Page 23 - 2018-19全民健康保險年報

全民有保 財務永續
Universal Coverage and Financial Sustainability
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on capital gains. As of the end of June 2018, the cumulative balance was NT$227.6 billion.
Although NHI’s financial status is currently stable, Taiwan’s aging population and advances in medical technology will inevitably put financial pressure on the system in the long term. In an effort to ensure long-term financial soundness and an even fairer and more reasonable financial burden, the NHIA will continue to perform systematic reviews and take steps to ensure an even more stable financial system.
Calculation of Regular Premiums
The NHI regular insurance premium rate was kept at 4.25% from the start of NHI implementation until the end of August 2002, and was adjusted to 4.55% in September 2002. In order to stabilize NHI’s finances, the rate was raised to 5.17% in April 2010. However, since the implementation of the 2nd Generation NHI system, supplementary premium was introduced (initially at a rate of 2%), and the regular insurance premium rate was lowered to 4.91% on January 1, 2013. In January 2016, the regular insurance premium rate was adjusted to 4.69%, and the supplementary premium rate was also lowered to 1.91%. Moreover, the average number of dependents per insured also experienced several rounds of adjustment over the years, it has changed from the original 1.36 persons to the current 0.61.
Insurance premiums are jointly paid by insureds, insured units (employers), and the government. For insured classified in categories 1, 2, and 3, premiums are based on their salary basis × the regular premium rate. Regular premium for insured classified in categories 4, 5, and 6 are calculated as the average premium paid by those classified in categories 1 to 3 (Table 2-3 and Table 2-4).
Setting Payroll Brackets on Which Premiums are Based
With regard to the payroll brackets of insureds in categories 1 through 3, the Ministry of Health and Welfare drafts a periodically-updated payroll bracket table that is submitted to the Executive Yuan for approval. The payroll bracket table in effect since January 1, 2018 has 49 brackets (Table 2-5). The payroll basis of category 1 insured are reported by their insured units (employers), based as the brackets in the table corresponding to the insureds’monthly wage income. Starting from January 1, 2018, the minimum payroll basis of insured in category 2 with no fixed employer and the payroll basis of insured in category 3 (farmers, fishermen, and irrigation association members) have been set as NT$24, 000.
Calculation of Supplementary Premiums
Following the implementation of 2nd Generation NHI, apart from computing regular premiums based on the payroll bracket corresponding to an individual’s regular wages, NHIA also assesses supplementary premiums. The basis for the calculation of supplementary premiums includes large bonuses, part-time income, professional service income, dividend income, interest income, and rental income, which were not included in payroll bracket calculations in the past. It is expected that by expanding the NHI’s premium base, it can ensure that persons with equivalent incomes will pay similar premiums, and thereby achieve a fair burden (Chart 2-2). In addition, insureds in low-income households are exempt from contributing supplementary premiums. Furthermore, supplementary premiums are also
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Chapter