灵活就业人员参保是实现全民医保目标的关键之一,该群体参加职工医保的比例低,产生了逆向选择、保障不充分、参保地和就医地（常住地）分离等问题。各地围绕个人账户设立、参保门槛设定、缴费和待遇政策等制度要素,探索形成了灵活就业人员参加职工医保的五种模式。建议适当统一各地制度规定,不建立个人账户,对灵活就业人员分类管理,适当降低参保门槛,保护平台企业灵活就业人员参保权益。

Flexible employment group is the key to achieving the goal of universal medical insurance. The low proportion of this group participating in employees’ basic medical insurance has resulted in adverse selection, inadequate protection, and separation of places of insurance and places of medical treatment (permanent residence). Local governments have explored and formed five modes for flexible employees to participate in employees’ basic medical insurance based on institutional elements such as the establishment of individual accounts, the threshold of insurance participation, payment and benefits. It is suggested to properly unify local regulations, not to establish individual accounts, to manage flexible employment personnel by classification, to appropriately lower the threshold of insurance participation, and to protect the rights and interests of flexible employment groups in platform enterprises.