What are the circumstances under which social security can be reimbursed

What are the circumstances under which Social Security can be reimbursed? And what is the method of reimbursement? Social insurance contains a variety of types, including pension insurance, medical insurance, workers' compensation insurance and so on. These are the most common types of insurance in life, different types of insurance in the reimbursement, the process is different. The following and I came to understand what are the different situations of social security reimbursement of trivia it.

Pension insurance to receive social pension insurance type of basic pension insurance for urban workers

Payment ratio: enterprises pay 20%, employees pay 8%.

Account management: a combination of social integration and individual accounts.

Recipient conditions: enterprise workers who have reached the legal retirement age (60 years old for male workers, 55 years old for female cadres, and 50 years old for female workers) and have made personal contributions for 15 years can receive a monthly basic pension after retirement.

New Rural Social Pension Insurance

The scope of coverage: 16 years of age (excluding schoolchildren) and rural residents who have not participated in the basic pension insurance for urban workers.

Contributions: The new rural insurance fund consists of individual contributions, collective subsidies and government subsidies.

Requirements for receiving the pension: Elderly people with household registration in rural areas who have reached the age of 60 and are not entitled to basic pension insurance for urban workers can receive a monthly pension. Social Pension Insurance for Urban Residents

Scope of Participation: Non-employed urban residents who have reached the age of 16 (excluding schoolchildren) and who do not meet the requirements for participation in employee pension insurance.

Payment: Residents pay contributions and are subsidized by the government.

Enjoyment of benefits: When insured residents reach the age of 60, they can receive a monthly pension that includes a basic pension and a personal account pension. Urban residents who have reached the age of 60 and meet the prescribed conditions do not have to make contributions and can receive a basic pension on a monthly basis.

Requirements for receiving a pension

1. Reaching the legal retirement age and going through retirement procedures;

2. Participating in pension insurance and fulfilling the obligation to pay pension insurance contributions in accordance with the law by the organization and the individual;

3. Having paid contributions for a minimum of 15 years (the years of contributions during the transition period include the deemed years of contributions).

Age of eligibility for old-age pension

1, 60 years old for male workers;

2, 55 years old for female workers engaged in management and scientific research;

3, 50 years old for female workers engaged in production and labor support work;

4, 55 years old for female freelancers and individual entrepreneurs. More+

Materials to be Provided for Retirement Pension

1. Provide the individual's ID card, household registration book, filing card and a copy thereof;

2. Employees who have previously participated in the enterprise pension insurance are required to provide the transfer sheet of the pension insurance, handbook, and ledger;

3. Other materials required to be provided as required (recruitment form, military officer's certificate of transfer, etc.).

Retirement to receive pension operation process

1, make an appointment at the Social Security Service Center office hall, and queue up for the retirement audit procedures according to the appointment time and window;

2, go to the window set up by the Bureau of Human Resources and Social Security to handle the retirement approval procedures;

3, if you are eligible to retire, please bring the retirement approval form, and go to the window of individual contributions in person to modify the basic information and confirm the status of contributions;

4. Go to the designated bank for pension payment;

5. Go to the Fund Audit Section of the Social Security Bureau at the end of the following month after completing the retirement formalities to get the Calculation of Basic Pension Benefits Form.

2. If, at the time of retirement, the employee has worked for more than 30 years, the reimbursement rate for medical expenses is 90%.

3. If the retired employee has more than 21 years and less than 30 years of service, the reimbursement rate is 85%.

4. If the retired employee has 15 years of service but less than 21 years of service, the reimbursement rate is 80%.

5. If the retired employee has less than 15 years of service, the reimbursement rate is 75%. The scope of reimbursement of medical insurance

1. Outpatient, emergency, retail medicine, and expenses below the starting standard of the basic medical insurance coordinating fund, etc. paid under the individual account.

2. Expenses paid by the integrated fund for hospitalization, chemotherapy, emergency rescue, and hospitalization within seven days prior to hospitalization. Elderly medical insurance card reimbursement process

1, figure out what is included in the reimbursement of medical activities.

2. Select the medicines that can be reimbursed through medical insurance.

3. When seniors go to the hospital, doctors will prescribe medicines and tests that are covered by Medicare.

4. When the elderly need medical treatment, they will present their health insurance cards to register.

5. List the reimbursements on the health insurance claim.

6, submit the application and wait for the reimbursement department to review and approve.

7. Note: Make sure that the information is correct and that you don't omit any items from the reimbursement. More+

Student health insurance reimbursementStudent health insurance reimbursement standard

1, the part of the cost of less than 1,000 yuan, reimbursement of 35% (outpatient);

2, the part of the cost of 1,000 yuan (including 1,000 yuan) or more, less than 5,000 yuan, reimbursement of 45% (outpatient);

3, the cost of treatment of 5,000 yuan (including 5000 yuan (including 5000 yuan) or more, less than 10000 yuan part, reimbursement of 55% (outpatient);

4, the cost of 10000 yuan (including 10000 yuan) or more, reimbursement of 65% (outpatient). The reimbursement time for outpatient reimbursement is once every six months, around June for the first half of the year, and around late November to early December for the second half of the year. The process of reimbursement for university students

1. University medical office: Bring your personal information to the medical office for reimbursement.

2. Referral for medical treatment: 15 days after the referral, bring the medical bill of the referral to the university medical office for reimbursement.

3, foreign medical treatment: bring the information of foreign reimbursement to the school medical office for reimbursement. More+

Children's health insurance reimbursementChildren's health insurance reimbursement rate

1, outpatient reimbursement rate between 50% and 60%;

2, inpatient reimbursement rate between 75% and 90%;

3, the reimbursement rate for major illnesses between 80% and 95%. Children's health insurance reimbursement process

1, first of all, the insured children in the event of illness, with children's health insurance card to the designated medical institutions for treatment and consultation.

2. Collect the necessary materials for outpatient advance reimbursement (only for first-class hospitals and second-class hospitals carrying out public hospital reform).

3. Once the required reimbursement documents are collected, they can be submitted to the relevant departments for review and reimbursement.

Children's health insurance reimbursement can enjoy the protection

1, hospitalization medical insurance treatment.

2, outpatient special disease reimbursement treatment.

3, outpatient emergency room reimbursement treatment.

4. Student accidental injury additional insurance treatment. More+

Urban workers' health insurance reimbursement for working employees' health insurance reimbursement rate

1, only medical expenses above 2000 yuan can be reimbursed, and the reimbursement rate is 50%.

2. Retirees under the age of 70 can be reimbursed for expenses above 1,300 yuan, and the reimbursement rate is 70 percent.

3. Retirees over 70 years of age can be reimbursed for expenses over $1,300 and the reimbursement rate is 80 percent.

4. Regardless of the kind of person, the maximum limit of expenses paid for outpatient and emergency major medical expenses is 20,000 yuan.

Retired workers health insurance reimbursement rate

1, outpatient, emergency medical expenses: active employees in the year meet the provisions of the scope of the accumulated medical expenses more than 2,000 yuan or more part.

2. Settlement ratio: 50% reimbursement for the part of over 2,000 yuan for dispatched staff during the contract period, and 50% out-of-pocket payment by individuals.

3. The maximum amount of outpatient and emergency reimbursement paid to the dispatched personnel is 20,000 yuan in a year.

4. 85% of the cost of Class A drugs and general diagnosis and treatment will be paid by the Coordination Fund for active employees and 90% by the Coordination Fund for retirees.

5. 75% of the cost of Class B drugs will be paid by the Coordination Fund; 70% of the cost of high-precision examinations and treatments will be paid by the Coordination Fund. Reimbursement process

1, medical insurance reimbursement, you need to go to the local medical management center or designated medical institutions health insurance checkout window reimbursement.

2. Bring proof of procedures, including your ID card, health insurance card, original invoice, list of medication and other materials.

3. Apply for reimbursement and wait for the result. More+

Conditions for reimbursement of urban residents' health insurance

1, people under 18 years old: household registration book, ID card (people under 16 years old who have not received ID cards may not provide).

2. For those who are 18 years old or older and are still attending a full-time school: Household register, ID card, and a certificate of enrollment issued by the school where they are enrolled.

3, 18 years of age or older, urban non-working residents: household registration; ID card (military personnel need to provide military discharge or rehabilitation documents).

4. Low-income insurance recipients: household register, ID card, and urban and rural residents' (village) minimum subsistence allowance certificate. Medical insurance reimbursement rate

1. Reimbursement rate for students and children: 55% for tertiary hospitals; 60% for secondary hospitals; and 65% for primary hospitals.

2. Elderly people over 70 years old: 50% for tertiary hospitals; 60% for secondary hospitals; 65% for primary hospitals.

3. Other urban residents: the proportion of tertiary hospitals is 50%; the proportion of secondary hospitals is 55%; and the proportion of primary hospitals is 60%.

4. The reimbursement rate for basic drugs is 20% for first-level hospitals and 40% for those who have not implemented basic drugs.

5. Level II hospitals are reimbursed, and essential drugs are reimbursed at 42%. Tertiary hospital reimbursement, basic drugs at 55% reimbursement.

6. Category A outpatient chronic diseases have no ceiling and the reimbursement rate is 60%; Category B outpatient chronic diseases are reimbursed at 50%.

Medicare Reimbursement Scope

1. Reimbursement of drugs in Category A and B.

2. Reimbursement of diagnostic and treatment programs.

3. Reimbursement of service facilities.

4. Individual account reimbursement.

Medicare reimbursement process

1, application for settlement of information (hospitalization settlement invoice and stamp, health insurance card, hospitalization cost detailed list and stamp, etc.).

2. Settlement of expenses (Note: Reimbursement is suspended from the 28th to the end of each month and resumes from the 1st of the following month). More+

The new rural cooperative medical reimbursement how to enroll in the insurance carry hukou book before December 20 each year to their own hukou location of the village, neighborhood or community to apply for enrollment procedures.

Outpatient reimbursement rate

1, village health center, health clinic reimbursement rate of 60%;

2, township health center reimbursement rate of 40%;

3, second-level hospitals reimbursement rate of 30%;

4, third-level hospitals reimbursement rate of 20%;

5, township-level cooperative medical reimbursement for outpatient reimbursement limit of 5,000 yuan / year.

Hospitalization reimbursement rate

1, the limit of reimbursement for auxiliary examination items such as new electroencephalogram, X-ray fluoroscopy, filming, laboratory tests, etc. is 200 yuan;

2, surgical expenses within the starting line of 1,000 yuan are reimbursed according to the national standard, and those exceeding 1,000 yuan are reimbursed according to the 1,000 yuan;

3, the hospitalization treatment expenses of senior citizens over 60 years of age and nursing care expenses per day can be Reimbursement of 10 yuan per day, with a limit of 200 yuan;

4. The reimbursement rates for hospitals at all levels are as follows: town health centers reimburse 60%; secondary hospitals reimburse 40%; and tertiary hospitals reimburse 30%. Health insurance reimbursement process

1, the applicant to submit the corresponding information;

2, to the receiving organization;

3, apply for reimbursement. More+

Workers' compensation insurance reimbursement Workers' compensation insurance process 1, registration (the employer first goes to the workers' compensation insurance agency to register for insurance);

2, participation audit (the agency audits the original information and data provided by the employer);

3, data entry (the agency enters the information reported by the employer into the computer, and establishes for the employer and individual basic file information);

4. Approval of premiums (the initial contribution rate is determined according to the standard of the base rate of the classified industry and then multiplied by the current contribution base);

5. Enrollment and payment of premiums (the employer pays the premiums according to the Bill of Contribution and Payment for Workmen's Compensation Insurance issued by the Collection and Payment Unit).

Annual contributions for Workers' Compensation Insurance 1. The contribution rate for the first category of industry is 0.5% of the employee's gross salary;

2. The first class of the second category of industry is 0.8% of the employee's gross salary;

3. The second class of the second category of industry is 1.0% of the employee's gross salary;

4. The third class of the second category of industry is 1.5% of the employee's gross salary;

5. p>5, the first class of the third category of industries is 2.8% of the total wages of employees;

6, the second class of the third category of industries is 3.3% of the total wages of employees.

Workers' compensation costs 1, the compensation for causing general injuries: medical expenses, food subsidies during hospitalization of the injured, living care costs.

2. Compensation for disability: medical fees, auxiliary equipment, one-time disability benefit, disability allowance, etc.

3. Compensation for death: funeral grant, one-time casualty grant, and dependents' pension.

4, the employee's whereabouts are unknown: the compensation program for the employee's whereabouts are unknown when he is out of the house or in the rescue and relief efforts, depending on the circumstances. Workers' compensation standard calculation 1-10 one-time disability benefit

1st level of disability: my salary × 27;

Second level of disability: my salary × 25;

3rd level of disability: my salary × 23;

Fourth level of disability: my salary × 21;

Fifth level of disability: my salary × 18;

Sixth level of Disability: my salary × 16;

Seventh-grade disability: my salary × 13;

Eighth-grade disability: my salary × 11;

Ninth-grade disability: my salary × 9;

Tenth-grade disability: my salary × 7.

Grade 1-6 Disability Allowance (Monthly)

First-grade disability: my salary × 90 percent

Second-degree disability: my salary×85%;

Third-degree disability: my salary×80%;

Fourth-degree disability: my salary×75%;

Fifth-degree disability: my salary×70%;

Sixth-degree disability: my salary×60%.

Medical and Disability Employment Benefits for Work Injuries of Grades 5-10

Lump-sum medical benefits for work-related injuries: paid by the Workers' Compensation Insurance Fund;

Lump-sum disability employment benefits: paid by the employer. More+

Unemployment insurance reimbursement of unemployment insurance for 1, bring the processing vouchers (household register, ID card, unemployment insurance claim registration form, graduation certificate, etc.).

2. Bring the relevant information and go to the designated organization to complete the procedures within 30 days of unemployment.

3. Go to the "Unemployment Insurance Service Area" of the Social Security Bureau with the relevant documents to register for unemployment insurance benefits. Unemployment Insurance Contribution Ratio: 1. The contributing organization pays 2% of the total wages of its employees in the same month;

2. Individuals pay 1% of their monthly wages, which is deducted from their paychecks by the organization they work for. Conditions for receiving unemployment insurance benefits

1. Participating in unemployment insurance in accordance with the regulations, where the unit and the individual have fulfilled the obligation to pay contributions for one year in accordance with the regulations;

2. Interrupting employment not due to one's own will;

3. Having registered as unemployed in accordance with the legal procedures;

4. Having a request to find a job, and being willing to accept vocational training and job referral. Receiving standard

1. If the accumulated contribution time is less than 5 years, 70% of the minimum wage standard will be paid;

2. If the accumulated contribution time is 5 years but less than 10 years, 75% of the minimum wage standard will be paid;

3. If the accumulated contribution time is 10 years but less than 15 years, 80% of the minimum wage standard will be paid;

4. contribution time of 15 years but less than 20 years, 85% of the minimum wage standard;

5. If the accumulated contribution time is more than 20 years, 90% of the minimum wage standard;

6. Starting from the 13th month, the unemployment insurance benefit is always paid at 70% of the minimum wage standard.

The process of receiving the benefits

1. The Social Security Administration (SSA) stipulates that the unemployment report should be filed.

2. The Social Security Administration stipulates that you must have paid unemployment insurance premiums for more than one year before you can receive unemployment benefits.

3, for the preparation of the employer needs to submit the corresponding materials to the Social Security Administration, and stamped with the official seal of the unit.

4, the social security bureau review of unemployment registration, notify the unemployed to go to training and can receive unemployment benefits, and at the same time for the layoff certificate.

5, the unemployed since the termination with the employer. Procedures, from the next month, to the designated place to receive unemployment insurance benefits. More+

Maternity insurance reimbursementMaternity insurance reimbursement conditions 1, in line with the national family planning policy to give birth or to carry out family planning surgery.

2. Participate in maternity insurance at the organization in accordance with the regulations and make full and continuous contributions for that employee for more than one year.

3. Employees who are still insured at the time of childbirth (miscarriage) shall enjoy maternity insurance benefits in accordance with the relevant regulations.

Maternity insurance reimbursement amount 1, applicable to the municipal urban household registration and participate in the city's urban social insurance of working or unemployed women giving birth.

2. The base amount of urban pension insurance premiums paid by the employer is the base amount of urban maternity insurance premiums paid by the employer.

3. The employer pays monthly maternity insurance premiums at the rate of 0.8% of the contribution base. Individuals do not pay urban maternity insurance premiums.

4. The duration of the maternity living allowance: 3 months for births occurring at 7 months of pregnancy or more. If the pregnancy is less than 7 months and the birth is premature, the allowance shall be granted for 3 months. If the pregnancy is more than 3 months but less than 7 months, the allowance shall be granted for 1.5 months. If the pregnancy is less than 3 months and miscarriage or suffering from ectopic pregnancy, the entitlement is 1 month.

5. Maternity living allowances are paid at the standard rate (if a woman who has given birth has paid social insurance premiums for a total of one year).

The specific process of reimbursement of maternity insurance reimbursement time

1, maternity insurance need to buy 12 consecutive months, the baby was born within 18 months of reimbursement, while reimbursement needs to be in the insurance.

2, maternity insurance is a typical local policy, local regulations vary, so the local social security center should prevail. Documents required for reimbursement

1. Family planning certificate issued by the family planning department (original and copy);

2. Certificate of birth (death) of the baby issued by the medical department (original and copy);

3. Identity card of the woman worker and the family planning surgery worker (original and copy);

4. Application Form for Maternity Medical Card for Enterprise Employees;

5. Application Form for Medical Card for Family Planning Surgery for Enterprise Employees;

6. Application Form for Reimbursement of Maternity Medical Expenses for Enterprise Employees;

7. Approved Settlement Form for Maternity Insurance Benefits for Enterprise Employees;

8. Application Form for Out-of-town Medical Treatment for Enterprise Employees with Maternity Insurance;

9. Maternity Medical Expense Bills, Expense List, Outpatient Medical Record, Discharge Summary and Other Original Documents;

10, Receipt of Payment.

Insurance operation process

1, female workers in the maternity surgery before the employer to bring the declaration materials to the district social labor insurance office of the maternity insurance window;

2, the staff acceptance and approval, the issuance of medical certificates;

3, maternity female workers maternity leave within 30 days of the full, the employer to bring the declaration materials to the window of the maternity insurance for the settlement of the treatment

4. After accepting and approving the application, the staff will pay the maternity medical fee and maternity allowance. More+