2. A social insurance system in which medical services, maternity allowance and maternity leave are provided by the state and society, and the state or society provides necessary economic compensation and medical care for maternity workers. Maternity insurance benefits in China mainly include two items. One is maternity allowance, and the other is maternity medical care. The Measures for Maternity Insurance in Ministry of Human Resources and Social Security (Draft for Comment) has been open to the public for comments since 2012165438+10. The opinion draft makes it clear that maternity insurance benefits will no longer be limited to household registration, and units that do not pay maternity insurance must pay maternity fees.
3.2065438+ From May 1 day, 2006, all localities should continue to implement the decision of the State Council 20 15 on reducing the average rate of work-related injury insurance by 0.25 percentage point and maternity insurance by 0.5 percentage point, and ensure that the policies are put in place. The implementation of maternity insurance and basic medical insurance will be organized and implemented in a unified way after the relevant regulations are formulated and promulgated in the State Council. On February 24th, 20 17, Ministry of Human Resources and Social Security held a meeting on the implementation of the pilot project of the merger of maternity insurance and basic medical insurance. It is planned to start the merger of the two risks in the pilot area of 12 before the end of June 20 17. Ministry of Human Resources and Social Security emphasized that the merger of the two insurances is not simply to merge maternity insurance into medical insurance, but to retain their respective functions and realize integrated management.
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general clause
1, maternity medical expenses.
The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. Medical business expenses and drug expenses (including self-funded drugs and nutritional drugs) exceeding the prescribed amount shall be borne by the employees themselves.
After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs rest and treatment due to illness, it shall be handled in accordance with the relevant provisions on sick leave and medical insurance benefits.
2. Maternity allowance.
Female employees shall enjoy maternity allowance according to law during maternity leave, which shall be calculated and paid by maternity insurance fund according to the average monthly salary of employees in the previous year.
Regulations of Guangdong Province
1, maternity medical expenses.
Medical expenses incurred by female workers during pregnancy, childbirth or termination of pregnancy.
2. Maternity allowance.
Female employees enjoy maternity allowance during maternity leave. Maternity allowance is based on the average monthly salary of employees in the last year as a whole, and is calculated and paid in accordance with the provisions of maternity leave. If the maternity allowance is lower than my salary standard, it shall be made up by the employer.
Maternity allowance = the average payment salary of this unit in the current month ÷30 (days) × holiday days.
Maternity leave calculation:
(1) basic maternity leave is 98 days, including prenatal leave 15 days;
(2) Maternity leave can be increased by 30 days in case of death during childbirth (such as caesarean section and third degree rupture of perineum);
(3) If the pregnancy is less than four months, according to the opinions of the medical department, maternity leave is given 15 to 30 days;
(4) If the abortion lasts for more than four months (including four months), maternity leave shall be granted for 42 days;
(five) voluntary birth of an only child, an increase of 35 days;
(6) Late childbearing, increased by 15 days;
3. One-time childbirth nutrition subsidy.
According to a certain proportion of the average monthly salary of employees in the overall planning area last year. The specific proportion shall be determined by the people's government of the overall planning area.
4, the cost of family planning surgery.
Including medical expenses incurred by workers in placing or taking out intrauterine devices, abortion, induced labor, sterilization and recanalization due to family planning.
5. Holiday allowance for male employees.
The nursing leave allowance enjoyed by the insured male workers according to the regulations shall be calculated and paid according to the stipulated holiday time based on the average monthly salary of employees in the last year in the overall planning area.
Nursing leave allowance = the average payment salary of this unit in the current month ÷30 (days) × holiday days.
Maternity insurance fund shall not pay the following fees:
1, which does not meet the national and provincial basic medical insurance and maternity insurance drug list, diagnosis and treatment items, medical service facilities and related medical management regulations;
2. Expenses incurred due to medical accidents;
3, the cost of treatment of postpartum complications.