&# 8203;&# 8203;&# 8203;&# 8203;&# 8203;&# 8203; Recently, there is news that maternity insurance has been cancelled. Is this true? Of course, it's not that social security will usher in a big change. Five insurances and one fund will become four insurances and one fund, which means that maternity insurance and medical insurance will be merged into one insurance, so that employees will no longer have to be afraid that the company and employers will not buy maternity insurance. So what big changes will social security usher in? What are the impacts and benefits of the policy? This article brings you an introduction to the changes of the social security office and an analysis of the impact and benefits of the policies on people. Let's have a look.
Combination of maternity insurance and basic medical insurance for employees
On March 25, the general office of the State Council issued the opinions of the general office of the State Council on comprehensively promoting the combined implementation of maternity insurance and basic medical insurance for employees (hereinafter referred to as the opinions). The opinions clearly states that the maternity insurance fund shall be incorporated into the basic medical insurance fund for employees, collected and paid in a unified manner, with the same level of overall planning, and the merger shall be implemented before the end of 2019.
In other words, maternity insurance is not cancelled, but merged with basic medical insurance for employees.
The usual five risks will become four. If the two insurances are implemented together, will the maternity insurance benefits enjoyed by employees change? Will the burden of insured enterprises increase?
"Five insurance" changed to "four insurance" treatment unchanged
Five insurances: endowment insurance, unemployment insurance, medical insurance, industrial injury insurance and maternity insurance.
Now the "five insurances" have become the "four insurances", and childbirth has been incorporated into medical treatment.
The relevant person in charge of the National Medical Insurance Bureau said that the merger of the two insurances is to ensure that the treatment remains unchanged and does not decline, and the second is to ensure the sustainability of the system. The maternity insurance benefits enjoyed by employees will not affect in any way.
Chen Jinfu, deputy director of the State Medical Security Bureau: it just changed the channel of a fund (handling), but it did not change the scope of the insured, nor did it change the set maternity insurance security items and payment level. Similarly, maternity insurance individuals do not pay, and units pay, and this policy is also retained.
Six benefits brought by the introduction of policies
The main policies proposed in the opinions to promote the combined implementation of maternity insurance and basic medical insurance for employees will bring six benefits & DARR& darr;& darr;
1. Unified insurance registration
The in-service employees who participate in the basic medical insurance for employees shall participate in the maternity insurance at the same time. Improve the scope of insurance and promote the realization of all insurance coverage.
2. Unified fund collection and management
The maternity insurance fund shall be incorporated into the basic medical insurance fund for employees, collected and paid uniformly, and the overall planning level shall be consistent. The new unit rate shall be determined according to the sum of the payment proportion of the employer's participation in maternity insurance and basic medical insurance for employees.
3. Unified medical service management
After the combined implementation of the two insurances, a unified fixed-point medical service management shall be implemented, and the drug catalogue of basic medical insurance, work-related injury insurance and maternity insurance, as well as the diagnosis and treatment items of basic medical insurance and the scope of medical service facilities shall be implemented. In principle, maternity medical expenses shall be settled directly between medical insurance agencies and designated medical institutions. We will promote norms of conduct for reproductive medical services and strengthen monitoring and audit.
4. Unified handling and information services
The basic medical insurance agency shall be responsible for the handling and management, and the integrated operation of information system shall be implemented.
5. Ensure that the maternity insurance benefits of employees remain unchanged during childbirth
The maternity medical expenses, maternity allowances and other maternity insurance benefits of the insured shall be implemented in accordance with the current laws and regulations, and the required funds shall be paid from the employee's basic medical insurance fund.
6. Ensuring institutional sustainability
All localities should enhance the ability of fund co-ordination, enhance the awareness of risk prevention and the ability of system guarantee, reasonably guide expectations, improve the monitoring indicators of maternity insurance, and establish a dynamic rate adjustment mechanism according to the expenditure demand of maternity insurance.
According to the National Medical Security Bureau, China has solved the problem of employment discrimination and balanced the social burden of different enterprises by promoting maternity insurance. From the process of the merger and implementation of the two insurances, it not only does not increase the difficulty for small and micro enterprises to participate in maternity insurance, but also simplifies insurance participation and improves management and service capacity.
'I feel like my child was born a few years earlier'
In fact, this is only the comprehensive promotion of the measure throughout the country. Since 2017, 12 cities have launched pilot projects.
After the introduction of the opinions, some netizens said they did not know much about the impact of the merger of the two insurances on individual fertility.
This change will bring at least two benefits to wage earners.
Good one: I'm not afraid that the company won't pay maternity insurance
Let's look at a case first.
Zhang hang, who works in a province in Central China, was a little depressed. He told reporters that he was a child in 2014. Because the enterprise where he and his wife are located only paid basic endowment insurance, medical insurance and other types of insurance, and did not pay maternity insurance, he can only bear all the expenses of giving birth to his own children, and there is no way to reimburse them.
In fact, Zhang Hang's experience is not a case. Let's look at a set of data.
According to the data from the National Medical Insurance Bureau, by the end of 2018, 1.344 billion people had participated in basic medical insurance. Among them, 316.7 million people participated in basic medical insurance for employees, and 204 million people participated in maternity insurance in the whole year.
In other words, more than 110 million employees have participated in basic medical insurance, but not maternity insurance.
However, according to the requirements of the opinions: the in-service employees who participate in the basic medical insurance for employees participate in maternity insurance at the same time. In other words, there will be no participation in basic medical insurance but not maternity insurance.
Fang Lianquan, Secretary General of the world social security research center of the Chinese Academy of Social Sciences, said that after the merger, a large number of employees who previously participated in medical insurance but did not participate in maternity insurance will be included in maternity insurance and enjoy maternity insurance benefits.
In this regard, Zhang hang said with a smile that if he had a child after the implementation of the opinions, he would certainly enjoy maternity insurance and feel that his child was born a few years earlier.
Benefit 2: more convenient reimbursement
Another advantage of the combination of the two insurances is that it is more convenient for reimbursement.
Mr. Xu, who both husband and wife worked in Hefei, told reporters that when giving birth to a child, he first paid the expenses, then took the relevant materials to his wife's company, took the reimbursement process of maternity insurance from the company, spent a total of thousands of yuan, and finally reimbursed more than 1000 yuan.
However, after the merger, the maternity insurance part can be directly deducted from the social security card during the settlement of maternity discharge.
Individuals do not pay maternity insurance
After the merger, the treatment will remain unchanged and the reimbursement will be more convenient, but will the payment rate be increased?
For the issue of payment rate that is generally concerned by the society, the opinions gives clear requirements: determine the new rate of basic medical insurance for employees of employers according to the sum of the payment proportion of employers participating in maternity insurance and basic medical insurance for employees, and individuals do not pay maternity insurance premium.
To sum up, after the merger, the payment proportion of units and enterprises is the sum of the existing medical insurance rate and maternity insurance rate. Individuals only pay medical insurance and do not pay maternity insurance.
So, for enterprises, is this rate up or down?
The requirement in the opinions is to establish a rate determination and adjustment mechanism according to the expenditure of employees' basic medical insurance fund and the demand for maternity treatment and the principle of balance of revenue and expenditure.
This also means that the payment rate of the merged medical insurance can be adjusted, and the key is to look at the income and expenditure of the fund.
By the end of 2018, the accumulated balance of basic medical insurance was RMB 23.374 billion, and the accumulated balance of employee medical insurance fund was RMB 1860.538 billion at the end of 2018; The cumulative balance of maternity insurance fund was 57.429 billion yuan.
Fang Lianquan believes that from the current trend of national tax reduction and fee reduction, the total rate after the merger may be lower than the sum of the two before the merger. However, the situation may be different in different places. Whether the combined rate decreases depends on the balance of the local medical insurance fund.
Fang Lianquan said: 'compared with the size of the medical insurance fund, the size of the maternity insurance fund is very small. If there is a large balance of the medical insurance fund in a region, there is room for the decline of the total rate after the merger, otherwise it is difficult to decline. In fact, in some areas, the income of medical insurance has not exceeded the expenditure. "
Source: comprehensive CCTV finance, Xinhua news agency, daily economic news