Recently, the general office of the State Council issued the "opinions on comprehensively promoting the merger and implementation of maternity insurance and basic medical insurance for employees". The opinions put forward the main policies to promote the merger of maternity insurance and basic medical insurance for employees. What's going on with the merger of maternity insurance and medical insurance? What will be the impact of the five insurances changing into the four insurances? Let's have a look.
By the end of 2019, maternity insurance and medical insurance will be implemented together
The basic maternity fund should be incorporated into the unified medical insurance, and the unified opinions should be made clear. According to the sum of the payment proportion of maternity insurance and basic medical insurance for employees, the new basic medical insurance rate for employees of the employer shall be determined, and individuals shall not pay maternity insurance premium.
At the same time, according to the expenditure of the basic medical insurance fund and the demand for maternity treatment, we should establish the rate determination and adjustment mechanism according to the principle of balance of income and expenditure.
The "opinion" requires that after the implementation of the two insurances, medical expenses for childbirth should be included in the scope of medical insurance payment reform, and medical expenses such as hospitalization and childbirth should be paid by disease type and prenatal examination by head. In principle, medical insurance agencies and designated medical institutions should settle medical expenses directly.
The "opinions" require that the maternity insurance benefits of employees during childbearing period remain unchanged. Maternity insurance benefits include maternity medical expenses and maternity allowance stipulated in the social insurance law of the people's Republic of China, and the required funds are paid from the basic medical insurance fund of employees. The payment period of maternity allowance shall be implemented in accordance with the period of maternity leave stipulated in the special provisions on labor protection of female workers and other laws and regulations.
It is required that the two opinions should be implemented before the end of 2019.
National Medical Insurance Bureau: it will not affect the maternity insurance benefits of employees
At the regular policy briefing of the State Council held on March 25, a reporter asked: will the merger of maternity insurance and basic medical insurance affect the maternity insurance benefits enjoyed by employees?
'it doesn't matter. "Chen Jinfu, deputy director of the state medical security administration, responded that the focus of this work is to retain insurance types and benefits. Among the two guarantee policies and measures, the first one is to ensure the benefits. The benefits of the original maternity insurance remain unchanged, but the channels of enjoyment are changed in handling, but the scope of insurance, the security items and payment level of maternity insurance are not changed.
Chen Jinfu pointed out that maternity insurance is actually related to several major categories of security benefits. First, medical expenses of childbirth are reimbursed within the prescribed scope. Whether they are implemented in combination or not, they are not the same as the security benefits of medical insurance, because medical insurance benefits are paid in proportion, which reflects a special arrangement of population fertility policy. Similarly, maternity insurance is not paid by individuals, but by units. This policy is also retained. At the same time, more consideration was given to the life and health of female employees during childbirth, including salary, and maternity allowance during maternity leave was stipulated. If there is no maternity insurance, it is either the unit's burden or the individual's burden, which involves the burden of the enterprise and the source of personal life. The maternity insurance clearly stipulates that the maternity allowance shall be paid by the maternity insurance fund within 98 days of the statutory maternity leave, including certain incentive leave in various places. Therefore, these benefits will not change. With the development of society and economy, maternity security will only get better and better, and will not be reduced.
Will "five insurances and one fund" become "four insurances and one fund"? National Health Insurance Bureau: This is a misunderstanding
Chen Jinfu said that when the pilot project for the merger of two kinds of insurance was implemented the year before last, the society put forward that in the future, the "five insurances and one fund" would become the "four insurances and one fund" and the "maternity insurance would be cancelled". This is actually a misunderstanding of the previous pilot project and the "opinions on comprehensively promoting the merger and implementation of maternity insurance and basic medical insurance for employees".
He pointed out that by promoting maternity insurance, China has solved the problem of employment discrimination, balanced the social burden of different enterprises, and effectively promoted the employment of female workers. The United Nations, the international labor organization and other international organizations have recommended China's promotion of maternity insurance system as a pioneering undertaking to Member States, which is also an important system for us to promote the protection of women's rights and interests Arrangements.
Therefore, there is no question of cancellation of maternity insurance. 'said Chen Jinfu.