Measures of Tianjin Economic Technological Area on Childbearing, Childbirth and Children Medical Insurance

(Adopted at the meeting of the Administrative Commission of Tianjin Economic Technological Development Area on October 30, 1996; amended at the 24th meeting of chairmen of the Administrative Commission of Tianjin Economic Technological Development Area on December 19, 2001)

Article 1 [purpose and basis] These Measures are formulated with a view to safeguarding the lawful rights and interests of staff and workers of Tianjin Economic-Technological Development Area (hereinafter referred to as "TEDA"), ensuing women staff and workers to have the necessary economic compensation and medical care during their periods of childbearing, childbirth and child nursing, and ensuing their children to have medical care and as per Provisions of Tianjin Economic-Technological Development Area on Social Insurance and relevant laws and regulations.

Article 2 [treatment requirements] The staff and workers who are in conformity with the following conditions may enjoy the treatment of the child-bearing and only child's medical insurance (hereinafter referred as child-bearing insurance):

(1) The employing units have paid the premium of the child-bearing insurance of the staff and workers;

(2) The child-bearing of the staff or worker is in conformity with the State policy of family planning;

(3) The child was born in conformity with the State policy of family planning.

Article 3 [premium computation] The premiums of the child-bearing insurance shall be paid as follows:

(1) Employing units shall make full and timely payment of the premiums at a rate of 3% of the average monthly wages of staff and workers in the previous year, and the banks where the employing units open their accounts shall withhold the amounts in priority each month on their behalf; The staff and workers themselves do not pay the child-bearing insurance premiums.

(2) The part which exceeds 150 % of the average monthly wages of staff and workers of Tianjin Municipality in the previous year in the average monthly wages of the staff and workers in the previous year shall not serve as the wages basis for the payment of premiums of the child-bearing insurance; in case that the average monthly wages of the staff and workers in the previous year are below the minimum wages standard of Tianjin Municipality, the minimum wages standard of Tianjin Municipality shall serve as the wages basis for the payment of their premiums;

(3) When the staff and workers reach fully the age of forty-five, their child-bearing insurance shall be no longer paid for; in case that their children are under 18 years old, the premium payment of the child-bearing insurance shall be continued;

(4) During the maternity leaves period of the women staff and workers, the employing units shall pay social insurance premiums at a base no less than the average monthly wages of staff and workers of Tianjin Municipality in the previous year.

(5) During the period of baby-nursing leaves for women staff and workers, the employing units shall pay social insurance premiums at a base no less than the minimum wage standard of Tianjin Municipality.

Article 4 [minimum period of premium payment] The minimum period for the continuous payments of the child-bearing insurance premiums before childbirth shall not be less than 9 months or the accumulative period before childbirth for a staff member or worker who is still paying the premiums shall be 24 full months (makeup payments excluded).

Article 5 [medical treatment on childbearing and childbirth] Women staff or workers may choose a hospital of their own accord for child delivery and the reimbursement of the child delivery expenses shall be controlled and within a certain quota. TEDA Social Insurance Agency (hereinafter referred to as "Insurance Agency") shall apply the correspondent upper limits in light of the different grades of the hospitals where the women staff or workers stay and how the child delivery is.

If the childbearing and childbirth examination expenses (expenses on diseases excluded), hospitalization and operation expenses incurred by the women staff or workers as well as pharmaceutical expenses relating to childbirth within the prescribed scope exceed the upper limit, the child-bearing insurance fund shall make payment in accordance with the upper limit; if the expenses do not exceed the upper limit, they shall be paid as the actual expenses incurred within the scope of payment. The exceeding expenses on medical service and pharmaceuticals beyond the upper limit (including pharmaceuticals at their own expenses and expenses on nutriment pharmaceuticals) shall be entirely borne by individuals.

The upper limit of reimbursement of expenses on prenatal examination and for child delivery shall be adjusted in light of the change of medical expenses and be annually made public in the first season of the year by the labor administrative department of TEDA.

The operation expenses for staff and workers to take contraceptive or sterilized measures for birth control as well as the operation expenses on artificial abortion shall be fully paid by the childbearing insurance fund.

Article 6 [maternity leave allowances] Women staff and workers shall enjoy maternity leave as prescribed by laws and regulations; during their maternity leave, the insurance agency shall pay them allowances on maternity leave at specific standard as follows:

(1) The maternity leave shall follow the stipulations under Articles 12 and 13 of Provisions of Tianjin Economic- Technological Development Area on Labor Protection of Women Staff and Workers;

(2) Maternity allowances shall be monthly calculated and paid in accordance with the standards of the average monthly wages of staff and workers of Tianjin Municipality in the previous year.

Article 7 [subsidy on nursing-child leave] With respect to the women staff and workers who are in conformity with the provisions of family planning, at the expiry of their maternity leave, they may enjoy a nursing-child leave of nine months subject to their application to and approval by the employing units.
The subsidy on nursing period shall be drawn each month in accordance with the standard of minimum wage of Tianjin Municipality, and no payment shall be made beyond the time limit.

Article 8 [child medical treatment] The medicine expenses incurred by the only child (including twins and multiparity) of the staff and workers who have participated the child-bearing insurance, may be reimbursed at the ratio of 50 %; and the medicine expenses incurred by the child of the second birth in line with the State policy of family planning may be reimbursed at the ratio of 25%; however, children with congenital diseases and complications or children of fully 18 years old are excluded.

The standard of starting reimbursement of outpatient medicine expenses for children shall be 2 % of the average annual wages of staff and workers of Tianjin Municipality in the previous year and the maximum reimbursement shall be 50% of the average annual wages of staff and workers of Tianjin Municipality in the previous year. The standard of starting reimbursement of hospitalization expenses for children shall be 5 % of the average annual wages of staff and workers of Tianjin Municipality in the previous year and the maximum reimbursement shall be four times the average annual wages of staff and workers of Tianjin Municipality in the previous year.

The scope of reimbursement of medicine expenses and the procedure shall follow the relevant stipulations of the Provisions of Tianjin Municipality on the Basic Medical Insurance of Urban and Town Staff and Workers.

Article 9 [procedures] Women staff and workers should register with the insurance agency before childbirth;. hospitalization treatment and transfer to another city for treatment are subject to approval by the insurance agency; in case of being hospitalized for treatment on account of the sudden attack of a disease, subsequent application for approval may be made within 3 days. After childbirth, the women staff or workers or their employing units shall, on the strength of the certifications by the family panning department and by the medical institution, go through the relevant formalities of reimbursement with the insurance agency and draw the money.

With respect to the reimbursement of medicine expenses of their children, the staff or workers shall, after confirmation of the qualifications of their children who require to reimburse the medicine expenses in accordance with these Measures and the relevant policies concerning family planning by the insurance agency, submit an application and fill in the consolidated form of medicine expenses and go through formalities of reimbursement with the insurance agency within the year on the strength of the outpatient case history or diagnosis certification, prescription, receipts of medical expenses, the detailed medicine list.

Article 10 [right to interpretation] The Administrative Commission of TEDA shall be responsible for the interpretation of these Measures.

Article 11 [effective date] These Measures shall come into effect as of April 1, 2002.