20 19 the full text of the measures for the implementation of the basic medical insurance for urban residents in qianxinan prefecture (provisional)

Article 2 These Measures shall apply to urban residents who have non-agricultural household registration in this state and are not included in the basic medical insurance system for urban workers within the administrative area of this state.

Employees and retirees of state-owned and collective enterprises with difficulties who have been unable to pay the basic medical insurance premium for urban workers may voluntarily participate in the basic medical insurance for urban residents. After the unit has the ability to pay, it should participate in the basic medical insurance for urban workers.

Article 3 The basic medical insurance fund for urban residents shall be co-ordinated by the state. The whole state implements a unified fund-raising standard and guaranteed treatment. Establish a meeting system of the leading group for urban residents' basic medical insurance in Southwest Guizhou. State labor and social security, development and reform, finance, education, civil affairs, disabled persons' federations, health, drug supervision and other departments shall, according to their respective functions and duties, coordinate in the management of basic medical insurance for urban residents.

Article 4 The state administrative department of labor security is the competent department of the basic medical insurance for urban residents in this state, and is responsible for the management, supervision and inspection of the basic medical insurance for urban residents in this state. The administrative departments of labor and social security of counties (cities) and Ding Xiao Development Zone are responsible for the supervision and management of medical insurance for local insured residents.

State social insurance agencies are responsible for the overall planning, coordination, guidance and management of the basic medical insurance for urban residents in Quanzhou, the production of medical insurance certificates for urban residents, the agreement management and fund allocation of designated medical institutions.

Counties (cities) and Ding Xiao Development Zone social insurance agencies are responsible for local urban residents' insurance registration, declaration and payment, fees, issuance of urban residents' medical insurance certificates, settlement of medical expenses of designated medical institutions and reimbursement of medical expenses of non-designated medical institutions.

Counties (cities) and top-effect development zones should establish and improve the service platform of township and community labor security, and strive to create conditions to extend the work of insurance registration, declaration of payment and fee collection to township labor security offices and community labor security workstations.

Article 5 Establish a unified management information system and centralized data management for urban residents' basic medical insurance in the whole state, and extend the handling services to counties (cities), townships (towns) in top-effect development zones and community labor and social security departments to improve work efficiency and quality. Health, finance, labor and social security, civil affairs and other departments should implement relevant responsibilities, strengthen the construction of community service platforms, and improve the utilization efficiency of community health resources. Two or three designated medical institutions should give full play to the advantages of medical resources and actively create conditions to extend the medical service function to community health service institutions.

Sixth basic medical insurance for urban residents is mainly paid by families (individuals), and the finance gives appropriate subsidies. Encourage qualified employers to subsidize the insurance payment of employees' families.

The use of the basic medical insurance fund for urban residents follows the principle of fixed expenditure based on income, balance of payments and slight balance.

Seventh counties (cities), the top effect development zone finance subsidies in accordance with the household registration of urban residents.

Chapter II Insurance Registration and Payment Declaration

Article 8 Insurance registration

The insured shall provide relevant certificates and two 1 inch bareheaded photos to the local county (city) and Ding Xiao Development Zone, and go through the insurance registration formalities in the following ways:

(a) residents with residence booklet, ID card and copy of household registration to the neighborhood offices or township (town) people's government labor and social security agencies to declare registration, fill in the registration form. When applying for registration, people who enjoy the urban minimum living guarantee should also provide effective minimum living guarantee certificates and other relevant documents. The management institution accepts the application materials after verification, and timely inputs the accepted basic information into the information system, and reports the application materials of the insured person to the local county (city) and social security agency of the Development Zone before 25th of the month.

(two) the elderly over the age of 60 in low-income families (hereinafter referred to as "low-income elderly") shall provide valid certificates issued by the local civil affairs departments when registering for insurance.

(three) severely disabled students or severely disabled children who have lost their ability to work shall provide relevant certificates issued by the local disabled persons' Federation and apply for insurance registration.

(4) When applying for registration, persons who have no source of income, no ability to work and no dependents (hereinafter referred to as "three persons without support") shall also provide relevant certificates issued by local civil affairs departments.

(five) the definition standard of "low-income" elderly and severely disabled people who have lost the ability to work shall be formulated by the State Civil Affairs Bureau in conjunction with the State Finance Bureau, the State Labor and Social Security Bureau and other relevant departments and submitted to the state government for approval. Unless otherwise provided by the provincial government, such provisions shall prevail.

Ninth to participate in the basic medical insurance for urban residents, can not participate in the basic medical insurance for urban workers or the new rural cooperative medical care.

Land-expropriated farmers who transfer to urban household registration in this state can choose to continue to participate in the new rural cooperative medical system, or they can choose to participate in the basic medical insurance for urban residents (converted by natural year).

Tenth payment of basic medical insurance premiums.

(a) the basic medical insurance premium is paid according to the natural year. After payment, if the insured terminates the basic medical insurance relationship, the social insurance agency that has paid the basic medical insurance premium before termination will not be refunded.

(II) The basic medical insurance premium for urban residents shall be paid by the family (individual) to the township (town) labor and social security office, community labor and social security workstation or county (city) or top-effect development zone social insurance agency where the household registration is located according to the number of insured persons.

(three) to enjoy urban subsistence allowances, "low-income" elderly people, "three noes" personnel should meet the conditions when issuing.

Article 11 If the basic medical insurance for urban residents is changed to the basic medical insurance for urban workers, the insured residents shall go through the insurance formalities at the social insurance agency and pay the medical insurance premium for urban workers in accordance with the regulations. The payment period of basic medical insurance for urban residents is not calculated as the payment period of basic medical insurance for urban employees.

Article 12 If the basic medical insurance for urban workers is changed to the basic medical insurance for urban residents, the unit or individual where the insured workers work shall stop the basic medical insurance for urban workers at the social security agency, and then apply for the registration of the basic medical insurance for urban residents at the social insurance agency where the household registration is located, and pay the basic medical insurance premium for urban residents according to the regulations. The payment period of basic medical insurance for urban workers is not calculated as the payment period of basic medical insurance for urban residents.

Chapter III Raising of Basic Medical Insurance Fund

Thirteenth urban residents' basic medical insurance fund is raised according to law and managed by the national social insurance agency in a centralized and unified way, which is mainly used for the basic medical payment of insured residents in hospital and out-patient.

Fourteenth basic medical insurance fund composition:

(1) Medical insurance premiums paid by the insured individuals;

(2) Financial subsidies at all levels;

(3) Interest income of the medical insurance fund;

(four) medical insurance premiums paid by the employer for the families of its employees;

(five) medical assistance funds for medical insurance premiums paid by the insured;

(6) Funds donated by the society;

(seven) other income as prescribed by laws and regulations.

Article 15 Payment standard

(1) The subsidy standard for all kinds of primary and secondary schools/students under the age of 0/8 (including 18), children and other urban residents is 120 yuan per person per year, in which: families (individuals) pay 40 yuan and the government subsidizes 80 yuan. Family (individual) payment of students and children with severe disabilities with minimum living allowance 10 yuan, government subsidy 1 10 yuan.

(2) The funding standard for other urban residents 18 years old (excluding 18 years old) is 180 yuan per person per year, in which: the family (individual) pays 100 yuan, and the government subsidizes 80 yuan. Family (individual) contributions1low-income households over 8 years old, severely disabled people and "low-income" elderly people over 60 years old 10 yuan, government subsidies 170 yuan.

Sixteenth "three noes" personnel to participate in the basic medical insurance for urban residents, families (individuals) to pay part of the full subsidy by the government.

Seventeenth urban residents basic medical insurance local subsidy funds, according to the provincial government subsidies 35%, state government subsidies 65%+05%, county (city) government subsidies 50% of the proportion of distribution. The proportion of local subsidies, if adjusted by the provincial government, shall be appropriately adjusted by the state and county (city), and the adjustment plan shall be submitted to the state government for approval by the state finance, labor and social security departments.

The government subsidy funds shall be subject to the budget and final accounts system. At the initial stage, the county (city) finance and the top-effect development zone finance will allocate financial subsidy funds to local social security agencies according to the number of residents participating in the insurance. After normal operation, at the end of the year, the social security agencies of counties (cities) and Ding Xiao Development Zone will draw up the annual budget according to the enrollment expansion plan of the following year, and the finance of counties (cities) and Ding Xiao Development Zone will allocate it twice in the following year 1 month and July, and make final accounts according to the actual enrollment situation of the whole year at the end of the year.

Eighteenth the establishment of the basic medical insurance for urban residents risk premium system. From 2008 to 2009, the state finance allocated 2 million yuan of risk money to the special financial account of urban residents' basic medical insurance every year. 1 2