Notice on further strengthening the management of basic medical insurance funds for urban employees

Counties (cities), Mawei District Labor and Social Security Bureau and Finance Bureau:

In accordance with the spirit of the municipal government's "Fuzhou Urban Employees' Basic Medical Insurance Municipal Coordination and Implementation Opinions" (Rongzhengzong [2010] No. 100), in order to effectively strengthen the standardized management of the city's urban employees' basic medical insurance funds, promote the insurance coverage and payment standards The "six unifications" of benefit levels, handling procedures, fund management, and information systems ensure the safe and smooth operation of medical insurance funds after municipal coordination. The relevant regulations are hereby notified as follows:

1. Payment base and payment Years

1. Starting from January 1, 2010, all counties (cities) and Mawei District must strictly use the total wages of employees as the base for medical insurance payment. If the total wage of active employees is less than 70% of the average social wage of employees in Fuzhou City in the previous year, 70% of the average social wage will be used as the payment base; for self-employed employees, 60% of the average social wage of employees in Fuzhou City in the previous year will be used as the payment base.

2. The payment base of insured persons (including pensions for retirees) shall be adjusted once a year. The application time is: March 10th to March 25th every year for government agencies and institutions; April 10th to April 25th or May 10th to May 25th every year for enterprises. The new base will be changed from the month following the declaration, and the difference before the declaration will not be paid back or transferred to the personal account.

3. Newly insured persons in enterprises will start to pay premiums and enjoy medical insurance benefits from the month following the declaration; newly insured persons in government agencies and institutions will start to pay premiums and enjoy medical insurance benefits from the month when wages are paid as approved by the personnel department. .

4. If an employee’s insurance coverage is interrupted due to the termination of the labor relationship, when applying for renewal of insurance, the medical insurance premium during the interruption period shall be paid based on 60% of the average social salary of employees in Fuzhou City in the previous year, and the medical insurance premium shall be paid from the declaration You will begin to enjoy medical insurance benefits in accordance with relevant regulations in the month following the application. During the period of suspension of insurance, you will not enjoy medical insurance benefits paid by the unified fund.

5. When insured persons reach the legal retirement age, they should promptly apply for medical insurance on-the-job transfer to retirement procedures, and start to enjoy medical insurance benefits in accordance with relevant regulations from the month after the application is made. After exceeding the legal retirement age, they should pay medical insurance premiums The years cannot be calculated as the medical insurance payment years. If the insured person retires and does not reach the specified number of medical insurance payment years, he should make additional payments based on the average social salary of employees in Fuzhou City in the previous year when the unit or individual applies for transition from employment to retirement. Retirees' supplementary payment data should be entered into the medical insurance payment management system in real time.

If the employer is closed down, bankrupt, restructured or terminated for other reasons, its retirees shall pay a one-time reserved medical insurance premium for 10 years. The following regulations are implemented: state-owned enterprises pay based on the standards of reserved medical insurance premiums approved by the Human Resources and Social Security Bureau, the Finance Bureau, and the Supervisory Bureau; other enterprises pay based on the average social salary of employees in Fuzhou City in the previous year when the enterprise came to handle the procedures. Base payment.

If the former state-owned or urban collective enterprise terminated labor relations are re-employed in a non-public enterprise and the enterprise is closed and deregistered, if the payment period is 25 years or more and the actual payment period is 10 years or more at the time of retirement, the one-time reservation can no longer be made Ten years of medical insurance premiums. (Persons whose labor relations were terminated before January 1, 2005 are not subject to the restriction of 10 years of actual payment period)

2. Cross-county continuation within the coordinating area

1. Coordinating area When the employee medical insurance relationship is extended across counties, personal account transfer procedures will no longer be handled. The business department of the Fuzhou Medical Insurance Center will be responsible for reviewing and handling the inter-county personnel transfer procedures. The individual account balance status of the insured personnel will be automatically recorded in the system and settled annually. once. If there are medical insurance premiums in arrears for more than three months (including three months), the transfer procedures will be completed after the arrears are cleared.

2. If people who are insured at the mobile window (that is, people whose insurance number starts with 9) and those who participate in urban resident medical insurance are employed across counties in the coordinating area, the employment unit shall apply for additional employees. There is no need to go to the original insured place to apply for downsizing, but individuals need to fill in the application form for suspension of insurance and declare it together when the unit adds employees; those who are insured at the mobile window can apply for a change of insured place in the coordination area directly with their personal identity Please go to the medical insurance center where your household registration is located to apply for insurance renewal procedures with your ID card and household registration booklet. There is no need to go to the place of transfer to go through the attrition procedures.

3. Those who participate in the insurance at the mobile window and have paid normally during the year can directly handle the transfer. The medical insurance premiums paid in the current year will not be offset and they can directly enjoy medical insurance benefits in the place of transfer. If payment is interrupted or medical insurance premiums are in arrears, the transfer procedures should be completed at the medical insurance center in the place of transfer. The transfer procedures can only be completed after the medical insurance premiums for the current year have been paid.

3. Deemed payment period

1. Each (county) city and Mawei District will include different types of enterprises in the urban employee basic medical insurance system according to local regulations. The cumulative length of service in state agencies, institutions, state-owned enterprises, and collective enterprises above the county level can be regarded as the basic medical insurance payment period. If the insured person fails to participate in the insurance within the prescribed time, the period of service will not be regarded as the same.

2. Self-employed persons who terminate their labor relationship with county (district) state-owned or urban collective enterprises should go through the insurance registration procedures at the floating employee window from the second month after the labor relationship is terminated. Self-employed persons who have terminated their labor relations before each county (district) includes state-owned and urban collective enterprises in the urban employee basic medical insurance system shall pay back the basic medical insurance starting from the month when such enterprises are included in the urban employee basic medical insurance system. insurance.

4. Fund Settlement

1. After municipal co-ordination, each county (city) and Mawei District will still retain the original special fund account, and the remaining funds over the years before co-ordination will be retained for local adjustment use. The balance fund of the past years before the overall planning includes the balance of fund income and expenditure in the previous years, the risk funds reserved for the 10 years before the overall planning, and the medical insurance funds owed by enterprises, individuals and local finance before the overall planning (the specific amount shall be determined by the Municipal Finance Bureau, Municipal Human Resources and Approved by the Social Security Administration).

2. After municipal coordination, according to the "About the Transfer of Basic Medical Insurance Premiums for Urban Employees, Work-related Injury Insurance Premiums, and Maternity Insurance Premiums to Local Taxes" by the Fujian Provincial Local Taxation Bureau, the Fujian Provincial Department of Finance, and the Fuzhou Central Branch of the People's Bank of China "Notice on Issues Concerning the Collection and Defunding of the Treasury" (Mindi Shuifa [2010] No. 179) stipulates that starting from September 1, 2010, the income of the basic medical insurance fund for urban employees at the municipal level, counties (cities), and Mawei District will be from Local taxes are collected and paid to the municipal treasury, and the municipal finance department will transfer the fund revenue of the previous month from the municipal treasury to the special financial account of the medical insurance fund at the municipal level, each county (city), and Mawei District before the 10th of each month. The Municipal Finance Bureau and the Municipal Human Resources and Social Security Bureau will review and settle the previous year's fund income and expenditure for each county (city) and Mawei District in the first quarter of the following year. If there is a balance in fund revenue and expenditure for the current year, 40% will be turned over to the municipal fiscal account and included in the municipal overall fund management, and 60% will be retained in the local area and included in the local surplus fund management over the years. If there is a loss in fund income and expenditure for the current year, the loss will be made up from the previous years' balance fund before local coordination. If the surplus funds over the years are insufficient to make up for losses and need to use municipal coordinating funds to make up for losses, on the basis of completing the expansion of medical insurance coverage and collection tasks on time, each county (city) and Mawei District should submit a written notice to the city in the first quarter of the following year. After the Finance Bureau and the Municipal Human Resources and Social Security Bureau submit an application, and upon approval by the Municipal Finance Bureau and the Municipal Human Resources and Social Security Bureau, 40% of the insufficient payment will be paid by the municipal overall planning fund, and 60% will be paid by the local overall balance fund over the years. .

This notice will be effective from July 1, 2010.

Fuzhou Municipal Human Resources and Social Security Bureau Fuzhou Municipal Finance Bureau

September 6, 2010