Insurance work plan for the second half of the year

In the first half of this year, with the care and support of the municipal party committee and the municipal government, under the correct leadership of the provincial labor security department and the municipal labor security bureau, the bureau took Deng Xiaoping Theory, Comrade Jiang Zemin’s important thinking of the "Three Represents" and the spirit of the 16th Party Congress. Guide, combined with the actual work of medical insurance in our city, actively explore, boldly practice, and work diligently, and achieve the goal of “more than half of the time and more than half of the tasks”.

I. Progress of the main work

Progress of three insurance extensions

1. Medical insurance. By the end of June, the total number of insured persons in the city reached 303,000, including 219,000 in the city, 48,000 in Daye, and 36,000 in Yangxin. In the first half of the year, the city expanded by 12483 people and completed 62% of the annual plan of 20,000 people. Among them: 7978 people with direct expansion of the city, 2454 people with Daye expansion, and 2051 people with Yang Xin expansion.

2. Work injury insurance. By the end of June, the total number of insured persons in the city reached 164,000, of which 101,000 were in the city, 37,000 in Daye, and 21,000 in Yangxin. In the first half of the year, the city expanded its number of 10017 people and completed 67% of the 15,000 people. Among them: 7070 people in the city directly expanded, 2294 people in Daye expansion, and 653 people in Yangxin.

3. Maternity insurance. By the end of June, the total number of insured persons in the city reached 247,300, of which 192,900 were in the city, 34,700 in Daye, and 19,700 in Yangxin. In the first half of the year, the city expanded its number of 4,064 people and completed 102% of the 4,000 people. Among them: 2,520 people in the city's direct expansion, 1213 in Daye, and 331 in Yangxin.

Income and expenditure of three insurance funds

In the first half of this year, the city collected 141.74 million yuan of medical insurance funds and completed 68% of the annual plan of 210 million yuan, including 84.295 million yuan of unified funds, 57.445 million yuan of personal account funds, and 11.1325 million yuan of medical insurance funds, including 63.495 million of unified funds. Yuan; the balance medical insurance fund was 304.15 million yuan, of which the unified fund was 20.8 million yuan; the medical insurance fund rolled over the balance of 21.534 million yuan, of which the unified fund was 93.129 million yuan.

The city directly levied a medical insurance fund of 112.89 million yuan, including 67.25 million yuan for the unified fund, 45.64 million yuan for the personal account fund, 96.98 million yuan for the medical insurance fund, 56.65 million yuan for the unified fund, and 15.91 million yuan for the surplus medical insurance fund, including the unified fund 1060. Ten thousand yuan; the medical insurance fund has a balance of 158.58 million yuan, of which 55.17 million yuan is the unified fund.

In the first half of this year, the city collected 120.96 million yuan of work-related injury insurance funds, 67% of the annual plan of 18 million yuan; 74.46 million yuan of work-related injury insurance funds; 4.65 million yuan of surplus work-related injury insurance funds; and a surplus of 27.27 million yuan of work-related injury insurance funds.

The city directly collected industrial labor insurance funds of 94.47 million yuan; expenditures for industrial injury insurance funds of 6.085 million yuan; work accident insurance fund deposit balance of 1998.2 million yuan.

In the first half of this year, the city collected 4.721 million yuan of maternity insurance funds, completed 47% of the annual plan of 10 million yuan; expenditure of maternity insurance fund of 17.12 million yuan; balance of maternity insurance fund of 3.009 million yuan; maternity insurance fund rollover balance of 44.076 million yuan.

The city directly collected the maternity insurance fund of 4.182 million yuan; the expenditure of the maternity insurance fund was 1.59 million yuan; the maternity insurance fund rolled over the balance of 39.928 million yuan.

Second, the main practice

Actively promote the expansion

In order to do a good job in expanding the surface, at the beginning of the year, we formulated a plan for the expansion of the work, decomposed the expansion of the task, implemented it to the people, and classified the retirees, flexible employees, and normal production enterprises in difficulty according to the plan. The expansion of private and private enterprises has been more than half of the time.

1. Actively carry out the work of retirees of difficult enterprises. There are many difficult enterprises in our city. According to the affordability of the medical insurance fund, we actively carry out work according to the relevant arrangements of the municipal government, and gradually incorporate the retirees of difficult enterprises into the scope of medical insurance. In the first half of the year, we have applied for medical insurance for 1008 people from five difficult state-owned enterprises such as Huangshi Printing Factory. The city's financial subsidy fund is 1.16 million yuan. We also handled a one-time payment procedure for 3,314 retirees from 29 difficult enterprises such as Hubei Tianhua Co., Ltd., which has been insured, so that they have no worries.

2. Strengthen publicity and service, and do a good job in participating in and maintaining the employment of flexible employees. In order to do a good job in the employment and renewal of flexible employment, we first step up publicity, publicize policies through newspapers, television, radio and other media, and issue notices many times through the city's laid-off reemployment service center, street offices, and community services. Stations and other service windows posted, issued leaflets, and sent the policy to the hands of flexible employees; second, the development of convenience services, the internal optimization process, providing one-stop service, opening the insurance formalities window, external and bank Networked two-way operation reduces the time for flexible employees to work. At present, the number of people directly employed by the city has reached 31,000.

3. Do a good job in unit insurance. First, do a good job in the expansion of the normal production and operation enterprises and financial institutions that have not yet participated in the insurance. In the first half of the year, 2,718 people from 82 units including the Agricultural Bank participated in medical insurance. The second is to increase the expansion of private and private enterprises, through the social insurance bureau, fund settlement centers and other relevant units to timely grasp the situation of private and private enterprises registered with new social insurance, on-site publicity policy, patient work, the first half has been 988 employees from 47 companies including Shengmao Special Steel were included in the scope of medical insurance.

Improve medical management

1. Improve agreement management. Agreement management is the basis of medical management. At the beginning of each year, we must revise and improve the medical insurance service agreement based on the implementation of the previous year's agreement. This year we mainly made three aspects of improvement: First, the medical violations were clearly defined, and the penalties were refined accordingly. Second, the actual medical expenses of the agreed diseases were measured in detail, and some unreasonable adjustments were made. The settlement basis of the agreed disease; thirdly, according to the affordability of the fund and the actual development of medical technology, some new medical technologies are appropriately added to the scope of medical insurance pooling fund settlement.

2. Do an annual assessment of the “two-set” institutions. In the first half of the year, we will work with the relevant departments of health, drug supervision, and price to assess the implementation of the medical insurance policy of the designated medical institutions and designated pharmacies in 2006. In general, the “two-definite” institutions have further provisions on medical insurance policies. Awareness and implementation are better. However, there are also a few units that do not understand deeply, are not strict in implementation, and even have deliberately violated regulations in order to make profits.

3. Improve fund analysis and strengthen supervision in a targeted manner. In the first half of this year, we used the chart analysis for the first time to analyze the operation of the medical insurance fund in the first four months. Through analysis, we found out the key problems in the operation of the fund, such as the proportion of the agreed disease growth rate. The reason.