National Health Insurance (Self-Employed Insured) > Health Insurance Premiums > Calculati
Calculation of Insurance Premiums
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 locally insured person is affiliated: income (monthly income of the locally insured person × insurance premium rate) + property (property contribution points × amount per property contribution point)
· Insurance premium rate: The insurance premium rate for the locally insured person is set at 7.09% (Article 44(1) of 「Enforcement Decree of the National Health Insurance Act」).
· Property contribution points: Calculated based on the property of the locally insured person. Provided, that where the locally insured person, as prescribed by Presidential Decree, receives a loan from a financial company, etc., pursuant to subparagraph 1 of Article 2 of 「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 amount shall be excluded from the calculation of property contribution points based on the assessment prescribed by Presidential Decree (Article 72(1) of 「National Health Insurance Act」 and Article 42(1) of 「Enforcement Decree of the National Health Insurance Act」).
· Amount per property contribution point: The amount per property contribution point of the locally insured person is KRW 208.4 (Article 73(3) of 「National Health Insurance Act」 and Article 44(2) of 「Enforcement Decree of the National Health Insurance Act」).
※ Types and scopes of “income” and “property”
The income included in the calculation of monthly income amount refers to the following types of income (excluding non-taxable income) (Article 41(1) of 「Enforcement Decree of the National Health Insurance Act」):
· Interest income
· Dividend income
· Business income
· Earned income (provided that the earnedincome deduction referred to the “Income Tax Act” does not apply)
· Pension income (provided that Article20-3(2) of the Income Tax Act does not apply to the public pension income andall pension income earned during the relevant taxable period shall be deemed aspension income.
· Other income
The types of property considered when calculating the property contribution points are as follows (Article 42(1) of 「Enforcement Decree of the National Health Insurance Act」):
· Land, buildings, housing, vessels, andairplanes subject to the property tax according to the “Local Tax Act”(provided that family property, village property, and other buildings and landsimilar thereto for the purpose of common use will be excluded)
· Forthe self-employed insured who own no houses, the deposit money and monthly rentfor the leased houses
- 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: 4,504,170 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
Exclusion for the calculation of national health insurance premiums Exclusion of contribution points- If a locally insured person falls into any of the following categories, when calculating the insurance premium for the household to which he/she is affiliated, the monthly income amount and property contribution points of the said insured will be excluded (Article 74(2), subparagraph 2 of Article 6(2), and subparagraphs 2 to 4 Article 54 of 「National Health Insurance Act」):
· If the person is working abroad
· Soldiers on active duty (including non-commissioned officers appointed without application), persons who have served alternative to the military service, and candidates for military officers under the “Military Service Act”
· If a person is being held in a prison or other equivalent facility
Period of exclusion for premiums- The monthly income amount and property contribution points excluded from calculating insurance premiums will be applied from the month following that in which the date of exclusion falls until the month under which the date of exclusion falls. However, in any of the following circumstances, insurance premiums for the month will not be exempted or monthly income amount and property contribution points will not be excluded from calculating the insurance premium (Article 74(3) of 「National Health Insurance Act」):
1. When the reason for suspension of payment ceases to exist on the 1st of each month
2. When a self-employed insured staying abroad enters Korea and receives insurance benefits in the month under which the date of entry falls and leaves the country within that month