New social security regulations in September 1 day.

1. The insured person has participated in the basic medical insurance for more than 2 years (including 2 years) continuously, and the insured relationship switches between employee medical insurance and resident medical insurance due to personal identity changes such as employment, and the payment is interrupted for less than 3 months, so the insured person can enjoy the treatment normally after paying the fee, ensuring the seamless connection of the treatment of the insured person.

2. If the payment is interrupted for more than 3 months, each co-ordination area can set a waiting period of no more than 6 months according to its own situation, and the original insured relationship will be suspended after the waiting period expires.

3. Clean up the duplicate insurance in an orderly manner, and in principle, duplicate insurance is not allowed.

(1) If you repeatedly participate in employee medical insurance, in principle, you will keep the insured relationship at the place of employment;

(two) repeated participation in medical insurance for residents, in principle, to retain the insured relationship of permanent residence;

(3) Students who repeatedly participate in the insurance should, in principle, keep their insurance relationship;

(4) In case of cross-system repeated participation and continuous participation in employee medical insurance 1 year or above (including 1 year), the employee medical insurance participation relationship shall be retained in principle.

In-depth implementation of the national insurance plan, since 20021insurance year, the national insurance information has been interconnected, dynamically updated and queried in real time, and the quality of insurance information has been significantly improved; By 2025, the participation rate of basic medical insurance will increase steadily, the level of management services will be significantly improved, and the satisfaction of the people will continue to increase.

First of all, some areas will fully use social security cards to receive pensions from September 1. For example, the Shanghai Municipal Bureau of Human Resources and Social Security announced in late August that from September 1, social security cards can be used to receive pensions throughout Shanghai, and the coverage will be promoted in batches. Then in xingning city, Guangdong Province, it is also clear that urban and rural residents' pension recipients will use social security cards to receive benefits from September 20 12; In addition, there is another way to pay pensions in September, which is different from August! The pension will be paid in two installments in August and will be merged into one installment in September.

legal ground

Guiding opinions on strengthening and improving the basic medical insurance.

Second, the main task

(1) Set a reasonable expansion target.

All localities should scientifically and reasonably determine the annual enrollment expansion target according to the local resident population, registered population, employed population, urbanization rate and other indicators. The basic medical insurance for employees (hereinafter referred to as "employee medical insurance") should gradually cover the local working population, and the basic medical insurance for urban and rural residents (hereinafter referred to as "resident medical insurance") should gradually realize the coverage of local non-employed residents. Further implement the residence permit insurance policy.

(2) Implementing the insurance compensation policy.

Adhere to and improve the basic medical insurance system covering the whole people and participating in insurance according to law. Medical security departments at all levels should improve the data sharing and exchange mechanism with local public security, civil affairs, human resources and social security, health and health, market supervision, taxation, education, justice, poverty alleviation, disabled persons' federations and other departments, strengthen the comparison and sharing of personnel information, verify the situation of people who have stopped insurance, accurately locate the uninsured, and form a national insurance plan library in the region. Personnel who sign labor contracts with employers and establish stable labor relations shall participate in employee medical insurance in accordance with regulations. Implement the subsidy policy for eligible people with difficulties to participate in residents' medical insurance. Focusing on migrant workers, urban and rural residents, disabled people, flexible employees and people with difficulties in life, we will strengthen insurance services and implement various insurance policies. Improve the payment methods for employees participating in new forms of employment.

(3) Do a good job in cross-system insurance.

The insured person has participated in the basic medical insurance for more than two consecutive years (including two years), and the insured relationship has switched between employee medical insurance and resident medical insurance due to personal identity changes such as employment. If the payment is interrupted for no more than three months, the insured person can enjoy the treatment normally after payment, ensuring the seamless connection of the insured person's treatment. If the payment is interrupted for more than 3 months, each overall planning area can set a waiting period of no more than 6 months according to its own situation, and the original insured relationship will be suspended after the waiting period expires.

(4) Clean up duplicate insurance in an orderly manner.

Repeated enrollment refers to the same insured person's repeated enrollment under the same basic medical insurance system (repeated enrollment within the system) or repeated enrollment under different basic medical insurance systems (repeated enrollment across systems), which is embodied in the fact that the same insured person has two or more normal enrollment payment records in the same time period. In principle, repeated insurance is not allowed. Repeatedly participating in employee medical insurance, in principle, retain the employment insurance relationship; Repeatedly participating in residents' medical insurance, in principle, keep the insured relationship of permanent residence; Students who repeatedly participate in the insurance shall, in principle, retain their school status. Cross-system repeated insurance and continuous participation in employee medical insurance 1 year or above (including 1 year), in principle, the employee medical insurance participation relationship is retained. In the above circumstances, while retaining one insured relationship, the duplicate insured relationship should be terminated in time. Repeatedly participate in cross-system insurance in the form of flexible employment such as part-time and temporary work, retain the insured relationship that can enjoy the treatment, and suspend the repeated insured relationship.

(5) Improve the personal insurance payment service mechanism.

After the completion of the basic information management subsystem of the national medical insurance information platform, the medical security departments at all levels should make use of the real-time check function of the basic information management subsystem of the national unified medical insurance information platform to inquire about the payment of the insured in time, cooperate with the tax authorities to improve the insurance payment service and reduce the repeated insurance payment. Increase the publicity and guidance of insurance payment, promote the service to sink to the grassroots level, increase the promotion and use of medical insurance electronic certificate, expand diversified insurance payment channels by using mobile terminals, network platforms, sharing economic platforms and other channels, improve the awareness of insurance payment policies, and enhance service convenience. After paying the residents' medical insurance premium, the insured can apply for a refund for the individual at the same time because of repeated payment before the start of the corresponding treatment enjoyment period, or participating in employee medical insurance or other regional medical insurance as a whole, and terminating the medical insurance participation relationship of the relevant residents. After the start of the treatment period, the individual payment part will not be returned to the suspended residents' medical insurance participation relationship in principle; Recipients who have enjoyed the subsidy for insurance payment through medical assistance channels may, according to their applications, complete the refund by terminating the payment channels of the insurance relationship as needed; Flexible employees pay medical insurance premiums once a year, and if they participate in employee medical insurance with the unit during their employment, they can return the medical insurance premiums paid by flexible employees in the remaining months of the year after their employment according to the application; In other cases, the provincial medical security department shall, in conjunction with the relevant departments, make clear the specific circumstances of refund and non-refund in light of local conditions.

(six) to strengthen the management of financial subsidies.

In addition to the college students who participated in the residents' medical insurance repeatedly in the same year, other people who participated in the residents' medical insurance repeatedly need to terminate the relevant residents' medical insurance participation relationship and deduct the financial subsidy funds at all levels involved in the repeated insurance year. Cross-system repeated insurance and continuous participation in employee medical insurance 1 year or above (including 1 year), and the payment status of insurance is normal, the financial subsidy funds at all levels for repeated insurance of residents' medical insurance in that year shall be deducted after treatment according to the principles stipulated in this opinion.