Recently, the Tangshan Medical Security Bureau, Tangshan Finance Bureau, Tangshan Municipal Health and Health Committee, and the Tangshan Taxation Bureau of the State Taxation Administration issued the "Notice on Printing and Distributing the Implementation Rules for the Implementation of Tangshan Maternity Insurance and the Implementation of Basic Medical Insurance in Employees".
Payment base verification standard
The approval standard for maternity insurance payment base is consistent with the basic medical insurance of urban employees. In accordance with the average salary of employment personnel of the full -caliber urban unit in the previous year, the personal payment base is approved, which is lower than the average salary of the employment of employment personnel in the full -caliber urban unit in the previous year.The average salary of the unit’s employment personnel is the payment base, which is higher than the average salary of the employment personnel of the full -caliber urban unit in the previous year, and the actual salary is the payment base.
Difficult enterprises and flexible employees based on the average monthly salary of 60%of the monthly average monthly salary of employment in Tangshan City in Tangshan City in 2018, and retired soldiers were implemented in accordance with relevant national and provincial policies.
Determine the payment ratio of the basic medical insurance payment of employees in the new employee of employees in accordance with the sum of the total medical insurance payment ratio of the employees’ basic medical insurance for maternity insurance and urban employees.(0.25%of maternity insurance, 7%of the basic medical insurance for employees), 7.8%of other employers (0.8%of maternity insurance, 7%of the basic medical insurance for employees), and personal payment ratio is 2%.
Flexible employment participants do not pay maternity insurance premiums, and the proportion of individuals’ personal medical insurance for employees is 9%.
1. If the employer pays for full fees on time and the employee will be born in accordance with the law, the female employees of the institution and the financial allocation of public institutions shall be issued by the female employees of the public institution, and the salary of the employer shall be paid by the employer according to the pre -maternal leave.After completing the medical treatment of maternity insurance from the month, the employees have been paid for 12 months or more (excluding the replenishment time) before they can enjoy the benefits of maternity insurance allowances.The maternity allowance is paid according to the average monthly salary of employees in the previous year of employees.
2. Female employees terminate pregnancy or planned fertility, and enjoy fertility allowances in accordance with national and provincial regulations:
⑴ If you meet the children of children and regulations, enjoy 158 days of fertility allowance;
If you have a miscarriage for less than 4 months of pregnancy, you will enjoy 15 days of fertility allowance;
(3) If you have a miscarriage for 4 months of pregnancy, you can enjoy a 42 -day fertility allowance.
3. If the employee implements the following birth measures, enjoy the maternity allowance:
⑴ If you place it and remove the in -palace, you will enjoy a 2 -day fertility allowance from the date of surgery;
⑵ Place and remove the subcutaneous buried agent to enjoy the 3 -day fertility allowance;
(3) Those who perform vasters and ligations to enjoy 7 -day fertility allowances;
管 Those who perform the tubal ligation and enjoy the 21 -day fertility allowance.
4. If it belongs to the following situation, increase the maternity allowance:
⑴ If the cesarean section and artificial intervention of childbirth will increase the fertility allowance by 15 days;
, If you have a polyphony, you have one baby every extra babies and increase the fertility allowance by 15 days;
妊 Those who performed the end of the palace at the same time were performed at the same time, and the fertility allowance was increased by 2 days;
妊 Performing the decision surgery and performing tubal ligation at the same time, adding a 10 -day fertility allowance.
5. Payment of maternity insurance funds in the planned medical expenses, and implement limited payment.
查 Subsidy Subsidy Standards for Preparation Examination Expenses:
For more than 4 months of pregnancy (including 4 months) to give birth or terminate pregnancy, the prenatal outpatient examination does not exceed 8 times, and the cumulative maximum payment is 800 yuan.
用 Payment standard for hospitalization fertility expenses:
①Pouring (including induction of labor for more than 7 months) pays a maximum of 2,000 yuan;
② Artificial intervention delivery:
Performing placenta, artificial membrane, artificial film stripping, intravenous dot oxygen induction of production and other projects, the highest payment is 2,100 yuan;
Practicing uterine rupture repair, pliebining, hip traction, fetal head suction, fetal head rotation, hip delivery, fetal destruction surgery and other projects, the maximum payment is 2300 yuan;
When the above application of artificial intervention is overlapping, pay the highest standard payment subsidy;
③ The highest payment of cesarean section is 2800 yuan;
④ Different fertility, increase subsidy of 500 yuan for each extra childbirth.
6. Payment of family planning medical expenses for maternity insurance funds, and implement limited payment.Specific payment standards:
⑴ If the pregnancy is terminated due to maternal and infant reasons, the maximum subsidy is 120 yuan per subsidy;
以 For the maximum payment of 800 yuan for induction or abortion inpatient subsidies for 2 months of pregnancy or less (over 7 months of induction or miscarriage), the maximum payment of 400 yuan for induction or abortion outpatient subsidies for output or abortion outpatient clinic for 2 months;
最 The maximum subsidy of 1,500 yuan per case;
最 The maximum subsidy of each case of resumed surgery is 2500 yuan;
取 The outpatient ring and the loop of the loop and the subsidy of 50 yuan each time (the inlaid inlaid and other hospitalizations are paid in accordance with the relevant regulations of the employee’s medical insurance).
7. Employees will enjoy the medical treatment of maternity insurance from the month of the payment of the payment.
8. Allow employees to pay for the personal burden of maternity and medical expenses occurred in outpatient clinics and hospitalization.
9. If a female employee who participates in maternity insurance will give birth after the filing of different places, the fertility medical expenses will be reimbursed according to the policies of the participating place and enjoying maternity allowances; those who go to Hong Kong, Macao and Taiwan and abroad will enjoy maternity allowances according to the policy of participating in the place of insurance.burden.
10. Employees participating in maternity insurance have paid compliance with compliance or complications due to fertility, termination of pregnancy or implementing family planning surgery, and are paid by employee basic medical insurance funds.
11. If a useless unit and participate in the basic medical insurance of employees as flexible employees, enjoy the treatment of maternity medical expenses at 50%of the Tangshan payment standards and do not enjoy the treatment of maternity allowances.Male employees who participated in maternity insurance have not employed spouses, and enjoy the treatment of maternity medical expenses at 50%of Tangshan’s payment standards and do not enjoy the treatment allowance. If their spouse has participated in the basic medical insurance of urban and rural residents, it shall be in accordance with the quota specified in the basic medical insurance regulations of urban and rural residents.Reim on maternity medical expenses and do not enjoy maternity insurance benefits.
Source: Tangshan Published