Provisions On Maternity Insurance For Employees Of Enterprises In Beijing

The provisions on the maternity insurance for employees of enterprises in Beijing have been deliberated and adopted by the thirty-fifth executive meeting of the Municipal People's Government on December 28, 2004. They are hereby promulgated and shall be implemented as of July 1, 2005.

Mayor: Wang Qishan

January 5th, two, five

Provisions on maternity insurance for employees of enterprises in Beijing

general provisions

Article 1. These Provisions are formulated in accordance with the labor law of the People's Republic of China, the relevant laws and regulations and the actual conditions of the city in order to ensure the necessary financial compensation and medical security for the employees during their childbearing period.

The second provision applies to all kinds of enterprises in the administrative area of the city and workers who have formed labor relations with permanent residence in this Municipality.

The Third Municipal Labor and social security administrative department is responsible for the birth insurance work in the whole city.

The labor and social security administrative departments of districts and counties are responsible for maternity insurance in their respective administrative areas.

The social insurance agencies established by the municipal and district administrative departments of labor and social security specifically undertake the business of maternity insurance.

The fourth financial and auditing departments shall supervise the payment and management of the maternity insurance fund in accordance with the law.

The departments of health, drug supervision, price, family planning and other departments shall, within their respective responsibilities, assist the labor and social security administrative departments in the work of maternity insurance.

The second chapter is maternity insurance fund.

The fifth maternity insurance fund is raised in accordance with the principle of "fixed income" and "balance of payments", which is incorporated into the special financial account and implements two line management of revenue and expenditure.

The sixth maternity insurance fund consists of the following:

(1) maternity insurance premiums paid by enterprises;

(two) interest of the fund;

(three) late payment;

(four) other funds incorporated into the maternity insurance fund in accordance with the law.

The seventh birth insurance premium is paid by the enterprise on a monthly basis.

Individual workers do not pay maternity insurance premiums.

The enterprise pays the maternity insurance premium in accordance with 0.8% of its total payment base.

The total base of enterprise payment is the sum of the employees' payment base that accords with the conditions of the enterprise.

The number of employees' payment base is calculated according to the average monthly salary of the previous year, which is less than 60% of the monthly average wage of the workers in the previous year, according to the 60% of the monthly average wage of the workers in the previous year, which is higher than that of the workers in the previous year.

If the average wage is more than 3 times, it is calculated according to the 3 times the monthly average wage of the workers in the previous year.

When the eighth payment criteria for maternity insurance need to be adjusted, the municipal labor and social security administrative department shall put forward an adjustment plan in conjunction with the municipal finance department, which shall be promulgated and implemented after being approved by the Municipal People's government.

The maternity insurance premiums paid by the ninth enterprises shall be withheld by the depositary bank entrusted by the social insurance agency to the bank in the way of "entrusting the bank to collect money (no payment period)".

Social insurance agencies should set up payment records for enterprises and employees.

The collection of tenth maternity insurance premiums shall be carried out in accordance with the regulations of the State Council on the collection and payment of social insurance premiums and the provisions on the collection of social insurance premiums in Beijing.

The third chapter is the treatment of maternity insurance.

Eleventh, the treatment of maternity insurance benefits for workers shall be in line with the relevant provisions of the state and the family planning in this Municipality.

The twelfth payment of maternity insurance fund includes:

(1) maternity allowance;

(two) childbirth medical expenses;

(three) medical expenses for family planning operation;

(four) other expenses stipulated by the state and the municipality.

When the payment standard of the thirteenth maternity insurance fund needs to be adjusted, the municipal labor and social security administrative department shall submit an adjustment plan together with the municipal financial department, and it shall be promulgated and implemented after being approved by the Municipal People's government.

The maternity leave of fourteenth female workers was 90 days for normal childbirth, 15 days for dystocia, 15 days for every 1 babies born, and 30 days for late childbirth.

The maternity leave of female workers who have been pregnant for 4 months is 15 days to 30 days, and the maternity leave for 42 months is more than 4 months.

The fifteenth maternity allowance is calculated by dividing the payment base of the female worker's birth month by 30 and multiplying the number of days of maternity leave.

The maternity allowance is the wages for female workers during their maternity leave, and the maternity allowance is lower than the wage standard. The difference is partly made up by the enterprises.

The sixteenth birth medical expenses include medical examination fees, delivery costs, operation expenses, hospitalization expenses and drug fees for female workers due to pregnancy and childbirth.

The cost of family planning surgery includes the medical expenses incurred by the workers due to family planning, placement, removal, intrauterine device, abortion, induced labor, sterilization and reoperation.

The cost of maternity and family planning operation and medical services is in accordance with the provisions of the basic medical insurance drugs list, diagnosis and treatment items and medical service facilities items of this Municipality, and shall be paid by the maternity insurance fund.

The seventeenth way of settlement of childbirth and family planning operation medical expenses by the maternity insurance fund shall be formulated by the municipal labor and social security administrative department.

The eighteenth workers' childbirth and family planning operation should be treated according to the provisions of the basic medical insurance in this Municipality to the designated medical institutions with the basic medical insurance of midwifery and family planning operation (hereinafter referred to as designated medical institutions).

Medical workers should produce the "Beijing Medical Insurance Manual". If they need to be hospitalized, they should produce the certificate of childbirth service in Beijing at the same time, and keep copies by the designated medical institutions.

Nineteenth the following maternity, family planning operation and medical expenses maternity insurance fund will not be paid:

(1) it does not conform to the provisions of the state or the family planning of this Municipality;

(two) it does not meet the requirements for medical treatment of basic medical insurance in this Municipality;

(three) it does not conform to the provisions of the basic medical insurance drugs list, diagnosis and treatment items and medical service facilities projects in this Municipality.

(four) medical expenses in foreign countries or in Hongkong, Macao Special Administrative Region and Taiwan;

(five) medical expenses arising from medical accidents;

(six) the cost of treating fertility complications;

(seven) expenses that should be borne by individuals in accordance with the provisions of the state or municipality.

The twentieth application for maternity allowance and reimbursement for prenatal examination and outpatient medical expenses for family planning operation shall be handled by the enterprise in charge of its social insurance agency participating in maternity insurance.

When handling the formalities, the enterprise shall submit the "Beijing Medical Insurance Manual", the "Beijing birth certificate", and the certificate of birth, death or abortion, family planning operation certificate and charge certificate issued by the designated medical institution.

Twenty-first hospitalization expenses for family planning and family planning operations shall be handled by the designated medical institutions to the social insurance agency of the maternity insurance company.

The twenty-second social insurance agencies shall, after receiving the application for maternity allowance, reimbursement for prenatal examination, outpatient medical expenses for family planning operation, or the application of a designated medical institution to settle the hospitalization expenses for family planning and family planning operations, shall, within 20 days, check and settle the settlement for those who meet the requirements, and notify the applicants in writing within 20 days if they fail to meet the requirements.

The fourth chapter is legal liability.

If twenty-third enterprises fail to participate in maternity insurance in accordance with these Provisions, the maternity insurance benefits of employees shall be paid by the enterprises in accordance with the provisions of this regulation.

If an enterprise fails to pay maternity insurance premiums, the child's maternity insurance benefits shall be paid by the enterprise in accordance with the provisions of this regulation.

When twenty-fourth enterprises declare to the social insurance agency the amount of child insurance premiums payable, if they concede wages or the number of employees participating in the insurance, the labor and social security administrative department shall order them to make corrections, and shall also report a fine of 1 times or more than 3 times the amount of wages.

The twenty-fifth designated medical institutions have one of the following acts, causing the loss of the maternity insurance fund, and shall compensate for the loss. The labor and social security administrative department may impose a fine of not less than 5000 yuan or less than 20 thousand yuan. If the circumstances are serious, the basic medical insurance designated medical institution shall be abolished.

(1) the medical expenses of the non birth insurance personnel shall be included in the maternity insurance fund;

(two) the expenses not covered by maternity insurance shall be included in the maternity insurance fund.

(three) issuing false certificates or false charging certificates;

(four) violation of medical, pharmaceutical, price and other administrative provisions.

The twenty-sixth is to defraud the maternity insurance benefits or to defraud the maternity insurance fund expenditures, and the labor and social security administrative departments shall order them to refund and impose a fine of 1 times or more than 3 times the amount of the fraud.

If the staff of the twenty-seventh labor security administrative departments or social insurance agencies violate the provisions to cause losses to the fund, the labor and social security administrative departments recover the losses, and have not yet constituted a crime, and shall be given administrative sanctions according to law. If a crime is constituted, they shall be investigated for criminal responsibility according to law.

Fifth chapter supplementary provisions

Twenty-eighth the private non enterprise units in the administrative area of the municipality, institutions that carry out enterprise management and workers who form labor relations and have permanent residence accounts in this Municipality shall refer to these provisions.

The twenty-ninth Provisions come into effect on July 1, 2005.