Does Yangquan city's subsistence allowance pay residents' medical insurance? How to deal with it?

According to the provincial people's government's "Implementation Opinions on Integrating the Basic Medical Insurance System for Urban and Rural Residents" (Notice on Printing and Distributing the Implementation Plan for Integrating the Basic Medical Insurance System for Urban and Rural Residents (Yang Zhengfa No. ), the Provincial Department of Human Resources and Social Security, and the Provincial Department of Finance "Notice on Doing a Good Job in Medical Insurance in the Province in 20 17" (No.53 issued by the People's Government of Jin [2065438+07]) and other documents.

I. Work tasks

In accordance with the principle of universal participation and non-repetition, we will actively organize the implementation of the basic medical insurance for urban and rural residents in 20 18, fully implement the subsidy policy for people in need, and ensure the full coverage of poor people, low-income households, and poverty-stricken people with filing cards.

Second, the scope and object of insurance

The insurance coverage does not belong to the basic medical insurance system for urban workers in Yangquan City within the administrative area of this Municipality, and mainly includes the following personnel: senior high schools, technical schools, college students, etc. ) and child labor; Migrant workers and their minor children who have obtained residence permits in this city and have not participated in basic medical insurance in their places of origin; Retired workers who have participated in poor post management in cities and towns and are unable to pay the basic medical insurance for urban workers; Religious personnel of this Municipality who have been put on record by the administrative department of religious affairs of the government; Difficult returned overseas Chinese and their relatives scattered in Yangquan City; Persons who have participated in the basic medical insurance and are now detained in detention centers, detention centers, asylum education centers and compulsory isolation drug rehabilitation centers shall participate in the basic medical insurance for urban and rural residents. All kinds of personnel, such as officers and men of the grass-roots units affiliated to Yangquan detachment of Shanxi Armed Police Corps, can also participate in the basic medical insurance for urban and rural residents in our city according to the Document Opinions on the Basic Medical Insurance for Urban Residents of Shanxi Armed Police issued by Shanxi Provincial People's Social Welfare Department (No.Jin People's Social Welfare Department 12).

Third, insurance payment.

From 20 18, the individual payment of urban and rural residents no longer distinguishes between adults and minors. The time collected in urban and rural areas in 20 18 this year is 180 yuan.

Four, the insured payment time

The time for registration and payment is from September, 2065438 to February, 3, 2007, and the benefits are enjoyed until February, 3, 2007.

If you miss the payment period and want to repay the insured who originally participated in the new rural cooperative medical system or the original medical insurance for urban residents, you need to go to the county (district) medical insurance agency on 20 17 to pay the individual payment and financial subsidies at all levels in full, and begin to enjoy the basic medical insurance benefits for urban and rural residents 30 days after the payment date.

Newborns enjoy the medical insurance benefits of the year from the date of registration; Those who were born during the insurance payment period and went through the insurance payment procedures for the next year, from the date of birth to 65438+February 3 1 day, will enjoy the medical insurance benefits for residents in that year and the medical insurance benefits for the next year.

Verb (abbreviation of verb) individual contribution subsidy policy

Financial difficulties include:

The elderly, minors and orphans over the age of 60 among the members of the subsistence allowances recognized by the civil affairs department;

The poverty-stricken population identified by the poverty alleviation department as the poverty-stricken population;

Severely disabled persons recognized by the Disabled Persons' Federation;

Persons with special difficulties in family planning identified by the health and family planning department

The individual contributions of the above-mentioned difficult personnel are partly funded by urban and rural medical assistance funds.

Encourage qualified towns, streets, village collectives and communities to subsidize the individual contributions of urban and rural residents to participate in medical insurance for urban and rural residents.

VI. Payment Method of the Insured

(1) Urban and rural residents. According to the principle of territoriality, urban and rural governments and villages (communities) should work in a unified way. Conditional counties (districts) can pay fees through bank pos machines, bank outlets, social security cards and bank cards.

Rural residents who have not yet issued social security cards are still insured by their families (students are still insured by their schools)

Migrant workers register in their places of residence and pay insurance.

Now detained in detention centers, detention centers, drug rehabilitation centers and supervision rooms inform their families to participate in insurance in time.

(2) students at school. Full-time tuition for primary and secondary school students, colleges and universities.

(3) newborns. Newborns can apply for insurance registration in the community where their household registration is located or in the community where they are about to settle down.

(four) the officers and men of the armed police force as a whole to participate in the registration and payment, financial subsidies paid in full by the armed police force.

(5) do it.

1, social security card, resident ID card or certificate. Residents who have not applied for social security cards need to provide the original medical certificate of the new rural cooperative medical system or the original medical security for urban residents, and two recent 2-inch bareheaded photos on a white background;

2. Non-local registered floating population (except college students) shall provide the residence permit and uninsured certificate issued by the medical insurance agency for urban and rural residents in their original place of residence, and 2 recent 2-inch bareheaded photos on a white background;

3, newborn insurance registration by the agent to provide residence booklet or birth medical certificate;

4. Persons with financial difficulties should also provide valid certification materials approved or issued by relevant departments.

(6) Collection and payment of supplementary insurance for accidental injury.

According to the Notice of Yangquan Human Resources and Social Security Bureau on Doing a Good Job in Supplementary Insurance for Accidental Injuries of Urban Residents (Yang Ren Shefa [2015] No.80), the supplementary insurance premium for accidental injuries and the medical insurance premium for urban and rural residents are collected synchronously on the premise of the insured's willingness, and the related matters such as premium collection, claim limit and treatment standard are handled and explained by the commercial insurance company specifically undertaken.

Seven, the insured medical management

20 18 insured urban and rural residents need social security cards for medical treatment. Residents who have not applied for social security cards are required to provide the original new rural cooperative medical insurance (the original medical insurance for urban residents or the new medical insurance for urban and rural residents) and identity cards (or household registration books).

The human and social departments should speed up the issuance of social security cards for urban and rural residents, especially minors under the age of 16, improve the environment for card use, vigorously promote the withholding of basic medical insurance cards for urban and rural residents, and gradually realize the "one card" for enrollment, registration, payment and medical treatment.

Eight, the insured information data management

The city's insurance information is uniformly entered into the "Yangquan Medical, Work Injury and Maternity Insurance Integrated Information System". All collection and handling points should do a good job in the registration and entry of insurance information for urban and rural residents to ensure the accuracy and completeness of insurance information. The information of the insured on 20 18 shall be registered and entered before the end of February 20 17.

Nine. fund management

The insured funds collected by each administrative village (community) shall be paid in time to the township (street) financial fund account or the county (district) medical insurance agency medical insurance fund income households; The insured funds collected by the school should be paid to the township (street) financial fund account or the county (district) medical insurance agency medical insurance fund income households in a timely manner; Towns (streets) at the end of each month to the county (District) medical insurance agencies medical insurance fund income households pay insurance funds and interest. At the end of each month, the county (district) medical insurance agency will pay the insured funds and interest in full to the income households of the basic medical insurance fund for urban and rural residents in Yangquan Medical Insurance Management Service Center, and then the Yangquan Medical Insurance Management Service Center will pay the insured funds and interest in full to the financial special account of the basic medical insurance for urban and rural residents in Yangquan City, so as to ensure that the number of insured people corresponds to the payment amount, prevent the fund from being intercepted and misappropriated, and ensure the safety of the fund.

X. Work measures and requirements

(1) Strengthen leadership and clarify tasks. 20 18 medical insurance payment for urban and rural residents is in the transition period of integration of medical insurance system for urban and rural residents. Counties (districts) should fully understand the complexity of the current insurance payment work, effectively enhance the sense of urgency and responsibility, and strengthen the main responsibility of the government insurance payment. Governments at all levels should seriously organize and convene a mobilization meeting for insurance payment, make overall arrangements and elaborate organizations, clarify the work responsibilities of towns (streets), villages (communities) and schools, establish a working mechanism of all-inclusive responsibility and responsibility to people, and incorporate insurance payment into government performance appraisal to ensure that "all insurance should be guaranteed and all insurance should be guaranteed".

(two) extensive publicity, create an atmosphere. It is necessary to further do a good job in propaganda and mobilization, and make full use of television, newspapers, radio, websites, mobile phone messages, billboards and other forms to widely publicize the relevant policy adjustments after the integration of basic medical insurance for urban and rural residents to key groups such as people in remote mountainous areas and migrant workers. Through extensive publicity, we should constantly improve the enthusiasm and initiative of the broad masses of people to participate in insurance, and create a good atmosphere for the smooth development of insurance claims.

(3) Strengthen cooperation and clarify responsibilities. All relevant functional departments should carry out their duties, keep close contact, coordinate with each other and work together.

1, county (district) governments and development zone administrative committees are responsible for arranging and supervising the payment of basic medical insurance for urban and rural residents in their respective jurisdictions. The township (town) government, sub-district offices and schools are responsible for the publicity, organization, implementation, supervision and inspection of the insurance policies for urban and rural residents in their respective jurisdictions and departments. Village (community), school, etc. Full-time (part-time) staff of medical insurance co-organizers should be established to be responsible for the notification, registration, information change, medical insurance premium collection, information entry and daily related medical insurance services of village (community) and school residents.

2, the propaganda department should do a good job in urban and rural residents' basic medical insurance registration and other news reports.

3, the financial sector should be responsible for doing a good job in the budget and arrangement of the basic medical insurance fund for urban and rural residents, timely and fully implement the financial matching funds of the city and county (district) and the work funds needed to carry out the insurance payment work, and earnestly do a good job in fund management and bill management.

4, human resources and social security departments to implement the social security card, medical insurance system, actively do a good job in insurance payment training, and strengthen the business guidance of counties (districts) insurance payment work; At the same time, it is necessary to coordinate the financial department at the same level to arrange special funds to purchase the equipment needed for the work and issue it in advance to ensure that the insurance compensation work is not affected.

5, the education department should be responsible for the overall enrollment and payment of students, especially colleges and universities. At the same time, after signing the relevant agreement with the human resources department and waiting for the completion of student registration on September 1 day, provide the student registration information in time for the insured registrants to verify.

6. The public security department shall provide the household registration information of residents in this Municipality to the human society department for verification by the insured registration personnel.

7, civil affairs, disabled persons' federations, health planning departments should strictly do a good job in the examination and identification of the people in need, and poverty alleviation departments should do a good job in the dynamic management of the poor people who set up a file to establish a card, and provide timely information and data that meet the funding conditions to the human and social departments; The civil affairs department shall, in conjunction with the human and social departments, verify the number of people with financial difficulties and implement full funding from individual contributions; Health and family planning departments should actively organize medical institutions at the township and village levels to assist the township and village to carry out insurance payment.

8, supervision and auditing departments should do a good job in the supervision and audit of the management and use of medical insurance funds.

(4) Standardize operation to ensure efficiency. In the process of organizing urban and rural residents to pay insurance premiums, counties (districts) should innovate their working methods according to their own actual conditions. In view of the characteristics of wide service population and scattered residence, in rural areas, not only administrative villages can be adhered to as units, but also special personnel can be appointed to register and collect residents' insurance premiums; You can also set up working groups in towns and villages to concentrate on registration and collect insurance premiums. The collection agencies should carefully check the relevant information, unified records, detailed input insurance information; When paying insurance premiums, it is necessary to issue special receipts to residents under the unified supervision of the financial department, so that the insurance funds, the number of insured persons, the insurance roster and the insurance receipts issued are "four consistent"; The collected insured funds should be paid into the local financial accounts in full and on time, or paid into the income households of the county (district) medical insurance agencies, and strictly follow the principles of special account storage, special account management, earmarking and closed operation. For illegal phenomena such as interception and misappropriation of insurance funds, once discovered, the responsible person will be resolutely and seriously investigated.

(5) Strengthen supervision and pay close attention to implementation. Medical insurance payment for urban and rural residents is a very specific and tedious work, and new situations and problems may appear at any time. All counties (districts) should actively put forward new measures and methods to solve problems and realize the innovation of working mechanism and methods. The municipal government will strengthen the supervision of this work, and all counties and districts should strengthen the supervision, do a good job of implementation at all levels, implement a regular reporting system for the progress of insurance payment, and submit true and accurate data to ensure the smooth completion of the 20 18 insurance payment for urban and rural residents.