November 2018
Amendments to the Enforcement Rules of the National Health Insurance Act (Taiwan)
2018.9.19
Sophia Tsai
The Ministry of Health and Welfare promulgated Article 46 of the Enforcement Rules of the National Health Insurance Act (hereinafter, the "Enforcement Rules") as amended via the Amendment-Wei-Bao-1071260419 Directive of September 19, 2018. The amendments are highlighted below:
For starter, the last sentence of Article 46, Paragraph 1, Subparagraph 2(2) of the Enforcement Rules is added to specifically stipulate that for an employee whose monthly wage is not fixed, the insured amount may be declared based on the average wage in the past three months. However, it shall not fall below the lower limit of the insured amount for the pertinent category.
In addition, since members of a professional association are different, in terms of their basis, from employees of public or private business organizations in this country in that they mostly do not have fixed employers or are self-employed, the insured amount of the members of a professional association shall be adjusted based on the growth rate of the monthly average insured amount of those professional association members who are excluded from the application of the lower limit declaration. The enrollment category for members of professional associations under Article 46, Paragraph 1, Subparagraph 5 of the Enforcement Rules as amended does not use the growth rate of the monthly average insured amount of those whose declaration is based on the minimum insured amount to replace the growth rate of the average insured amount of employees of public and private business organizations in this country. The effective date is adjusted to prevent any impact on the premium payment operation of professional associations as a result of insufficient time allowed in an insurer's announcement. If the cumulative growth rate for the first half of the year reaches the adjustment threshold of 4.5%, the lower declaration limit in January of the following year shall still be raised by one level. However, if the adjustment threshold is reached for the second half of the year, the requirement is amended so that the adjustment shall be made in July of the following year.
Sophia Tsai
The Ministry of Health and Welfare promulgated Article 46 of the Enforcement Rules of the National Health Insurance Act (hereinafter, the "Enforcement Rules") as amended via the Amendment-Wei-Bao-1071260419 Directive of September 19, 2018. The amendments are highlighted below:
For starter, the last sentence of Article 46, Paragraph 1, Subparagraph 2(2) of the Enforcement Rules is added to specifically stipulate that for an employee whose monthly wage is not fixed, the insured amount may be declared based on the average wage in the past three months. However, it shall not fall below the lower limit of the insured amount for the pertinent category.
In addition, since members of a professional association are different, in terms of their basis, from employees of public or private business organizations in this country in that they mostly do not have fixed employers or are self-employed, the insured amount of the members of a professional association shall be adjusted based on the growth rate of the monthly average insured amount of those professional association members who are excluded from the application of the lower limit declaration. The enrollment category for members of professional associations under Article 46, Paragraph 1, Subparagraph 5 of the Enforcement Rules as amended does not use the growth rate of the monthly average insured amount of those whose declaration is based on the minimum insured amount to replace the growth rate of the average insured amount of employees of public and private business organizations in this country. The effective date is adjusted to prevent any impact on the premium payment operation of professional associations as a result of insufficient time allowed in an insurer's announcement. If the cumulative growth rate for the first half of the year reaches the adjustment threshold of 4.5%, the lower declaration limit in January of the following year shall still be raised by one level. However, if the adjustment threshold is reached for the second half of the year, the requirement is amended so that the adjustment shall be made in July of the following year.
