Chapter II Insurer, Insured Units, and Insured Persons
Section 1 Insurer
The insurer and the Bureau of Labor Funds, Ministry of Labor must each submit the following forms to the central competent authority for future reference:
1.The statistical records showing insured units, number of insured persons and insurance salary.
2.The statistical records showing all insurance benefits payments.
3.The accounting records showing all transactions involving insurance incomes and expenditures.
4.The insurance fund utilization status.
Insurer shall compile an annual report at the end of each year and send the report to the central competent authority for reference.
Insurer or the central competent authority, when conducting the labor insurance inspections in accordance with Article 28 of the Act, shall present their identification documents.
For purposes of reviewing insurance benefits, the insurer may request the assistance of physicians or professionals in related medical fields according to individual need.
The competent authorities referred to in Paragraph 2 of Article 6 of the Act are the municipalities or county (or city) governments where the workers' worksites are located.
Section 2 Insured Units
The persons employed outside of the industries mentioned in Subparagraph 1 of Paragraph 1 of Article 8 of the Act, refer to the workers approved and recognized by the central competent authority for insurance coverage from other businesses or civil organizations.
Employed persons with no definite employer or self-employed and participating in two or more professional labor unions shall select the major union as their basis for insurance coverage.
The insured unit shall establish roll list (card) of employees or members, attendance and work records, payroll, and account book of salary.
The roll list (card) of employees or members shall include the following contents:
1.Name, sex/gender, date of birth, address, and serial number of I.D. Card.
2.Date of accession, enrollment, or attendance in training.
3.Category of work.
4.Working hours and salary.
5.Period of leave without pay caused by injury or sick leave.
The attendance and work records, payroll, and account book of salary mentioned in the first paragraph, as well as Subparagraph 4 and Subparagraph 5 of the above paragraph are not applicable to occupational union, fishermen's association, association of Chinese Ship Owners, and Chinese Seamen's union.
Workers without definite employers referred to in Subparagraphs 7 to 8 of Paragraph 1 of Article 6 of the Act are those who are always employed by over two employers that do not belong to the categories of Subparagraphs 1 to 5 of the same Article in the past three months, and whose job opportunities, working times, quantities of work, workplaces and remuneration are not steady.
Self-employed persons referred to in Subparagraphs 7 to 8 of Paragraph 1 of Article 6 of the Act are those who perform their job or technique independently and obtain remuneration accordingly, and do not hire persons to help them to do the work with payments.
When units apply for coverage of insurance and undertake insurance procedures, they shall fill out application forms for insurance coverage and joining insurance coverage, and submit each of them to the insurer.
The information for the application for joining insurance coverage should be recorded in detail according to the household registration and related data.
When employers, associations or affiliated authorities hiring workers referred to in Article 6 and Article 8 of the Act apply for coverage of insurance, except for governmental authorities agencies (institutions), public schools and the insured units which use the on-line requisition system providing by governmental agencies (institutions) to apply for coverage of insurance, they shall submit the copies of the front and back pages of the national identification cards of the persons in charge and the copies of the following related documents issued by related business competent authorities:
1.Factories：shall submit the factory related registration certificates.
2.Minefields：shall submit the minefield registration certificates, minefield excavating or prospecting certificates.
3.Salt, ranges, pastures, forest and tea plantations：shall submit registration certificates or related certifying documents.
4.Transportation entities：shall submit transportation permits or other related certifying documents.
5.Public utilities：shall submit business licenses or other related certifying documents.
6.Companies and business entities：shall submit company registration certificates or business registration certificates.
7.Private schools, news media, cultural entities, public-interest entities, cooperative entities, fisheries, occupational training institutions and civil organizations for various businesses：shall submit their accredited or registration certificates.
8.Other industries should provide license or related registration, approval or reference certificates .
Should insured units are unable to obtain certificates described in the preceding paragraphs, they should attach the organization or alteration register application for the withholder or the uniform invoice purchase certificate issued by the revenue service organizations when applying for insurance.
For those workers qualified under Article 6 of the Act, when an insured unit informs the insurer with a namelist on the date the workers formally report for work, become a member of its associations or receive professional training, the effective date of the insurance shall commence at zero hour of the day on which the insured unit delivers the insurance enrollment application or mails the application to the insurer. If the insured unit does not inform the insurer with a namelist on the day the workers formally report for work, become a member of its association or receive professional training, the effective date of the insurance shall commence at zero hour of the next day following the day on which the insured unit delivers the insurance enrollment application or mails the application to the insurer.
When a worker mentioned in the preceding paragraph reports for work at the following time, the insured unit shall, no later than the next working day, deliver or mail the insurance enrollment application and proof of employment to the insurer, and the effective date of the insurance shall commence at zero hour of the day on which the worker reports for work:
1. A non-working day for the insurer according to rules; or
2. After 17:00 and before 24:00 on the day of reporting for work.
When a worker reports for work on a day the local government at where the insured unit is located has announced as a no-work day according to rules, the insured unit shall, no later than the next working day, deliver or mail the insurance enrollment application and proof of employment to the insurer, and the effective date of the insurance shall commence at zero hour of the day on which the worker reports for work
When the insured units withdraw from insurance coverage on the dates after their employees leave their jobs, withdraw memberships from their associations or finish (or withdraw from) professional training programs, the effectiveness of the insurance shall be terminated from the 24th hour of the dates when the application forms for withdrawing from insurance coverage from the insured units reached the insurer or when they are mailed; when the insured units did not withdraw from the insurance coverage on the dates after their employees leave their jobs, withdraw memberships from their associations or finish (or withdraw from) professional training programs, the effectiveness of the insurance shall be terminated on the 24th hour of the dates when employees leave their jobs, withdraw their memberships or finish (or withdraw from) professional training programs.
In the event that the insured unit has withdrawn from the insurance coverage before their employees leave their jobs, withdraw memberships from their associations or finish (or withdraw from) professional training programs, the effectiveness of the insurance shall be terminated from midnight on the date when the application forms for withdrawing from insurance coverage sent by the insured units reached the insurer or when they are mailed. Pursuant to Article 72 of the Act, the insured unit shall be responsible for any loss suffered by the worker caused therefrom.
The dates of the mailing referred to in the five preceding paragraphs are set in accordance with the post-marks of the original sending post offices.
The regulations stipulated in the above six paragraphs with regard to the commencement and termination of the insurance coverage shall also apply to individuals who are approved to participate in the labor insurance according to Article 8 Paragraph 1 of the Act.
If the insured unit applying for insurance did not fill out and submit an application form or the application form did not include the seals of the insured unit and the responsible person, the insurer shall notify the insured unit in writing to amend the same. The insured unit shall make the amendment within ten days starting on the day following the receipt of the notice.
Insurance enrollment application forms, insurance transferring application forms or insurance salary adjustment forms submitted by insured units will not be accepted for processing if neither the name nor the National ID No. of the insured is specified on the application form(s). Forms will also not be accepted if the official seals of the insured unit and executive officer are missing, or if the name, birth date, National ID No. or insured salary of the insured is missing or erroneous. In the event the insured is an employee of foreign nationality as regulated by Paragraph 3, Article 6 of this Act, and if duplicates of the employee's working permit have not be submitted, the insured units shall be notified in writing and requested to provide supplementary documentation; insured units must provide the requested documentation within ten (10) days after the day of receiving the written notice.
When forms for applying insurance enrollment or insurance transferring are corrected by the insured units on time, they shall take effect on the date of submission. When the corrections are overdue, they shall take effect on the next day of the date of submission.
When forms for adjusting insurance salary are corrected by the insured units on time, they shall take effect on the first day of the next month from the date of submission. When the corrections are overdue, they shall take effect on the first day of the next month from the date of correction.
The submission of the corrections referred in the preceding four paragraphs shall be set on the date which they reach the insurer. When the corrections are mailed, they shall be set in accordance with the post-marks of the original sending post offices.
When the insured units make an overdue correction or make no correction at all after overdue, they shall be liable for all loss incurred to workers.
The seal of the person in charge specified in Paragraph 1 and 2 may be replaced by his or her signature.
In case the suspension, dissolution, revocation, abolishment and bankruptcy of the insured units, or are deemed to have no fact of operation, and do not hire any workers, the insurer may cancel or revoke the insurance coverage to the insured units.
For the insured units whose insurance coverage is cancelled or revoked according to the regulation in previous paragraph and don't withdraw from the insurance coverage for their employee according to regulations, the insurer may withdraw insurance coverage immediately; the termination of the effectiveness of insurance, the calculation of the premiums payable and the added penalties for overdue premiums shall be set on the dates the facts have been confirmed. If the dates could not be confirmed, it is set on the date when the insure finds out the fact.
The insured units shall submit the application forms for the changes in the insured units and other related documents to the insurer within 30 days after the occurrence of the following: 1.The changes of names, addresses or other corresponding addresses of the insured units.
2.The changes of persons in charge of the insured units.
3.The changes of major business items of the insured units.
In the event insured units have not submitted applications for insurance changes according to the previous paragraph, the insurer may make changes according to the information registered at related authorities.
When the persons in charge of the insured units are changed, the unpaid premiums or the penalties for overdue premiums owed by the original persons shall be individually and jointly assumed by the new persons.
When the insured units are terminated after merger and acquisition, their unpaid premiums or penalties shall be assumed by the remaining insured units after merger and acquisition or the new insured units.
Section 3 Insured Person
Foreign workers referred to in Paragraph 3 of Article 6 of the Act are referring to one of the following situations:
1.Approved by the central competent authority or responsible entity to work according to Employment Service Act or other regulations.
2.Allowed to work according to related regulations.
when the insured units apply for joining insurance coverage for the foreign workers identified in the subparagraph 1 of the previous paragraph, they shall submit copies of work permits approved and issued by the related authority.
If the insured persons are foreigners or do not have the nationality of this country, the national identification cards referred to in these Regulations shall be replaced by the insured persons' residence permits for foreign nationals or foreign passports.
When the insured persons referred to in Article 9 of the Act and in Paragraph 2, Article 16 of the Act of Gender Equality in Employment intend to continue to join insurance coverage, the insured units shall not deny them.
When the insured persons referred to in Article 9 of the Act continue to join insurance coverage, the insured units they affiliated with shall continue to pay premiums for them, and except under the circumstances of Subparagraphs 2 and 4 of the same Article, shall notify in writing to the insurer about their names, birthdates, serial numbers of their national identification cards, the dates of their national military service, unpaid leaves, suspension from the job because of pending lawsuits or detention. The same procedure shall apply when the insured persons are discharged from national military service, reinstated to the former positions or their detention are revoked or stopped.
When the insured persons referred to in Subparagraph 3 of Article 9 of the Act continue to join insurance coverage, in addition to processing according to the procedures stipulated in the preceding paragraph, they shall also submit medical records issued by the hospitals or clinics.
According to Paragraph 2, Article 16 of the Act of Gender Equality in Employment, in the event the insured continues to be enrolled, the insured unit to which the insured is affiliated must complete the Labor Insurance Insured Non-pay Parental Leave Continuous Enrollment Application Form and notify the insurer; for purposes of case review, the insurer may require the insured unit to submit additional documentation in the form of the insured's child's birth certificate or copy of the insured's household registration certification; when the insured is reinstated, the insured unit must additionally complete and submit a Notification of Reinstatement to the insurer.
In the event that the insured person's death, termination of employment, withdrawal from membership of associations, or conclusion (or withdrawal) of vocational training programs, the insured units shall, on the dates on which death, termination of employment, withdrawal from membership of associations, or conclusion (or withdrawal) of vocational training programs occurred, fill out the application forms for withdrawal of insurance coverage and submit them to the insurer.
In the event that the insured persons are on the leave of absence due to injuries or illness, the insured units may not withdraw their insurance coverage.
In the event that the insured persons are transferred in the insured units with the same affiliation, the transferring units shall fill out the transfer-out part of the application forms for transfer of insurance coverage and forward them directly to the receiving units. The receiving units shall fill out the receiving part of the forms and submit both parts to the insurer. The effectiveness of the transfer of insurance coverage shall be set on the date when the application forms for transfer of insurance coverage reach the insurer. In case of mailing, they shall be set in accordance with the post-marks of the original sending post offices.
In the event that there are changes to or errors in the insured persons' name, birthdates, serial numbers of the national identification cards, the insured units shall fill out the application forms for change in items of the insured persons and submit the copies of the front and back pages of the national identification cards or other related documents to the insurer to process the changes .
If there is a need to change or correct the personal information of the insured person referred to in the preceding paragraph, the insured person should inform his/her insured unit immediately.
If the insured person failed to inform his/her insured unit as required in the preceding paragraph, or if the insured unit failed to submit to the insurer the relevant documents according to paragraph 1, the insurer may proactively update the information in accordance with the record kept with the relevant institutions.
Persons who are eligible for labor insurance coverage or civil service insurance may only be permitted to select one for insurance coverage .
For those insured persons who are qualified under Subparagraph 7 of Paragraph 1 of Article 6 of the Act, if there is any one of the following condition exists, the insurer shall notify the original insured units to transfer insurance coverage for the insured person within a set time-limit:
1.The insured units they belonged to are not the labor unions affiliated with their own specialties.
2.The insured persons who have changed their own specialties but have not transferred to the labor unions with their own specialties.
The insurer should conduct an actuarial analysis at least once every three years to evaluate the ordinary insurance premium rate prescribed in Article 13 of the Act. Each actuarial analysis shall cover a period of 50 years.