Measures of Suzhou Municipality on the Administration of Social Basic Medical Insurance (20 16)

Chapter I General Provisions Article 1 These Measures are formulated in accordance with the Social Insurance Law of People's Republic of China (PRC), the Regulations on the Supervision of Social Insurance Funds of Jiangsu Province and other laws and regulations, combined with the actual situation of this Municipality, in order to standardize the relationship between social basic medical insurance, guarantee the legitimate rights and interests of the insured persons to enjoy the benefits of social basic medical insurance, and make overall plans for urban and rural medical security. Article 2 These Measures shall apply to the participation, treatment, service, supervision and management of social basic medical insurance within the administrative area of this Municipality. Article 3 The social basic medical insurance mentioned in these Measures includes basic medical insurance for employees, basic medical insurance for urban and rural residents, supplementary medical insurance and social medical assistance. Article 4 The social basic medical insurance system of this Municipality adheres to the principles of full coverage, basic insurance, multi-level and sustainability, and follows the principles of multi-channel financing, matching the level of security with the level of economic and social development, corresponding rights and obligations, implementing territorial management and gradually promoting municipal overall planning. Fifth city and county-level city (District) people's governments (administrative committees) will incorporate social basic medical insurance into the national economic and social development plan, and increase investment in social basic medical insurance.

City, county-level city (District) people's government (Administrative Committee) set up a social basic medical insurance policy advisory committee, composed of human resources and social security, development and reform, civil affairs, finance, health and family planning, food and drug supervision and management, price and other departments to provide advice and suggestions on the development goals, planning and policy formulation of social basic medical insurance. Article 6 The municipal social insurance administrative department is responsible for the formulation, organization, implementation, supervision and management of the city's social basic medical insurance policies and the management of social basic medical insurance funds. The social insurance administrative department of the county-level city (District) people's government (Administrative Committee) is responsible for the management of social basic medical insurance within its administrative area.

City, county-level city (District) people's government (Administrative Committee) social insurance agencies provide basic social medical insurance services, specifically undertake medical insurance affairs related to the income and expenditure and use of social basic medical insurance funds, and be responsible for social insurance registration, personal rights and interests record, medical insurance treatment payment, agreement management of medical institutions, medical expenses audit and settlement, etc.

City, county-level city (District) people's government (Guan Weihui) financial department is responsible for the administrative area of social basic medical insurance fund special account management, supervision of fund revenue and expenditure; The auditing department shall supervise the social basic medical insurance fund through auditing according to law.

City, county-level city (District) people's government (CMC) health and family planning, food and drug supervision and management, price, civil affairs, public security, education, local taxation, disabled persons' federations, Federation of trade unions and other departments and units shall, according to their respective functions and duties, do a good job in the management of social basic medical insurance. Chapter II Basic Medical Insurance for Employees Article 7 The following persons participate in the basic medical insurance for employees:

(1) Employees;

(2) Unemployed persons receiving unemployment insurance benefits in this Municipality (hereinafter referred to as those receiving unemployment insurance benefits);

(3) Foreigners applying for employment registration in this Municipality and personnel from Hongkong, Macao and Taiwan Province provinces;

(four) level 1 to level 6 disabled soldiers (hereinafter referred to as disabled soldiers).

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, other flexible employees with household registration in this city and other qualified personnel can participate in the basic medical insurance for employees.

The insured persons of basic medical insurance for employees are collectively referred to as insured employees. Article 8 The basic medical insurance funds for employees include basic medical insurance funds (divided into individual accounts and basic medical insurance pooling funds), local supplementary medical insurance pooling funds and social mutual funds with large medical expenses:

(a) the basic medical insurance premiums paid by employers and employees. The employer's payment standard shall be implemented in accordance with relevant regulations, and the on-the-job employees shall pay 2% of their wages. The payment base of flexible employees shall be implemented in accordance with the relevant regulations, and the payment ratio shall be the sum of the payment ratio of the unit and the employees on the job. Individuals who participate in the basic medical insurance for employees in disabled soldiers do not pay fees, and the management unit pays them at the beginning of each year according to the quota standard.

(two) the local supplementary medical insurance premium is composed of the employer's payment, the flexible employment personnel's payment, the basic medical insurance fund transfer payment and financial subsidies. The employer shall pay 1% of the total wages of all employees on a monthly basis, and the institutions and institutions with full financial allocation shall not pay; Flexible employees are paid monthly by individuals according to 1% of the basic medical insurance payment base for flexible employees; Social insurance agencies set aside 0.5% of the total wages of all employees from the basic medical insurance premium and transfer it to the local supplementary medical insurance pooling fund on a monthly basis; The social insurance co-ordination area at the same level (hereinafter referred to as the co-ordination area) is included in the fiscal budget of the year according to the standard of 100 yuan per retiree per year, and directly allocated to the special account of the local supplementary medical insurance co-ordination fund.

(three) the social mutual fund for large medical expenses shall be paid by employees and flexible employees according to the standard of 5 yuan per person per month; Retirees do not pay fees, and the social insurance agencies will transfer them from the basic medical insurance fund according to the standard of 60 yuan per person per year.

(4) The basic medical insurance premium, local supplementary medical insurance premium and social mutual fund for large medical expenses that should be paid by persons receiving unemployment benefits shall be transferred from the unemployment insurance fund by social insurance agencies on a monthly basis, and individuals shall not pay.

(five) to participate in the basic medical insurance payment standards of other employees in accordance with the relevant provisions.