Notice of Guangdong Provincial Department of Human Resources and Social Security, Guangdong Provincial Department of Finance, State Administration of Taxation, Guangdong Provincial Taxation Bureau on Printing and Distributing the Provincial Overall Implementation Plan of Guangdong Province's Industrial Injury Insurance Fund
Municipal people's governments at or above the local level, all departments and institutions directly under the provincial government:
With the approval of the provincial party committee and provincial government, the Provincial Overall Implementation Plan of Guangdong Industrial Injury Insurance Fund is hereby printed and distributed to you. Please implement it carefully.
Department of Human Resources and Social Security of Guangdong Province
Guangdong Provincial Department of Finance, State Administration of Taxation, Guangdong Provincial Taxation Bureau
June 23, 2019
Provincial Overall Implementation Plan of Guangdong Industrial Injury Insurance Fund
In accordance with the Social Insurance Law of the People's Republic of China, the Regulations on Work related Injury Insurance, the Regulations on Work related Injury Insurance in Guangdong Province, the Guiding Opinions of the Ministry of Finance of the Ministry of Human Resources and Social Security on the Provincial Overall Planning of Work related Injury Insurance Fund (RSBF [2017] No. 60) and other relevant provisions, this implementation plan is formulated to promote the provincial overall planning reform of the work related injury insurance fund in our province.
1、 General requirements
（1） Work objectives. Promote the unified fund management, unified insurance coverage and insured objects, unified rate policies and payment standards, unified treatment payment standards, unified industrial injury identification and labor capacity identification methods, unified handling procedures and information systems throughout the province, and promote the high-quality development of industrial injury insurance in our province.
（2） Basic principles.
Adhere to the principle of unification and standardization. Take the opportunity to improve the overall planning level, improve the system, standardize the business process, establish a unified business platform, and achieve policy institutionalization, business standardization, and accurate management.
Adhere to gap sharing. The Fund implements unified revenue, unified branch and unified management, establishes a gap sharing mechanism, improves the mutual economic function and use efficiency of the Fund, and ensures "revenue, allocation, timely delivery and sustainability".
Adhere to hierarchical management. Distinguish the boundary between provincial and local responsibilities, clarify the division of responsibilities, fully implement territorial responsibilities, and achieve "unified funds and sinking services".
Adhere to incentives and constraints. We will improve the system of responsibility for expanding insurance coverage and fund collection, promote the implementation of responsibilities, strengthen supervision and management, prevent moral risks, and avoid the phenomenon of "eating the pot".
2、 Main contents
（1） To implement the management of unified income and expenditure of industrial injury insurance funds at the provincial level.
1. The fund is collected and disbursed at the provincial level. From July 1, 2019, the industrial injury insurance fund will be uniformly managed and used throughout the province, with unified accounting and settlement. The tax authorities at all levels directly transfer the industrial injury insurance premium into the special financial account of the provincial social security fund during the collection process to form a provincial overall industrial injury insurance fund. Each municipal social security agency, together with the financial department at the same level, shall propose a quarterly fund use plan to the provincial social security fund management bureau according to the conditions of industrial injury insurance benefits and special fund expenditure. After the review and approval, the provincial social security fund management bureau shall allocate the fund to the social security fund expenditure account of each municipal social security agency. The industrial injury insurance fund shall be subject to unified budget and final account management. The provincial finance department shall take the lead in organizing the preparation of the industrial injury insurance fund budget. The provincial human resources and social security department shall liquidate the industrial injury insurance fund annually. The fund budget and financial management measures shall be separately formulated by the provincial finance department and the provincial human resources and social security department.
2. Handle the original accumulated balance funds of each city as a whole. The accumulated balance fund (including the interest generated by the principal) of each city (including the provincial level, the same below) before July 1, 2019 shall be managed and used uniformly by the province; In addition to reserving three months' industrial injury insurance benefits according to the average monthly expenditure of the previous year as revolving fund in the social insurance fund expenditure accounts of local social insurance agencies, the rest are entrusted to local depositories, with the right of use in the province. The municipal financial departments shall allocate the working capital in place before July 5.
When there is a gap in the provincial overall industrial injury insurance fund in the current period, it shall be solved in principle in the order of using the accumulated balance of the provincial overall industrial injury insurance fund, the original accumulated balance fund of each city, and the provincial reserve fund; If the original accumulated balance fund of the city needs to be released for settlement, the Provincial Department of Finance shall transfer it from the original accumulated balance fund of the city with the balance to the special financial account of the provincial social security fund in the same proportion. Before July 31, 2019, the accumulated balance of 12% of the original industrial injury insurance fund was uniformly released by each city for the first time to the provincial overall industrial injury insurance fund, making up for the gap of the provincial overall industrial injury insurance fund during the period of phased reduction of the industrial injury insurance rate. The provincial audit office takes the lead in verifying the original accumulated balance fund of each city before the implementation of the provincial overall planning of the industrial injury insurance fund.
3. Improve the provincial reserve system for industrial injury insurance. The provincial reserve for industrial injury insurance shall be established, which consists of the retained amount of the original provincial reserve, the balance of the provincial overall industrial injury insurance fund in the current year and the original accumulated balance fund of each city. The original municipal reserves will not be retained and will be directly incorporated into the accumulated balance fund of the city. The original accumulative balance fund release plan of each city shall be issued by the Provincial Finance Department together with the Provincial Human Resources and Social Security Department. The provincial reserve fund for industrial injury insurance is earmarked for special purposes, mainly used for adjustment when the fund is insufficient, payment of industrial injury insurance benefits for major accidents and other expenditures. In principle, it is controlled at the balance scale of 9 months according to the monthly average expenditure of the provincial industrial injury insurance benefits in the previous year.
（2） Unify the coverage and objects of industrial injury insurance.
All kinds of employing units in the province shall participate in work-related injury insurance for all their employees, and construction enterprises shall participate in work-related injury insurance for construction projects undertaken. The insurance participation management of the central, provincial and military employing units stationed in Guangzhou will remain unchanged. In the future, territorial management will be gradually implemented in accordance with relevant national and provincial regulations. The Provincial Department of Human Resources and Social Security, the Department of Finance, the Tax Bureau, and the Statistics Bureau, in accordance with the fund budget every year, on the basis of comprehensive consideration of changes in indicators such as wage growth rate and employment, and in combination with the state's assignment of insurance coverage expansion and fund collection tasks in our province, as well as the participation of industrial injury insurance in each city, formulate the plan of insurance coverage expansion and fund collection tasks in each city, and submit it to the provincial government to assign it to each city for implementation.
（3） Unify the rate policy and payment standard of work-related injury insurance.
Establish a unified differentiated and floating industrial injury insurance rate policy across the province. The provincial industrial benchmark rate standards for industrial injury insurance in categories I to VIII are 0.2%, 0.4%, 0.6%, 0.8%, 0.9%, 1.0%, 1.2% and 1.4% respectively. In accordance with the principle of "setting revenue based on expenditure and balancing revenue and expenditure", the specific standard of the industry benchmark rate can be adjusted according to the changes in the economic and industrial structure of our province and the use of industrial injury insurance premiums. During the period of implementing the periodic rate reduction, the current industry benchmark rate standards and floating rate methods and other work-related injury insurance rate policies of cities at or above the local level and the provincial level will remain unchanged. The implementation time and floating rate method of the provincial unified eight industry benchmark rate standard shall be separately stipulated by the Provincial Human Resources and Social Security Department, together with the Provincial Department of Finance and the Provincial Taxation Bureau, in due course according to the provincial economic development and fund revenue and expenditure. The payment proportion of industrial injury insurance premiums for housing construction and municipal infrastructure construction projects in the whole province will be adjusted to 0.8 ‰ of the total contract cost including tax from July 1, 2019. In the future, the province can adjust it in due time according to fund income and expenditure.
（4） Unify the payment standard of work-related injury insurance benefits.
1. Uniform treatment payment standard. Local social insurance agencies shall pay relevant treatment fees in accordance with the Regulations on Work related Injury Insurance, the Regulations on Work related Injury Insurance of Guangdong Province, and the treatment items and standards of work related injury insurance stipulated by the state and province. Including:
Hospitalization board allowance of the provincial industrial injury insurance: according to the provisions of the Guidance of the Ministry of Human Resources and Social Security on the Adjustment and Determination Mechanism of Industrial Injury Insurance Benefits (RSBF [2017] No. 58), in principle, it shall not exceed 40% of the average daily consumption expenditure of urban residents in the province in the previous year, and shall be paid by the industrial injury insurance fund according to the provisions; To ensure a smooth transition of treatment, the standard of 50 yuan/day will be implemented from July 1, 2019; In areas where the original standard of hospitalization food allowance is higher than 50 yuan/day, the injured employees have been hospitalized for treatment and rehabilitation before July 1, 2019, and have not been discharged from hospital until July 1, 2019, the hospitalization food allowance during this hospitalization shall be implemented according to the original standard.
Transportation, board and lodging expenses for medical treatment in other places: transportation, board and lodging expenses for medical treatment in cities beyond the prefecture level and above after approval shall be paid by the industrial injury insurance fund according to the regulations. Among them, the transportation expenses for a round trip between cities shall be reimbursed with valid bills, which are limited to buses, hard seats on trains, second-class seats on high-speed trains (bullet trains), third class seats on ships, economy class seats on airplanes, and ambulances in medical institutions. The expenses exceeding the specified standards shall be borne by themselves; During the transfer period (excluding the period of hospitalization), if the local transportation and accommodation expenses in the transfer area are within the total limit of 530 yuan/day, the reimbursement shall be made according to the regulations. The lump sum standard for food expenses is 50 yuan/day, which will not be enjoyed repeatedly with the food allowance for hospitalization. The transfer period shall not exceed three days.
The treatment standards related to industrial injury insurance shall be adjusted by the Provincial Human Resources and Social Security Department together with the Provincial Finance Department in accordance with the provisions. The diagnosis and treatment catalogue and hospitalization service standards of industrial injury insurance shall be standardized by the Provincial Human Resources and Social Security Department in accordance with relevant national regulations.
2. Clarify the base for payment. If the average monthly salary of employees in cities above prefecture level is higher than the average monthly salary of employees in the whole province, the average monthly salary of employees in the whole province involved in the calculation and payment of work-related injury insurance benefits shall be subject to the average monthly salary of employees in the city. The average monthly salary of employees shall be implemented according to the average monthly salary of on-the-job employees in urban non private units.
3. Improve the long-term compensation adjustment method of industrial injury insurance. In accordance with the provisions of the Ministry of Human Resources and Social Security [2017] No. 58 Document, the adjustment methods for long-term benefits of industrial injury insurance such as the disability allowance for level I to level IV injured workers, the pension for the dependents of workers who died, and the living care expenses are specified. The annual adjustment plan is formulated by the Provincial Human Resources and Social Security Department in conjunction with the Provincial Department of Finance.
（5） Unify the methods for identification of work-related injuries and identification of labor capacity.
The human resources and social security departments of cities above the prefecture level are responsible for organizing and implementing the identification of work-related injuries and labor capacity in their respective regions. We will strengthen training, guidance, assessment and supervision on industrial injury identification and labor capacity identification, establish a provincial and municipal consultation linkage mechanism for difficult cases, and unify the discretion of industrial injury identification and labor capacity identification across the province. If there is a dispute over the jurisdiction of work-related injury identification cases that are cross prefecture level and listed, the Provincial Human Resources and Social Security Department shall provide guidance. When the insured employee applies for labor capacity appraisal, the appraisal fee shall be paid by the industrial injury insurance fund, and the labor capacity appraisal fee paid in advance when the applicant applies for reexamination, reexamination one year later, and reexamination shall be canceled.
（6） Unify the handling process and information system of industrial injury insurance.
1. Formulate unified business procedures and agreement text. Strengthen business management, standardize and optimize business processes, implement the reform requirements of "decentralization, management and service", and handle business in accordance with the business procedures uniformly formulated by the province. The social insurance agency should strengthen the management of the service agreement of industrial injury insurance, and strengthen the review and supervision of the service fees of industrial injury insurance according to the agreement. The municipal social security agencies and qualified service agencies shall sign agreements in accordance with the text of service agreements on medical treatment, rehabilitation, auxiliary equipment allocation, and occupational injury prevention of industrial injury insurance uniformly formulated by the province. The industrial injury insurance service agreement signed before the implementation of provincial overall planning shall continue to be performed until the agreement expires, and then be signed according to the text uniformly formulated by the province.
2. Establish industrial injury insurance information system. From July 1, 2019, the human resources and social security departments of various regions will launch the provincial centralized social insurance integrated information system to handle the industrial injury insurance business in batches according to the provincial deployment. Strengthen the management of work-related injury medical treatment, actively promote the networking between social insurance agencies and work-related injury insurance service agreement institutions, accelerate the realization of online settlement and intelligent monitoring of work-related injury insurance medical expenses, and the social insurance agencies will guide the work-related injury insurance service agreement institutions to conduct system interface transformation according to the unified provincial interface specifications. Increase the application of social security card in the application, settlement, distribution, query and other links of industrial injury insurance business.
3. Improve business linkage service capability. Gradually realize information sharing between human resources and social security departments and institutions, public security, civil affairs, finance, housing and urban and rural construction, transportation, health, emergency management, market supervision, medical insurance, taxation, courts and other units, as well as financial institutions and service agreement institutions. Strengthen the business cooperation of departments. The medical expenses incurred by the insured employees before the identification of work-related injury shall be paid by the basic medical insurance fund according to the regulations. After the identification of work-related injury, the work-related injury insurance fund shall settle the work-related injury medical expenses that have been paid by the basic medical insurance fund to the basic medical insurance fund, and then settle them regularly according to the actual situation.
3、 Safeguards
（1） Strengthen organizational leadership. All localities and relevant departments should fully understand the significance of implementing the provincial overall planning of industrial injury insurance funds, establish relevant working mechanisms, define the division of tasks, schedule and safeguard measures for reform, and ensure the implementation of reform. The prefecture level listed and county (district) governments are responsible for the expanded collection and payment of industrial injury insurance and ensuring the timely and full payment of industrial injury insurance benefits. Each city shall regularly report the work progress, relevant public opinion disposal and conflict resolution to the Provincial Human Resources and Social Security Department. The provincial human resources and social security, financial departments and tax authorities should strengthen communication, division of labor and cooperation, improve the mechanism of restriction of duties, rights and responsibilities, urge and guide cities to earnestly implement the policies and measures of provincial coordination of industrial injury insurance funds, and ensure the smooth progress of reform.
（2） Prevent reform risks. All localities shall comprehensively clean up their own industrial injury insurance policies and rectify and standardize the policies and business procedures that are inconsistent with the current national and provincial laws, regulations and policies. We should carefully study and judge the possible risks in the implementation process, formulate emergency plans, take effective response measures, and try to resolve the risks in the embryonic stage. Strengthen targeted publicity, do a good job in monitoring and handling public opinion and resolving conflicts, and create a good atmosphere of public opinion.
（3） Strengthen supervision and management. Human resources and social security departments, financial departments and audit institutions at or above the county level shall, in accordance with their respective responsibilities and laws, supervise the income, expenditure and management of the industrial injury insurance fund, strictly prevent and resolve fund risks, and ensure the safety and integrity of the fund. The provincial social security fund management bureau should strengthen the daily management of the provincial industrial injury insurance fund, improve the internal control system, improve the supervision system before, during and after the event, and guide and standardize the social security agencies in various cities to carry out fund payment and management. Social security agencies at all levels should regularly publish the income and expenditure of the local industrial injury insurance fund, and accept the supervision of human resources and social security, financial departments and audit institutions according to laws and regulations.
This implementation plan will be implemented from July 1, 2019. In case of any inconsistency between the provisions of the documents issued by our province and this plan, the provisions of this plan shall prevail. If there are new provisions in laws, regulations and the state in the future, such provisions shall prevail.
Annex 1
Measures of Guangdong Province on Adjustment of Long term Benefits of Industrial Injury Insurance
1、 The adjustment formula of the disability allowance for workers with work-related injuries from level one to level four in the province. Per capita adjustment amount of disability allowance for workers with industrial injuries from level 1 to level 4=per capita monthly disability allowance for workers with industrial injuries from level 1 to level 4 in the province last year × (Average wage growth rate of employees in the whole province last year × 0.7+provincial consumer price index of last year × 0.3) ± comprehensive adjustment amount.
2、 The adjustment formula of the pension for the dependents of the deceased workers. Per capita adjusted amount of dependant pension=monthly per capita dependant pension of the whole province in the previous year × (Average wage growth rate of employees in the whole province last year × 0.4+provincial consumer price index of the previous year × 0.6) ± comprehensive adjustment amount.
3、 Measures for adjustment of living care expenses. The living care expenses shall be adjusted at the same time every year according to the growth rate of the average wages of employees in the province in the previous year, and shall not be adjusted when the average wages of employees in the province fall in the previous year.
4、 In the above formula 1 and 2, the average salary of the current employee
