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. 2018 Mar 7;13(3):e0193273. doi: 10.1371/journal.pone.0193273

Table 1. Characteristics of the UMIS in 2014.

Content UEBMI NRCMS URBMI
Year initiated 1998 2003 2007
Main target population [33] Urban employees (including private sector employees) Rural residents (household unit) Urban informal employees, students, children, elderly people without previous employment
Population covered 5.1 million (1998) [34]
283.3 million (2014)
80 million (2004)
736 million (2014)
42.9 million (2007)
314.5 million (2014)
Risk-pooling At prefecture level At county level At prefecture level
Covered cities 333 municipalities 2854 counties 333 municipalities
Enrollment feature Mandatory Voluntary Voluntary
Benefit package Outpatient and inpatient medical service Inpatient medical service Inpatient and catastrophic outpatient medical service
Source of funding [35] 8% of annual payroll (6% from employers and 2% from employees) Government subsidy and individual premium Government subsidy and individual premium
Annual premium per capita [36] 383 RMB (1998)
2841 RMB (2014)
30 RMB (2003)
411 RMB (2014)
50 RMB (2007)
409 RMB (2014)
Annual reimbursement ceiling [33] Six-times average wage of employee in the city Six-times disposable income of local residents Six-times income of local farmers
Predominate payment method Global budget, capitation, diagnosis related groups (DRGs) [37] Global budget, capitation, DRGs DRGs, bed per day payment, capitation, global budget [38]
Medical provider Enrolled hospitals Enrolled hospitals Enrolled hospitals

Note: UEBMI: Urban Employee’s Basic Medical Insurance; NRCMS: New Rural Cooperative Medical scheme; URBMI: Urban Resident Basic Medical Insurance.