What is the reimbursement rate of maternity insurance?

Maternity insurance reimbursement ratio is based on the average monthly salary of employees in the previous year, and it is paid in one lump sum according to a certain proportion.

These include:

1, natural delivery was 270%;

2. Caesarean section is 420%;

3, dystocia is 320%.

The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. The medical service fee and medicine fee (including self-funded medicine and nutritional medicine) exceeding the prescribed amount shall be borne by the employees themselves. After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs rest and treatment due to illness, it shall be handled in accordance with the relevant provisions on sick leave and medical insurance benefits.

Proportion of reimbursement for men's maternity insurance

1. Male employees who meet the following conditions can apply for a one-time maternity allowance:

(a) in line with the national family planning policy and statutory fertility conditions;

(2) When the spouse gives birth or miscarries due to pathological reasons, the employer has participated in maternity insurance and paid maternity insurance premiums for male employees normally and continuously (excluding overdue, unpaid and interrupted payment) 12 months or more;

⑶ Spouses are not covered by maternity insurance, which is in line with the national maternity policy.

2. Male employees who meet the above conditions can apply for a one-time maternity allowance: 200 yuan, the abortion; Natural childbirth 1200 yuan; 2000 yuan for dystocia or multiple births.

3. After the spouse gives birth or miscarries due to pathological reasons, the male employee holds the spouse's resident ID card, marriage certificate, birth status certificate or first birth certificate issued by the family planning department, medical certificate of newborn birth, discharge record, detailed list of expenses (the above materials must be original and photocopy), my medical card, original invoice, and the street (town) where the spouse's household registration is located, and there is no work unit or fixed. After the social security agency reviews, print the Payment Form of Male Workers' One-time Maternity Allowance, and the male workers sign it to confirm the amount of the allowance.

4, "birth certificate" or "first birth certificate" to the family planning commission. No proof of unemployment time is required, but a proof of no work unit and no fixed income source issued by the street (town) where the spouse's household registration is located.

legal ground

People's Republic of China (PRC) social insurance law

Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Fifty-third employees should participate in maternity insurance, the employer should pay maternity insurance premiums in accordance with state regulations, and employees do not pay maternity insurance premiums.

Fifty-fourth employers have paid maternity insurance premiums, and their employees enjoy maternity insurance benefits; Unemployed spouses of employees enjoy maternity medical expenses in accordance with state regulations. The required funds are paid from the maternity insurance fund.

Maternity insurance benefits include maternity medical expenses and maternity allowance.

Fifty-fifth maternity medical expenses include the following:

(1) Maternity medical expenses;

(two) family planning medical expenses;

(3) Other project expenses stipulated by laws and regulations.

Fifty-sixth employees in any of the following circumstances, can enjoy maternity allowance in accordance with state regulations:

(1) Female employees enjoy maternity leave;

(2) Enjoy family planning operation leave;

(3) Other circumstances stipulated by laws and regulations.

Maternity allowance is calculated and paid according to the average monthly salary of employees in the previous year of the employer.