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Chapter Law Content

Title: National Health Insurance Act CH
Category: Ministry of Health and Welfare(衛生福利部)
Chapter 4 Collection and Calculation of Premiums
Article 27
This Insurance contribution rates shall be calculated according to the following provisions of Articles 18 and 23:
1.For the insured in Category 1:
(1)The insured and their dependents referred to item 1, subparagraph 1, paragraph 1 of Article 10 shall pay 30 percent of the premium, with the other 70 percent of it paid by the group insurance applicants. Nonetheless, for the premiums charged for the employees of private schools, the insured and their dependents shall pay 30 percent of the premiums, with 35 percent of them paid by their schools; the remaining 35 percent shall be subsidized by the central government.
(2)The insured and their dependents referred to in items 2 and 3 of subparagraph 1, paragraph 1 of Article 10 pay 30 percent of the premiums, the group insurance applicants pay 60 percent of them, and the remaining 10 percent shall be subsidized by the central government.
(3)The insured and their dependents referred to in items 4 and 5 of subparagraph 1, paragraph 1 of Article 10 shall pay the full premium.
2.The insured and their dependents in Category 2 pay 60 percent of the premiums, with the other 40 percent subsidized by the central government.
3.The insured and their dependents in Category 3 pay 30 percent of the premiums, with the other 70 percent subsidized by the central government.
4.For the insured in Category 4:
(1)For the insured in item 1, subparagraph 4, paragraph 1 of Article 10, the institutions they belong shall subsidize their premiums in full.
(2)For the insured in item 2, subparagraph 4, paragraph 1, Article 10, the central military training administrative authority shall subsidize the premium in full.
(3)For the insured in item 3, subparagraph 4, paragraph 1 of Article 10, the central correctional authority and the Ministry of Defense shall subsidize the premium in full.
5.For the insured in Category 5, the central competent authority in charge of social welfare shall subsidize the premium in full.
6.The premium payable by the insured referred to in item 1, subparagraph 6, paragraph 1 of Article 10 shall be subsidized by the Veterans Affairs Commission, Executive Yuan. Whereas 30 percent of the premium of the insured dependents shall be self-covered and 70 percent subsidized by the Veterans Affairs Commission, Executive Yuan.
7.The insured and their dependents referred to in item 2, subparagraph 6, paragraph 1 of Article 10, shall pay 60 percent of the premium and the central government shall subsidize 40 percent.
Article 28
Before the promulgation of this amendment on January 4, 2011, every level of government, which has been unable to appropriate funds to pay the Insurer in accordance with Article 29 (pre-amendment), should present a payback plan to the Insurer. Timeframe for the payback should not exceed eight years and Insurer shall request interest payments in accordance with Article 30 (pre-amendment).
Article 29
The number of dependents in items 1 to 3 of Category 1 , for whom the group insurance applicants or the government subsidize premium, shall be the average number of the dependents that the insured in items 1 to 3 of Category 1 actually have.
Article 30
The premium of this Insurance shall be paid monthly according to the following provisions in Articles 18 and 23:
1.The premium to be contributed by the insured in Category 1 shall be deducted from the pay roll and paid by the group insurance applicants to the Insurer, together with the group insurance applicant’s contributions, by the end of the following month.
2.The premium to be contributed by the insured in Categories 2, 3 and 6 shall be paid monthly to the group insurance applicants to which they belong, and the group insurance applicants shall forward the accumulated premiums to the Insurer no later than the end of the following month.
3.The premium payable by the insured in Category 5 shall be paid by the central competent authority regarding social welfare to the Insurer no later than the fifth day of the current month.
4.For the insured in Categories 1 to 4 and 6, the premiums shall be partly subsidized by the various levels of governments and shall be paid in advance to the Insurer twice a year by the end of January and of July. The account shall be settled at the end of the year.
The premium of the Insurance for the month in the previous paragraph when the insured subscribes to coverage shall be fully paid; and that for the month when the insured withdraw from coverage shall be exempted.
Article 31
The insured belonging to Categories 1 to 4 and 6 should pay supplementary insurance premium based on the supplementary insurance rate according to law, which shall be deducted by the premium withholder upon payment and given to the Insurer before the end of the following month after payment. However, single benefit payments in excess of ten million as well as those not reaching a certain amount are exempted from deductions:
1.Accumulated annual bonus given by group insurance applicant in excess of four times the monthly premium ratable wages.
2.Salary earnings outside of those from the group insurance applicant. However, this is not applicable for the salary earnings of Category 2 individuals.
3.Income from professional practice; however income from professional practice designated by Article 20 as insured payroll-related amount is not to be included in the calculation of premium ratable wages;
4.Stock earnings; however this is not applicable to premium already included in the premium ratable wages;
5.Interest earnings;
6.Earnings from rentals.
The premium withholder shall pay first if he is unable to deduct within the specified time.
The Competent Authority shall determine the amount referred to in Paragraph 1, the method of deduction and payment of supplementary premium, as well as other relevant matters.
Article 32
Those who are not eligible, who have lost their eligibility, or who are deemed as not requiring premium withholder to deduct supplementary premium should notify premium withholder prior to receiving benefit payments so that no supplementary premium will be deducted.
Article 33
The supplementary premium rates of Article 31 shall be calculated at 2 percent one year after the implementation of the amendment of the Act on January 4, 2011. On the second year, it should be adjusted in accordance with the growth rate of the insurance premium rate, which shall be announced by the Competent Authority.
Article 34
For the group insurance applicant of items 1 to 3 of Category 1, when the total amount of salary paid exceeds the insured payroll-related amount for that month, supplementary premium should be calculated based on the difference as well as the rate in the previous article and paid jointly per month in accordance with payment structure in Article 27.
Article 35
A grace period of fifteen days shall be allowed in case that the group insurance applicants, the insured, or the premium withholder do not pay the premium during the period provided in this Act. If payment is not made by the end of the grace period, an overdue charge of 0.1 percent of the amount payable shall be levied for each day of delay after the expiry day of the said grace period until the premium is fully paid up with the maximum amounts as follows:
1.15 percent of the payment to be made by the group insurance applicant and premium withholder.
2.5 percent of the payment to be made by the insured.
The overdue charge mentioned in the previous paragraph may be waived if it is less than the amount to be fixed by the Competent Authority.
If the premium and the overdue charge referred to in Paragraph 1 payable by the group insurance applicant/premium withholder remains unpaid for thirty days, the Insurer may refer the case to the court for compulsory execution under the law; the same shall apply to the insured [who has failed to pay either the premium or the overdue charge] for one hundred and fifty days.
Article 36
Those who are unable to pay the premium, overdue charge, or full self-covered premium due to economic difficulties should apply for installment payments with the Insurer or apply for loans or subsidies according to Article 99. The Insurer should provide assistance and, if necessary, work with social agencies or relevant private professional groups to look for assistance within the society.
The Insurer shall determine the conditions of applications, review procedures, installment payment schedule, and other relevant matters in the previous paragraph and report to the Competent Authority for approval and announcement.
Article 37
The Insurer may temporarily suspend benefits for those group insurance applicants or those insured that have been proven to have the ability to pay the premium and the overdue charge through investigation and supervision, but have chosen not to do so. However such restrictions do not apply to portion of the premium payable withheld by or paid to the group insurance applicants, those approved by the Insurer as having to be paid in installments according to the previous article, or the premium payable during the period of time the insured is receiving protection under the Domestic Violence Prevention Act.
The premium during the temporary suspension of benefits should still be collected.
Article 38
Whenever the group insurance applicants or premium withholder owe premium or the overdue charge, but have no property for execution or do not have property to pay off their debts, the persons in charge or the persons dealing with the businesses should be responsible for clearing the debts.
Article 39
Premiums and overdue charges of this Insurance take precedence over general claims.