What Is Notional Pooling?

For payments that are not credited to the account, you need to enter the pooled funds. The unified fund is that all the unit contributions are put into a common fund part, and then the funds are spent from this unified unified fund to those who need to enjoy benefits.

Pool funds

Right!

For payments that are not credited to the account, you need to enter the pooled funds. The unified fund is that all the unit contributions are put into a common fund part, and then the funds are spent from this unified unified fund to those who need to enjoy benefits.

Chinese name

Pool funds

Explanation

Generally refers to pooled funds

Including

Payments not credited to account

Service object

Insured

Pooled funds generally refer to pooled funds

The pooled funds for each insurance category are managed separately, that is, each category has its own pooled funds.

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Funding for Basic Medical Insurance

Implementation of basic medical insurance

Social pooling funds

Funds for basic medical insurance are divided into two parts: pooled funds and personal accounts. They are calculated separately according to their respective payment scopes and cannot be crowded out. ? 1. Overall funding

(1) Source of funds:

The portion of the basic medical insurance premiums paid by the employer and transferred to the pooled funds;

The portion of transitional basic medical insurance for retirees is included in the pooled funds;

Interest income from pooled funds;

Late fees collected in accordance with regulations;

Government funding;

Other legal income.

(2) Scope of payment

Of the basic medical expenses for inpatient and outpatient specific items corresponding to the minimum payment standard and within the maximum payment limit of the pooled funds, the proportion shall be paid by the pooled funds in proportion.

Personal account

(1) Source of funds:

All the personal contributions paid by employees;

The portion of the basic medical insurance premium paid by the employer and transferred to the employee's personal account;

The portion of the transitional basic medical insurance for retirees into the personal account;

Legal income such as personal account interest.

(2) Payment range:

Outpatient medical expenses;

Basic medical expenses for inpatient and outpatient specific items below the threshold;

The proportion of the basic medical expenses for the specific items of inpatient and outpatient clinics corresponding to the minimum payment standards and within the maximum payment limit of the pooled funds shall be proportionately paid by individuals.

(3) The principal and interest of the personal account belong to the employee, and can be carried forward and inherited according to law. It can only be used for medical expenses, and cannot be used for cash withdrawal or other purposes. ?

3. Distribution of employer's payment

The employer pays the fees for the establishment of the overall fund and transfer to the personal account. When the employer's payment is transferred to a personal account, it is first transferred at a basic fund of 100 yuan per person per year, and then the current employee pays his monthly salary for the current month, and the monthly average salary of retired employees in the previous year is used as the base. Account: 1% under the age of 35; 2% from the age of 35 to 45; 2.8% from the age of 45 to before retirement; 5.1% for retirees

4. Decide on the minimum payment standard for overall funds

(1) Minimum payment standard: The average salary of city employees in the previous year is used as the base and is calculated based on each hospitalization. Current employees: 4% in primary hospitals; 6% in secondary hospitals; 10% in tertiary hospitals. Retirees are 70% of active employees.

(2) Set a minimum payment standard, mainly to avoid excessive hospitalization of minor illnesses, crowding out of the pooled funds for outpatient expenses, and ensure that the pooled funds have sufficient "guarantee for major illnesses". Setting the payment standard too low will not play a role (or a small role); too high, it will cause employees to be overburdened when they are seriously ill or unable to live in the hospital. In order to facilitate the "threshold" function of the payment standard and facilitate operation, the payment standard is basically determined by the State Council according to the State Council, that is, 10% of the average salary of local employees. The "Plan" also adopts this approach, setting different village starting standards according to different hospital levels. The comprehensive average is 7.8% of the average wage of the city's employees in the previous year, which is slightly lower than the state's 10%. This can appropriately reduce the burden on staff and make it easier for patients with large medical expenses. In particular, retirees have lower pay standards (30% lower than the standard for serving employees) and benefit more.

5. Determination of the maximum payment limit for pooled funds

(1) Maximum payment limit: Accumulated on an annual basis, which is 4 times the average wage of the city's employees in the previous year.

(2) According to estimates, the 2000 maximum salary of 75,972 yuan (75,888 yuan) was used as the maximum payment limit for 2001, and the corresponding total medical expenses amounted to 87,271 yuan (including the in-service employees living in tertiary hospitals). Personal out-of-pocket expenses), the number of cases only accounted for 0.38% of the number of hospitalized patients. For example, according to the annual hospitalization rate obtained from the survey, in-service employees are 5.4% and retirees are 15.2%. When covering 1.5 million employees, there are only 515 over-capped patients. It can be seen that the maximum payment limit set in this Plan can not only allow the vast majority of patients (99.6%) to be "capped", can receive unified fund payments, but also avoid a very small number of people using excessive funds , Affecting the payment of medical expenses for the vast majority of employees.

Labor insurance pooling funds

Since 1951, China s labor insurance funds for construction projects have always been composed of indirect costs of construction costs. The state determines the rate based on the actual expenditure of labor insurance funds of construction enterprises, and construction enterprises collect their own fees from construction units at prescribed rates. Self-management. In a certain period, the state adjusted the content of labor insurance funds in the construction cost according to changes in the burden of labor insurance funds of construction enterprises.

Since the reform and opening up, the rapid development of various types of construction and construction enterprises have coexisted, and the burdens between the enterprises have been uneven, making it difficult to determine the standard for labor insurance funds to calculate in the project cost. In addition, fierce and unregulated market competition has made labor insurance funds The mass loss situation is getting worse. In order to fundamentally solve the shortcomings of labor insurance fund management for construction projects, the autonomous region's government will separate the labor insurance funds calculated by the construction enterprise through engineering indirect costs from the construction cost quota, and the construction administrative department will charge the construction unit in accordance with uniform standards. Provide unified funding to enterprises to provide a reliable source of funds for the overall social insurance coverage. The unified management of labor insurance funds for construction projects is a major reform of labor insurance fund management methods. Therefore, labor insurance funds after unified management are still a component of construction cost

Pension Funds

According to reports, as of the end of 2007, a total of 13 provinces, counties, municipalities and autonomous regions in China had nominally implemented provincial-level co-ordination of endowment insurance. About 10 provinces and regions were predominantly prefecture-level and city-level co-ordination, while the remaining provinces and regions were still predominantly county-level. It can be seen that the overall level of China's endowment insurance is very low, and the endowment insurance is divided into more than 2,000 overall planning areas.

The so-called overall planning refers to the unified planning, collection, management and use of pension insurance funds within a certain range. Each coordinating district is responsible for the balance of endowment insurance funds in the region. The balance is mainly controlled and used by the coordinating district. The gap generally needs to be filled by the government and finance at the same level.

If the insureds want to transfer the endowment insurance relationship between different pools, it may affect the collection and use of the pension insurance funds in the two pools. Therefore, most pools do not support the "no "Barriers" transfer, but to add some conditions to reduce possible losses, for example, require insured personnel to accumulate 5 to 10 years of premiums in the place of transfer in order to enjoy the old-age benefits in the place of transfer after retirement.

For workers who move frequently, especially migrant workers, such conditions are difficult to meet, so many people prefer to surrender. These people are still relatively young. As they get older, the lack of protection caused by the inability to smoothly transfer pension insurance relationships will become an increasingly prominent problem. In developed regions where the economy is more developed and labor flows are more frequent, except for the three municipalities directly under the Central Government and Fujian Province, where the provincial-level coordination is implemented, the rest are mainly at the county level. This situation makes the problem more general and important.

How to realize the smooth transfer of old-age insurance relations between different pools? Many regions have taken measures to reduce the obstacles to the transfer of pension insurance relations. Some experts also suggested that, without changing the level of overall planning, the pension insurance relationship could be smoothly transferred by improving the methods of premium collection and benefit distribution. But none of these methods can really solve the problem.