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生育保险和职工医保合并 不必提高单位和职工缴费标准

2017-08-26 08:55:56   中国青年网

本报讯 (记者 罗薛梅)我市作为生育保险和城镇职工基本医疗保险合并试点城市,这一政策已开始实施。生育保险和职工医保合并,是否意味着需要多缴钱?昨日,记者从市人社局获悉,不必提高单位和职工的缴费标准,在参加职工医保的同时即参加了生育保险。

两险合并不影响参保待遇

据悉,生育保险和职工医保合并实施,是国家层面推进的一项社会保险制度改革,我市是全国首批12个试点城市之一,按照国家部署,我市的两险合并政策,遵循了以下原则:统一参保登记、统一基金征缴、统一定点医疗机构管理、统一经办和信息系统、统一基金管理、职工生育期间的生育保险待遇不变。“有了这‘五统一、一不变’,两个保险的参保及待遇基本没有大变化。”市人社局相关负责人介绍。

新参保和欠费都要注意

两险合并实施后,市人社局提醒市民有几种情况要注意。首先,新参保的单位职工享受两类待遇,因为参保时间有规定,享受待遇也有时间限制。新参保单位缴费次月起,享受职工医保规定的有关待遇;连续缴费满6个月的次月起,享受生育保险规定的有关待遇。可用个人账户支付超过限额部分:职工生育或终止妊娠,在我市生育保险定点机构住院期间,发生的符合规定的生育医疗费超过限额部分,可以使用职工医保个人账户结算。

其次,有欠费情况的参保单位及其职工需要注意以下规定。合并前欠费的:参保单位职工医保费或生育保险费欠费的,合并实施后继续停止享受对应的职工医保或生育保险待遇。合并后欠费的:从欠费次月起,停止两项保险的待遇;欠费3个月内的,足额补缴后,按规定支付两险待遇;欠费3个月以上不足6个月的,足额补缴后,按规定支付生育保险待遇,职工医保不予支付,欠费期间职工医保待遇由单位支付;欠费超过6个月的,欠缴期间其职工两险待遇由单位支付。

只参加了一项保险需完善手续

欠费单位及其职工一定要及时完清欠费,职工才能享受待遇。此外,只参加了两险中一项的单位,需及时到社保经办机构完善手续,“两险”参保单位费率为8.5%。“两险”缴费基数为职工医保的缴费基数。

据了解,“两险”合并实施,目前在随单位参加两险的在职职工中执行。

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