New rules of Shanghai medical insurance payment

The new provisions of medical insurance payment in 2023 are as follows: adjust the payment period of phased deferred social insurance premium policy.

The "Notice" clarifies that employers who defer payment of social insurance premiums by stages according to the relevant regulations of the state and Shanghai may repay the deferred social insurance premiums by stages (in full) or monthly before the end of 2023.

If the employer delays the payment of basic medical insurance premiums (including maternity insurance premiums) for employees by means of free application and instant enjoyment in accordance with the relevant policies of medical insurance, it shall refer to the time limit for payment.

The "Notice" requires that when providing social security payment inquiries and issuing payment certificates, the social security agency shall, in accordance with the policy, determine that the employer is in a normal payment state during the period of deferred payment and overdue payment. During the holdover period, if the employer fulfills the obligation of withholding and remitting employees' individual contributions according to law, the status of employees' individual contributions will be recognized as normal contributions.

At the same time, social security agencies should actively cooperate with relevant departments to properly handle the convergence problems with policies such as employees' settlement, purchase of houses, purchase of cars, and children's admission qualifications.

Harm of medical insurance withholding

1, affecting the enjoyment of medical insurance benefits. After the medical insurance is paid off, you can't enjoy medical insurance reimbursement when you go to the hospital. In addition, if the employer fails to pay the social insurance premium in full and on time, the social insurance premium collection agency shall order it to pay it within a time limit or make up for it, and from the date of default, an overdue fine of 5/10000 shall be added daily.

2, affect the enjoyment of maternity treatment. Female employees who fail to pay maternity insurance 1 month before production or fail to pay maternity insurance during production cannot enjoy the maternity insurance benefits of that month.

3. Affect retirement benefits. Long-term interruption of payment, retirement accumulated payment period is insufficient, after the prescribed payment period, you can enjoy basic medical insurance benefits according to regulations.

Refer to the above contents: Ministry of Human Resources and Social Security-Shanghai, People's Republic of China (PRC): Adjust the phased holdover of social security.