文 | 赵伟、贾东旭、侯倩楠、耿佩璇 联系人 | 侯倩楠 摘要 人口结构快速变化下，社保制度的完善及改革可能是"十五五"期间重点推进领域之一。当前，我国社保 体系现状如何，面临哪些压力？海外社保制度有何经验？ 本文系统分析，供参考。 一、我国社保改革的历史沿革？我国社保体系正从"广覆盖"迈向高质量发展与全国统筹阶段 我国社会保障制度随经济社会发展需求历经多阶段演进。 1951年《中华人民共和国劳动保险条例》初步 建立城镇职工社保制度；1986年养老保险探索企业与个人共缴的社会统筹，1991年明确国家、企业、个 人三方共担机制，标志从"企业保险"向"社会保险"转型。1998 年起社保体系加速建设，劳动和社会保障 部成立实现行政统一。2010年《社会保险法》推动社保制度进入法治化阶段。 眼下，我国社会保障体系正从"广覆盖"迈向高质量发展与全国统筹阶段。 2014 年，我国整合新农保与城 镇居民养老保险，建立统一的城乡居民基本养老保险制度，逐步打破城乡社保二元分割；2018年，通过 建立企业职工基本养老保险基金中央调剂制度。2022 年第三支柱个人养老金正式实施，形成"基本养老保 险+企业年金和职业年金+个人养老金 ...

Core Viewpoint - The article discusses the increasing attention on the rights protection of "aged workers" who are beyond the statutory retirement age, highlighting recent regulatory changes aimed at improving their legal status and rights [1][4][8]. Group 1: Current Challenges for Aged Workers - Aged workers face unclear legal identities, lack of rights protection, and ambiguous legal remedies, making it difficult for them to establish labor relations with employers [4][6]. - The current labor laws in China create a dichotomy between labor relations and civil relations, leading to aged workers often being excluded from labor law protections [4][6]. - The termination of labor contracts upon reaching retirement age or starting to receive pension benefits further complicates their ability to maintain employment [4][6]. Group 2: Regulatory Changes and Trends - The Ministry of Human Resources and Social Security's recent draft regulations aim to include all aged workers, regardless of their pension status, under protective measures [8][12]. - The draft regulations outline specific rights and obligations, including work agreements, working hours, wages, and mandatory participation in work injury insurance [8][12]. - The overall trend is towards strengthening the basic rights of aged workers, reflecting societal expectations and addressing the challenges posed by an aging population [8][12]. Group 3: Work Injury Insurance - Work injury insurance is a significant concern for aged workers, as their lack of recognized labor relations can prevent them from accessing such benefits [10][11]. - Recent draft regulations propose mandatory work injury insurance for aged workers, shifting the responsibility to employers [11][12]. - This change is expected to lower costs for companies employing aged workers while expanding coverage for this demographic [12][13]. Group 4: Future Legislative Needs - Experts suggest that future amendments to labor laws and contracts are necessary to provide a stronger legal basis for the protection of aged workers [13]. - There is a call for improved legal awareness and streamlined legal remedies for aged workers to facilitate their rights protection [13].

原标题： 2024年全省城镇职工基本养老保险基金收入1826.98亿元，支出1716.66亿元。年末城镇职工基本养老保 险基金累计结余1662.56亿元。 2024年末全省参加城乡居民基本养老保险人数1597.73万人，其中实际领取待遇人数497.97万人。 2024年全省城乡居民基本养老保险基金收入222.97亿元，支出124.28亿元。年末城乡居民基本养老保险 基金累计结余573.56亿元。 失业保险方面，2024年末全省参加失业保险人数571.09万人，比上年末增加17.71万人，领取失业保险金 人数4.52万人。全年为8.20万名失业人员发放不同期限的失业保险金，发放金额8.96亿元，同比增加1.62 亿元，失业保险金月人均水平1782元。全年为领取失业保险金人员代缴基本医疗保险费（含生育保险 费）1.60亿元，同比增加0.41亿元。 2024年全省实施阶段性降低失业保险费率政策，为企业减负29.35亿元。全年向6.36万户企业发放稳岗返 还资金10.28亿元，惠及职工286.39万人；发放技能提升补贴1.67亿元，惠及职工10.28万人。 2024年全省失业保险基金收入39.23亿元，支出23.04 ...

Core Viewpoint - The recent judicial interpretation by the Supreme Court invalidates any agreements between employers and employees regarding the non-payment of social insurance fees, emphasizing that social insurance is a legal obligation akin to taxation [1][3][4]. Summary by Sections Legal Implications - Any agreement to avoid social insurance payments, whether initiated by employers or employees, will be deemed invalid after September 1, 2023, significantly increasing the cost of avoiding social insurance for employers [3][4]. - The Supreme Court's stance highlights the legal necessity of social insurance, reinforcing its mandatory nature for both employers and employees [4]. Current Social Insurance Landscape - As of 2024, China has approximately 734 million employed individuals, but only about 246 million, or 33.5%, are fully covered by social insurance [4]. - The social insurance system in China, which includes five types of insurance and housing fund, has been historically mandatory since its inception [5][6]. Financial Aspects - The minimum social insurance contribution in Beijing for 2024 totals approximately 2,524 yuan per month, with individuals contributing around 716 yuan if they are self-employed [6]. - The 2024 national social insurance fund budget anticipates revenues of 11.89 trillion yuan, a 5.2% increase, against expenditures of 10.61 trillion yuan, indicating a surplus of 1.29 trillion yuan [10]. Demographic Challenges - China is facing a demographic shift with a significant increase in retirees, projected to exceed 20 million annually, while the potential labor supply is only about 17-18 million per year [13][14]. - The imbalance between the growing retired population and the working-age population poses a long-term challenge for the social insurance system [14]. Government Measures - The government is exploring various strategies to address the funding gap in the social insurance system, including increasing fiscal subsidies and reallocating funds from wealthier provinces to support less affluent regions [15][16]. - There is a focus on enhancing compliance with social insurance payments among employers, which may lead to increased operational costs for businesses, particularly in low-margin sectors [17][18]. Future Considerations - The current social insurance system may require further improvements to enhance its attractiveness and coverage, especially for younger, mobile workers [20][21]. - The necessity of social insurance is framed not only as a legal obligation but also as a long-term investment for individuals, with potential benefits in times of need [21].

Core Points - The article discusses situations where medical insurance (医保) does not provide reimbursement for medical expenses, highlighting six specific scenarios [2][4][5][7]. Group 1: Situations Where Medical Insurance Does Not Cover Expenses - Work-related injuries are covered by work injury insurance, not medical insurance [2]. - Medical expenses from accidents caused by third parties, such as traffic accidents or fights, are not covered unless the responsible party is identified [2]. - Public health services funded by the government, such as free vaccinations and disease prevention, are not reimbursed by medical insurance [2][4]. - Medical expenses incurred while receiving treatment abroad are not covered by medical insurance [4]. - Preventive health measures, such as routine check-ups and wellness treatments, are not included in the coverage [4]. - Only expenses listed in the three major directories (medical insurance drug directory, medical treatment project directory, and medical service facility directory) are eligible for reimbursement [5][7]. Group 2: The Three Major Directories of Medical Insurance - The drug directory includes: - Class A drugs, which are fully reimbursed [8]. - Class B drugs, which require a personal contribution of 10% or 14% [8]. - Non-reimbursable drugs, often expensive or for rare diseases, are excluded from coverage [8]. - The medical treatment project directory includes necessary and effective clinical treatment projects, but excludes cosmetic procedures and certain fees [9]. - The medical service facility directory covers essential services provided by designated medical institutions, but excludes non-essential services like entertainment fees [9].

Core Viewpoint - The article provides a detailed explanation of how social insurance fees are calculated for employees in Chongqing, including the components of the fees, the calculation methods, and how to check personal payment records. Group 1: Social Insurance Fee Components - The social insurance fees for employees generally include pension insurance, medical insurance (including maternity insurance), unemployment insurance, and work injury insurance [2][3]. - The monthly payment amount is calculated using the formula: Monthly Payment Amount = Monthly Payment Base × (Employer Contribution Rate + Employee Contribution Rate) [2]. Group 2: Contribution Rates - The contribution rates for various types of insurance are as follows: - Basic Pension Insurance: Employer 16%, Employee 8% - Basic Medical Insurance (including maternity): Employer 8.5% (0.5% for maternity), Employee 2% - Major Medical Mutual Insurance: Employer 1.5%, Employee 5 yuan per month - Unemployment Insurance: Employer 0.5%, Employee 0.5% - Work Injury Insurance: Employer 0.3%-2.2%, Employee does not contribute [3]. Group 3: Payment Base Determination - The payment base is determined based on the employee's declared salary, which is generally the average monthly salary of the previous year. New employees use their starting salary [5]. - If the declared salary is below 60% of the average salary, the base is set at 60% of the average. If it exceeds 300%, the base is capped at 300% of the average [5]. Group 4: 2024 Payment Base Limits - For 2024, the upper limit for the social insurance payment base in Chongqing is set at 21,793 yuan, while the lower limit is 4,359 yuan [6]. Group 5: Example Calculations - An example is provided where an employee with a declared salary of 4,200 yuan will have their payment base adjusted to 4,359 yuan due to being below the lower limit. The total monthly contributions are calculated accordingly [7][9]. - Another example shows an employee with a declared salary of 5,000 yuan, which falls within the limits, leading to a straightforward calculation of contributions [10]. Group 6: How to Check Payment Records - Employees can check their social insurance payment records through various online platforms, including: - Yukuai Ban APP - Chongqing Human Resources and Social Security App - Chongqing Medical Security Bureau WeChat account - Chongqing Taxation WeChat account - Electronic Taxation Bureau App [11][12][13].

Employment Procedures for Graduates - Graduates with confirmed employment should sign labor contracts promptly and follow up on social security contributions, as well as complete household registration and organizational relationship transfer procedures within the stipulated time [2][3] - Graduates without confirmed employment can retain their household registration and archives at the school for two years or transfer them to their original household registration location. They can register for job search services at local employment agencies or online platforms to access job information and career guidance [3][5] Archive Management - Archives should not be personally retained; they must be managed by educational institutions or relevant employment agencies. If a graduate has their archive, they should contact their original school for proper transfer [4][5][6] Labor Contract Essentials - Labor contracts must include essential clauses such as the employer's name, employee's details, contract duration, job description, working hours, salary, social insurance, and other legal requirements. Additional terms like probation, training, and benefits can also be included [7][8] Social Insurance and Housing Fund - The "Five Insurances and One Fund" include pension, medical, unemployment, work injury, maternity insurance, and housing provident fund, which provide various forms of financial support. The contribution rates for these insurances vary by region and should be verified before signing a labor contract [9]

Core Viewpoint - The article discusses the significance of employer liability insurance in supporting small and medium-sized enterprises (SMEs) in China, especially in the context of rising employment demands and new employment forms [1][6]. Group 1: Employer Liability Insurance Overview - Employer liability insurance is a type of property insurance that covers economic compensation responsibilities that employers must bear when employees suffer injuries or occupational diseases during work [1][7]. - It serves as a crucial risk transfer tool for employers, distinguishing itself from mandatory workers' compensation insurance and personal accident insurance [5][7]. Group 2: Legal and Industry Context - The Beijing Financial Court has identified that disputes related to employer liability insurance are characterized by diverse litigants, complex legal relationships, and significant differences in industry standards [6]. - Most disputes arise in labor-intensive industries, including manufacturing, service, special employment, and new business models [6]. Group 3: Recommendations for Employers and Insurers - Employers should ensure the authenticity of employment relationships, accurately report employee job information, carefully read insurance terms, and follow the "pay first, claim later" principle during claims [8]. - Insurers are encouraged to improve service quality by optimizing product design and standardizing clause interpretations to address the "easy to insure, hard to claim" issue [8][9]. Group 4: Implications for Employees - For employees, employer liability insurance provides an additional layer of protection, allowing them to claim directly from insurance companies if employers fail to fulfill their responsibilities [10]. - Employees are advised to preserve evidence and understand the company's insurance status in case of work-related injuries [10].

Core Viewpoint - Beijing Financial Court has introduced guidelines to enhance the role of employer liability insurance in protecting the rights of small and medium-sized enterprises and workers, aiming to support high-quality economic and financial development [1][2]. Group 1: Employer Liability Insurance Overview - Employer liability insurance is a type of property insurance that covers economic compensation responsibilities that employers must fulfill when employees suffer injuries or occupational diseases during work [2]. - This insurance serves as an important tool for transferring employment risks and is distinct from mandatory workers' compensation insurance and personal accident insurance [2]. Group 2: Guidelines for Employers and Employees - Companies are advised to ensure that insurance contracts are legally valid and effective, manage contract performance, and report claims promptly [3]. - Employees should assert their legal rights for occupational injury compensation, actively participate in the claims process, and adhere to legal standards to maintain market order [3][4]. Group 3: Distinction Between Insurance Types - It is crucial for employees to differentiate between employer liability insurance and personal accident insurance, as both provide different types of coverage [4]. - Employees can claim compensation from both employer liability insurance and personal accident insurance if their occupational injury is due to an accident, allowing for more comprehensive protection [4].

Group 1 - The new policy allows specific groups, including elderly workers and interns, to participate in work injury insurance, ensuring their rights are protected [1][2] - From May this year, workers over the legal retirement age up to 70, vocational school interns, recent graduates, and unemployed youth aged 16-24 can enroll in work injury insurance without personal contributions [1][2] - Employers are required to enroll these specific workers in work injury insurance and pay the corresponding fees [1][2] Group 2 - Employers must accurately report the labor remuneration of these specific workers, with a minimum monthly contribution based on the lower limit of the annual average wage for urban employees [2] - For example, an intern in a mechanical manufacturing company would have a monthly insurance fee of 47 yuan based on a contribution base of 4273 yuan [2] - If employers fail to pay the required insurance fees, they are responsible for compensating work injury benefits according to regulations, and the insurance fund will cover new expenses after payment is made [2]