Key Benefits:
(The 29th ordinary meeting of the Government of the city of Vavhan, 20 June 2005, considered the adoption of Decree No. 164 of 22 July 2005 of the Order of the People's Government of Vavhan, which came into force on 1 September 2005) The Government of the city decides to amend the Basic Health Insurance Scheme for Employers in the city of Vilhan as follows: Article 28, paragraph 3, was amended to read: “The specific amount of the payment criteria and the maximum payment thresholds for the Integrated Fund and the proportion of the burdens of the Fund and the individual are adjusted by the Ministry of Labour and Social Security Administration, which will make observations with the city's financial sector, to be made available to society after the approval of the Government. Article 46, paragraph 2, was amended to read: “The large-scale health insurance is carried out by the medical insurance agencies affiliated with the municipal labour and social security administration, or by the municipal labour and social security administration, on behalf of workers, retirees in commercial insurance companies, and agreements with them”. Article 47, paragraph 1, was amended to read: “The large amount of health insurance is paid by the person participating in the basic health insurance, in accordance with the monthly payment of the basic medical insurance expenses, which are paid by the unit of the payment of retirement payments; and the termination of the dismissal of labour contract personnel from continuing to participate in the basic health insurance and to pay to the health insurance agencies”. Article 48, paragraph 1, was amended to read: “A staff member participating in the major health insurance, a portion of the medical expenses incurred by retired persons within one year exceeding a certain limit, which falls under the supervision of the health insurance agency and is subject to a certain proportion of the medical expenses paid shall not exceed the maximum. The compensation for medical expenses of the insured person is vested in the insurance company and is executed in accordance with the agreement signed between the municipal labour and social security administration and the commercial insurance company.” Paragraph 2 was amended to read: “The specific approach to health insurance, including the monthly payment criteria for the insured person, the proportion of the payment criteria and medical expenses, and the amount of the accumulated compensation paid, shall be established by the municipal labour and social security administration in accordance with the relevant provisions of the State and in conjunction with the actual provisions of this city.” The Basic Health Insurance Scheme for Employers in the city of Vilhan was released in accordance with this decision. Annex: Basic health insurance scheme for urban workers in Vhan City (as amended) (Act No. 126 of 31 October 2001 No. 126 of the Government of the city of Vavhan, amended by the Decision of the Government of the city of 20 June 2005 on the revision of the Basic Health Insurance Scheme for Employers in the city of Vilhan) Chapter I General In order to guarantee basic medical treatment for urban workers and retirees, this approach is based on the State Department's Decision on the establishment of a basic health insurance system for urban workers (No. [1998]44) in conjunction with the current city. Article 2 governs the management of basic health insurance and related matters within the city's executive region, the cause unit, social groups, town enterprises, non-commercial units (hereinafter referred to as the user unit) and their employees and retirees (non-exploited expatriate personnel). Article 3. Basic health insurance costs are jointly burdened by user units and workers; the basic health insurance fund combines social integration and personal accounts to receive payment, balance of payments; and the level of basic health insurance is adapted to the level of economic development in the city, as well as financial, user units and personal affordability. Article IV provides for the integration of basic health insurance across the city and is administered on the ground. The basic health insurance for urban workers in the areas of Kyung, Kang, East and Lake Hannan, Xang, Chung and New continents is managed in an integrated manner in the area and is integrated throughout the city. Article 5 The sectors such as finance, health, pharmacies, levies, audits, prices, are in line with their respective responsibilities and work related to basic health insurance. Article 6 builds on the establishment of a basic health insurance system for urban workers. Chapter II Article 7. Basic health insurance expenses are paid by the user unit and the employee in the month. Article 8. The average monthly wage of the worker is the contributory base and pays basic health insurance payments by 2 per cent, which is paid by the unit from the employee's own salary. Employers do not have the average monthly salary of the previous year, which is based on the average monthly wage as the pay base; there is no average monthly salary for the current year to serve as the pay base for the month. The average monthly wage of the employee or the average monthly wage of 60 per cent of the previous year's full-market employee, 60 per cent of the average monthly salary of the full-market worker for the previous year, up from 30 per cent of the average monthly salary of the previous year's full-market employee, and 30 per cent of the average monthly salary of the full-market employee for the year. Retirements who have been subject to retirement procedures under national regulations do not pay basic medical insurance payments. Article 9 The user unit shall pay a one-time basic health insurance fee for retirees at 50 per cent of the average salary of the full-market worker in the previous year, which is developed by the municipal labour and social security administration. Article 10. The Government of the city may, in accordance with the needs of economic development and the level of medical consumption of workers in towns, make adjustments to the proportion of payments for basic health insurance payments and report on the implementation of the approval of the Provincial Government. Article 11 The basic health insurance payments paid to workers are exempted from personal income tax. Article 12 User units shall, within 30 days of the provision for participation in the basic health insurance, be registered and paid by the health insurance agencies and local tax authorities for the registration of the basic health insurance; the newly established unit shall be registered within 30 days of the date of the establishment. The merger, separation, insolvency, revocation and dismissal of labour relations by a user unit shall take place within 30 days of the registration or write-off of basic medical insurance changes by the Medical Insurance Service and local tax authorities. Article 13. Local tax authorities are responsible for the collection of basic health insurance fees and the timely transfer of basic health insurance fees to the financial exclusives of the basic health insurance fund. Article 14. The user unit shall pay the basic medical insurance expenses to local tax authorities on time and in full. Article 15, recognized State-owned enterprises and insolvency, re-engineered employees of the labour contract and the re-employment service centre removed the hosting agreement, distributing the labour contract, could properly reduce the proportion of the payment of basic health insurance expenses by the user unit, and the number of employees hosted by the State enterprise re-employment service centre, whose personal and user units could pay the basic medical insurance fees properly reduced and paid by the re-employment service centre. Specific approaches are developed by the municipal labour and social security administration. Chapter III Basic Medical Insurance Fund Article 16 (i) Basic medical insurance fees paid by a person's unit; (ii) Basic health insurance payments paid by workers; (iii) Interests of the Basic Health Insurance Fund; (iv) Flags for basic health insurance fees; (v) Other funds included in the Basic Health Insurance Fund under the law. Article 17 The Medical Insurance Service shall establish an individual account for workers participating in the basic health insurance, and administer the social security card (ICC). Individual accounts are financed by the following funds: (i) Basic medical insurance payments paid by the individual worker; (ii) The portion of the basic health insurance payments paid by the user unit; (iii) Interest on funds in the personal accounts; (iv) Other funds included in the personal accounts by law. Article 18 Basic health insurance payments made by a person's unit shall be classified in the personal accounts as follows: (i) The age of the worker is at the age of 35 years (with 35 years) and is divided into 1.1 per cent of his/her contribution base; (ii) The age of the worker is between 35 and 45 years, with 1.4 per cent of his/her contribution base; (iii) The age of the worker over 45 years of age is attributed to 1.7 per cent of his/her contribution base; (iv) The age of retirees is at the age of 70 years (70 years) and is calculated at 4.8 per cent on average monthly retirement rates for himself; (v) The age of retirees over 70 years of age is based on an average annual retirement rate of 5.1 per cent per annum. Retires do not have an average monthly retirement fee of up to the previous year, which is based on an average monthly retirement fee for themselves; no average monthly retirement fee for the current year is based on the monthly retirement rate; the retirement rate is less than 80 per cent of the average monthly salary for all employees of the previous year; and the average monthly salary of 80 per cent of the entire municipal worker for the year. Article 19 Deducts the basic medical insurance fees paid by the person's unit as part of the personal accounts, as an integrated fund for basic health insurance (hereinafter referred to as the Integrated Fund). The following funds are included in the Integrated Fund: (i) Interest in the Integrated Fund; (ii) The lag of the Fund; (iii) Incorporating funds under the law into the Integrated Fund. Article 20 Employers and retirees have died by converting their personal accounts to their successors' personal accounts; the successors have not participated in the basic health insurance to pay their successors on a one-time basis; and have not succeeded in bringing funds stored in their personal accounts into the integrated fund. Employers are transferred and transferred into the city, and their personal accounts are transferred as prescribed. Article 21, the basic health insurance fund is integrated into the management of the financial exclusive family, with no specific funds being diverted. The basic health insurance fund, which was raised in the current year, is based on the bank's current deposit interest rate; the last year's retransfer fund takes the bank deposit interest on three months; the deposit fund of the basic health insurance finance occupants, which is not less interest than the amount of the deposit. Article 23 should establish financial accounting and internal audit systems for the basic health insurance fund, as prescribed, and prepare pre- and final reports of the basic health insurance fund. Article 24, the labour and social security administration and the fiscal sector should enhance oversight of the basic health insurance fund. The audit sector should conduct regular audits of the payments and management of the basic health insurance fund. Article 25 is established by the Government's relevant departments, user units, targeted medical services, trade unions, representatives of persons participating in basic health insurance, and the basic health insurance fund overseeing the basic health insurance fund composed of experts. Chapter IV Basic health insurance treatment Article 26 After one month after the payment of basic health insurance fees by the user unit and its staff, the workers and retirees started to receive basic health insurance treatment, without paying the basic medical insurance expenses as prescribed, and shall not be treated with basic health insurance. Article 27 limits for the payment of basic health insurance expenses for workers (including the period of the same-payment and the actual pay period) for men who have reached 30 years and women have reached 25 years of age, and the basic health insurance treatment of retirees may be granted after the retirement process is provided. The contributory period is limited to the period specified in this article, when the retirement is paid by the user's unit, the worker himself shall pay the basic health insurance fee. The calculations for the contributory period are developed by the municipal labour and social security administration. Article 28 pays for medical expenses incurred by workers, retirees in hospitalization in targeted medical institutions and for emergency medical care in compliance with basic health insurance requirements, as set out below: (i) Medical costs are paid by individuals on the basis of the standard of payment for the Integrated Fund. (ii) Medical costs are paid in part of the standard of payment for the Integrated Fund and, according to the level of medical institutions, are paid by the Integrated Fund and the individual of the employee, with a proportion of 80 per cent of the self-payment rate for retired persons: 8.8 per cent of the Fund for Integrated Medical Institutions at the level, and 12 per cent for the individual worker; The Integrated Fund of the Secondary Medical Institutions pays 85 per cent and the individual pays 15 per cent of the workforce; The Integrated Fund of the three-tier medical institutions paid 82 per cent and the individual paid 18 per cent. (iii) The maximum payment limit for the Integrated Fund within one year is determined by about four times the average salary for the full-marketed workers. The standard of payment for the Integrated Fund has been determined at about 10 per cent of the average salary for all workers in the previous year and in the light of the different levels of the medical institution; the decrease of more than two inpatients in the same year. The specific amount of the payment criteria and the maximum payment limits, as well as the adjustments in the proportion of the burdens of the Integrated Fund with individuals, will be made available to society by the municipal labour and social security administration, with the approval of the municipal finance sector. Article 29 provides treatment for workers, retired persons with a portion of severe illness, in line with the medical fees provided for in the basic health insurance, which is paid by the Integrated Fund at 80 per cent of the workforce and paid at a rate of 85 per cent for retirees. The provision for treatment in part of the disease is developed by the municipal labour and social security administration with the municipal health administration. Article 33 Medical expenses for workers, retirees, inpatient care and treatment of serious illnesses in the context of the Integrated Health Insurance Fund for the payment of part of the cost of medical treatment, and the Catalics of Basic Health Insurance medicines, should be paid by individuals by 20 per cent and the balance should be processed in accordance with article 28 of the scheme. Article 31 Employees, retirees, with the consent of the health insurance agency, are treated in the wards between targeted medical institutions in the city, in accordance with article 33 of the scheme. After the agreement of the Medical Insurance Service to retrieval outside the city, its hospitalization costs were paid by individuals for 10 per cent and the balance was processed in accordance with article 30 of the scheme. Article 32, the Chief of Staff in the Field and the Retirement, which is facilitated by the Medical Insurance Service, is appointed by the Medical Insurance Agency with the user's units to the local medical institutions, which are subject to the relevant provisions of the scheme and are specifically designed by the municipal labour and social security administration. Article 33 includes one of the following cases for the employee, whose medical expenses for emergency rescue in the city are governed by article 33 of the scheme: (i) External; (ii) During family leave; (iii) Period of statutory leave. Article 34, Medical expenses incurred by workers, retirees and retirees as a result of the outbreak of infectious diseases, are reported to be coordinated by the Government of the city. The following medical costs are not covered by the Integrated Fund and the Personal Account funds: (i) Medical costs incurred in non-scheduled medical institutions and non-sidental retail pharmacies, in addition to the provisions of this approach; (ii) Medical expenses incurred in connection with medical treatment or purchase of medicines that are not in compliance with basic health insurance treatment projects, a directory of medicines, the scope of medical services facilities and the payment standards; (iii) Medical costs incurred as a result of criminal offences, suicides and maiming; (iv) Medical costs payable in other insurance or other terms of compensation. Chapter V Article 36 of the Basic Health Insurance is governed by a targeted medical institution and the customized retail pharmacies. Medical institutions and retail pharmacies that have been approved and obtained by the Ministry of Health and Medicine, may apply to the municipal labour and social security administration for the qualifications of the basic medical insurance; In accordance with secondary medical care, the municipal labour and social security administration sector, in line with the principle of medical and purchase of medicines, facilitates the provision of basic medical services for workers and retirees, in accordance with the principle of medical and medical care. Employers, retirees may choose to select targeted medical institutions and custom retail pharmacies for medical care and purchase of medicines. Article 338 The health insurance agency shall enter into a basic health insurance agreement with the targeted medical institutions and the targeted retail pharmacies to clarify the rights and obligations of both parties. Article 39 Medical institutions and customised retail pharmacies should establish specialized agencies or be equipped with dedicated personnel responsible for basic health insurance-related work, strict implementation of the directory of basic health insurance medicines, treatment projects, coverage of medical services facilities and standard management provisions, and non-permissible access to health insurance funds by means of counterfeiting information, cost documents. The directory of basic health insurance medicines, therapeutic projects, the scope of medical services and the management of payment standards are developed by the municipal labour and social security administration. Article 40 retail pharmacies must ensure the availability and quality of basic medical medicines, and the procurement of qualified medicines by the pharmaceutical-sector for units holding a licence for the operation of medicines and the implementation of the price standards for medicines provided by the price sector. Article 40. Staff members, retirees in targeted medical institutions for medical treatment or purchase of medicines at targeted retail pharmacies should present their basic health insurance documents; buying or selling therapy at the targeted medical establishment or by the head of service to the pharmacies, with self-determined decisions. The targeted medical institutions, the pharmacies, should conduct a nuclear test of basic health insurance documents. Basic health insurance documents must not be used, forged and borrowed. Article 42 Article 43 thirteenthly, the medical costs incurred by workers, retirees in targeted medical institutions consistent with basic medical insurance requirements, emergency care and treatment of serious illnesses should be covered by a personal burden, by themselves and by a targeted medical institution; the portion of the payments made by the Integrated Fund shall be settled by the health insurance agencies and targeted medical institutions. Specifically, the municipal labour and social security administration will be developed with the urban health, financial sectors. Article 44 states that the municipal labour and social security administration should organize health, pharmacies, prices, etc., in accordance with the relevant provisions of the basic health insurance, conduct an annual examination of the targeted medical institutions and conduct annual accreditation of the pharmacies; conduct the vetting of the non-qualified or vetting of the non-qualified nature of the tender and remove their qualifications. Article 42, the municipal health, pharmacies, price administration, should strengthen the supervision of targeted medical services, establish a new system of medical institutions, implement a system of separate accounting for medicines, separate management and pooling of pharmaceutical solicitation, adapt the prices of medicines and improve the quality of medical services, in accordance with the guidance and requirements of national, provincial, municipal medicine systems. Chapter VI Supplementary health insurance Article 46 establishes a major health insurance that helps workers and retirees to mitigate the burden of large medical costs. The general health insurance is carried out by health insurance agencies affiliated with the municipal labour and social security administration, or by the municipal labour and social insurance administration on behalf of workers, retirees in commercial insurance companies. Article 47 provides for a medical insurance fee, paid by a person participating in the basic health insurance at the monthly rate of payment of the basic medical insurance expenses, which are paid by a unit of the payment of retirement fees; and termination of the dismissal of workers in the basic health insurance system and payment to health insurance agencies. A person participating in the major health insurance was insured for a period of one month, with the introduction of the treatment of the major health insurance; no major medical insurance was granted without the payment of the royalties. Article 48 workers participating in the major health insurance, retirees are covered by health insurance institutions and individuals with a proportion of the medical costs paid in the year, but the accumulated medical costs are not limited to the maximum. The payment of the medical expenses of the insured person is covered by the agreement signed between the municipal labour and social security administration and commercial insurance companies. Specific approaches to health insurance, including monthly payment standards for insured persons, the proportion of payment standards and medical costs, and the amount of the accumulated compensation paid, are developed by the municipal labour and social security administration, in accordance with the relevant provisions of the State and in conjunction with the actual provisions of the city. Article 49 participates in the basic health insurance enterprises, which may establish a supplementary health insurance based on the actual circumstances, to assist individuals in paying medical expenses. Complementary health insurance costs can be included at a level of 4 per cent of the total number of employees in this unit. Business supplements health insurance guidance, developed by the municipal labour and social security administration. Article 50 provides for medical assistance based on basic health insurance. The National Civil Service Medical Benefit is administered at the municipal, district level, and the provision for medical assistance is subject to the existing financial management system. The National Civil Servants' Health Benefit scheme is developed by the Ministry of Labour and Social Security in conjunction with the municipal financial sector. The scope of the medical assistance provided by the National Civil Service is implemented in accordance with the Ministry of Labour Guarantee's Ministry of Finance's notification of the application of the State's medical grant (No. A user unit participating in the basic health insurance may establish a mutual medical assistance insurance for the employee of the unit to support personal self-payment. Employer medical assistance insurance guidance is developed by the municipal labour and social security administration with the general municipal trade unions. Article 52 establishes a system of medical assistance for special hardships to help special hardships alleviate the burden of medical care for individuals. Specific approaches have been developed by the municipal civil affairs sector with sectors such as the city's finance, health. Chapter VII Legal responsibility Article 53, in violation of article 12 of this approach, has not been registered under the provisions for the registration, modification or write-off of registration, and the labour and social security administration may be responsible for changing the period of time; in the case of serious circumstances, a fine of up to 5,000 dollars for the direct responsible supervisors and other direct responsibilities; in exceptional circumstances, a fine of up to 500,000 dollars. Article 54, in violation of article 14 of this scheme, amounts owed to basic medical insurance expenses, the labour and social security administration or local tax authorities shall be charged with the period of time, from the date of the contributions, 2 per 1,000 per 1,000 dollars per person who is directly responsible and other direct responsible personnel, and the failure to pay the basic medical insurance expenses, the lag of payments shall be applied by law to the People's Court of Justice, and the payment of the basic medical insurance and compensation for the loss incurred by retirees. Article 55 and the unit responsible for retirement payments are not charged with the payment of a major medical insurance fee in accordance with article 47 of this scheme, which is paid by the labour and social security administration. The loss of the payment of a contributory health insurance fee to a worker and a retired person is compensated by the user unit and the unit responsible for the payment of retirement fees. Article 56 of the final medical institution and the customized retail pharmacies violate article 39 of the scheme, article 41, paragraph 2, which provides that losses of the health insurance fund shall be compensated and fined up to 1,000 dollars in the labour and social security administration sector. Article 57, in violation of article 41 of this approach, takes the use, falsification, transfer of medical insurance documents and obtains a fine of up to 100 million dollars in the Labour and Social Security Administration; constitutes a crime to bring the judiciary to criminal responsibility in accordance with the law; resulting in losses and liability under the law. Article 58 violates the provisions of this approach relating to health, pharmacies, price management, and is dealt with by the relevant administration. Article 599, the labour and social security administration and local tax authorities shall pay a fine collected in a timely manner to the collateral of the receiving State, which will be incorporated in the Integrated Fund for Basic Health Insurance in a timely manner. Article sixtieth does not carry out their duties and do not provide for the payment of basic health insurance expenses, which is criticized by the labour and social security administration and are rectified, with serious consequences being given administrative treatment by law. Article sixtieth of the Ministry of Labour and Social Security Administration, the staff of the Medical Insurance Agency, in violation of the relevant provisions of the scheme, abuse of authority, provocative fraud, negligence, resulting in losses of the basic health insurance fund, recovery by the labour and social security administration sector, and administrative disposition by law, which constitutes a crime, brought to justice by the judiciary. Article 62, units and individuals may report to the labour and social security administration the following violations of the provisions of the scheme: (i) The user unit does not pay and deduct the basic medical insurance fee as prescribed; (ii) The user unit and the unit responsible for the payment of the retirement fee are not charged with the payment of the major medical insurance expenses as prescribed; (iii) No provision of medical services by targeted medical institutions, a terminal retail pharmacies; (iv) The Medical Insurance Service does not pay the basic medical insurance fee as prescribed; (v) Other violations of the provisions of this approach. The labour and social security administration authorities should be checked in a timely manner, following a complaint received. Article 63 engages in disputes between persons participating in the basic health insurance and the user's unit with respect to basic health insurance may apply to arbitration by law to the Labour Dispute Arbitration Commission, and in the absence of arbitration decisions may be prosecuted by law. Article 64 does not apply for administrative review and administrative proceedings, in accordance with the provisions of the provisional regulations on social insurance payments and the National People's Republic of China Administrative Review Act. Chapter VIII Article 55 Terrestrial Economies and their practitioners and entities other than those provided for in article 15 of this approach terminate and eliminate the basic health insurance scheme for workers by the municipal labour and social security administration. The medical costs of the fraternal, old, second-class revolutionary, disabled military personnel are addressed on the basis of the source of funds, specifically by the municipal labour and social security administration. The medical costs of the immediate family and the general high school attendance at the basic health insurance personnel are charged by the source funds. Specific issues in the implementation of Article 46 are explained by the municipal labour and social security administration. Article 67 provides for the development of implementation programmes based on this approach by the Votien, Giang, East and Lake, Hannan, yellow fever and new continents to report to the Government of the city on its approval. Article 68 is implemented from the date of publication, with specific implementation steps to be arranged by the municipal labour and social security administration. |
