Regulations Governing the Deduction and Payment of the Supplementary Insurance Premium of the National Health Insurance
2024-03-20
手機睡眠
語音選擇
Article 1
These regulations are promulgated in accordance with Paragraph 3 of Article 31 of the National Health Insurance Act (hereinafter referred to as the “Act”).
Article 2
The term “upon payment” prescribed in Paragraph 1 of Article 31 of the Act refers to the time when actual payment, payment by transfer or remittance is made.
Article 3
The term “earnings and income” set forth in the subparagraphs of Paragraph 1 of Article 31 of the Act are the following:
1.Bonus: payments deemed as income from salaries and wages prescribed in Category 3 of Paragraph 1 of Article 14 of the Income Tax Act as incentive which have not yet been included in the calculation of the insured payroll-related amount, such as year-end bonus, festival bonus, bonus;
2.Income from salaries and wages: income from salaries and wages defined under Category 3 of Paragraph 1 of Article 14 of the Income Tax Act;
3.Income from professional practice: any income of an individual from professional practice or performances prescribed in Category 2 of Paragraph 1 of Article 14 of the Income Tax Act;
4.Stock earnings: the dividend received by each shareholder of a company prescribed in Category 1 of Paragraph 1 of Article 14 of the Income Tax Act;
5. Income from interest: any income from interest prescribed in Category 4 of Paragraph 1 of Article 14 of the Income Tax Act;
6.Income from lease: any income from lease of property in Subparagraph 1 of Category 5 of Paragraph 1 of Article 14 of the Income Tax Act and income from long-lasting tenant right and superficies created for fixed terms prescribed in Subparagraph 2 of the same Category.
The earnings and income in the preceding paragraph are limited to cash, negotiable instruments, stocks and gift vouchers which can be exchanged for cash of equivalent value. In the case of stock or foreign currency, its price or exchange rate should be determined by the applicable provisions prescribed in the Income Tax Act.
1.Bonus: payments deemed as income from salaries and wages prescribed in Category 3 of Paragraph 1 of Article 14 of the Income Tax Act as incentive which have not yet been included in the calculation of the insured payroll-related amount, such as year-end bonus, festival bonus, bonus;
2.Income from salaries and wages: income from salaries and wages defined under Category 3 of Paragraph 1 of Article 14 of the Income Tax Act;
3.Income from professional practice: any income of an individual from professional practice or performances prescribed in Category 2 of Paragraph 1 of Article 14 of the Income Tax Act;
4.Stock earnings: the dividend received by each shareholder of a company prescribed in Category 1 of Paragraph 1 of Article 14 of the Income Tax Act;
5. Income from interest: any income from interest prescribed in Category 4 of Paragraph 1 of Article 14 of the Income Tax Act;
6.Income from lease: any income from lease of property in Subparagraph 1 of Category 5 of Paragraph 1 of Article 14 of the Income Tax Act and income from long-lasting tenant right and superficies created for fixed terms prescribed in Subparagraph 2 of the same Category.
The earnings and income in the preceding paragraph are limited to cash, negotiable instruments, stocks and gift vouchers which can be exchanged for cash of equivalent value. In the case of stock or foreign currency, its price or exchange rate should be determined by the applicable provisions prescribed in the Income Tax Act.
Article 4
Where the premium withholders pay earnings or income prescribed in Paragraph 1 of Article 31 of the Act in a single benefit payment which reaches NT$20,000, they shall deduct the supplementary insurance premium in accordance with the supplementary insurance rate upon payment, and complete the payment form and submit the deducted premium to the Insurer before the end of the following month of the date of payment. Notwithstanding, all bonus which is in excess four times the insured payroll-related amount for that month prescribed in Subparagraph 1 of Paragraph 1 of Article 31 of the Act shall be subject to the deduction of the supplementary insurance premium.
The following are exempted from the deduction of the supplementary insurance premium set forth in the preceding paragraph:
1.The part of a single benefit payment which exceeds NT$10 Million;
2.Stock earnings which have been included in the calculation of the insured payroll-related amount of the insured in the capacity of employer or self-employed during the insurance period;
3.Income from professional practice of professionals and technicians who practice independently, or are members of occupational unions having no particular employers or self-employed;
4.Income from salaries and wages of the insured which are classified in Category 2;
5.All types of income of the insured which are classified in category 5;
6.All types of income of those who are not eligible or have lost their eligibility;
7.Income from salaries and wages is not paid by their group insurance applicants and less than the minimum wage publicized by the central labor competent authority;
8.Income from independent professional practice income, dividend income, interest income, and rental income, with an amount less than the minimum wage publicized by the central labor competent authority paid in a single payment to middle-low-income households, mid or low-income senior citizens, disadvantaged children and youth subsidized with life assistance, individuals with disabilities receiving life subsidies, families in hardship receiving subsidies, and any person who has financial difficulties set forth in Article 100 of the Act.
The following are exempted from the deduction of the supplementary insurance premium set forth in the preceding paragraph:
1.The part of a single benefit payment which exceeds NT$10 Million;
2.Stock earnings which have been included in the calculation of the insured payroll-related amount of the insured in the capacity of employer or self-employed during the insurance period;
3.Income from professional practice of professionals and technicians who practice independently, or are members of occupational unions having no particular employers or self-employed;
4.Income from salaries and wages of the insured which are classified in Category 2;
5.All types of income of the insured which are classified in category 5;
6.All types of income of those who are not eligible or have lost their eligibility;
7.Income from salaries and wages is not paid by their group insurance applicants and less than the minimum wage publicized by the central labor competent authority;
8.Income from independent professional practice income, dividend income, interest income, and rental income, with an amount less than the minimum wage publicized by the central labor competent authority paid in a single payment to middle-low-income households, mid or low-income senior citizens, disadvantaged children and youth subsidized with life assistance, individuals with disabilities receiving life subsidies, families in hardship receiving subsidies, and any person who has financial difficulties set forth in Article 100 of the Act.
Article 5
Individuals who are qualified the exempted from the deduction of the supplementary insurance premium by the premium withholders prescribed in Article 31 of the Act shall, prior to receipt of payments, submit the following supporting documents before the deduction can be exempted. Notwithstanding, stock earnings which have been included in the calculation of the insured payroll-related amount should be directly determined by premium withholders:
1. Professionals and technicians who practice independently and the insured classified in Category 2: certificate issued by the group insurance applicant;
2. The insured classified in Category 5 and middle-low-income household members: valid supporting documents of middle-low-income households approved by the social welfare authority;
3. Individuals who are not eligible or have lost their eligibility: the premium withholders are to confirm with the insurer after being notified;
4. Mid or low-income senior citizens, disadvantaged children and youth subsidized with life assistance, individuals with disabilities receiving life subsidies, and families in hardship receiving subsidies: an approval letter issued by the competent social administration agency certifying the relevant qualification; and
5. Any person who has financial difficulties set forth in Article 100 of the Act: valid supporting documents of the financial difficulties issued by the insurer.
The premium withholders, if necessary, may enquire and confirm with the insurer in respect of the identification documents required for exempting the deduction of the supplementary insurance premium set forth in Subparagraphs 1, 2, 4 and 5 of the preceding paragraph as the basis for exemption.
The information which the premium withholders obtain from the insurer by way of enquiry or confirmation shall be valid for two months from the date when the confirmation of enquiry is made.
1. Professionals and technicians who practice independently and the insured classified in Category 2: certificate issued by the group insurance applicant;
2. The insured classified in Category 5 and middle-low-income household members: valid supporting documents of middle-low-income households approved by the social welfare authority;
3. Individuals who are not eligible or have lost their eligibility: the premium withholders are to confirm with the insurer after being notified;
4. Mid or low-income senior citizens, disadvantaged children and youth subsidized with life assistance, individuals with disabilities receiving life subsidies, and families in hardship receiving subsidies: an approval letter issued by the competent social administration agency certifying the relevant qualification; and
5. Any person who has financial difficulties set forth in Article 100 of the Act: valid supporting documents of the financial difficulties issued by the insurer.
The premium withholders, if necessary, may enquire and confirm with the insurer in respect of the identification documents required for exempting the deduction of the supplementary insurance premium set forth in Subparagraphs 1, 2, 4 and 5 of the preceding paragraph as the basis for exemption.
The information which the premium withholders obtain from the insurer by way of enquiry or confirmation shall be valid for two months from the date when the confirmation of enquiry is made.
Article 6
The term “accumulated annual” bonus prescribed in Subparagraph 1 of Paragraph 1 of Article 31 refers to the accumulated amount of bonus that a group insurance applicant pays to the insured between January 1 of the year and the time when the single benefit payment concerned is made in the same year.
Where the insured has already terminated his or her employment when the group insurance applicant pays the bonus, it shall still deduct the supplementary insurance premium from the part of the accumulated bonus which is in excess of four times the insured payroll-related amount when the insured withdrew from the insurance.
Where the insured has already terminated his or her employment when the group insurance applicant pays the bonus, it shall still deduct the supplementary insurance premium from the part of the accumulated bonus which is in excess of four times the insured payroll-related amount when the insured withdrew from the insurance.
Article 7
Where an enterprise distributes stock or cash dividends, its responsible person shall be the premium withholder and deduct the supplementary insurance premium pursuant to Article 31 of the Act.
Dividends which are distributed on the same base day should be deemed as a single payment. If a single payment comprehends stock dividends and cash dividends concurrently, premium withholders shall deduct the supplement insurance premium from the single payment concerned when distributing cash dividends.
Where there is no cash dividend or insufficient cash dividend for deduction, the premium withholders shall notify the insured and the insurer will charge the premium in the following year.
In the case of unpaid premium in the preceding paragraph, the premium withholders shall make a list in accordance with the required format and submit such list to the insurer by January 31 of the following year for the latter to charge the premium.
The supplementary insurance premium which shall be deducted according to Article 31 of the Act shall be handled pursuant to the preceding two paragraphs when there is no cash or insufficient cash for such deduction.
Dividends which are distributed on the same base day should be deemed as a single payment. If a single payment comprehends stock dividends and cash dividends concurrently, premium withholders shall deduct the supplement insurance premium from the single payment concerned when distributing cash dividends.
Where there is no cash dividend or insufficient cash dividend for deduction, the premium withholders shall notify the insured and the insurer will charge the premium in the following year.
In the case of unpaid premium in the preceding paragraph, the premium withholders shall make a list in accordance with the required format and submit such list to the insurer by January 31 of the following year for the latter to charge the premium.
The supplementary insurance premium which shall be deducted according to Article 31 of the Act shall be handled pursuant to the preceding two paragraphs when there is no cash or insufficient cash for such deduction.
Article 8
In the case of income from dividends, interest or lease of trust property, the trustee of such trust property shall be the premium withholder who should deduct the supplementary insurance premium upon calculation or distribution according to Article 31 of the Act, and may make all premium payments to the insurer in a lump sum payment before January 31 of the following year. Notwithstanding, in the event of special circumstance, the premium withholder may request the insurer to extend the deadline to February 15 of the following year.
Article 9
Premium withholders shall notify beneficiaries the amount of the supplementary insurance premium that it has deducted each fiscal year. Notwithstanding, premium withholders may be exempted from notifying beneficiaries if they have submitted the statement of deductions to the insurer according to Article 10.
A beneficiary may apply to the premium withholder for certificate of deductions, or apply for certificate of payment from the insurer from April 1 of the following year of the deduction.
Where a premium withholder has over-deducted the supplementary insurance premium, the premium withholder shall refund the over-deducted amount to the beneficiary. In the event that any amount of the supplementary insurance premium is under-deducted, the premium withholder shall make up for the shortage and may subsequently demand the payment from the beneficiary. Notwithstanding, where the information was confirmed by the insurer after the premium withholder has issued an enquiry according to Article 5, where the supplementary insurance premium becomes applicable to the category of income corrected by the tax authorities, or where the failure of deductions or under-deduction was due to non-attributable causes, the premium withholder is neither required to make up for the shortage nor to demand payment from the beneficiary. And the insurer may directly charge the premium from the beneficiary.
If the supplementary insurance premium of a beneficiary is under-deducted, he or she shall make up for the shortage. In the event of over-deductions, the beneficiary may apply to the premium withholder for refund within six months from the following day of the date when the premium is deducted, or apply to the insurer for refund if the afore-mentioned six-month period expires. Notwithstanding, where a premium withholder of the supplementary insurance premium completes the statement of deductions when paying the premium and sends such statement to the insurer via electronic media, the beneficiary may directly apply to the insurer for refund.
The unpaid premium required for making up pursuant to Paragraph 3 and Paragraph5 of Article 7 may be exempted if the amount is less than NT$100 in each occurrence.
Where a premium withholder has already paid the over-deductions to the insurer, which should be returned to the beneficiary, the premium withholder may apply to the insurer for refund or offsetting the supplementary insurance premium which it is required to deduct.
A beneficiary may apply to the premium withholder for certificate of deductions, or apply for certificate of payment from the insurer from April 1 of the following year of the deduction.
Where a premium withholder has over-deducted the supplementary insurance premium, the premium withholder shall refund the over-deducted amount to the beneficiary. In the event that any amount of the supplementary insurance premium is under-deducted, the premium withholder shall make up for the shortage and may subsequently demand the payment from the beneficiary. Notwithstanding, where the information was confirmed by the insurer after the premium withholder has issued an enquiry according to Article 5, where the supplementary insurance premium becomes applicable to the category of income corrected by the tax authorities, or where the failure of deductions or under-deduction was due to non-attributable causes, the premium withholder is neither required to make up for the shortage nor to demand payment from the beneficiary. And the insurer may directly charge the premium from the beneficiary.
If the supplementary insurance premium of a beneficiary is under-deducted, he or she shall make up for the shortage. In the event of over-deductions, the beneficiary may apply to the premium withholder for refund within six months from the following day of the date when the premium is deducted, or apply to the insurer for refund if the afore-mentioned six-month period expires. Notwithstanding, where a premium withholder of the supplementary insurance premium completes the statement of deductions when paying the premium and sends such statement to the insurer via electronic media, the beneficiary may directly apply to the insurer for refund.
The unpaid premium required for making up pursuant to Paragraph 3 and Paragraph5 of Article 7 may be exempted if the amount is less than NT$100 in each occurrence.
Where a premium withholder has already paid the over-deductions to the insurer, which should be returned to the beneficiary, the premium withholder may apply to the insurer for refund or offsetting the supplementary insurance premium which it is required to deduct.
Article 10
The premium withholders should complete the statement of deductions by specifying the amount of the supplementary insurance premium deducted from the beneficiaries in the previous fiscal year and submit such statement to the insurer before January 31 of each year. Where there are three consecutive national holidays in January of a given year, the deadline for submitting the statement of deductions will be extended to February 5 of that year. Notwithstanding, if a profit-seeking enterprise is dissolved, abolished, merged or transferred, or an institution or organization is abolished or restructured, its premium withholder shall complete the statement of deductions whenever any insurance premium is deducted and submit such statement to the insurer within ten days.
In the event of special circumstance, the premium withholder of trust property may apply to the insurer to extend the deadline for submitting the statement of deduction to February 15.
Where a supplementary insurance premium withholder completes the statement of deductions when paying the premium and sends such statement to the insurer via electronic media, it may be exempted from making submission to the insurer before January 31 of each year.
The premium withholders shall accurately specify the name, address, national identity number (Alien Resident Certificate) of each payee, date of payment, income category, amount of payment, deductions, etc., in the statement of deductions according to the required format.
Where the insurer handles an application for refund of over-deductions from a beneficiary, the insurer may notify the premium withholder to complete and submit within 10 days a statement of deductions of the amount of the insurance premium already deducted.
In the event of special circumstance, the premium withholder of trust property may apply to the insurer to extend the deadline for submitting the statement of deduction to February 15.
Where a supplementary insurance premium withholder completes the statement of deductions when paying the premium and sends such statement to the insurer via electronic media, it may be exempted from making submission to the insurer before January 31 of each year.
The premium withholders shall accurately specify the name, address, national identity number (Alien Resident Certificate) of each payee, date of payment, income category, amount of payment, deductions, etc., in the statement of deductions according to the required format.
Where the insurer handles an application for refund of over-deductions from a beneficiary, the insurer may notify the premium withholder to complete and submit within 10 days a statement of deductions of the amount of the insurance premium already deducted.
Article 11
The supplementary insurance premium which is required to be paid by the premium withholders to the insurer shall be paid to the institutions authorized by the Insurer to receive the insurance premium on its behalf as set forth in Articles 18 and 23 of the Act. The authorized financial institutions may re-authorize other institutions to receive such premium payments.
Article 12
These Regulations shall be effective on January 1 2013.
The amended articles of these Regulations promulgated on July 21, 2014 shall come into force on September 1, 2014.
The amended articles of these Regulations promulgated on January 29, 2015 shall come into force on January 1, 2015.
The amended articles of these Regulations promulgated on June 18, 2015 and December 2, 2015 shall come into force on January 1, 2016.
The amended articles of these Regulations promulgated on April 2, 2019 shall come into force on January 1, 2018.
The amended articles of these Regulations promulgated on March 20, 2024 shall come into force on the date of promulgation.
The amended articles of these Regulations promulgated on July 21, 2014 shall come into force on September 1, 2014.
The amended articles of these Regulations promulgated on January 29, 2015 shall come into force on January 1, 2015.
The amended articles of these Regulations promulgated on June 18, 2015 and December 2, 2015 shall come into force on January 1, 2016.
The amended articles of these Regulations promulgated on April 2, 2019 shall come into force on January 1, 2018.
The amended articles of these Regulations promulgated on March 20, 2024 shall come into force on the date of promulgation.