Calculation of national health insurance premiums
Calculation of monthly insurance premiums- The amount of monthly insurance premiums for the self-employed insured shall be calculated per unit of household (Article 69 (5) of the “National Health Insurance Act”).
Monthly amount of insurance premiums for the household to which the self-employed insured is affiliated = Contribution points X Amount per contribution point
· Contribution points: Calculated based on the income and property of the self-employed insured: Provided, That where the self-employed insured, as prescribed by Presidential Decree, receives a loan from a financial company, etc. pursuant to subparagraph 1 of Article 2 of the Act on Real Name Financial Transactions and Confidentiality to purchase or rent a house that does not exceed the standards prescribed by Presidential Decree for the purpose of actual residence, and then gives notice to the NHIS of such fact, the loan shall be excluded when calculating the contribution point, subject to assessment pursuant to Presidential Decree. (Article 72(1) of the National Health Insurance Act and Article 42(1) of the Enforcement Decree of the National Health Insurance Act).
· Amount per contribution point: The amount per contribution point of the self-employed insured is 208.4 won (Article 73 (3) of the “National Health Insurance Act” and Article 44 (2) of the “Enforcement Decree of the National Health Insurance Act”).
※ Types and scopes of “income” and “property”
The income considered when calculating the contribution points refers to the following types of income under the “Income Tax Act” (Article 42 (2) and Article 41 (1) of the “Enforcement Decree of the National Health Insurance Act”):
· Interest income
· Dividend income
· Business income
· Earned income (provided that the earned income deduction referred to the “Income Tax Act” does not apply)
· Pension income (provided that Article 20-3(2) of the Income Tax Act does not apply to the public pension income and all pension income earned during the relevant taxable period shall be deemed as pension income.
· Other income
The types of property considered when calculating the contribution points are as follows (Article 42 (3) of the “Enforcement Decree of the National Health Insurance Act”):
· Land, buildings, housing, vessels, and airplanes subject to the property tax according to the “Local Tax Act” (provided that family property, village property, and other buildings and land similar thereto for the purpose of common use will be excluded)
· For the self-employed insured who own no houses, the deposit money and monthly rent for the leased houses
· Passenger vehicles referred to in the “Local Tax Act”, and other passenger vehicles referred to in Article 123, subparagraph 2 of the “Enforcement Decree of the Local Tax Act”. However, the following vehicles will be excluded:
√ If the vehicle has been in use for nine or more years
√ Where the value of the vehicle calculated by applying the rate announced by the Minister of Health and Welfare to the tax base, on account of the residual value rate by the number of years elapsed for the vehicle under Article 4(1)3 of the Enforcement Decree of the Local Tax Act, is less than 40 million won.
√ A vehicle owned by a disabled person registered under the “Act on Welfare of Persons with Disabilities”
√ A vehicle not taxed under the “Restrictions of Special Local Taxation Act”
√ A commercial vehicle under the “Enforcement Decree of the Local Tax Act”
- The upper and lower limits on the monthly insurance premium are as follows [Article 69 (6) of the “National Health Insurance Act”, Article 32 of the “Enforcement Decree of the National Health Insurance Act”, and Articles 2 and 3 of the “Notice for the Upper and Lower Limits on Monthly Health Insurance Premiums”]:
· Upper limit: 3,911,280 won
· Lower limit: 19,780 won
Separation of households with self-employed insured- If a self-employed insured falls into any of the following categories, the National Health Insurance Service (hereinafter referred to as the “NHIS”) may separate him/her from the relevant household and create a separate household (Article 43 of the “Enforcement Decree of the National Health Insurance Act”):
· A person who has filed an application for the separation of household with the NHIS because he/she resides in a different household and maintains a separate livelihood from the relevant household
· A person who is subject to the application of co-payment under attached Table 2, subparagraph 3 (d) of the “Enforcement Decree of the National Health Insurance Act”
· A person servicing as full-time reserve personnel or social service personnel after being called into to serve under the “Military Service Act”
· A person who has been called into to serve as an alternative service personnel under the “Act on the Assignment and Performance of the Alternative Service”
Period of insurance premium collection- While insurance premiums collected from the month following that in which the date the insured becomes eligible falls until the month in which the date before the date the insured loses his/her eligibility falls, if the eligibility as an insured is obtained on the first day of any month or upon his/her request for health insurance coverage among those subject to medical protection such as the men of merit (Article 5 (1) 2 (a) of the “National Health Insurance Act”), the insurance premiums will be collected from the relevant month (Article 69 (2) of the “National Health Insurance Act”).
Insurance premiums for the self-employed insured who are overseas Korean nationals and foreign nationals- The insurance premiums of the self-employed insured who are overseas Korean nationals and foreign nationals [excluding the self-employed insured whose status of stay is permanent resident (F-5) or marriage with Korean citizen (F-6), and the same will apply hereinafter] are calculated for each unit of household according to the identical standards as the self-employed insured who are Korean citizens (Article 109 (9) of the “National Health Insurance Act”, Article 76-4 of the “Enforcement Decree of the National Health Insurance Act”, and Article 6 (1) and the main text of the attached Table 2, subparagraph 1 of the “Application Standards for Overseas Korean Nationals and Foreign Nationals who Stay in Korea for a Long Period of Time”).
· However, if the calculated premium is less than the average premium, the average premium will be determined as the premium (Article 6 (1) and proviso to the attached Table 2, subparagraph 1 of the “Application Standards for Overseas Korean Nationals from and Foreign Nationals who Stay in Korea for a Long Period of Time”).
※ “Average premium” refers to the sum of the premiums payable by all households with a self-employed insured [referring to households whose head of household is a Korean and whose status of stay is permanent resident (F-5) or marriage with Korean citizen (F-6)] and the sum of all premiums payable by employee insured (Including monthly income premium, and for monthly remuneration premium, excluding the amount payable by the employer and the State under Article 76 (1) of the “National Health Insurance Act”) in November divided by the sum of the number of households with a self-employed insured and the number of employee insured (attached Table 2, subparagraph 2 of the “Application Standards for Overseas Korean Nationals and Foreign Nationals who Stay in Korea for a Long Period of Time”).
※ Insurance premiums for the self-employed insured who are overseas Korean nationals and foreign nationals are calculated by considering each individual as one household. However, if an application has been filed by an insured himself/herself, the said person will be the head of a household as determined by the NHIS, and a household may be formed with members comprised of the spouse who is an overseas Korean national or a foreign national (excluding a person who is in a relationship of de fact marriage) or a child aged younger than 19 (including the child of his/her spouse) (attached Table 2, subparagraph 4 of the “Application Standards for Overseas Korean Nationals and Foreign Nationals who Stay in Korea for a Long Period of Time”).
· The insurance premium for the following households will be either the premium estimated according to the same standards as the self-employed insured who are Korean citizens or the amount equivalent to the lower limit on the monthly insurance premium of the self-employed insured, whichever is greater (attached Table 2, subparagraph 3 of the “Application Standards for Overseas Korean Nationals and Foreign Nationals who Stay in Korea for a Long Period of Time”).
√ If the head of the household is a person whose status of stay has been recognized as a family member of a person recognized as a refugee is for visiting or joining family (F-1)
√ If the head of the household is a person recognized as a refugee and his/her status of stay is for resident (F-2)
√ If the head of the household is a minor