(a) Female workers who give birth or have an abortion (induced), in accordance with the relevant provisions of the state and the province to enjoy maternity leave wages, maternity leave wages by the employing unit in accordance with the provisions of the Maternity Insurance Fund in the form of maternity allowances to be reimbursed. The maternity allowance shall be based on the average contributory wage base for the 12 months prior to the delivery or abortion of the female worker, and if the insurance coverage is less than 12 months, the minimum contributory wage base for the previous year in the city in the month of the delivery or abortion shall be used as the standard;
(b) the prenatal examination fee for the female worker after pregnancy, the examination fee required for the birth or abortion of a child, the delivery fee, the surgical fee, and the hospitalization fee for the general ward, medical expenses for childbirth, such as medical fees and basic treatment fees for postpartum recovery, shall be paid by the Maternity Insurance Fund in accordance with the regulations;
(3) medical expenses incurred by female workers after pregnancy and within four months after childbirth due to childbirth complications shall be paid by the Maternity Insurance Fund. medical expenses incurred after four months shall be paid by the Maternity Insurance Fund in accordance with the relevant provisions of the urban basic medical insurance for those who have taken part in the urban basic medical insurance;
(4) For women workers who give birth who are entitled to maternity leave of three months or more in accordance with State regulations, they shall be granted a one-time nutritional subsidy, the cost of which shall be paid by the Maternity Insurance Fund at the rate of 2% of the average wage of the workers of the city for the preceding year.
Article 8 If the spouse of a male employee participating in maternity insurance is unemployed, the expenses incurred for prenatal examination and delivery, abortion (induced) in accordance with the provisions of the family planning regulations shall be paid in accordance with 50 per cent of the standards set by the maternity insurance, and he or she shall not be entitled to any other maternity insurance benefits.
Article 9: Medical expenses incurred by an employee as a result of family planning surgeries such as placing (removing) intrauterine devices, abortions (induced abortions), sterilizations and reopenings, etc., shall be paid by the Maternity Insurance Fund in accordance with the regulations. Medical expenses incurred in connection with complications arising from family-planning surgeries shall be paid out of the urban basic medical insurance fund in accordance with the relevant provisions if the patient is enrolled in the urban basic medical insurance.
Article 10: When an employee who was originally enrolled in maternity insurance becomes unemployed and gives birth to a child or undergoes a family planning operation in accordance with the family planning regulations during the period approved for receiving unemployment benefits, the medical expenses for the birth of a child, the one-time nutritional allowance and the expenses for the family planning operation shall be paid by the Maternity Insurance Fund.
After the retirement of a female employee who has participated in maternity insurance at her former organization, the costs of surgical procedures such as removal of intrauterine devices and abortion (induced abortion) in accordance with family planning regulations shall be paid by the Maternity Insurance Fund.
Article 11 Female workers who give birth to children or undergo family planning surgery shall visit designated medical institutions for maternity insurance in the city. The qualification and management of the designated medical institutions for maternity insurance shall be implemented with reference to the regulations on the management of designated medical institutions for basic medical insurance. The agency shall implement agreement management for the designated medical institutions for maternity insurance.
The maternity insurance medication and medical service catalogs are published on the basis of the basic medical insurance medication and medical service catalogs, with appropriate additions and deletions in accordance with the characteristics of maternity insurance.
The settlement between the agency and the designated medical institutions for maternity insurance is carried out on the basis of items and disease quotas. Specific settlement methods shall be formulated separately by the administrative department of labor security in conjunction with the financial and other departments.
Article 12 The Maternity Insurance Fund shall be collected in accordance with the principle of "expenditure against income" and "basic balance of income and expenditure", and the specific collection, payment and management shall be carried out in accordance with the provisions of the Provisional Regulations on the Collection and Payment of Social Insurance Premiums of the State Council.
The Maternity Insurance Fund shall be managed through a special financial account and two lines of income and expenditure, and shall be supervised by the financial and auditing departments in accordance with the law.
Article 13 Employers shall pay maternity insurance premiums at the rate of 0.8% of the wage base of all employees' contributions for the previous year; if the payment is overdue, in addition to being ordered to pay the premiums within a certain period of time, the employer shall be required to pay a late fee of 2 per cent of the amount payable on a daily basis. Individual employees do not pay maternity insurance premiums.
Enterprises, private non-enterprise units and individual economic organizations pay maternity insurance premiums in the cost (expenses). Maternity insurance premiums paid by self-supporting institutions are charged to social security fees.
Article 14: Maternity insurance funds deposited in banks shall be calculated in accordance with the deposit interest rates stipulated by the People's Bank of China, and the interest earned shall be credited to the Maternity Insurance Fund.
Article 15 When a unit is separated, merged or transferred, it shall settle the maternity insurance expenses it is liable for in a lump sum in accordance with the relevant provisions of laws and regulations.
Article 16 The Maternity Insurance Fund shall not pay the medical expenses, maternity allowance and one-time nutritional allowance incurred under the following circumstances:
(1) violation of the national, provincial and municipal family planning policies;
(2) termination of pregnancy due to unlawful selection of the sex of the fetus, suicide, self-inflicted injuries, brawls, alcoholism, drug addiction and so on;
(3) pregnancy due to ectopic pregnancy, gravid fetus and so on; and (c) Termination of pregnancy due to ectopic pregnancy, gravida, etc.
(d) Traffic accidents, medical malpractice, pharmaceutical accidents for which a third party is liable for compensation;
(e) Treatment of infertility, sexual dysfunction, etc.
(f) Medical expenses incurred for giving birth or performing family planning surgeries in foreign countries, Hong Kong, Macao, Taiwan, etc.
(g) Medical expenses of newborns;
(h) Medical expenses of newborns;
(i) Medical expenses of newborns expenses;
(viii) complications of family planning surgery;
(ix) childbirth or family planning surgery (except for resuscitation) in non-maternity insurance designated medical institutions in the city;
(x) failure of insured employees to present their Social Security Cards and vouchers for maternity insurance medical treatment when seeking medical treatment;
(xi) other expenses that do not conform to the scope and standard of payment of the provisions of maternity insurance. (k) Other expenses that do not meet the scope and standard of payment of maternity insurance.
Article 17 If a unit, a designated maternity insurance medical institution or an individual fraudulently obtains the maternity insurance fund, the administrative department of labor security shall be responsible for recovering it and shall impose penalties; if a crime is constituted, it shall be investigated for criminal responsibility in accordance with the law.
Article 18 If a staff member of an agency violates the law and causes a loss of the Maternity Insurance Fund, the administrative department of labor security shall be responsible for recovering the loss and imposing administrative sanctions on the responsible person according to the seriousness of the case; if a crime is committed, the person shall be held criminally liable in accordance with the law.
Article 19 If an employee has any doubts about his entitlement to maternity insurance benefits, he may make inquiries directly with the employer or the organization. Where a labor dispute arises between an employee and an employer over maternity insurance benefits, the employee may apply to the Labor Dispute Arbitration Committee for arbitration; if the employee is not satisfied with the arbitration decision, he or she may bring a lawsuit to the People's Court in accordance with the law.
Article 20 If the parties concerned are not satisfied with the administrative decision, they may apply for administrative reconsideration or file an administrative lawsuit according to law.