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济南市槐荫区的医疗保险制度改革主要是依据济南市政府令第98号《济南市企业职工医疗保险试行办法》进行试点,改革的主要内容是在驻区各企业全面实行由个人医疗账户金、企业调济金、社会统筹金组成的医疗管理制度。个人账户金由两部分组成,一是职工个人按上年度本人工资总额的1%缴纳,二是企业按上年度工资总额一定比例(45岁以下按4%,45岁以上按6%)提取。个人账户金归个人所有,主要用于小病医疗费支出。离退休人员的个人账户金按上年度本单位人均离退休费的12%提取。企业调济金按本单位上年度工资总额的3%提取,主要用于中病医疗费的支付。个人账户金、企业调济金由企业负责管理。社会统筹金按企业上年度工资总额的3%提取,主要用于大病医疗费的支付,社会统筹金由社会劳动保险机构管理。
The reform of the medical insurance system in Huaiyin District, Jinan City is mainly based on the Jinan Municipal Government Order No. 98, “Measures for the Trial of Medical Staff and Workers in Jinan City” to conduct pilot projects. The main content of the reform is the full implementation of personal medical accounts in all enterprises in the district. , Corporate finances, and social pooling funds constitute a medical management system. The individual account gold consists of two parts. First, the individual employee pays 1% of his/her own salary in the previous year. Second, the company takes a certain percentage of the total salary (4 percent for people under 45 years of age, and 6% for persons over 45 years of age) according to the previous year. The individual account gold is owned by individuals and is mainly used for expenditures for minor medical expenses. The retiree’s personal account gold is withdrawn based on 12% of the per capita retirement fee for the previous year. Corporate fundraising is based on 3% of the total salary of the company in the previous year and is mainly used for the payment of medical expenses for the disease. Personal accounts gold and corporate funds are managed by the company. The social pooling fund is drawn at 3% of the total salary of the company in the previous year. It is mainly used for the payment of medical expenses for serious illness, and the social pooling fund is managed by social labor insurance agencies.