【中英文对照版】社会保险经办条例.docx

社会保险经办条例RegulationontheProvisionofSocialInsuranceServices制定机关：国务院发文字号：中华人民共和国国务院令第765号公布日期：2023.08.16施行日期：2023.12.01效力位阶：行政法规法规类别：保险综合规定IssuingAuthority：StateCouncilDocumentNumber:OrderNo.765oftheStateCouncilofthePeople'sRepublicofChinaDateIssued：08-16-2023EffectiveDate：12-01-20231.evelofAuthority：AdministrativeRegulationsAreaofLaw：GeneralProvisionsonInsuranceCouncil of the People's中华人民共和国国务院令OrderoftheStateRepublicofChina(No.765)（第765号）TheRegulationontheProvisionofSocialInsuranceServices,asadoptedatthe11thexecutivemeetingoftheStateCouncilonJuly2152023,isherebyissued,andshallcomeintoforceonDecember1,2023.社会保险经办条例已经2023年7月21日国务院第11次常务会议通过，现予公布，自2023年12月1日起施行。Premie匚LiQiang总理李强August16,20232023年8月16日RegulationontheProvisionofSocialInsurance社会保险经力、条例Services第一章总 则第一条为了规范社会保 险经办，优化社会保险服务， 保障社会保险基金安全，维护 用人单位和个人的合法权益， 促进社会公平，根据中华人 民共和国社会保险法，制定 本条例。Chapter I GeneralProvisionsArticle1ThisRegulationisdevelopedinaccordancewiththeSocialInsuranceLawofthePeople'sRepublicofChinatoregulatetheprovisionofsocialinsuranceservices,optimizesocialsecurityservices,ensurethesecurityofsocialsecurityfunds,protectthelawfulrightsandinterestsofemployersandindividuals,andpromotesocialfairness.第二条经办基本养老保 险、基本医疗保险、工伤保 险、失业保险、生育保险等国 家规定的社会保险，适用本条 例。Article2ThisRegulationshallapplytotheprovisionofbasicpensioninsurance,basicmedicalinsurance,work-relatedinjuryinsurance,unemploymentinsurance,maternityinsurance,andothersocialinsuranceservicesprescribedbythestate.第三条社会保险经办工 作坚持中国共产党的领导，坚 持以人民为中心，遵循合法、 便民、及时、公开、安全的原 则。Article3TheprovisionofsocialinsuranceservicesshalladheretotheleadershipoftheCommunistPartyofChina,adheretothepeoplecenteredapproach,andfollowtheprinciplesoflegality,convenienceforthepeople,timeliness,openness,andsecurity.第四条国务院人力资源 社会保障行政部门主管全国基 本养老保险、工伤保险、失业 保险等社会保险经办工作。国 务院医疗保障行政部门主管全 国基本医疗保险、生育保险等 社会保险经办工作。Article4TheadministrativedepartmentofhumanresourcesandsocialsecurityoftheStateCouncilshalltakechargeoftheprovisionofbasicpensioninsurance,work-relatedinjuryinsurance,unemploymentinsurance,andothersocialinsuranceservicesnationwide.ThemedicalinsuranceadministrativedepartmentoftheStateCouncilshalltakechargeoftheprovisionofbasicmedicalinsurance,maternityinsurance,andothersocialinsuranceservices.Theadministrativedepartmentofhumanresourcesandsocialsecurityofthelocalpeople'sgovernmentatorabovethecountylevelshalltakechargeoftheprovisionofbasicpensioninsurance,work-relatedinjuryinsurance,unemploymentinsurance,andothersocialinsuranceservicesaccordingtothecoordinatinglevel.Themedicalinsuranceadministrativedepartmentofthelocalpeople'sgovernmentatorabovethecountylevelshalltakechargeofthebasicmedicalinsurance,maternityinsurance,andothersocialinsuranceservicesaccordingtothecoordinatinglevel.Article5Theadministrativedepartmentofhumanresourcesandsocialsecurity,themedicalinsuranceadministrativedepartment,andotherrelevantdepartmentsoftheStateCouncilshall,accordingtotheirrespectiveduties,closelycooperatetojointlyprovidegoodsocialinsuranceservices.Thelocalpeople,sgovernmentatorabovethecountylevelshallstrengthentheleadershipoftheprovisionofsocialinsuranceserviceswithinitsadministrativeregion,enhancethebuildingofsocialinsuranceservicecapacity,andprovideguaranteesfortheprovisionofsocialinsuranceservices.县级以上地方人民政府人力资 源社会保障行政部门按照统筹 层次主管基本养老保险、工伤 保险、失业保险等社会保险经 办工作。县级以上地方人民政 府医疗保障行政部门按照统筹 层次主管基本医疗保险、生育 保险等社会保险经办工作。第五条国务院人力资源 社会保障行政部门、医疗保障 行政部门以及其他有关部门按 照各自职责，密切配合、相互 协作，共同做好社会保险经办 工作。县级以上地方人民政府应当加 强对本行政区域社会保险经办 工作的领导，加强社会保险经 办能力建设，为社会保险经办 工作提供保障。Chapter II SocialInsuranceRegistrationand第二章TransferofRelations转移社会保险登记和关系Article6Anemployershallundergosocialinsuranceregistrationwhenundergoingregistrationattheregistrationadministrativeauthority.第六条用人单位在登记 管理机关办理登记时同步办理 社会保险登记。个人申请办理社会保险登记,Anindividualapplyingforsocialinsurance以公民身份号码作为社会保障 号码，取得社会保障卡和医保 电子凭证。社会保险经办机构 应当自收到申请之日起10个工 作日内办理完毕。第七条社会保障卡是个 人参加基本养老保险、基本医 疗保险、工伤保险、失业保 险、生育保险等社会保险和享 受各项社会保险待遇的凭证， 包括实体社会保障卡和电子社 会保障卡。registrationshallusehisorhercitizenidentificationnumberasthesocialsecuritynumberandobtainasocialsecuritycardandelectronicmedicalinsurancecertificate.Thesocialinsuranceagencyshallcompletetheprocessingoftheapplicationwithin10workingdaysofreceiptoftheapplication.Article7Thesocialsecuritycardisacertificateforindividualstoparticipateinbasicpensioninsurance,basicmedicalinsurance,work-relatedinjuryinsurance,unemploymentinsurance,maternityinsurance,andothersocialinsurance,andenjoyvarioussocialinsurancebenefits,includingboththephysicalsocialsecuritycardandelectronicsocialsecuritycard.医保电子凭证是个人参加基本 医疗保险、生育保险等社会保 险和享受基本医疗保险、生育 保险等社会保险待遇的凭证。Theelectronicmedicalinsurancecertificateisacertificateforindividualstoparticipateinbasicmedicalinsurance,maternityinsurance,andothersocialinsuranceandenjoythebenefitsofbasicmedicalinsurance,maternityinsurance,andothersocialinsurance.第八条登记管理机关应 当将用人单位设立、变更、注 销登记的信息与社会保险经办 机构共享，公安、民政、卫生 健康、司法行政等部门应当将 个人的出生、死亡以及户口登 记、迁移、注销等信息与社会 保险经办机构共享。Article8Theregistrationadministrativeauthorityshallsharetheinformationontheformation,registrationmodification,andderegistrationofemployerswithsocialinsuranceagencies,andpublicsecurity,civilaffairs,health,judicial,andotherdepartmentsshallsharetheinformationonindividuals'birth,death,householdregistration,transferandcancellationofhouseholdregistration,andotherinformationwithsocialinsuranceagencies.第九条用人单位的性 质、银行账户、用工等参保信 息发生变化，以及个人参保信 息发生变化的，用人单位和个Article9Incaseofanychangeinthenature,bankaccount,employment,andotherinsuranceinformationoftheemployerandindividualinsuranceinformation,theemployerandtheindividualshallinformthesocialinsuranceagency人应当及时告知社会保险经办 机构。社会保险经办机构应当 对用人单位和个人提供的参保 信息与共享信息进行比对核 实。第十条用人单位和个人 申请变更、注销社会保险登 记，社会保险经办机构应当自 收到申请之日起10个工作日内 办理完毕。用人单位注销社会 保险登记的，应当先结清欠缴 的社会保险费、滞纳金、罚 款Qinatimelymanner.Thesocialinsuranceagencyshallcompareandverifytheinsuranceinformationprovidedbytheemployerandtheindividualwiththesharedinformation.Article10Whereanemployerorindividualappliesforthemodificationorcancellationofsocialinsuranceregistration,thesocialinsuranceagencyshallcompletetheprocessingoftheapplicationwithin10workingdaysofreceiptoftheapplication.Ifanemployercancelsitssocialinsuranceregistration,itshallfirstpayupthesocialinsurancepremiumsowedbyit,latefee,andfine.第十一条社会保险经办 机构应当及时、完整、准确记 录下列信息：Article11Asocialinsuranceagencyshallrecordthefollowinginformationinatimely,complete,andaccuratemanner:（一）社会保险登记情况；（二）社会保险费缴纳情况；（三）社会保险待遇享受情 况；(1) Socialinsuranceregistrationinformation.(2) Paymentofsocialinsurancepremiums.(3) Enjoymentofsocialinsurancebenefits.（四）个人账户情况;(4) Personalaccountinformation.（五）与社会保险经办相关的 其他情况。(5) Otherinformationrelatedtotheprovisionofsocialinsuranceservices.第十二条参加职工基本 养老保险的个人跨统筹地区就 业，其职工基本养老保险关系Article 12 Whereanindividualparticipatinginbasicpensioninsuranceforemployeesisemployedacrossdifferentcoordinatingregions,hisorherrelationsofbasicpensioninsurancefor随同转移。employeesshallbetransferredwithhimorher.Ifanindividualparticipatinginbasicpensioninsuranceforemployeesisemployedbyemployersofdifferentnaturessuchasgovernmentorgans,publicinstitutions,andenterprises,hisorherrelationsofbasicpensioninsuranceforemployeesshallbetransferredwithhimorher.Ifanindividualparticipatinginbasicpensioninsuranceforurbanandruralresidentsbutnotentitledtoinsurancebenefitstransfershisorherhouseholdregistrationtoanothercoordinatingregion,hisorherrelationsofbasicpensioninsuranceforurbanandruralresidentsmaybetransferredwithhimorher.Article 13 Whereanindividualparticipatinginbasicmedicalinsuranceforemployeesisemployedacrossdifferentcoordinatingregions,hisorherrelationsofbasicmedicalinsuranceforemployeesshallbetransferredwithhimorher.Ifanindividualparticipatinginbasicmedicalinsuranceforurbanandruralresidentstransfershisorherhouseholdregistrationorplaceofhabitualresidencefromonecoordinatingregiontoanother,hisorherrelationsofbasicmedicalinsuranceforurbanandruralresidentsmaybetransferredwithhimorheraccordingtoapplicableprovisions.参加职工基本养老保险的个人 在机关事业单位与企业等不同 性质用人单位之间流动就业， 其职工基本养老保险关系随同 转移。参加城乡居民基本养老保险且 未享受待遇的个人跨统筹地区 迁移户籍，其城乡居民基本养 老保险关系可以随同转移。第十三条参加职工基本 医疗保险的个人跨统筹地区就 业，其职工基本医疗保险关系 随同转移。参加城乡居民基本医疗保险的 个人跨统筹地区迁移户籍或者 变动经常居住地，其城乡居民 基本医疗保险关系可以按照规 定随同转移。职工基本医疗保险与城乡居民 基本医疗保险之间的关系转 移，按照规定执行。Therelationsbetweenthebasicmedicalinsuranceforemployeesandthebasicmedicalinsuranceforurbanandruralresidentsshallbetransferredinaccordancewithrelevantprovisions.第十四条参加失业保险 的个人跨统筹地区就业，其失 业保险关系随同转移。Article 14 Whereanindividualparticipatinginunemploymentinsuranceisemployedacrossdifferentcoordinatingregions,hisorherunemploymentinsurancerelationsshallbetransferredwithhimorher.第十五条参加工伤保 险、生育保险的个人跨统筹地 区就业，在新就业地参加工伤 保险、生育保险。Article 15 Whereanindividualparticipatinginwork-relatedinjuryinsuranceormaternityinsuranceisemployedacrossdifferentcoordinatingregions,heorsheshallparticipateinwork-relatedinjuryinsuranceormaternityinsuranceinthenewplaceofemployment.第十六条用人单位和个 人办理社会保险关系转移接续 手续的，社会保险经办机构应 当在规定时限内办理完毕，并 将结果告知用人单位和个人， 或者提供办理情况查询服务。第十七条军事机关和社 会保险经办机构，按照各自职 责办理军人保险与社会保险关 系转移接续手续。Article 16 Whereanemployerorindividualundergoesformalitiesforthetransferandcontinuationofsocialinsurancerelations,thesocialinsuranceagencyshallcompletesuchformalitieswithintheprescribedtimelimit,andinformtheemployerorindividualoftheresultsorprovidehandlingsituationinquiryservices.Article 17 Amilitaryorganandsocialinsuranceagencyshall,accordingtotheirrespectiveduties,undergotheformalitiesforthetransferandcontinuityofservicemeninsuranceandsocialinsurancerelations.社会保险经办机构应当为军人 保险与社会保险关系转移接续 手续办理优先提供服务。Asocialinsuranceagencyshallgiveprioritytoprovidingservicesforundergoingtheformalitiesforthetransferandcontinuityofservicemeninsuranceandsocialinsurancerelations.第三章社会保险待遇核定和 支付ChapterIIIApprovalandPaymentofSocialInsuranceBenefits第十八条用人单位和个 人应当按照国家规定，向社会 保险经办机构提出领取基本养Article18Anemployeroranindividualshallfileanapplicationforreceivingbasicpensionbenefitswithasocialinsuranceagencyaccordingtothe老金的申请。社会保险经办机 构应当自收到申请之日起20个 工作日内办理完毕。applicableprovisionsofthestate.Thesocialinsuranceagencyshallcompletetheprocessingoftheapplicationwithin20daysofreceiptoftheapplication.第十九条参加职工基本 养老保险的个人死亡或者失业 人员在领取失业保险金期间死 亡，其遗属可以依法向社会保 险经办机构申领丧葬补助金和 抚恤金。社会保险经办机构应 当及时核实有关情况，按照规 定核定并发放丧葬补助金和抚 恤金。第二十条个人医疗费 用、生育医疗费用中应当由基 本医疗保险（含生育保险）基 金支付的部分，由社会保险经 办机构审核后与医疗机构、药 品经营单位直接结算。Article19Whereanindividualparticipatinginbasicpensioninsuranceforemployeesdiesoranunemployedpersondiesduringtheperiodofreceivingunemploymentinsurancebenefits,hisorhersurvivingfamilymembersmayapplytothesocialinsuranceagencyforthefuneralsubsidyandcondolencemoneyinaccordancewiththelaw.Thesocialinsuranceagencyshallpromptlyverifytherelevantinformationandapproveandissuethefuneralsubsidyandcondolencemoneyaccordingtotheapplicableprovisions.Article20Thepartofanindividual'smedicalexpensesandmaternitymedicalexpensespayablefromthebasicmedicalinsurance(includingmaternityinsurance)fundshallbesettleddirectlywiththemedicalinstitutionandthedistributorofmedicinalproductsupontheexaminationofthesocialinsuranceagency.因特殊情况个人申请手工报 销，应当向社会保险经办机构 提供医疗机构、药品经营单位 的收费票据、费用清单、诊断 证明、病历资料。社会保险经 办机构应当对收费票据、费用 清单、诊断证明、病历资料进 行审核，并自收到申请之日起 30个工作日内办理完毕。Ifanindividualappliesformanualreimbursementduetospecialcircumstances,heorsheshallprovidethesocialinsuranceagencywiththebills,listofexpenses,diagnosiscertificates,andmedicalrecordsfromthemedicalinstitutionordistributorofmedicinalproducts.ThesocialinsuranceagencyshallexaminetheNils,listofexpenses,diagnosiscertificates,andmedicalrecordsandcompletetheprocessingoftheapplicationwithin30workingdaysofreceiptoftheapplication.参加生育保险的个人申领生育津贴，应当向社会保险经办机Anindividualparticipatinginmaternityinsurancewhoappliesformaternityallowancesshallprovidemedicalrecordstothesocialinsuranceagency.构提供病历资料。社会保险经 办机构应当对病历资料进行审 核，并自收到申请之日起10个 工作日内办理完毕。第二十一条工伤职工及 其用人单位依法申请劳动能力 鉴定、辅助器具配置确认、停 工留薪期延长确认、工伤旧伤 复发确认，应当向社会保险经 办机构提供诊断证明、病历资 料。Thesocialinsuranceagencyshallexaminetherelevantmedicalrecordsandcompletetheprocessingoftheapplicationwithin10workingdaysofreceiptoftheapplication.Article21Whenapplyingfortheappraisaloflaborcapacity,confirmationofassistivedeviceconfiguration,confirmationoftheextensionofworksuspensionwithpay,orconfirmationoftherecurrenceofoldwork-relatedinjuries,anemployeewithwork-relatedinjuriesandhisorheremployershallprovidediagnosiscertificatesandmedicalrecordstothesocialinsuranceagency.第二十二条个人治疗工 伤的医疗费用、康复费用、安 装配置辅助器具费用中应当由 工伤保险基金支付的部分，由 社会保险经办机构审核后与医 疗机构、辅助器具配置机构直 接结算。Article22Thepartofanindividual'smedicalexpenses,rehabilitationexpenses,andexpensesfortheinstallationandconfigurationofassistivedevicesforthetreatmentofwork-relatedinjuriespayablefromthework-relatedinjuryinsurancefund,shallbedirectlysettledwiththemedicalinstitutionandassistivedeviceconfigurationinstitutionupontheexaminationofthesocialinsuranceagency.因特殊情况用人单位或者个人 申请手工报销，应当向社会保 险经办机构提供医疗机构、辅 助器具配置机构的收费票据、 费用清单、诊断证明、病历资 料。社会保险经办机构应当对 收费票据、费用清单、诊断证 明、病历资料进行审核，并自 收到申请之日起20个工作日内 办理完毕。AnemployeroranindividualthatappliesformanualreimbursementduetospecialcircumstancesshallprovidethesocialinsuranceagencywiththeNIIsJistofexpenses,diagnosticcertificates,andmedicalrecordsfromthemedicalinstitutionorassistivedeviceconfigurationinstitution.ThesocialinsuranceagencyshallexaminetheHlls,listofexpenses,diagnosiscertificates,andmedicalrecordsandcompletetheprocessingoftheapplicationwithin20workingdaysofreceiptoftheapplication.第二十三条 人力资源社 会保障行政部门、医疗保障行 政部门应当按照各自职责建立Article 23 Theadministrativedepartmentofhumanresourcesandsocialsecurityandmedicalinsuranceadministrativedepartmentshall,健全异地就医医疗费用结算制 度。社会保险经办机构应当做 好异地就医医疗费用结算工 作。accordingtotheirrespectiveduties,establishandimprovetherulesforthesettlementofmedicalexpensesincurredfromnon-localmedicalservices.Thesocialinsuranceagencyshalleffectivelysettlemedicalexpensesincurredfromnon-localmedicalservices.第二十四条个人申领失 业保险金，社会保险经办机构 应当自收到申请之日起10个工 作日内办理完毕。Article 24 Whereanindividualappliesforunemploymentinsurancebenefits,thesocialinsuranceagencyshallcompletetheprocessingoftheapplicationwithin10workingdaysofreceiptoftheapplication.个人在领取失业保险金期间， 社会保险经办机构应当从失业 保险基金中支付其应当缴纳的 基本医疗保险（含生育保险） 费。个人申领职业培训等补贴，应 当提供职业资格证书或者职业 技能等级证书。社会保险经办 机构应当对职业资格证书或者 职业技能等级证书进行审核， 并自收到申请之日起10个工作 日内办理完毕。Duringtheperiodwhenanindividualreceivesunemploymentinsurancebenefits,thesocialinsuranceagencyshallpaythebasicmedicalinsurance(includingmaternityinsurance)premiumpayablefromtheunemploymentinsurancefund.Individualswhoapplyforvocationaltrainingandothersubsidiesshallprovidevocationalqualificationcertificatesorvocationalskilllevelcertificates.Thesocialinsuranceagencyshallexaminethevocationalqualificationcertificatesorvocationalskilllevelcertificatesandcompletetheprocessingoftheapplicationwithin10workingdaysofreceiptoftheapplication.第二十五条个人出现国 家规定的停止享受社会保险待 遇的情形，用人单位、待遇享 受人员或者其亲属应当自相关 情形发生之日起20个工作日内 告知社会保险经办机构。社会 保险经办机构核实后应当停止 发放相应的社会保险待遇。Article 25 Whereanindividualfallsunderanycircumstanceunderwhichheorsheceasestoenjoysocialinsurancebenefit