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根据市政府(94)烟劳险函字第一号文件精神,在没有实行大病医疗社会统筹前,为保障职工医疗保险费用的科学管理和使用,结合我公司实际情况,对职工现行医疗保险制度,提出如下改革试行意见。 一、建立医疗保险专项基金 医疗保险专项基金由职工(含退休、退职人员,下同)个人医疗保险包干金、基层单位医疗保险调剂金和公司大病医疗保险统筹金三部分组成。 1、职工个人医疗包干金归职工个人所有,用于职工及供养直系亲属患病(含非因工负伤,下同)的医疗费用,超支部分由个人负担,结余部分归个人所有。 2、基层单位医疗保险调剂金主要用于职工大病医疗费用公司统筹以外由企业负担的部分,对医疗费个人负担过重职工给予适当的医疗救济,以及因工负伤人员的医疗费开支。
According to the spirit of the first letter of the municipal government (No. 94), prior to the implementation of social co-ordination for serious illness and medical care, in order to protect the scientific management and use of medical insurance expenses for employees and integrate the actual situation of our company, the existing medical insurance system , Put forward the following reform and trial opinions. First, the establishment of a special medical insurance fund Medical insurance special fund consists of employees (including retirees, resignations, the same below) personal medical insurance package dry gold, the grass-roots unit medical insurance transfers and the company’s overall medical insurance plan composed of three parts. 1, personal medical staff cadres and workers go back to their personal belongings, for the workers and the support of immediate family members (including non-work-related injuries, the same below) medical expenses, the excess part of the personal burden, the balance of the part owned by individuals. 2, the grass-roots units of medical insurance transfers are mainly used for serious illness and medical expenses of workers outside the company as a whole to pay the burden on the enterprise, medical expenses for individuals who are overburdened to give appropriate medical relief, as well as medical expenses for workers injured.