The general business process of participating in the provincial medical insurance is as follows: the unit preparing to participate in the insurance will get the registration form from the Medical Insurance Management Center for Urban Workers in Heilongjiang Province (hereinafter referred to as the Medical Insurance Center), fill in the form and related materials → report it to the Medical Insurance Center for review, collation and entry → return it to the insured unit for verification. After inspection, the medical insurance center establishes the archives of the insured unit → issues the provincial medical insurance registration certificate → issues the provincial medical insurance card → issues the notice of verification of the provincial medical insurance payment → goes to the bank to receive the medical insurance fee or directly pay the fee within the specified time → issues the provincial medical insurance card and the provincial medical insurance outpatient manual to the insured → enjoys the provincial medical insurance treatment with the provincial medical insurance card → goes through the change procedures for the unit and the insured. The specific business process is as follows:
I. Insurance registration
1. Coverage: directly under the authority, institutions and social organizations (hereinafter referred to as insured units) and their employees and retirees (hereinafter referred to as insured persons) of the central and provincial governments in Harbin must participate in the provincial basic medical insurance in Heilongjiang Province and register for insurance.
2, the insured units to designate a person (collectively referred to as the agent) is responsible for the medical insurance business of the unit, for the registration of the unit, payment, card, change of registration and other work.
3. When the insured unit registers, it is required to provide the organization approval document, organization unified code certificate, organization management certificate issued by the provincial editorial board and other related materials, receive the provincial medical insurance software, and fill in the medical insurance registration form of Heilongjiang Province. The medical insurance center shall complete the audit within 10 days from the date of acceptance, register those who meet the requirements, and issue the provincial medical insurance registration certificate.
4, the insured units to print the insured information table and the insured "Heilongjiang medical insurance registration form" and the corresponding floppy disk. The medical insurance center shall complete the audit within 10 days from the date of acceptance, return it to the insured unit for proofreading, and then send it back to the medical insurance center for revision. Through the photo data collector, the provincial medical insurance card and the provincial medical insurance manual are issued. When handling the insurance formalities, the following materials shall be provided:
(1) the approval document of the organization establishment of the insured unit, the organization establishment management certificate, the organization unified code certificate, the salary fund manual and the salary account of the previous year;
(two) the roster of employees and retirees of this unit and the annual salary table of employees of this unit;
(3) Enjoy the relevant certificates and certificates of medical and nursing personnel;
(four) the examination and approval form for early retirement, the relevant certificates and approval documents of retired personnel, the old Red Army, and the disabled revolutionary soldiers above the second class B. ..
5, "provincial medical insurance registration certificate" by the insured unit custody, the implementation of regular verification and replacement system.
II. Verification of payment base
1, the total wages and retirement fees of the insured units and employees in the above years are used as the payment base.
2. The basic medical insurance premium shall be paid jointly by the insured units and employees. The contribution rate of the insured units is 7.5% of the total wages of the previous year (according to the unified caliber stipulated by the National Bureau of Statistics), and the contribution rate of employees is 2% of the total wages of the previous year. Retirees do not pay the basic medical insurance premium.
3. When reporting the total wages of employees on the job, it should be reported in strict accordance with the caliber stipulated by the National Bureau of Statistics. For the insured who participated in the work in that year and mobilized within the scope of provincial insurance, the total monthly salary of the actual month is multiplied by 12 to calculate the total salary of the previous year.
4. If the annual wage income of the insured is lower than 60% of the province's average wage last year, the total wages shall be approved according to 60% of the province's average wage, and if the annual wage income of the insured is higher than 300% of the province's average wage last year, the total wages shall be approved according to 300% of the province's average wage.
5, the insured units in the first quarter of each year by the medical insurance center for the annual total wages approved procedures, reported the total annual wages of employees within the specified time.
6. After reviewing the total annual salary, the medical insurance center will verify the payment amount, and issue the Notice of Verification of Provincial Medical Insurance Payment in Heilongjiang Province to the insured units.
Third, charge
1. The medical insurance premium is paid monthly. The insured unit shall pay this month's medical insurance fee to the medical insurance center before 10 every month, and the individual payment shall be withheld and remitted by the unit.
2. Payment methods include entrusted bank withholding and direct payment.
3. If the insured unit changes, it shall go to the medical insurance center to receive the changed payment verification notice from 1 to 10 every month to pay the fee; The insured units that have not changed still pay according to the amount paid last month.
4, the insured units such as payment problems, should be timely check with the medical center.
5. For the insured units that fail to pay the medical insurance premium in full and on time, the medical insurance center will issue the Notice of Urging the Provincial Medical Insurance Premium in Heilongjiang Province. Fails to pay, shall be ordered to pay the arrears, from the date of default, a daily surcharge of 2‰, incorporated into the basic medical insurance fund.
6, more than a month to pay the unit, stop the basic medical insurance benefits of the employees of the unit, to pay arrears and late fees, from the next month to resume its basic medical insurance benefits.
Fourth, the file change procedure
(1) All file change procedures shall be handled from 25th of each month to 15.
(two) the insured unit file changes
(1) When the registered items such as the name, address, unit type, legal representative or person in charge, bank account number, unified organization code, competent department and affiliation of the insured unit change, it shall go through the formalities for the change or cancellation of registration of provincial medical insurance at the medical insurance center within 30 days from the date of change; Involving the "provincial medical insurance registration certificate" changes, the medical insurance center to recover the original certificate, and re issued according to the changed content.
(2) In case of dissolution, cancellation or merger of the insured unit, if it is necessary to terminate the payment business according to law, it shall go through the formalities for the change or cancellation of registration of provincial medical insurance at the medical insurance center within 30 days from the date of change.
(3) If the insured unit moves in different places due to the change of address, involving the change of the agency, it shall, within 30 days from the date of the change, go through the transfer or cancellation of the provincial medical insurance registration formalities at the medical insurance center.
(three) the insured file changes
(1) The newly transferred and re-employed personnel of the insured unit shall be prepared with the management certificate by the handling personnel, and the monthly payroll shall go through the insurance formalities at the medical insurance center, fill in the Registration Form for the Insured Personnel of Provincial Medical Insurance in Heilongjiang Province, report it to the medical insurance center for review and filing, and issue provincial medical insurance cards and provincial medical insurance treatment manuals.
(2) If the insured is transferred within the province, fill in the Approval Form for the Change of the Basic Situation of the Provincial Medical Insurance Insured, and the agent of the original unit will go to the medical insurance center to stop the insurance, and the agent of the new unit will go to the medical insurance center to go through the transfer formalities with the relevant transfer certificate, and the personal account will be transferred accordingly.
(3) If the insured is transferred across provinces, fill in the Approval Form for Changes in the Basic Situation of the Provincial Medical Insurance Insured, provide relevant procedures, and the medical insurance center will settle personal accounts, transfer the balance of personal accounts, issue a personal account transfer form, and cancel the provincial medical insurance card at the same time.
(4) After filling in the Approval Form for Changes in the Basic Situation of the Provincial Medical Insurance Insured, the new retirees and promotion personnel of the insured units should also provide retirement approval forms, promotion documents and other related materials, and report them to the medical insurance center for verification before adjusting their insurance files.
(5) If the insured dies, is sentenced, rescinds or terminates the labor contract, the agent shall fill in the Approval Form for the Change of the Basic Information of the Insured in Provincial Medical Insurance within 30 days from the date of occurrence, approval or announcement, and go to the medical insurance center to handle the medical insurance cancellation registration with the provincial medical insurance card. The medical insurance center settles the personal account, transfers the balance of the personal account, issues a transfer notice, and cancels. "
Five, the provincial medical insurance card, book management
1, the "provincial medical insurance card" is uniformly issued by the medical insurance center.
2. The insured can hold the provincial medical insurance card to inquire personal accounts at designated medical institutions and medical insurance centers at any time, or through the provincial medical insurance voice service hotline, and the telephone number is 16800 120.
3, found that the "provincial medical insurance card" is lost, damaged, wrong card and waste card, should be timely to the medical center to apply for a replacement or renewal. The medical insurance center will issue a new card within 15 days.
4, the insured "provincial medical insurance handbook" is lost or used up, to the medical insurance center to receive.