Measures for the implementation of maternity insurance for employees in Dezhou City

Chapter I General Provisions

Article 1 In order to safeguard the legitimate rights and interests of enterprise employees and ensure the basic living and basic medical needs of female employees during childbirth, these measures are formulated in accordance with the Provisional Regulations on the Collection and Payment of Social Insurance Fees, the Provisions on Maternity Insurance for Enterprise Employees in Shandong Province and other laws and regulations, combined with the actual situation of this Municipality.

Article 2 Enterprises within the administrative area of this Municipality (hereinafter referred to as employers) shall participate in maternity insurance in accordance with these Measures and pay maternity insurance premiums for their employees.

The enterprises mentioned in these Provisions refer to state-owned enterprises, urban collective enterprises, foreign-invested enterprises, urban private enterprises and other enterprises.

According to the overall development of social security in this city, individual industrial and commercial households, flexible employees, private non-enterprise units and urban employees will be gradually incorporated into the maternity security system.

Article 3 The maternity insurance for enterprise employees shall take counties (cities, districts) as the overall planning units, and gradually transition to municipal overall planning. County (city, district) administrative department of labor and social security is responsible for the work of maternity insurance within their respective administrative areas, and social insurance agencies specifically undertake maternity insurance business.

Maternity insurance is managed in a territorial way, and central and provincial enterprises and their employees in Germany participate in the social pooling of maternity insurance for residents.

Article 4 Departments of finance, health, population and family planning, economy and trade, auditing, taxation and price at the same level shall actively assist and cooperate with the labor and social security departments to do a good job in maternity insurance and promote the development of maternity insurance in our city. Trade unions and women's federations shall supervise the implementation of these provisions according to law.

Chapter II Maternity Insurance Fund

Article 5 The maternity insurance fund shall be raised in accordance with the principle of "supporting fixed income and balancing revenue and expenditure", incorporated into the financial special account, and managed by two lines of revenue and expenditure. The employer shall pay the maternity insurance premium on a monthly basis based on the total wages of its employees in the previous year at the rate of 1%. Self-employed workers do not pay maternity insurance premiums.

The municipal payment ratio shall be adjusted by the administrative department of labor security according to the future annual economic development and the use of funds, and shall be implemented after being approved by the municipal government.

Article 6 The employing unit shall, in accordance with the provisions of the Interim Regulations on the Collection and Payment of Social Insurance Premium, register maternity insurance with the social insurance agency and pay maternity insurance premium.

The newly established employer shall go through the relevant registration formalities within 30 days from the date of establishment.

If the employer terminates or changes the registered items of maternity insurance according to law, it shall go through the cancellation or change of registration with the original registration authority within 30 days from the date of termination or change.

Article 7 If the employing unit is declared to be revoked, dissolved, bankrupt or terminated for other reasons according to law, the unpaid maternity insurance premium shall be paid in one lump sum from the bankruptcy liquidation fund in accordance with the relevant provisions of the Enterprise Bankruptcy Law of the People's Republic of China.

Article 8 The maternity insurance fund consists of the following items: (1) Maternity insurance premium; (2) Interest income of maternity insurance fund; (3) Maternity insurance premium; (four) other funds incorporated into the maternity insurance fund according to law. Maternity insurance funds are exempt from taxes and fees.

Chapter III Maternity Insurance Benefits

Article 9 Employees who meet the following conditions at the same time shall enjoy maternity insurance benefits: (1) Those who give birth or perform family planning operations in line with the national family planning policy; (two) the unit has participated in maternity insurance for more than one year in accordance with the regulations.

Article 10 Maternity insurance benefits include: (1) maternity allowance for female employees during maternity leave; (two) the medical expenses incurred by the birth of female employees; (3) Medical expenses incurred by employees in carrying out family planning operations; (four) other expenses related to maternity insurance as stipulated by the state.

Eleventh maternity allowance for female employees is the average monthly payment salary of the previous year divided by 30 days multiplied by the number of maternity leave days. The number of maternity leave days is determined according to the following standards: (1) The maternity leave for normal childbirth of female employees is 90 days, including prenatal leave 15 days; Increased dystocia 15 days; For multiple births, each additional baby will be increased by 15 days; Late childbearing increased by 60 days. If a second child is born within the plan, the maternity leave does not enjoy the treatment of late childbirth. (2) If a female employee miscarries within 2 months of pregnancy, the maternity leave is 15 days; Pregnant for more than 2 months but less than 3 months, maternity leave is 20 days; Maternity leave is 30 days for those who are pregnant for more than 3 months but less than 4 months; Pregnant for more than 4 months, maternity leave is 42 days.

Article 12 Maternity medical expenses include examination expenses, delivery expenses, operation expenses, hospitalization expenses, medicine expenses and treatment expenses incurred by female employees due to pregnancy and childbirth. The medical expenses incurred by female employees due to maternity diseases shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the relevant provisions of the basic medical insurance.

The medical expenses of family planning operation include the medical expenses incurred by workers in placing (taking out) intrauterine devices, abortion, induced labor, sterilization and recanalization.

Thirteenth maternity medical expenses and family planning surgery medical expenses to implement single disease limit payment. The expenses exceeding the limit shall be borne by the employees themselves.

The specific measures for the quota management of single diseases shall be formulated separately by the labor and social security department in conjunction with the departments of finance, health, population and family planning, auditing and price. County (city, district) labor and social security departments can formulate diseases and quota standards suitable for local conditions.

Fourteenth spouses of male workers who participate in maternity insurance have no work units, and their fertility conforms to the provisions of the family planning policy, and they enjoy maternity grants according to 50% of the maximum standard of maternity medical expenses in Article 13. When receiving subsidies, the certificate of the village (neighborhood) Committee where the spouse's household registration is located shall be submitted.

Fifteenth workers who meet the provisions of Article 9 of these measures may apply for maternity allowance to the local social insurance agency with the following materials:

(a) the original and photocopy of the employee's ID card, marriage certificate, family planning service manual, maternity insurance manual, medical certificate of birth of newborn or medical certificate of death;

(two) the implementation of family planning surgery, submit relevant medical certificates.

Sixteenth social insurance agencies shall, within 3 days from the date of accepting the application, conduct a preliminary examination of the application materials. If the materials are incomplete, it shall inform all the materials that need to be supplemented at one time; If the materials are complete and fall within the responsibilities of this organ, it shall be accepted, and the applicant shall be informed of the audit results within 15 days from the date of acceptance. To meet the conditions, one-time payment of maternity insurance benefits; If it does not meet the requirements, it shall inform the applicant in writing and explain the reasons.

Chapter IV Supervision and Administration

Seventeenth financial and auditing departments shall supervise the income and expenditure and management of maternity insurance funds according to law.

Article 18 In addition to emergency treatment and first aid, employees of the employing unit who carry out prenatal examination, hospital delivery and family planning operation shall go to the designated medical institutions and family planning technical service institutions (hereinafter referred to as designated medical institutions) determined by the administrative department of labor and social security for treatment.

Nineteenth designated medical institutions management and maternity insurance drug list, diagnosis and treatment items and medical service facilities with reference to the relevant provisions of the basic medical insurance for urban workers. Designated medical institutions in violation of the provisions on the administration of designated medical institutions, the administrative department of labor security shall, depending on the seriousness of the case, make rectification within a time limit. Refused to rectification or rectification is invalid, cancel the designated qualification.

Twentieth social insurance agencies to review the materials submitted by the applicant, the designated medical institutions need to issue records, documents and related certificates, the designated medical institutions shall truthfully provide.

Twenty-first employees think that social insurance agencies have not paid maternity insurance premiums according to regulations, they may apply for administrative reconsideration or bring an administrative lawsuit according to law.

Twenty-second social insurance agencies required funds and maternity insurance fee collection, payment of business expenses, included in the fiscal budget at the same level, by the financial allocation.

Chapter V Legal Liability

Article 23 If the employing unit fails to participate in maternity insurance in accordance with these provisions, the administrative department of labor security shall order it to make corrections and punish it in accordance with the Provisional Regulations on the Collection and Payment of Social Insurance Fees in the State Council; The maternity insurance benefits of employees who have not participated in maternity insurance shall be paid by the employer in accordance with the maternity insurance benefits items and standards stipulated in these Measures.

Twenty-fourth penalties for illegal acts such as defrauding maternity insurance benefits or defrauding maternity insurance fund expenditures in violation of these regulations shall be implemented in accordance with the provisions of relevant laws, regulations and rules.

Article 25 If the staff of the administrative department of labor security, other relevant departments and social insurance agencies fail to perform their duties according to law, or abuse their powers or engage in malpractices for selfish ends, they shall be given administrative sanctions by their units or relevant authorities according to law; If a crime is constituted, criminal responsibility shall be investigated according to law.

Chapter VI Supplementary Provisions

Twenty-sixth female workers in the process of childbirth due to medical accidents caused by medical expenses, in accordance with the provisions of the "Regulations" of the State Council, maternity insurance fund will not be paid.

Twenty-seventh maternity insurance of state organs, institutions and social organizations shall be implemented with reference to these measures. The specific proportion of insurance payment shall be formulated separately by the Municipal Labor and Social Security Bureau in conjunction with the Municipal Finance Bureau.

Article 28 These Measures shall come into force on June 1 day, 2008. The original "Trial Measures for Maternity Insurance for Enterprise Employees in Dezhou" (Defa [1996] No.54) shall be abolished at the same time.