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SECURITIES AND FUTURES COMMISSION ORDINANCE

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SECURITIES AND FUTURES COMMISSION ORDINANCE ——附加英文版

Hong Kong


SECURITIES AND FUTURES COMMISSION ORDINANCE
 (CHAPTER 24)
 ARRANGEMENT OF SECTIONS
  
  ion
  I    PRELIMINARY
  hort title
  nterpretation
  II    SECURITIES AND FUTURES COMMISSION
  ecurities and Futures Commission
  unctions of Commission
  onstitution of Commission
  ommission may establish committees
  taff of Commission
  eneral powers of Commission
  elegation and sub-delegation of Commission's functions
  Advisory Committee
  Directions to Commission
  Annual report of Commission
  Commission to furnish information
  Financial year and estimates of income and expenditure
  Accounts
  Auditors and audit
  Investment of funds
  III   SECURITIES AND FUTURES APPEALS PANEL
  Constitution of Appeals Panel
  Appeals (registration, forfeiture and notices)
  Hearing of appeals by tribunal
  Procedure for appeals
  Case stated
  IV    ADDITIONAL REGISTRATION REQUIREMENTS
  Applications under section 51 of Securities Ordinance or section
30 of
  odities Trading Ordinance; supplementary provisions
  Applicant under Securities Ordinance or Commodities Trading
Ordinance
  urnish information to Commission
  Certificates of registration to continue in force
  Section 23 (2) and (3) to apply to inquiries under section 56 of
  rities Ordinance or section 36 of Commodities Trading Ordinance
  Registered persons to notify Commission where records etc. kept
  Financial resources rules
  Modification of financial resources rules in particular cases
  
  V    REGULATION OF REGISTERED PERSONS' BUSINESS, ETC.
  Supervision
  Information relating to transactions
  Certification to High Court relating to non-compliance under
section
  r 31 33. Investigations
  Returns
  Production of computerized information
  Magistrate's warrant
  Destruction etc. of documents
  Powers of intervention
  Restriction of business
  Restriction on dealing with assets
  Maintenance of assets
  Provisions relating to notices under section 39, 40, 41 or 43
  Withdrawal, substitution or variation of notices under section
39, 40
  1 44. Appeals against notices under this Part
  Winding-up orders
  Receiving orders
  VI    SPECIAL PROVISIONS RELATING TO EXCHANGE COMPANIES AND
  RING HOUSES 47. Transfer and resumption of functions
  Information: Exchange Companies and clearing houses
  Notice of closure or re-opening
  Additional powers--restriction notices relating to Exchange
Companies
  clearing houses
  Additional powers--suspension orders relating to Exchange
Companies
  clearing houses
  VII   FUNDING
  Levies
  Appropriation
  Fees and other charges
  VIII MISCELLANEOUS
  Injunctions to restrain contraventions
  Waiver or modification of requirements
  Immunity, etc.
  Liability of directors, etc.
  Evidence
  Preservation of secrecy, etc.
  Service of notices
  Penalties for offences
  Prosecution of certain offences by Commission
  Dissolution of Provisional Securities and Futures Commission
Limited
  transfer of property
  Transitional
  DULE Functions of Commission to which section 9 does not apply
  establish the Securities and Futures Commission and to amend the 
law
  ting to dealing in securities and trading in futures contracts;
and to
  ide for connected or incidental matters.
  he Ordinance other than sections 27 (1) to (8), 30, 31, 32 and 
65 as
  with item 1 (b) of paragraph 4 of Schedule 2 insofar as they 
relate
  he repeal of sections 122 and 123 of the Securities Ordinance
  y 1989 L. N. 126 of 1989
  remaining provisions: 1 August 1989] L. N. 230 of 1989
 PART I PRELIMINARY
  
  hort title
  Ordinance may be cited as the Securities and Futures 
Commission
  nance.
  nterpretation
  his Ordinance, unless the context otherwise requires-
  aring house" means a clearing house within the meaning of section
2
  of the Commodities Trading Ordinance (Cap. 250) or a 
recognized
  ring house within the meaning of section 2 of the Securities
(Clearing
  es) Ordinance (Cap. 420); (Amended 66 of 1990 s. 2; 68 of 1992
s. 20)
  Commission" means the Securities and Futures Commission 
established
  ection 3; "Commodity Exchange" has the meaning assigned to 
it by
  ion 2 (1) of the Commodities Trading Ordinance (Cap. 250);
  pany" means any company within the meaning of the Companies
Ordinance
  . 32) and includes an overseas company within the meaning of 
that
  nance or any other body corporate incorporated in Hong Kong 
having a
  e capital;
  a equipment" has the meaning assigned to it by section 27;
  a material" means any document or other material used in 
connection
  or produced by data equipment;
  ablishment day" means the day on which section 3 comes into
operation;
  hange Company" means-
  the Stock Exchange Company; or
  the Futures Exchange Company,
  "Exchange Companies" means both of those companies;
  cutive director" and "non-executive director" mean a director 
of the
  ission who is appointed under section 5 as an executive director
and a
  executive director thereof, respectively; "exempt dealer" 
has the
  ing assigned to it by section 2 (1) of the Securities Ordinance 
(Cap.
  ;
  ancial resources rules" means rules made under section 28; 
"financial
  " means the period specified in section 14 (1);
  m" has the meaning assigned to it by section 2 (1) of the 
Commodities
  ing Ordinance (Cap. 250);
  ction" includes power and duty;
  ures contract" has the meaning assigned to it by section 2 (1)
of the
  odities Trading Ordinance (Cap. 250);
  ures Exchange Company" means the Exchange Company within the 
meaning
  ection 2 (1) of the Commodities Trading Ordinance (Cap. 250);
  up of companies" has the meaning assigned to it by section 2 (1) 
of
  Companies Ordinance (Cap. 32);
  etary Authority" means the Monetary Authority appointed under 
section
  f the Exchange Fund Ordinance (Cap. 66); (Added 82 of 1992 s. 6)
  icer", in relation to a company, has the meaning assigned to 
it by
  ion 2 (1) of the Companies Ordinance (Cap. 32);
  el" means the Securities and Futures Appeals Panel 
established by
  ion 18;  "property  investment  arrangements"  means 
investment
  ngements as defined in relation to property other than 
securities by
  ion 2 of the Protection of Investors Ordinance (Cap. 335);
  
  ord or other document" includes--
  a book, voucher, receipt or data material, or information 
which is
  rded in a non-legible form but is capable of being reproduced 
in a
  ble form; and (b) any document, disc, tape, sound track or 
other
  ce in which sounds or other data (not being visual 
images) are
  died so as to be capable (with or without the aid of other 
equipment)
  eing reproduced and any film (including a microfilm), tape or 
other
  ce in which visual images are embodied so as to be 
capable (as
  esaid) of being reproduced;
  istered person" means a person who is registered under the 
Securities
  nance (Cap. 333), the Commodities Trading Ordinance (Cap. 
250) (or
  those Ordinances) as a dealer, dealing partnership, 
dealer's
  esentative, investment adviser, commodity trading adviser, 
investment
  sers' partnership, investment representative or a commodity 
trading
  ser's representative;
  relevant Ordinances" means this Ordinance, Part II of the 
Companies
  nance (Cap. 32) (insofar as that Part relates, whether 
directly or
  rectly, to the performance of functions by the Commission in 
relation
  rospectuses and purchase by a company of its own shares) and Part 
XII
  hat Ordinance (insofar as that part relates, whether 
directly or
  rectly, to the performance of functions by the Commission in 
relation
  rospectuses), the Securities Ordinance (Cap. 333), the 
Commodity
  anges (Prohibition) Ordinance (Cap. 82), the Commodities 
Trading
  nance (Cap. 250), the Protection of Investors Ordinance (Cap. 
335),
  Stock Exchanges Unification Ordinance (Cap. 361), the Securities
  aring Houses) Ordinance (Cap. 420), the Securities 
(Disclosure of
  rests) Ordinance (Cap. 396) and the Securities (Insider 
Dealing)
  nance (Cap. 395); (Amended 62 of 1990 s. 41; 68 of 1992 s. 20; 
87 of
  s. 2) "securities" has the meaning assigned to it by section 2
(1) of
  Securities Ordinance (Cap. 333);
  ck Exchange Company" means the Exchange Company within the
meaning of
  ion 2 (1) of the Stock Exchanges Unification Ordinance (Cap. 361);
  ding in commodity futures contracts" has the meaning assigned to
it by
  ion 2 (1) of the Commodities Trading Ordinance (Cap. 250);
  bunal" means a tribunal appointed under section 20;
  fied Exchange" has the meaning assigned to it by section 2 (1)
of the
  k Exchanges Unification Ordinance (Cap. 361).
 PART II SECURITIES AND FUTURES COMMISSION
  
  ecurities and Futures Commission
  There is hereby established a body to be known as the Securities 
and
  res Commission.
  The Commission shall be a body corporate with power to sue 
and be
  . (3) The receipts of the Commission shall not be subject to
taxation
  r the Inland Revenue Ordinance (Cap. 112).
  (a) The Commission shall provide itself with a seal.
  The seal of the Commission shall be authenticated by the signature 
of
  chairman or deputy chairman of the Commission or, if both the
chairman
  deputy chairman of the Commission are absent from Hong Kong or 
unable
  ct, the signature of some other director of the Commission 
authorized
  t to act in that behalf.
  
  unctions of Commission
  The Commission shall have the following functions--
  to advise the Financial Secretary on all matters 
relating to
  rities, futures contracts and property investment arrangements;
  without prejudice to any duties imposed or powers conferred 
on any
  r person in regard to the enforcement of the law 
relating to
  rities, futures contracts and property investment arrangements,
to be
  onsible for ensuring that the provisions of the relevant 
Ordinances,
  the provisions of any other Ordinance so far as they 
relate to
  rities, futures contracts and property investment 
arrangements, are
  lied with;
  to report to the Financial Secretary the occurrence of any dealing 
in
  tion to securities which it reasonably believes or suspects to 
be an
  der dealing within the meaning of section 9 of the Securities
(Insider
  ing) Ordinance (Cap. 395); (Amended 62 of 1990 s. 42)
  to be responsible for supervising and monitoring the activities
of the
  ange Companies and clearing houses;
  to take all reasonable steps to safeguard the interests of 
persons
  ing in securities or trading in futures contracts or entering 
into
  erty investment arrangements;
  to promote and encourage proper conduct amongst members 
of the
  ange Companies and clearing houses, and other registered persons;
  to suppress illegal, dishonourable and improper practices in 
dealing
  ecurities, trading in futures contracts, entering into 
property
  stment arrangements, and the provision of investment advice or 
other
  ices relating to securities, futures contracts and property
investment
  ngements;
  to promote and maintain the integrity of registered 
persons and
  urage the promulgation by registered persons of balanced and 
informed
  ce to their clients and to the public generally;
  to consider and suggest reforms of the law relating to 
securities,
  res contracts and property investment arrangements;
  to encourage the development of securities and futures markets
in Hong
  and the increased use of such markets by investors in Hong Kong 
and
  where; (k) to promote and develop self-regulation by market
bodies in
  securities and futures industries;
  subject to the provisions of this Ordinance, to co-operate with 
and
  st authorities or regulatory organizations, in Hong Kong or
elsewhere,
  are concerned with securities and futures, or with banking,
insurance
  ther financial services or with the affairs of corporations;
(Added 67
  991 s. 2)
  to perform any other functions conferred by or under 
any other
  nance.
  As regards any function, the Commission may, for the 
guidance of
  stered persons and others, prepare and cause to be published in 
the
  tte guidelines indicating the manner in which, in the absence of 
any
  icular consideration or circumstance, it proposes to 
perform the
  tion.
  The Commission may from time to time engage such 
consultants or
  sers as it may consider necessary to assist the Commission 
in the
  ormance of its functions. (4) Nothing in subsection (1) (k)
shall be
  rded as limiting or otherwise affecting any other function 
of the
  ission.
  
  onstitution of Commission
  Subject to subsection (2), the Commission shall consist of a 
chairman
  inted by the Governor and such uneven number, not being less than 
7,
  ther directors so appointed as the Governor may determine; and 
when
  number of such other directors ceases to be an uneven 
number the
  rnor shall make such appointment or appointments as may be 
necessary
  omply with this subsection.
  Half of the directors of the Commission, including the chairman,
shall
  ppointed to be executive directors and the remainder 
shall be
  inted to be non-executive directors.
  The Governor may appoint an executive director to be deputy 
chairman
  he Commission.
  (a) If no appointment has been made under subsection (3) or if 
the
  ce of deputy chairman of the Commission is vacant, the 
Financial
  etary may designate an executive director to act as chairman of 
the
  ission during any period during which the chairman of the 
Commission
  nable to act as chairman due to illness or other incapacity 
or is
  nt from Hong Kong.
  A designation under this subsection shall cease when revoked 
by the
  ncial Secretary or an appointment is made under 
subsection (3),
  hever first occurs. (5) The terms and conditions of office 
of a
  ctor of the Commission shall be such as the Governor may
determine.
  A director of the Commission may at any time resign his 
office by
  er sent to the Governor.
  A director of the Commission shall be paid by the Commission 
such
  neration, allowances or expenses as the Governor may determine.
  The Governor may by notice in writing remove from office any 
director
  he Commission whose removal appears to him to be desirable 
for the
  ctive performance by the Commission of its functions.
  Meetings of the Commission shall be held as often as may be 
necessary
  the performance of its functions, and may be convened by the 
chairman
  he deputy chairman or any 2 other directors.
  If the office of chairman of the Commission is vacant or the
chairman
  he Commission is unable to act as chairman due to illness or 
other
  pacity or is absent from Hong Kong the deputy chairman or an
executive
  ctor designated under subsection (4) shall act as chairman 
in his
  e.
  At a meeting of the Commission--
  the chairman shall be chairman of the meeting; or
  if the chairman is not present, the deputy chairman shall be 
chairman
  he meeting; or
  if neither the chairman nor the deputy chairman is 
present, the
  ctors present shall choose one of their number to be chairman of 
the
  ing.
  The quorum for a meeting of the Commission shall be 4 directors 
of
  2 shall be executive directors and 2 shall be non-
executive
  ctors.
  Each director of the Commission present at a meeting thereof 
shall
  a vote. (14) (a) Every question for decision at a meeting of 
the
  ission shall be determined by a majority of votes of the 
directors
  ent and, in the event that voting is equally divided, 
subject to
  graph (b) the chairman of the meeting shall have a casting vote. 
(b)
  chairman of a meeting shall not exercise a casting vote until
after he
  consulted the Financial Secretary as regards that exercise.
  The Commission may act notwithstanding a vacancy among its
directors.
  The Commission shall organize and regulate its 
administration,
  edure and business.
  
  ommission may establish committees
  The Commission may establish standing or special committees 
and may
  r or assign to any such committee any matter for 
consideration,
  iry or management by the committee.
  The Commission may appoint any person to be a member of any 
committee
  blished under this section, whether that person is a director of 
the
  ission or not. (3) Any reference or assignment under 
subsection (1)
  every appointment under subsection (2) may be withdrawn or
revoked by
  Commission at any time, and no such reference or assignment 
shall
  ent the performance by the Commission of any of its functions.
  A committee established under this section may elect any 
of its
  ers to be chairman and may regulate its own procedure and 
business;
  in the exercise of its powers under this subsection such 
committee
  l be subject to and act in accordance with any direction given
to the
  ittee by the Commission for the purposes of this subsection.
  Meetings of a committee established under this section shall be 
held
  uch times and places as the chairman of that committee may,
subject to
  ection (4), determine.
  taff of Commission
  The Commission may from time to time employ persons who shall be 
paid
  remuneration and allowances and shall hold their employment on 
such
  r terms and conditions as the Commission shall determine.
  The Commission may make arrangements for or in respect 
of the
  ision and maintenance of such schemes (whether contributory or 
not)
  the payment to its employees and their dependants of such 

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广元市大力引进高层次人才的暂行办法

四川省市广元人民政府 中共广元市委


中共广元市委 广元市人民政府

关于印发《广元市大力引进高层次人才的暂行办法》的通知

(广委发[2000]37号 )


各县区委、县区人民政府,市级各部门,各开发区党委、管委会,市属以上各企事业单位:
现将《广元市引进高层次人才的暂行办法》印发你们,请结合实际,认真贯彻执行。
附:《广元市引进高层次人才的暂行办法》


中共广元市委
广元市人民政府
2000年11月14日




广元市引进高层次人才的暂行办法

为大力推动我市高层次人才的引进工作,更好地服务于经济建设,推进我市经济追赶型、跨越式发展,特制定本暂行办法。
一、我市引进高层次人才的范围和重点
1、在省内外各学术技术领域领先的地市级以上学术技术带头人;
2、“两院”院士,取得博士、硕士学位或具有高级职称的专业技术人才;
3、兼具技术、管理的复合型高中级人才;
4、海外及港澳台专家、学者、经营管理人才和经教育行政主管部门认证的本科以上学历的留学回国人才;
5、我市急需的紧缺专业特别是高新技术产业、支柱产业、新兴产业、重点工程项目和大开发重点领域以及重点学科等方面具有大学本科以上学历且获学士以上学位的专业技术、经营管理人才,引进人才的专业重点是药业、冶金、电子、旅游等;
6、拥有国内、省内领先的发明专利的各类人才;
7、其他具有特殊专长、特殊才能、特殊技艺的人才。
二、我市引进高层次人才的方式
1、采取调动、录用到用人单位的方式,引进高层次人才到我市定居,长期在我市工作;
2、采取将引进高层次人才的各种关系放在政府人事部门所属人才服务中心办理人事代理,本人选择专业对口或适合的单位工作的方式到我市工作;
3、采取应聘、兼职、咨询、讲学、科研和合作开发项目、技术入股、投资办企业等多种方式,不办理任何调动手续,不转任何关系,不受年龄限制,引进高层次人才来我市长期或短期工作。
积极处理好引进人才与引进智力的关系,根据“不求所有,但求所用,但求所在”的原则,鼓励尝试周末教授、项目工程师等多种引智形式。其他有利于引进高层次人才的方式,可根据具体情况试行采用。
三、我市引进高层次人才的优惠政策
1、提供科研资助经费。对引进的高层次人才开展科研项目所需的科研启动资金,由用人单位在本单位或科技管理等有关部门的科研经费中安排解决。市、县财政还可视具体情况提供科研资助经费。
2、提供必要的工作生活条件。为引进高层次人才解决住房,住房的基本标准为:硕士及副高职称者三室一厅(不少于100m2),博士、 博士后及正高职称者三室两厅(不少于130m2),由用人单位无偿提供; “两院”院士四室两厅(不少于180m2),由财政无偿提供。 为引进高层次人才提供安家补助费,标准为:硕士、副高职称者每人2万元;博士、博士后及正高职称者每人4万元,由用人单位提供;“两院”院士每人8万元,由财政提供。 用人单位提供高层次人才的工作用车。
3、从优解决好引进的高层次人才的配偶、子女的安置、入学等问题。配偶、未婚子女随调随迁,配偶安置适当工作,符合条件子女优先就业,子女入学就近安排较好的中小学、幼儿园。高层次人才及随调随迁家属,一律免收城市增容费等费用。
4、用人单位除为高层次人才参加养老保险、基本医疗保险外,还要为其购买补充医疗保险。
5、优先解决引进高层次人才的专业技术职称评聘问题。对博士人员,在广元工作一年可直接送评高级职称;硕士毕业生工作满一年可直接评聘中级职称,满五年可送评高级职称。
6、切实解决好引进高层次人才的工资福利待遇,并实行工作津贴制度。引进的高层次人才其工资标准为:博士生每月工资1500元;硕士生每月工资1000元。工作津贴为:硕士及副高职称者每人每月300元,博士、 博士后及正高职称者每人每月800元,“两院”院士每人每月 3000元。对有特殊专长、特殊才能、特殊才艺的特殊人才,经组织人事部门进行资格认定后,也可发给相应的工作津贴。
7、建立和完善向优秀人才倾斜的分配机制。对引进的有技术、项目及科技成果转化为生产力并取得经济效益的高层次人才,其技术、项目和科技成果可作为生产要素参与分配。鼓励实行协议工资、年薪制。各企事业单位在职务科技成果转化取得的收益中,应提取一定的比例,用于奖励项目完成人员和对产业化有贡献的科技人员。
8、对急需专业的优秀本科毕业生,可将关系放在市人才中心,其工资由财政发放,分配到市积极扶持的新兴产业、支柱产业企业内工作。
9、每年由单位安排休假一个月或外出疗养一次。
10、被我市聘任的客座教授、科技顾问和进行短期技术指导的高层次专业技术人才,视工作情况给予相应补贴。
四、我市引进高层次人才的管理工作
1、我市高层次人才开发、引进、培养、管理等工作由市人才开发领导小组统一负责,具体工作由市人事局承担。
2、对引进高层次人才实行资格认定。即由单位申报,人才市场初审,由市人才开发办公室认定。
3、各级党委、政府要加强人才市场建设,完善人才市场机制,健全人才市场体系。政府人事部门所属人才市场,要在引进高层次人才工作中做好协调、联系、推荐、落实等具体工作。
五、本办法由市人事局负责解释。
六、本办法自发布之日起执行。

白城市人民政府关于印发白城市城镇职工补充医疗保险办法的通知

吉林省白城市人民政府


白城市人民政府关于印发白城市城镇职工补充医疗保险办法的通知

白政发〔2012〕13号



洮北区人民政府、开发区(园区)管委会,市政府各委办局、各直属机构:

  《白城市城镇职工补充医疗保险办法》已经市政府2012年5月31日第4次常务会讨论通过,现印发给你们,请认真遵照执行。



   二〇一二年六月十九日



  白城市城镇职工补充医疗保险办法



  第一条 为解决基本医疗保险最高支付限额以上的医疗费用问题,根据《中华人民共和国保险法》、《国务院关于建立城镇职工基本医疗保险制度的决定》(国发〔1998〕44号)、《中共中央、国务院关于深化医药卫生体制改革的意见》(中发〔2009〕6号)和《白城市建立城镇职工基本医疗保险制度实施方案》(白政发〔2000〕53号),结合我市实际,制定本办法。

  第二条 补充医疗保险是基本医疗保险的发展和完善,承担对基本医疗保险的补充责任&用以支付超出基本医疗保险金封顶线以上部分的医疗费,以提高职工抵御大病风险的能力,使劳动者在按国家规定享受基本医疗保险的基础上获得更多医疗保障的保险形式。

  第三条 补充医疗保险由市社会医疗保险局(以下简称市医保局)负责招标,由中标的商业保险公司为保险人承办。

  市医保局受保险人委托,负责统一组织补充医疗保险费的收缴、登记等相关事宜。

  第四条 凡已参加基本医疗保险的市本级。洮北区及各开发区的机关、企业、事业单位和社会团体均作为投保人,以团体投保的形式,为本单位所有参加基本医疗保险人员(不包括老红军、离休人员、二等乙级以上残废军人)办理补充医疗保险。

  参加补充医疗保险的职工为被保险人,被保险人对补充医疗保险金的给付享有独立请求权。

  第五条 市医保局负责统一经办补充医疗保险业务,具体职责是:

  (一)补充医疗保险的登记;

  (二)补充医疗保险费的收缴;

  (三)向保险人统一缴纳补充医疗保险费;

  (四)办理保险金的给付;

  (五)负责补充医疗保险的宣传工作。

  第六条 保险人负责补充医疗保险业务的管理,具体职责是:

  (一)审核市医保局统一报送的投保单;

  (二)签发正式保险单及被保险人清单;

  (三)按规定收取保险费、给付保险金;

  (四)配合市医保局做好补充医疗保险的宣传。

  第七条 市医保局与保险人签订补充医疗保险协议,明确各自权利、义务、责任。

  第八条 补充医疗保险费可由用人单位负担;也可按比例由单位和个人分别负担;还可以个人负担;个人负担部分由单位代为收缴。

  第九条 补充医疗保险采取“单独管理、以收定支”的基金型业务核算方式,补充医疗保险费与基本医疗保险费同时缴纳同时进行。缴费方式为年缴、缴费标准为每人每年100元。采取连续缴费方式,由投保人统一代收代缴,每年6月末前一次性缴纳当年补充医疗保险费。市医保局在每月30日前将当月收取的补充医疗保险费划转到保险人专用账户。

  第十条 保险人确认投保人缴纳补充医疗保险费后(以医保局开具缴费票据为准),负责签发正式保险单及被保险人清单。保单生效日期为当年1月1日。对于被保险人在保险年度内发生的医疗费用,保险人应按本办法规定支付被保险人补充医疗保险金。

  第十一条 年度内参保单位新增人员办理补充医疗保险,可在办理基本医疗保险的同时,办理补充医疗保险手续,同时补缴本年度内应缴纳的补充医疗保险费,享受本年度补充医疗保险待遇。

  第十二条 补充医疗保险金的给付标准。被保险人在市医保局定点的医院治疗,当年发生超过基本医疗保险统筹基金支付最高限额以上的住院医疗费用时,保险人按以下比例给付保险金:

  (一)职工基本医疗保险最高支付限额以上至8万元(含8万元)部分的医疗费用,保险人支付85%,个人自负15%。

  (二)8万元以上至12万元(含12万元)部分的医疗费用,保险人支付90%,个人自负10%。

  (三)12万元以上部分的医疗费用,保险人支付95%,个人自负5%。

  在每一年度内,保险人对每一被保险人累计赔付的保险金最高限额为16万元。

  第十三条 保险人对职工基本医疗保险统筹基金不予支付的项目,不承担给付补充医疗保险金的责任。

  第十四条 补充医疗保险金的给付范围、项目、标准按我市职工基本医疗保险的有关规定执行。

  第十五条 对于被保险人在保险期间内发生的符合白城市基本医疗保险政策及相关配套文件规定的医疗费用,保险人按照以下计算方法给付保险金:给付金额=(每一被保险人实际发生的符合职工基本医疗保险支付范围内的医疗费用-职工基本医疗保险统筹基金最高支付限额-职工基本医疗保险统筹内按政策应由

  个人承担比例的部分)×补充医疗保险对应的给付比例。

  第十六条 本保险的保险期为一年,与职工基本医疗保险的结算年度相一致,即自每年的1月1日零时起至当年12月31日24时止。在每一保险年度内,保险人对每一被保险人累计赔付的保险金,以其最高额16万元为限。被保险人在规定和认可的医院治疗跨两个保险年度时,保险人以被保险人实际医疗费用发生年度为准,分别给付保险金。

  第十七条 被保险人直接向市医保局申领补充医疗保险金。被保险人申请补充医疗保险金给付时,需先到市医保局登记、审核医疗费支出手续。市医保局向保险人申请给付补充医疗保险金。

  第十八条 保险人在收到市医保局提供的相关申请资料后,经核实,对申请资料齐全并确属补充医疗保险范围的,应在10日内给付补充医疗保险金。市医保局应在7日内将补充医疗保险金通知并转付给被保险人。

  第十九条 保险人对不属于保险责任的,要向市医保局发出拒绝给付补充医疗保险通知书,并做出书面说明。市医保局应在10日内将通知书和书面说明转送被保险人。

  第二十条 市医保局对保险人支付被保险人的保险金进行核查。如发现保险人不执行本《办法》规定,由市医保局责成保险人予以纠正。拒不纠正的,将取消保险人承保我市补充医疗保险资格。

  第二十一条 保险人每月%日前应向市医保局上报上月补充医疗保险赔付情况报表,要定期向市人社局、市财政局报送有关财务报告,并接受市人社局、市财政局、市审计局的监督检查。

  第二十二条 保险人、投保人和被保险人发生有关补充医疗保险争议时,由当事人协商解决;协商不成的,可向仲裁机构申请仲裁或者依法向人民法院提起诉讼。

  第二十三条 市医保局应按本 《办法》规定向保险人划转补充医疗保险费,不得拖欠、少缴。如发生拖欠、少缴,造成的后果由市医保局负责。

  第二十四条 投保人要及时将补充医疗保险费上缴到市医保局,不得拖欠、少缴。如发生拖欠、少缴,造成后果的,依法承担相应责任。

  第二十五条 大额补充医疗保险的费率、给付标准、最高支付限额可根据我市经济发展水平和大额补充医疗保险运营状况适时调整。

  第二十六条 保险人应及时将被保险人信息录入计算机系统,确保保单及时生效。

  第二十七条 本 (办法)未尽事宜,按照《中华人民共和国保险法》等国家相关法律、法规及规定执行。

  第二十八条 本办法由白城市人力资源和社会保障局负责解释并组织实施。

  第二十九条 本《办法》自发布之日起施行。原《白城市城镇职工补充医疗保险暂行办法(修订)》(白政发〔2006〕35号)同时废止。





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