What does the date of medical insurance participation mean?

The enrollment date refers to the date when employees apply for social security enrollment for the first time, which is generally the date when employees first register their personal information. Employee medical insurance personal account is a special medical account established by medical insurance agencies for the insured according to the principle of basic medical insurance fund distribution for urban employees in China, referred to as "personal account". The basic medical insurance premium paid by the insured units and their employees in the overall planning area is divided into two parts: most of them are used to establish the overall planning fund, and a small part is included in the personal account of the insured.

The time of medical insurance participation is calculated from the effective date. Employee medical insurance enrollment procedures:

New unit insurance:

1. The insured units go to the cashier's office of the medical insurance center to collect and fill in the Registration Form of the Insured Units of the Basic Medical Insurance for Urban Employees and the Register of the Insured Persons of the Basic Medical Insurance for Urban Employees in duplicate, and provide a copy of the business license, a copy of the organization code certificate and an account opening permit;

2. After receiving the unit's insurance information, the medical insurance center will review the insurance information within 15 days and verify the payment base. Those who pass the examination shall register for basic medical insurance;

3. The insured unit pays the first medical insurance premium, collects a copy of the insured person's ID card 1 piece, and a standard photo with white background 1 piece, and applies for a social security card;

4, the insured from the next month to enjoy the basic medical insurance benefits.

Settlement procedure:

(1) Settlement procedures for inpatient and outpatient treatment of special diseases

Designated medical institutions shall submit the expense list, hospitalization list and related materials of discharged patients last month to the medical insurance agency before 10 every month, which will be used as the basis for monthly pre-allocation and year-end final accounts after examination. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month.

Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately.

(2) Emergency settlement procedures

The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall handle the reimbursement procedures according to the provisions with the emergency hospitalization medical records, inspection, laboratory test sheets, invoices and detailed list of medical expenses.

(three) resettlement procedures for resettlement personnel in different places

1. The personnel resettled in different places shall be designated as the designated medical institution of 1-2 by the unit to which they belong, and shall be reported to the medical insurance agency for the record.

2. The medical expenses incurred by the off-site staff in the outpatient department of the designated medical institution where the disease occurs at the place of residence shall be paid in advance by themselves or their units. After the treatment, the unit shall settle the diagnosis and medical records, effective expense bills, compound prescriptions and hospitalization expense lists of the insured. Go to the social medical insurance agency on the specified date.

legal ground

"Insurance Law of People's Republic of China (PRC)" Article 116th An insurance company and its staff shall not commit the following acts in insurance business activities:

(1) Deceiving the applicant, the insured or the beneficiary;

(2) Concealing important information related to the insurance contract from the applicant;

(3) Obstructing the applicant from fulfilling the obligation of truthful disclosure as stipulated in this Law, or inducing him not to fulfill the obligation of truthful disclosure as stipulated in this Law;

(four) to give or promise to give the insured, the insured and the beneficiary insurance premiums or other benefits other than those stipulated in the insurance contract;

(5) Refusing to perform the obligation of compensation or payment of insurance benefits as stipulated in the insurance contract according to law;

(6) Deliberately fabricating an insurance accident that has never happened or fabricating an insurance contract, or deliberately exaggerating the loss of an insurance accident that has happened, making false claims, defrauding insurance money or seeking other illegitimate interests;

(seven) misappropriation, interception and occupation of insurance premiums;

(8) Entrusting an institution without legal qualifications to engage in insurance sales activities;

(9) Seeking illegitimate interests for other institutions or individuals by conducting insurance business;

(ten) the use of insurance agents, insurance brokers, insurance assessment agencies to engage in fictitious insurance intermediary business, fabricated surrender and other illegal activities;

(eleven) fabricating and spreading false facts to damage the business reputation of competitors, or disrupting the order of the insurance market by other unfair competition methods;

(12) disclosing the business secrets of the applicant and the insured that are known in business activities;

(thirteen) other acts in violation of laws, administrative regulations and the provisions of the the State Council insurance regulatory agency.