Qianjiang Evening News·Hourly News Reporter Zhan Chengkai Correspondent Wang Yuzhe Zhao Qiang
Be sure to take a careful look at this news.
From now on, medical mutual assistance for active employees in Hangzhou in 2022 can be applied for. Hourly News reporters learned that in order to better serve employees, there have been new adjustments to this year’s policies. Let’s take a look.
(Picture source: Visual China)
"Hangzhou Municipal Employees' Medical Mutual Assistance and Guarantee Measures" follows the mutual assistance concept of "I will help others if I am not sick, and I will help if I am sick", including mutual assistance and guarantee of self-pay medical expenses for hospitalization and outpatient services with specified diseases. , mutual aid and insurance for major diseases and hospitalization living allowances, and mutual aid and insurance for special diseases for female employees, are regarded by employees as the "second medical insurance" and play an important role in ensuring the normal life of employees and promoting the stability of the enterprise's workforce and social harmony. effect.
To put it simply, outside the scope of medical insurance, medical mutual aid is equivalent to " secondary reimbursement ". Within a mutual aid cycle, the maximum subsidy can reach 65,200 yuan.
"Medical mutual aid, as a supplementary medical insurance for employees, can not only effectively reduce the financial burden of some sick employees, but also enhance the centripetal force and cohesion of corporate employees." The trade union of Fuyang Sino-Dutch Electronics Co., Ltd. has been organizing employees to participate in on-the-job employee participation for many years. Medical mutual aid.
According to statistics, as of September 30, 48,687 people who participated in employee medical mutual aid in the city in 2021 have enjoyed medical mutual aid security funds of more than 59.12 million yuan.
From now on, the eleventh phase of medical cooperation for active employees in 2022 can be applied for.
Grassroots trade unions need to apply online to the Hangzhou Smart Trade Union System before December 15 this year and pay mutual aid funds in accordance with regulations. After completing the payment of mutual aid funds , issuance of electronic invoices requires each unit to log in to the Hangzhou Smart Trade Union Management Platform within 15 working days to apply for the issuance of the "Zhejiang Province Medical Mutual Aid Invoice (Electronic)", in which the name of the invoice should be the same as the payment The unit names are consistent. After
has been verified and issued by each service center, each unit can go to the " Zhejiang Office APP", "Zhejiang Government Affairs Network" or "Zhejiang Fiscal Notes Management Platform (http: //pjgl.czt.zj.gov.cn)" Download and print the "Zhejiang Province Medical Mutual Aid Special Notes (Electronic)" by yourself.
It should be noted that grassroots trade unions should enter employees who participate in medical mutual aid for active employees into the smart trade union real-name database, so that insured persons can apply for subsidies on their own through the "Hangzhou Gong Ejia" APP or the Hangzhou Trade Union Online Service Hall.
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It is understood that in order to effectively connect with the "Standards for the Use of Disease Definitions for Major Illness Insurance" (2020 Revised Edition) and further improve the medical mutual aid security for active employees in Hangzhou, according to the "Hangzhou Municipal Medical Mutual Aid Security Measures for Active Employees" (Hangzhou General Works Office [2015] No. 43), "Implementation Rules for Medical Mutual Assistance and Security Measures for In-Service Employees in Hangzhou" (Hangzhou General Works Office [2017] No. 56), Hangzhou Federation of Trade Unions recently issued the "Medical Mutual Assistance and Security Measures for In-Service Employees in Hangzhou" "Supplementary Provisions on the Implementation Rules of the Measures", which stipulates as follows:
1. Employees participating in the mutual medical assistance and security activities for active employees in Hangzhou must be active employees and have been registered in the Hangzhou Smart Trade Union Membership System with their real names, but do not include on-the-job employees who have gone through the retirement procedures. and re-employment of retired personnel.
2. When employees are hospitalized multiple times within a mutual aid cycle, they can apply for subsidies in installments or cumulatively. When the maximum payment limit is reached within a mutual aid cycle, the mutual aid liability for the current period ends. If the applicant is hospitalized due to illness over multiple years, the subsidy will be calculated in stages based on the period of mutual aid protection and the protection items.
3. For applicants whose trade union membership is affiliated with Hangzhou trade unions at all levels and whose social security coordinating place is in a non-Hangzhou area, when applying for mutual aid insurance for hospitalization and outpatient medical expenses for specified diseases, if the hospitalization invoice or settlement form does not indicate self-payment ( If you are paying) part, you need to provide the hospitalization settlement self-pay, self-pay, and self-pay (payment) split sheet issued by the medical insurance department in the place where social security is coordinating; when applying for self-pay medical expense subsidy for prescribed diseases, you should provide the medical insurance department in the insured place. Issued inquiry form for the outpatient responsibilities (payments) for specified diseases within the application period.
4. If there is any objection to the hospital grade, the query results of the National Health Commission of the People's Republic of China website (http://www.nhc.gov.cn/) shall prevail.
5. According to the "Specifications for the Use of Disease Definitions for Critical Illness Insurance" jointly revised by the China Insurance Industry Association and the Chinese Medical Doctors Association (2020 revised version, hereinafter referred to as the specifications), the critical illness and hospitalization living allowance mutual aid protection projects Major disease items are specifically defined in accordance with clauses 3.1.1.1--3.1.1.28 of the specification. If the applicant is diagnosed with one of the 28 major diseases (attachment) for the first time within the mutual aid guarantee year, he or she must submit relevant supporting materials such as discharge records (discharge summary) and postoperative pathology reports issued by secondary hospitals or above. The judgment of the third-party medical team commissioned by the Guarantee Association shall be final.
6. Major illness and hospitalization living subsidy mutual aid protection project, the following four types of diseases will receive a subsidy of 5,000 yuan, and it will be enjoyed at the same time as hospitalization living subsidy:
(1) Carcinoma in situ. The following conditions are considered to be carcinoma in situ: carcinoma in situ, precancerous lesions , non-invasive cancer, non-invasive cancer, tumor cells not invading the basal layer, high-grade intraepithelial neoplasia, severe cell atypia, Borderline tumors , borderline malignant tumors, tumors with low malignant potential, potential low-grade malignant tumors , tumors with uncertain malignant potential, etc.;
(2) malignant tumors --mild. The following conditions are considered " malignant tumors--mild": (1) papillary thyroid carcinoma , follicular thyroid carcinoma; (2) prostate cancer with TNM stage T1N0M0; (3) melanin Skin malignant tumors other than tumors without lymph node and distant metastasis; (4) Chronic lymphocytic leukemia equivalent to stage A of the Binet staging scheme; (5) Stage I of the Ann Arbor staging scheme Hodgkin's disease ; (6) No lymph node or distant metastasis occurs and WHO classification is G1 level (mitotic figures
(three) mild acute myocardial infarction (standard is based on specification 3.1.2.2);
(four ) Mild stroke sequelae (standards shall be subject to specification 3.1.2.3)
7. Treatment based on acupuncture, , massage, massage, physiotherapy and other treatment methods is regarded as rehabilitation treatment, and is not limited to departments and does not belong to the category. Scope of employee medical mutual aid subsidy.
8. If the applicant is diagnosed with one of the 28 major diseases for the first time during the mutual aid guarantee year, the labor union of the unit shall carry out door-to-door visits and condolences activities for eligible trade union members when participating in the mutual aid guarantee for major diseases and hospitalization living allowances. After the project enjoys 15,000 yuan of critical illness medical mutual aid insurance, you can apply for the one-time 1,000 yuan critical illness care and consolation payment yourself or have the grassroots trade union declare on your behalf. The critical illness care and consolation payment will take effect and end at the same time as the current mutual aid insurance period. . This supplementary provision will be interpreted by the Office of the Hangzhou Employee Medical Mutual Aid and Security Association.
10. This supplementary provision will be implemented from the date of the launch of the 11th phase of the Employee Medical Mutual Aid Project in 2022. The previous regulations on employee medical mutual aid are inconsistent with this " If there is any discrepancy with the Supplementary Provisions, this "Supplementary Provisions" shall prevail.
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