I. Documentary basis for the establishment of the family ****ji health account:
(I) ZJHSF [2016] No. 62, "Notice of the Department of Human Resources and Social Security of Zhejiang Province and Other 4 Departments on Further Adjustment and Improvement of Relevant Policies on Individual Accounts for Employee Medical Insurance"
(II) NINGBO HUMAN RESOURCES AND SOCIAL SECURITY FAT [2016] No. 126, "Notice on Adjustment of the Basic Medical Insurance Notice on Adjusting the Measures for the Use of the Funds in the Individual Account Balance in Calendar Years"
Two, how to form a family ****jianzi network:
(I) The concept of family ****jianzi network
In order to improve the efficiency of the use of the funds in the individual account balance of the employees' medical insurance in calendar years, the insured person can, according to the needs of his family members, form himself and other family members together, and give the funds in the family member's precipitated
(2) The way to set up a family ****ji network
1. Ningbo Health Insurance APP
2. Self-service terminals
3. Window of the agency
Note: Among the three ways to set up a family ****ji network, the main focus is to promote the APP and self-service terminals, and try to minimize the window processing.
(C) the conditions for the formation of family ****ji network
1. initiator: must be a participant in the basic medical insurance of the employees of Ningbo large city, and there is a balance in the personal account of the participants in the past year.
2. ****Ji network members: participate in the basic medical insurance of employees (including hospitalization medical insurance) or urban and rural residents in the city of Ningbo basic medical insurance participants (but does not include the children of the authorities, retired cadres, second-class B disabled military personnel and other co-ordinators).
3. There are only three kinds of relationships between members of the ****ji network and the initiator: spouse (limited to one), parents (limited to two), and children (unlimited);
4. The status of the social security cards of the initiator and the members must be normal, and the status of the account must be normal as long as it is not withdrawn or withdrawn to be liquidated;
5. Each participant can only join one family ****ji network.
(D) the formation process of the family ****ji network
1. Ningbo Medical Insurance Pass APP for
initiator must first be registered in the Ningbo Medical Insurance Pass APP and real-name authentication through, you can apply for the formation of the family ****ji network in the Medical Insurance Pass APP family ****ji webpage, and then select the relationship between family members and the initiator to add members, add the completed The order of payment must be determined, and the initiator's order of payment defaults to the first;
2. Self-service equipment terminals
The initiator can apply for the formation of a family ****ji network by holding the social security card or ID card of himself and his family members to the nearest social security hall and street human resources and social security self-service equipment, and then add family members to the network after the formation of the family, and determine the relationship of the family members and the initiator and the order of payment, the initiator's order of payment defaults to the first. The order of payment of the initiator is by default the first;
3. Window processing by the agency
The initiator must apply for the formation of a ****ji network at the service window of the health insurance (social security) agency in the place where the initiator participates in the insurance by holding the social security card of the initiator and the family members he/she is going to form, and the relationship between the family members he/she is going to form and the order of payment of the initiator must be determined after the application.
The characteristics of the three processing methods
APP: you need to register and authenticate your real name, but not subject to time and space constraints, and easy to operate;
Self-service terminals: there is no need to register, as long as you bring your social security card or ID card, the equipment recognizes the card but not the person, and go to the self-service terminals in the nearest agency or street;
Window processing: you must bring your social security card (because you have to swipe it to enter the system to do this business), and you must go to the agency where the applicant is insured, and you can't do it on behalf of the applicant. The agency must print the application form and keep it on file.
Third, the transfer of funds from the ****ji health account
(a) The concept of ****ji health account
After the formation of the family ****ji network, each participant who has been included in the family ****ji network can transfer all or part of the funds from his/her account in previous years to his/her own ****ji health account according to his/her needs, and the funds from the ****ji account are still owned by the person who transfers to him/her. The funds in the ****Care Account remain the property of the person who transferred them to the ****Care Account, and the funds transferred to the ****Care Account can also be re-transferred back to the calendar year account.
Note: Each member of the network can set up a new family ****ji network health account on the premise of the current year's account and the previous year's account of the current employee basic health insurance participant.
(2) Transfer of ****ji health account funds
1. Instant transfer
Conditions: the account status of the participant must be normal at the time of operation, and the type of insurance must be the city's employee basic medical insurance participants can apply for transferring part or all of the funds of their own account in previous years to their ****ji account through the Ningbo Medical Insurance Pass APP, human resources and social security self-service terminals, and the window of the handling organization. The funds in the account can be transferred into the account of the person, and in turn, the funds in the account of the ******* network can be transferred back to the account of the previous years.
2.****Jihji health account preset funds transfer
Participants who are enrolled in the city's basic medical insurance for employees and have joined the family ****Jihji network can preset an amount through the Ningbo Medical Insurance Pass APP, human social security self-service terminals, and the window of the agency (as long as the status of the account during the preset operation does not become withdrawn or withdrawn to be cleared), and the transfer operation (scheduled for the account to be cleared) will be carried out once every year after the preset operation is completed. The transfer operation will be carried out once a year (scheduled for June 1st).
There are two situations in which the system controls the transfer:
(1) the balance of the account in the calendar year at the time of the transfer is less than the preset amount;
(2) if the account status is abnormal, the system does not perform the transfer.
Instructions
(1) Each member processed through the APP must be registered in the Ningbo Medical Insurance Pass APP and authenticated by real name, the initiator of the formation of the ****JIWAN can add, delete members, change the order of payment, but also do not have the right to members of the account of the funds transfer operation.
(2) Through the window of the agency: you must apply for the transfer of funds between the calendar year account and the ****ji account at the window of the agency where you are insured with your social security card, and do not support a representative to do so. The initiator also has no right to transfer the funds of the member's account operation.
Fourth, the medical settlement of the ****ji health account
When the participant settles for medical treatment (including transferring out of the country for medical treatment and residing in a different place for medical treatment on the participant's one-card platform or for sporadic reimbursement), the funds of the ****ji health account can be used by him/herself and by members of the network in accordance with the regulations. Each member will use his/her own calendar year individual account funds first, followed by his/her own ****JIHEALTH account funds when settling expenses. In case he/she has no ****JIHEALTH account funds or his/her calendar year individual account is not enough to be used, he/she can use the ****JIHEALTH account funds of other members of the network according to the set order of payment. Only one ****Jean Health account funds can be used for one settlement.
Note: All the rules for the use of the ****ChiHealth account are the same as the rules for the use of the calendar year account (including the rules for the use of the self-funded, self-funded, assumed, and so on, and the account status of the person to be used when the status of the account is not normal is not allowed to be members of the use of the account)
Example: a family ***ChiHealth network initiator for A, with the members of the network B and C, such as A has the calendar year account funds of 1000 yuan,**** Ji network account funds 1000 yuan, B has a calendar year account funds 100 yuan, ***Ji network account funds 50 yuan, C no account funds, B medical total cost of 1000 yuan, of which 200 yuan, in the settlement can be used B's calendar year account 100 yuan plus ***Ji account 50 yuan to pay for the cost of assuming the account, because I have been using my own ***Ji account, so you can not use A's ***Ji account funds anymore.
V. Changes, withdrawals and revocations of the family ****ji network
(1) The initiator
The initiator can add and delete members of the ****ji network at any time through the (APP, terminals, the window of the office), and also change the order of payment of the members of the network's ****ji account, and can revoke the formation of the ****ji network, and revoke the ****ji network. The revocation of a ****JI network is deemed to be the dissolution of that ****JI network, and the other members of the network are deemed to have withdrawn from the ****JI network.
(ii) Members of the network
Other members of the network only have the right to choose their own withdrawal from the operation of the **** Je network.
VI. Refunds and Re-accounting of Medical Expenses for ****JI Accounts
If a participant has used a ****JI Health Account when seeking medical treatment, and a refund or re-accounting of medical expenses occurs, the overall principle is to return the funds in the same way as they were originally utilized. However, if the original member of the ****JI Network who was utilized at the time of the refund has already withdrawn from the ****JI Network, the funds will be refunded to the participant's calendar year account which was originally utilized, but not in real time, the system returns it to a virtual ****Jeeves account at the time of the refund, and then makes a synchronization operation every night, and the next day it will return that portion of the funds to the calendar year account.
Example: A member of the network A in the medical use of the network member B's ****Ji account funds, and then A for some reason in the hospital to do the refund process, the refund of members B has been withdrawn from the ****Ji network, then the system in the refund of the original use of the original B's ****Ji account funds to be retained temporarily, the next day will be returned to the account in the calendar year.
VII. Liquidation of the ****JI account:
(1) Participants need to liquidate their individual accounts due to death, transfer, etc.
The balance portion of the funds originally transferred from the calendar year account to the ****JI account is still attributable to the participant who originally transferred the funds, that is, the balance of the participant's calendar year and the ****JI account is added up and then processed with interest. Add up and then interest-bearing treatment, and then pay and transfer according to the rules of the original calendar year account funds.
(2) ****Ji account year-end consolidation
First, the ****Ji account funds are transferred back to the balance of the calendar year and then processed with interest, and the amount of interest accrued is added to the balance of the participant's calendar year account.
VIII. Family ****ji network business inquiries:
1. Individual account inquiries: the right then add a dedicated button
2. Individual account inquiries - individual account funds inquiries: to add a column of ****ji account
3. Individual account inquiries - costs: add ****ji account use Situation
4. There are also several batch inquiries: ***Ji network building network inquiries, ***Ji network information change inquiries, ***Ji network account change inquiries
The above information is for reference only, please refer to the local 12333 policy shall prevail.
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