Implementation Measures For Maternity Insurance For Urban Workers In Guiyang

Original Language Title: 贵阳市城镇职工生育保险实施办法

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$40 per month.
(August 3, 2005 Executive meeting of the Guiyang municipal people's Government on August 10, 2005, Guiyang municipal people's Government promulgated as of October 1, 2005, 16th) Chapter I General provisions article in accordance with the People's Republic of China Labour Code, the People's Republic of China on population and family planning law, the Guizhou province on population and family planning regulations and other relevant laws and regulations, combined with the city's actual, these measures are formulated.
    Article within the administrative area of the city of various types of enterprises and Government departments, institutions, social organizations, private non-enterprise units (hereinafter referred to as the employer) and its employees ' maternity insurance procedures apply.
    Article city, district and County (City) labour and social security administrative departments are responsible for maternity insurance work within their respective administrative areas.
    City, district and County (City) social insurance agency contractor maternity insurance business.
    Finance, audit, health, price, food and drug administration, population and family planning administrative departments and trade unions, women's federations, according to their respective duties, in collaboration with good management of maternity insurance.
    Fourth implement the city-level overall plan of birth insurance, maternity insurance by the municipal, district and County (City) social insurance institution grade collection, maternity insurance fund, administered by the social insurance agency in centralized management. Municipal social insurance agency is responsible for the territorial relationship, handle the above city and municipal employers and municipal provincial vertical management in public institutions, such as maternity insurance registration, Declaration fees, fee collection.
    Responsible for municipal workers fixed lump sum insured medical expenses and into municipal maternity hospital medical costs of clearing and settlement. District and County (City) social insurance agencies, responsible for district and County (City) belongs to the employer and the district and County (City) level provincial vertical management in public institutions, such as maternity insurance registration, Declaration fees, fee collection.
    Is responsible for the fixed lump sum insured workers the same level of medical costs paid and not included in the municipal maternity hospital medical costs of clearing clearing.
    Chapter fifth maternity insurance fund in accordance with the maternity insurance fund to fixed income, balanced budget principle of unified mobilization.
    Sixth maternity insurance fund constituted by the following funds: (a) the birth insurance fees paid by employer, (ii) maternity insurance fund's interest income, (iii) maternity insurance fees; (iv) other funds included maternity insurance fund by law.
    Seventh employer with average monthly wages of employees contribution base units the previous year, according to 0.7% pay maternity insurance premiums before the 10th of each month.
    Employees do not pay maternity insurance premiums. Employer workers ' average monthly salary the previous year, according to the units of each previous year's average monthly wage of employees and calculation.
    Employees of the unit on the previous year's average monthly wage is lower than the city's average monthly wage of employees 60% in the previous year, in accordance with the previous year calculated on the monthly wage of staff and workers in the city 60%; above the previous year's average monthly wage of employees in this city of 300% or more, according to the previous year's average monthly wage of workers in the city 300%.
    Eighth employer pay maternity insurance premium payment ratio, according to the city's economic development and maternity insurance fund balance, adjusted according to law and to the public.
    Nineth maternity insurance fund for the following expenditures: (a) women workers maternity medical costs, (b) women workers policy pregnancy spontaneous abortion in health care costs, (iii) family planning surgical medical expenses.
    Tenth Article birth insurance fund not paid following costs: (a) violation national and province population and family planning legal, and regulations, and regulations provides birth of medical costs; (ii) not belongs to birth insurance medical service range of medical costs; (three) parameter insurance workers birth or implementation family planning surgery during, for medical accident increased of medical costs; (four) embryos transplant of costs; (five) newborn of costs; (six) according to national, and province, and City provides should by personal burden of costs.
    11th maternity insurance fund of financial management, in accordance with the financial system of social insurance fund of the relevant provisions of the State.
    Municipal labor and social security, municipal finance, auditing and other administration within their respective areas of responsibility, the law on maternity insurance fund revenue and expenditure monitoring and management. Maternity insurance benefits the 12th chapter III from the employer pay the month of birth insurance, which insured workers enjoyed maternity insurance benefits as provided herein. Not paid maternity insurance premiums when the insured, as a break fee.
    Interrupted payment month stop by maternity insurance fund insured employee's maternity insurance benefits. Interrupt contributions during their insurants maternity insurance benefits paid by the insured.
    Interrupted insurance unit to pay maternity insurance fee payment arrears for the period starting the day after, the insurants may enjoy maternity insurance benefits, interrupted contributions paid by the insured for the period of maternity insurance benefits, maternity insurance fund without compensation.
    13th insured workers enjoyed maternity insurance benefits, shall comply with the following conditions: (a) the employer to participate in birth insurance, and meet their financial obligations, (ii) compliance with national and provincial population and family planning laws, regulations or rules provide for maternity or family planning operation. During the 14th article in fertility and pregnancy termination of women employees, according to the relevant provisions of national and provincial maternity.
    Wages of women workers during maternity leave, paid by the employer in accordance with the regulations. 15th fixed lump sum insured employee's prenatal medical expenses, each paid 500 standard, more than standard ones, borne by the individual.
    Clinic abortions (including labor, drugs and clamping) and outpatient family planning limits pay surgical expenses, maximum limit of 500 yuan each, expenses below the ceiling with real pay, higher than the ceiling part, borne by the individual.
    16th 15th herein provides medical and surgical outpatient family planning standards of fixed lump sum, according to the city's economic development and maternity insurance fund balance, adjust and made public.
    17th insured persons of the following in accordance with the province's basic medical insurance drug list, treatment programs and health care services project provides medical expenses, maternity insurance fund paid: (a) childbirth complications of medical expenses incurred during hospitalization and medical costs, (b) family planning complications of surgical medical expenses incurred during hospitalization and medical costs. 18th insurants spouse no work units and their compliance with national and provincial population and family planning laws and regulations, regulations of reproductive or family planning surgery hospital, in accordance with the insurants, average annual growth in the medical costs or average costs of family planning 50%, from paid maternity insurance fund.
    Compliance with national and provincial population and family planning law, regulations and rules provided prenatal expenses, outpatient abortion (including labor, drugs and clamping) and outpatient family planning operations, according to the provisions of article 15th payment 50%, from paid maternity insurance fund.
    19th article fixed lump sum of medical costs, first by I advance, in female workers production, and abortion operation Hou or male workers family planning outpatient surgery Hou, by parameter insurance units handling people to its participate in birth insurance of social insurance handling institutions apply for, and submitted following proved: (a) local population and family planning sector issued of family planning proved; (ii) agreement medical service institutions issued of prenatal outpatient check and the treatment report single or abortion proved; (three) charges voucher.
    20th according to the regulations enjoy maternity benefits insured workers, will not enjoy the provisions of the interim measures for the basic medical insurance for urban workers in Guiyang City planning surgical treatment, as well as other payments, such as maternity medical care.
    Medical services management in the fourth chapter the 21st social insurance agency shall be the insured units and staff to establish payment records.
    22nd social insurance agency has received the insurance unit to apply for a fixed lump sum of medical expenses and emergency insurance, emergency medical services workers in non-agreement for antenatal care, hospital birth and family planning operation cost of information for eligible should be audited in the 25th settlement; for not qualifying, it shall inform the applicant in writing within the 25th. 23rd section of medical service of birth insurance agreement management in medical institutions.
    To sign the agreement on health care and family planning services (hereinafter referred to as Protocol medical services), according to the regulations for workers with maternity insurance of insured medical services.
    24th birth insurance health care temporarily according to Guizhou provincial medical insurance drug list, treatment programs and health care facility standards and service provisions.
    25th insurants to Protocol medical services fertility, miscarriage, abortion or family planning operations, it shall provide family planning certificates, social security cards and other relevant certificates and documents, Protocol medical services should be carefully verified. 26th insurants can choose Protocol medical services for prenatal care, hospital delivery or implementation of the family planning operation. Agreement on health-care institutions should be strictly enforced in Guizhou province, the basic medical insurance drug list, treatment programs and health care facility standards and service provision, reasonable examination, treatment, medication.
    Guizhou province using basic medical insurance drug list, medical projects and projects outside the standard of medical service facilities, signed consent of the insured workers or their families, the cost borne by the individual.
    27th article in the emergency, first aid case, insurants in non-Protocol medical services for prenatal care, childbirth and family planning surgery in the hospital, according to the relevant provisions of these measures enjoy maternity insurance benefits.
    28th surgical hospital of birth, family planning medical expenses, medical service providers to the social insurance agency by agreement for the settlement procedures. Chapter fifth penalty 29th insurance unit that is not required to pay maternity insurance, issued by a social insurance agency paid notice, order the prescribed date.
    Late is still not paid, except to pay unpaid amount, from the date of default of payment, plus outstanding amounts by the day 2 of the late fee. 30th article violates these rules, and maternity insurance fraud by misrepresentation, false claim means medical costs, by the social insurance agency to recover funds fraudulently. The circumstances are serious, shall be investigated for criminal responsibility of the persons concerned by the related departments.
    Constitute a crime, criminal responsibility shall be investigated according to law. 31st, social insurance agencies or their staff have one of the following acts, the administrative departments of labor security rectification. Losses shall bear liability, and for supervisors and direct responsibility for administrative sanctions.
    Constitute a crime, criminal responsibility shall be investigated according to law: (a) unauthorized relief maternity insurance premiums payable by the employing unit, (ii) abuse of power, favoritism and negligence resulting in loss of maternity insurance fund (iii) interception, embezzlement, embezzlement, corruption of maternity insurance fund and (iv) other acts that violate laws and regulations. 32nd medical services in violation of the rules of the agreement, any of the following acts, the administrative departments of labor security warning, resulting in loss of maternity insurance fund shall compensate the loss, the administrative departments of labor security rectification.
    Refused to corrected or caused serious consequences of, labor guarantees administrative sector law terminated and agreement medical service institutions of birth insurance service agreement: (a) will not participate in birth insurance personnel medical with included birth Insurance Fund paid of; (ii) will not belongs to birth insurance paid of costs included birth Insurance Fund paid of; (three) issued false proved or false charges voucher of; (four) violation medical, and drug, and price, management provides of; (five) violation other legal, and regulations provides of.
    Sixth chapter supplementary articles article 33rd retirees who participate in the maternity insurance employer, in compliance with national and provincial population and family planning fertility or to implement family planning operation, and the relevant provisions of the maternity insurance benefits in accordance with the measures.
                                                                                                              34th article of the rules take effect on October 1, 2005.