1, the payment ratio is different. The down payment ratio of medical insurance is 8.2%, the unit pays 6.2%, and the individual pays 2%. The base of payment is the salary actually paid by employees, with a total payment of 368 yuan; The contribution rate of the second-grade medical insurance is 0.8%, the unit contribution is 0.6%, and the individual contribution is 0.2%. The payment base is the average monthly salary of employees in the previous year, with a total payment of 59.8 yuan;
2, the applicable population is different. The first file of medical insurance: deep households are forced to buy one file, and non-deep households can also buy one file, such as listed companies of well-known large companies; Second-class medical insurance: generally, companies pay second-class medical insurance, because enterprises also have benefits;
3. The principle of seeking medical treatment is different. First-class insured: any designated medical institution in this city for medical treatment; The second-level insured person goes to the binding social health center for medical treatment, is hospitalized in any designated medical institution in the city, and is seriously ill and goes to the prescribed medical institution for medical treatment;
4. Hospitalization reimbursement is different. Grade I: 90% of the hospitalization report, requiring hospitalization in a designated hospital; The second file: the hospitalization report is 90%, and hospitalization needs to be handled in a designated hospital;
5. Outpatient reimbursement is different. The first file: continuous insurance 12 months, and 70% of the annual self-expense exceeds 3 13 1; Social health report 30%; Large equipment inspection report 80%; Grade II: There is an annual outpatient fee of 1 1,000 yuan, which needs to be bound to a community health hospital. Maximum amount of outpatient large-scale equipment inspection and treatment1.20;
6. The time requirements for registration are different. If the first insured person has been insured for one year in a row, the average salary of supermarket employees is 5% of the basic outpatient medical expenses and supplementary medical expenses paid by himself in the same medical insurance year, and 70% of the excess is paid by the overall fund according to regulations. The secondary insured has no specific time requirement.
Legal basis: Article 13 of the Social Insurance Law of People's Republic of China (PRC).
Before employees of state-owned enterprises and institutions participate in the basic old-age insurance, the basic old-age insurance premiums payable during the payment period shall be borne by the government. When the basic old-age insurance fund is insufficient to pay, the government gives subsidies.
Article 60
The employing unit shall declare itself and pay social insurance premiums in full and on time, and shall not postpone or reduce the payment except for legal reasons such as force majeure. The social insurance premiums that employees should pay shall be withheld and remitted by the employer, and the employer shall inform me of the details of paying social insurance premiums on a monthly basis. Individual industrial and commercial households without employees, part-time employees who have not participated in social insurance in the employing units and other flexible employees can pay social insurance premiums directly to the social insurance premium collection agencies.