regional agencies to apply for. Agencies shall from the date of receipt to apply for in the 15th, on the fertility of female workers enjoy maternity benefits, reimbursement of reproductive medical conditions are audited.
    Qualified, and approved their terms and standards and a one-time calculation; does not meet the criteria, shall be notified in writing. Article 23rd insured women workers due to business trip, vacation, off-site out of reasons such as work in the integrated region, meets the required fertility medical expenses in accordance with the location of the insured maternity pay medical costs ranges and standards, maternity benefits by the 13th the implementation of these measures.
    Insured women workers leave, foreign birth, reproductive costs of compliance, by co-ordinating regional annual per capita growth of medical costs to pay, maternity benefits by the 13th the implementation of these measures. Fourth chapter article 24th birth maternity insurance management insurance medical institutions designated Protocol management.
    Have access to basic health care fixed-point medical institutions qualified in principle as a maternity insurance contracted medical institutions, by agreement between the Agency and its service, specify the responsibilities, rights and obligations of both parties, and to the public; without a designated qualified medical institutions, need to be integrated and finds that the application to the regional Labor and social security administration. Fixed-point medical institutions of medical service of birth insurance agreements signed a year.
    If one party breaches the agreement, the other party is entitled to terminate, subject to notify each other ahead of 30th, informed by the Agency insurance unit, and report to the administrative departments of labor security.
    25th birth insurance contracted medical institutions name, address changes and merger, Division, transfer, termination, 15th on the date in a notice shall carry the relevant ratification documents to the administrative departments of labor security change procedures. 26th female workers participate in the maternity insurance will be free to select the designated medical institutions for prenatal, hospital delivery or implementation of the family planning operation. Really necessary for special reasons referral referral, referral referral reasons put forward by the designated medical institutions admitted, after the host's seal, and manpower agencies for approval.
    Agencies should be made within 3 working days whether to agree to the referral referral advice.
    Referral referral including designated medical institutions within the State and transferred to the designated medical institutions outside the region.
    27th insured women workers due to business trip, vacation, off-site out of reasons such as work in the integrated region, should, in principle, to the local maternity insurance contracted medical institutions designated medical institution or medical insurance.
    Insured women workers due to premature delivery, first aid and other emergency reasons birth, should be close to medical treatment, of birth in a non-contracted medical institutions shall be made to the integrated area agencies submit the certificate of preterm birth, emergency medical, fertility medical costs in line with the relevant provisions of the maternity insurance.
    28th medication, diagnosis and treatment project of birth insurance and medical service facilities standards in my area urban workers ' basic medical insurance drug list, treatment programs and health care facility standards and service provisions, which no individual payment for class b drugs and treatment projects.
    Beyond the scope of maternity insurance fund and payment of excess borne by the individual, maternity insurance fund not be paid.
    Article 29th due to childbirth, pregnancy and family planning surgical medical expenses, which I paid in full, within 60 days after the end of health, as provided for in article 21st, 22nd, and manpower agencies to apply for health insurance benefits.
    Article 30th maternity insurance benefits the employees think the Agency fails to comply with these rules cover the cost of maternity insurance, may apply for administrative reconsideration or bring an administrative suit.
    31st designated medical institutions for breach of agreement, the Agency shall order correction within; medical institution for serious violations of the agreement, the labor Security Administration canceled their fixed-point medical institutions of birth insurance qualifications. 32nd administrative departments of labor security in conjunction with the health, administration, finance, population, family planning, maternity insurance, price and other administrative departments designated medical institutions conducting supervision and inspection.
    Daily supervision and inspection of supervision and inspection, periodic special inspection and acceptance report checking with a combination of approaches.
    Fifth chapter legal responsibility 33rd article employing units not according to this approach provides handle birth insurance registration, and payment declared of, by labor guarantees administrative sector ordered deadline corrected; plot serious of, on directly is responsible for of competent personnel and other directly responsibility personnel at 1000 Yuan above 5000 Yuan following of fine; plot special serious of, on directly is responsible for of competent personnel and other directly responsibility personnel at 5000 Yuan above 10000 Yuan following of fine.
    34th article employing units not by provides timely, and full paid birth premium of, by handling institutions to its issued social premium urged paid notice; on refused to implementation of, by labor guarantees administrative sector issued labor guarantees deadline corrected instruction book; late still not paid of, except Fill paid owes paid amounts outside, from owes paid next day up, by day added received 2 per thousand of late fees, and on directly is responsible for of competent personnel and other directly responsibility personnel sentenced 5000 Yuan above 20000 Yuan following of fine.
    35th employer in accordance with this regulation to participate in maternity insurance or during unpaid maternity insurance premiums and costs related to maternity insurance, maternity insurance fund not be paid by the employer be paid in accordance with the criteria set out in this way.
    Article 36th maternity insurance conditions are not met, false, falsely claimed maternity benefits, the administrative departments of labor security ordered to return, and fined not more than the amount defrauded more than 1 time 3 times. 37th article Sentinel medical service institutions violation this provides, to units or personal issued false of birth or family planning proved of, and using ultrasound technology and other means for others for non-medical need of fetal gender identification or selective others workers terminated pregnancy of, by labor guarantees administrative sector give warning; caused serious consequences of, by about provides can on directly responsibility people at 500 Yuan above 1000 Yuan following fine,
    Fixed-point medical institutions of 10000 Yuan more than 20000 fine, until cancel fixed qualified. 38th article labor guarantees administrative sector, and handling institutions or its staff abuse, and engages in, and negligence, caused birth insurance fund loss of, and has unauthorized increased or relief birth premium, for no reason extension allocated, and stopped birth insurance treatment, interception, and crowding out, and misappropriated, and corruption birth Insurance Fund, behavior of, by about sector recovered loss of birth Insurance Fund, and on directly is responsible for of competent personnel and other directly responsibility personnel by about provides give administrative sanctions; has crime suspected of,
    Transferred to judicial organs for handling.
    Sixth chapter supplementary articles article 39th meets the required female employees to maternity leave as natural days, including statutory holidays.
    40th army employed civilian personnel in accordance with these rules.
                                41st these measures shall come into force on March 1, 2007.