楚雄州职工大病补充保险运行情况分析

An Operation Analysis of Supplementary Insurance for Staffs’ Serious Illness in Chuxiong Prefecture

楚雄州职工大病补充保险引入商保公司,采取合署办公方式,共同经办管理。2008—2010年,除州本级、楚雄市的基金收支差异分别为-6.15%、-6.73%,禄丰县为7.32%外;其他县市患者在州内定点医疗机构支付的大病补充保险医疗费用,与缴纳的保费比例基本一致。但异地转诊比例高,达43.48%,医疗费支出占总赔款支出的52.03%。已成为基金支出的最大风险点。

The Introduction of commercial insurance company to supplementary insurance of staffs＇ serious illness in Chuxiong takes a mode of allied offices, and also offices could co-handle and co-manage. Through 2008 to 2010, the fund revenue and expenditure differences of prefectural level in Chuxiong and City of Chuxiong is -6.15% and -6.73%, and Lufeng County is 7.32%. While in other counties, the cost that patients pay for the complement insurance of a serious illness in designated medical institutions within Chuxiong Prefecture basically agree with the insurance premium rate who pay for. However, the rate of referral in different places remains high, is about 43.48%. Hence, medical expenses take a proportion of 52.03% in the total indemnity expenditure. As a result, this has become the most serious risk point for the fund expenditure.