As part of China's efforts to reform the healthcare landscape in the country, large changes to the basic structure of the social security apparatus have been drafted in order to modernize the financial infrastructure supporting the health care system. This has included a number of mandated social security mechanisms, including maternity insurance.

The maternity coverage that is provided through the social security system in China is mandatory. However, while the central government issues the mandate, it is up to each municipality to organize and manage the maternity coverage for their area. This means that while different cities will have maternity insurance offered as part of the required social security structure, the particulars such as contributions and benefits may vary.

Although it is up to local municipalities to set rates and organize the collection of funds for their maternity programs, the system itself is structured around employers, whether public agencies, institutions, private enterprises or businesses. Each business or organization must register their employees with the relevant local authority managing the maternity insurance fund; failing to do so may result in fines and additional measures from the local maternity insurance regulatory authority.

Maternity Insurance Contributions

The cost of contributing towards the local municipality's maternity fund is borne solely by the employer. Employers must contribute a certain percentage of their total wage bill towards the insurance fund. It is up to the local municipality to set the rate of contribution for employers within their purview, however most cities have set the rate at between 0.5 to 1 percent of the employer's total wages. In some cases, the rate of contribution towards the municipal maternity fund may be higher or lower based on how the municipality has decided to manage the program and fund.

Maternity Insurance Benefits

The Chinese social security system for maternity provides employees covered under the plan with a number of benefits. Mothers go on maternity leave which is generally 3 months in length. During her maternity leave the mother will receive a predetermined amount as a maternity allowance, which is paid to her out of the insurance fund and not by her employer. Previously, the maternity allowance paid out to the mother would be fixed relative to her salary, however a new law promulgated in mid-2011 requires that mothers should receive payments that are equal to the average of all wages paid by their employer. However, many municipalities require time to restructure their local maternity insurance structure and funds and some may not have adapted to the new policies.

Depending on local regulations and rules, other benefits may be offered as well, such as a lump sum at the time of birth to assist the mother in dealing with associated costs. Fathers may also receive a short period of paternity leave, although it is usually limited to a few days of paid leave.

Some cities have already reworked their municipal health insurance plans to take account of the new rules, with Beijing being the most prominent among them. The city of Beijing reworked their maternity insurance laws in late 2011 to take account of the fact that there are many women in important positions in businesses or organizations both public and private. Beijing has included in their new maternity insurance system the provision that if a mother's wage is greater than the average salary of the company, then the employer must make up the difference between the maternity allowance and the mother's monthly wages.

As other municipalities rewrite their local maternity insurance coverage policy to bring themselves into line with the changes sought by the national government, some may or may not adopt similar policies to Beijing. While both maternity leave and allowance are guaranteed by the maternity insurance provisions of the national social security directives, details of benefits or additional benefits such as lump sums to assist with the costs of childbirth are decided at a local level by the municipal maternity insurance authority.

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