Table 1.
Comparison of health insurance currently available for rural-to-urban migrant workers
| NCMS | URBMI | UEBMI | Early MWHI | |
|---|---|---|---|---|
| Launch year | 2003 | 2007 | 1998 | 2006 |
| Eligible conditions | ||||
| Eligible population | Rural, employed/non-employed | Urban, non-employed | Urban/rural, employed/self-employed | rural in urban, employed |
| contract | – | – | Necessary | Necessary |
| Dependence on employee | – | – | Yes | Yes |
| Coverage ratea | ||||
| In flow-out area | 57.6% + 3.5% | 3.4% + 3.5% | 3.0% | < 0.7% |
| In flow-in area | 6.7% + 1.4% | 3.7% + 1.4% | 18.6% | < 1.5% |
| Total | 64.7% + 4.9% | 7.2% + 4.9% | 21.9% | < 2.2% |
| Insurance typeb | Limited-duration health insurance | Limited-duration health insurance | Limited-payment whole-life health insurance | Limited-duration health insurance |
| Guarantee period | The following one year | The following one year | The following one year and future | The following one year |
| Account type | Risk-sharing account | Risk-sharing account | Individual account + risk-sharing account | Risk-sharing account |
| Financing strategy [6] | ||||
| Minimum financing unit | Family | Family |
Employed: employee + employer Self-employed: individual |
Employed: employee or + employer Self-employed: individual |
| Financing contribution rate |
Family: 20% Government subsidy:80% |
Family: 30% Government subsidy:70% |
8% of payroll Employed: employee: 2% employer: 6% Self-employed: 8% |
Low |
| Total financing amount per unit (RMB/year) | NA | NA | 3485 * 12 * 8% = 3345.6 | Low |
| Bundled with other welfare programs | NA | NA |
Pension insurance On-the-job injury insurance Unemployment insurance Maternity insurance Urban Minimum Standard Living Allowance Program Housing provident fund |
Yes or no |
| Employer’s total contribution rate [38] | – | – | Approximately 30% | Low |
| Employee or individual’s total contribution rate [38] | – | – | Employed: Approximately 10%Self-employed: 8% | Low |
| Total amount of burden for funders per unit (RMB/year/people) c |
Family: 220 Government subsidy: 490 |
Family: 220 Government subsidy: 490 |
Employed: employee: 3485 * 12 * 10% = 4182 employer: 3485 * 12 * 30% = 12,546 Self-employed: 3485 * 12 * 8% = 3345.6 |
Low |
| Covered services |
flow-out area: Outpatient + Inpatient flow-in area: Inpatient |
Outpatient + Inpatient | Outpatient + Inpatient | Inpatient |
| Matching with RUMWs’ health need | Mismatch | Match | Match | Mismatch |
| Geographic consistency for RUMWs | geographically separated | geographically consistent | geographically consistent | geographically consistent |
| Portability, in the view of RUMWs [64, 70, 73, 77] | Low | Low | Quite low | No |
| Membership selectivity [38, 64, 71] | ||||
| Employee | – | – | High | Low |
| Government | Low | Low | High | – |
aThe percentage is calculated from China Migrants Dynamic Survey, a national survey covering about 78 thousand RUMWs [78]. Several places integrated NCMS and URBMI in to one. The percentage after the plus sign is of those who took part in the integrated NCMS and URBMI
b Limited-payment whole-life health insurance refers to the insurance plan that has a set period, in which an insurance holder pay premiums into the policy. Once the holder reaches the target years, premiums are no longer required but the policy’s benefits lasts the insured’s entire life. Limited-duration health insurance refers to a plan with a limited duration, paid by years or less
c “220” is drawn from the payment standards for basic medical insurance of urban and rural residents in 2018 [79]; “3458” from the average payroll of RUMWs in 2017 [41]