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ENFORCEMENT DECREE OF THE NATIONAL HEALTH INSURANCE ACT

Wholly Amended by Presidential Decree No. 24077, Aug. 31, 2012

Amended by Presidential Decree No. 24128, Sep. 28, 2012

Presidential Decree No. 24247, Dec. 21, 2012

Presidential Decree No. 24261, Dec. 27, 2012

Presidential Decree No. 24341, Jan. 28, 2013

Presidential Decree No. 24454, Mar. 23, 2013

Presidential Decree No. 24520, May 3, 2013

Presidential Decree No. 24588, jun. 11, 2013

Presidential Decree No. 24776, Sep. 26, 2013

Presidential Decree No. 25429, jun. 30, 2014

Presidential Decree No. 25583, Aug. 29, 2014

Presidential Decree No. 25751, Nov. 19, 2014

Presidential Decree No. 25760, Nov. 20, 2014

Presidential Decree No. 26302, jun. 1, 2015

Presidential Decree No. 26367, jun. 30, 2015

Presidential Decree No. 27943, Mar. 20, 2017

Presidential Decree No. 27959, Mar. 27, 2017

Presidential Decree No. 27960, Mar. 27, 2017

Presidential Decree No. 28107, jun. 13, 2017

Presidential Decree No. 28206, Jul. 24, 2017

Presidential Decree No. 28211, Jul. 26, 2017

Presidential Decree No. 28222, Aug. 1, 2017

Presidential Decree No. 28317, Sep. 19, 2017

Presidential Decree No. 28348, Sep. 29, 2017

Presidential Decree No. 28551, Dec. 29, 2017

Presidential Decree No. 28602, Jan. 23, 2018

Presidential Decree No. 28693, Mar. 6, 2018

Presidential Decree No. 28710, Mar. 20, 2018

CHAPTER I GENERAL PROVISIONS
 Article 1 (Purpose)
The purpose of this Decree is to regulate matters mandated by the National Health Insurance Act and matters necessary for its enforcement.
 Article 2 (Head of Organ Who is Employer)
"Person determined by Presidential Decree" in subparagraph 2 (b) of Article 3 of the National Health Insurance Act (hereinafter referred to as the "Act") refers to heads of organizations referred to in attached Table 1: Provided, That when deemed necessary for efficiently dealing with the health insurance service, the National Health Insurance Service referred to in Article 13 of the Act (hereinafter referred to as the "NHIS") may separately designate the head of an organ that belongs to the head of an institution set forth in attached Table 1 as the head of an organ who is an employer, in consideration of the location of the organization, the number of its personnel and other conditions.
 Article 2-2 (Formulation, etc. of Comprehensive National Health Insurance Plans)
(1) Where the Minister of Health and Welfare formulates a comprehensive national health insurance plan under the former part of Article 3-2 (1) of the Act (hereinafter referred to as "comprehensive plan") and an annual implementation plan under Article 3-2 (3) of the Act (hereinafter referred to as "implementation plan"), he/she shall do so by the time classified as follows:
1. Comprehensive plan: By September 30 of the year immediately preceding the enforcement year;
2. Implementation plan: By December 31 of the year immediately preceding the enforcement year.
(2) Where the Minister of Health and Welfare formulates or modifies a comprehensive plan or implementation plan, he/she shall publish it by either of the following methods, whichever is relevant:
1. Comprehensive plan: Providing public notice in the official gazette;
2. Implementation plan: Posting it on the official website of the Ministry of Health and Welfare.
(3) Where the Minister of Health and Welfare formulates or modifies a comprehensive plan or implementation plan, he/she shall notify the details thereof to the heads of related central administrative agencies, the president of the NHIS, and the president of the Health Insurance Review and Assessment Service referred to in Article 62 of the Act (hereinafter referred to as the "Review and Assessment Service").
(4) Where the Minister of Health and Welfare evaluates performance results according to an implementation plan, pursuant to Article 3-2 (4) of the Act, he/she shall reflect results of the evaluation in both the comprehensive plan and implementation plan to be formulated thereafter.
(5) Except as otherwise expressly provided for in paragraphs (1) through (4), detailed matters necessary for formulation, implemention, evaluation, etc., comprehensive plans or implementation plans, shall be prescribed and publicly notified by the Minister of Health and Welfare.
[This Article Newly Inserted by Presidential Decree No. 27433, Aug. 2, 2016]
 Article 2-3 (Matters to Be Included into Comprehensive Plans)
"Matters prescribed by Presidential Decree" in Article 3-2 (2) 9 of the Act means any of the following:
1. Matters concerning the establishment of an institutional foundation for the health insurance;
2. Matters concerning international cooperation on the health insurance;
3. Any other matters that the Minister of Health and Welfare particularly deems necessary to improve the health insurance.
[This Article Newly Inserted by Presidential Decree No. 27433, Aug. 2, 2016]
 Article 3 (Matters Subject to Deliberation and Resolution by Deliberative Committee)
"Matters prescribed by Presidential Decree" in Article 4 (1) 6 of the Act means any of the following matters: <Amended by Presidential Decree No. 27433, Aug. 2, 2016>
1. The relative point value of each item of health care benefit provided for in Article 21 (2);
2. The upper-limit on the costs of the health care benefit of each medicine and materials for medical treatment provided for in Article 22;
3. Other important matters concerning health insurance under Article 5 (1) of the Act including the matters concerning additional benefits under Article 23, which are placed on the agenda of the meetings of the Health Insurance Policy Deliberative Committee provided for in Article 4 of the Act (hereinafter referred to as the "Deliberative Committee") by its chairperson.
 Article 4 (Members Who Are Public Officials)
"Public officials who belong to central administrative agencies prescribed by Presidential Decree" in Article 4 (4) 4 (a) of the Act means public officials, each one of whom is nominated by the head of an administrative agency for which he/she works, from among the public officials of Grade III who belong to the Ministry of Strategy and Finance or the Ministry of Health and Welfare or the public officials in general service who belong to the Senior Executive Service.
 Article 4-2 (Discharge or Dismissal of Deliberative Committee Members)
The Minister of Health and Welfare may discharge or dismiss a member of the Deliberative Committee referred to in each subparagraph of Article 4 (4) of the Act, in any of the following cases:
1. The member becomes unable to perform his/her duties due to any mental disorder;
2. The member commits misconduct in relation to his/her duties as a member;
3. The member is deemed inappropriate to serve as a member due to neglect of duties, injury to dignity, or any other reason;
4. The member voluntarily expresses the intention that it is impracticable to perform his/her duties.
[This Article Newly Inserted by Presidential Decree No. 26844, Dec. 31, 2015]
 Article 5 (Chairperson, etc. of Deliberative Committee)
(1) The chairperson of the Deliberative Committee under Article 4 of the Act shall represent the Deliberative Committee and exercise general supervision over the affairs thereof.
(2) The vice-chair person of the Deliberative Committee shall assist the chairperson and act on behalf of the chairperson, where the chairperson is unable to perform his/her duties due to any extenuating circumstances.
 Article 6 (Meetings of Deliberative Committee)
(1) The chairperson shall convene and preside over meetings of the Deliberative Committee.
(2) Meetings of the Deliberative Committee shall be convened upon request from at least one third of the total registered members, or where the chairperson deems it necessary.
(3) A majority of member of the Deliberative Committee shall constitute a quorum, and any decision thereof shall require the concurring vote of at least a majority of those present.
(4) The chairperson shall not participate in resolutions under paragraph (3): Provided, That when the numbers of votes of approval and disapproval are equal, the chairperson shall determine thereon.
(5) Where it is deemed necessary to ensure its efficient deliberation, the Deliberative Committee may set up subcommittees by field.
(6) Necessary matters concerning the operation of the Deliberative Committee and the subcommittees, other than those prescribed in paragraphs (1) through (5), shall be determined by the chairperson after undergoing the resolution thereon by the Deliberative Committee.
 Article 7 (Administrative Secretary of Deliberative Committee)
(1) The Deliberative Committee shall have one administrative secretary to administer the offices of the Deliberative Committee.
(2) The administrative secretary shall be nominated by the chairperson, from among the public officials of Grade IV or higher in rank who work for the Ministry of Health and Welfare, or from among public officials in general service who belong to the Senior Executive Service.
 Article 8 (Allowances, etc. of Members of Deliberative Committee)
Allowances, travel expenses, and other necessary expenses may be reimbursed to the members who attended the meeting of the Deliberative Committee within budgetary limits: Provided, That this shall not apply where any member who is a public official attends in direct connection with his/her duties.
CHAPTER II THE INSURED
 Article 9 (Persons Excluded from the Employee Insured)
"Workers and employers of workplaces, public officials, and school employees prescribed by Presidential Decree" in Article 6 (2) 4 of the Act means any of the following persons:
1. Part-time workers, or workers by the hour who are working less than 60 hours a month;
2. Part-time school employees, or public officials or school employees by the hour who are working less than 60 hours a month;
3. Workers and employers in places of business, the location of which is not fixed;
4. Employers who employ no workers or only those falling under subparagraph 1.
CHAPTER III NATIONAL HEALTH INSURANCE SERVICE
 Article 9-2 (Services of the NHIS)
“Programs prescribed by Presidential Decree” in Article 14 (1) 4 of the Act means the following:
1. Building and operating the electronic health information system for health management of the insured and their dependants;
2. Developing and providing programs or service for health management by life cycle, workplace, and function;
3. Collecting, analyzing, and researching information on major diseases by age, sex, and profession, and providing management plans;
4. Providing information on major chronic diseases, including high blood pressure and diabetics, and supporting health management;
5. Supporting a health management program by region through connection and cooperation with the regional health care institutions under Article 2 (1) of the Regional Public Health Act;
6. Other programs equivalent to those prescribed in subparagraphs 1 through 5, which the Minister of Health and Welfare deems particularly necessary for the health management of the insured and their dependants.
[This Article Newly Inserted by Presidential Decree No. 28222, Aug. 1, 2017]
 Article 10 (Executive Officer Who Is Public Official)
Pursuant to Article 20 (4) 2 of the Act, the Minister of Strategy and Finance, the Minster of Health and Welfare, and the Minister of Personnel Management shall recommend a non-standing director each, from among the public officials of Grade III at the relevant Ministries or the public officials in general service belonging to the Senior Executive Service. <Amended by Presidential Decree No. 24454, Mar. 23, 2013; Presidential Decree No. 25751, Nov. 19, 2014; Presidential Decree No. 26367, Jun. 30, 2015>
 Article 11 (Matters to Be Deliberated and Resolved at Meetings of Board of Directors)
Pursuant to Article 26 (4) of the Act, the matters under the following subparagraphs shall undergo deliberation and resolution at meetings of the board of directors of the NHIS (hereinafter referred to as the "board of directors"): Provided, That the matters subject to deliberation and resolution by the Deliberative Committee provided for in the provisions of Article 4 (1) of the Act and those subject to the financial operation committee provided for in Article 33 of the Act shall be excluded:
1. Plans for business operation and other matters concerning fundamental policies for the operation of the NHIS;
2. Matters concerning budgets and the settlement of accounts;
3. Matters concerning amendments to the articles of incorporation;
4. Matters concerning establishment of, amendments to, and repeal of regulations;
5. Matters concerning insurance contributions and other money to be collected (hereinafter referred to as "insurance contributions, etc.") and insurance benefits;
6. Matters concerning loan under Article 37 of the Act;
7. Matters concerning reserve funds and other acquisition, management, and disposal of major properties under Article 38 of the Act;
8. Other important matters concerning the operation of the NHIS.
 Article 12 (Meetings of Board of Directors)
(1) Meetings of the board of directors shall be classified into regular meetings and special meetings.
(2) Regular meetings shall be convened by the chair of the board of directors twice in a year at such time as determined by the articles of incorporation.
(3) Special meetings shall be convened by the chair of the board of directors where more than one third of incumbent directors (including the president; hereinafter the same shall apply) so request or where the president deems it necessary.
(4) A majority of incumbent members of the board of directors shall constitute a quorum, and any decision thereof shall require the concurring vote of at least a majority of those incumbent.
(5) The president shall be the chair of the board of directors.
(6) The procedure for convening matters of the board of directors and other matters necessary for operating the board of directors shall be prescribed by the articles of incorporation of the NHIS.
 Article 13 (Delegation of Authority of President)
"Those prescribed by Presidential Decree" in Article 32 of the Act means the following authority:
1. Authority for management of eligibility under Articles 5 and 8 through 10 of the Act;
2. Authority for management of workplaces under Article 7 of the Act;
3. Authority for restrictions of insurance benefits under Article 53 of the Act;
4. Authority for the imposition, collection, billing, overdue notice of insurance contributions, authority of collection according to examples of dispositions of national taxes in arrears etc. under Articles 57, 69, 79, and 81 of the Act;
5. Authority for the exercise of a right to claim compensation pursuant to Article 58 of the Act;
6. Authority to reduce insurance contributions pursuant to Article 75 of the Act;
7. Authority to approve payment in installments and to revoke such approval under Article 82 of the Act;
8. Authority to manage the eligibility of the insured, to restrict insurance benefits, and to impose and collect insurance contributions under Articles 109 and 110 of the Act;
9. Authority to collect pension contribution, employment insurance contributions, industrial accident compensation insurance contributions, contributions, and other charges entrusted (hereinafter referred to as a "insurance contributions, etc. entrusted with collection") under the National Pension Act, the Act on the Collection of Insurance Premiums, etc. for Employment Insurance and Industrial Accident Compensation Insurance, the Wage Claim Guarantee Act, and the Asbestos Injury Relief Act (hereinafter referred to as "applicable Acts to the entrustment with collection"), including the authority to billing of insurance contributions, etc., and overdue notice or disposition on default of insurance contributions;
10. Other authority determined by the articles of incorporation of the NHIS for efficient performance of the services of the NHIS.
 Article 14 (Composition of Financial Operation Committee)
(1) The agricultural and fisheries organization, the urban self-employed persons' organization, and the civic group under Article 34 (2) 2 of the Act shall recommend members prescribed in Article 34 (1) 2 of the Act according to the following distinctions:
1. The agricultural and fishery organization and the urban self-employed persons' organization: To recommend three persons each;
2. The civic group: To recommend four persons.
(2) "Relevant public officials determined by Presidential Decree" in Article 34 (2) 3 of the Act means each person designated by the Minister of Strategy and Finance and the Minister of Health and Welfare, respectively, from among the public officials who are not lower than Grade IV at the Ministry thereof, or public officials in general service belonging to the Senior Executive Service.
 Article 15 (Operation of Financial Operation Committee)
(1) Meetings of the financial operation committee shall consist of regular meetings and special meetings.
(2) Regular meetings shall be convened by the chairperson of the financial operation committee once a year at a time determined by the articles of incorporation.
(3) Special meetings shall be convened by the chairperson of the financial operation committee if the president of the NHIS so requests, at least one third of all incumbent members so request, or the chairperson of the financial operation committee deems it necessary.
(4) The chairperson of the financial operation committee shall preside over its meetings, and meetings shall commence with the attendance of a majority of the incumbent members, and pass resolutions by a concurrent vote of a majority of those present.
(5) Other matters necessary for operating the financial operation committee, such as procedures to convene meetings of the financial operation committee, shall be determined by the articles of incorporation of the NHIS.
 Article 16 (Administrative Secretary of Financial Operation Committee)
(1) The financial operation committee shall have an administrative secretary to administer offices of the financial operation committee.
(2) The administrative secretary shall be appointed by the chairperson from among personnel belonging to the NHIS.
 Article 17 (Minutes of Financial Operation Committee)
(1) The chairperson shall prepare and retain minutes in regard to the meetings of the financial operation committee.
(2) The minutes under paragraph (1) shall contain the proceedings of meetings, deliberated matters, and resolved matters, and be signed or sealed by the chairperson and the members present.
CHAPTER IV INSURANCE BENEFITS
 Article 18 (Medical Facilities, etc. Excluded from Health Care Institution)
(1) "Medical facilities, etc. determined by Presidential Decree" in the latter part of the main sentence of Article 42 (1) of the Act means the following medical institutions or drugstores: <Amended by Presidential Decree No. 27943, Mar. 20, 2017>
1. Affiliated medical institutions established under Article 35 of the Medical Service Act;
2. Medical institutions established for the purpose of medical treatment for the inmates of social service facilities under Article 34 of the Social Welfare Services Act;
3. Medical institutions falling under any of the following items which have become subject to disposition of business suspension, etc. due to activities of inducing the insured or his/her dependent by means of not receiving the amount of co-payment under Article 19 (1) or receiving it in the reduced amount, or performing excessive medical treatments in connection therewith, or demanding exorbitant medical fees:
(a) Medical institutions which have been subject to business suspension under Article 98 of the Act or disposition of penalty surcharges under Article 99 of the Act twice or more for five years;
(b) Medical institutions established and operated by medical persons who have been subject to a disposition of license suspension under Article 66 of the Medical Service Act twice or more for five years;
4. Medical institutions or drugstores established by the founder of the health care institutions subject to a business suspension or under the process of the procedures for business suspension under Article 98 of the Act.
(2) Where the medical institutions stipulated under paragraph (1) 1 and 2 intend to be excluded from among health care institutions, they shall file an application for exclusion from among health care institutions determined by the Minister of Health and Welfare.
(3) The period for which a medical institution, etc. is excluded from among health care institutions shall not exceed one year in cases under paragraph (1) 3, and by not later than the end of the business suspension period in cases under paragraph (1) 4.
 Article 18-2 (Criteria, etc. for Suspension of, Exclusion from Application of Health Care Benefit for Medicines)
(1) Where the Minister of Health and Welfare suspends any medicine from the application of health care benefit or excludes such medicine from health care benefit pursuant to Article 41-2 (1) or (2) of the Act, he/she shall notify the NHIS and the Review and Assessment Service of such fact to record and manage the details of each medicine subject to suspension of, and exclusion from the application of health care benefit. <Amended by Presidential Decree No. 27433, Aug. 2, 2016>
(2) Criteria and procedures for the suspension of, and exclusion from the application of health care benefit for medicines under Article 41-2 (3) of the Act shall be as set forth in attached Table 4-2.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
 Article 18-3 (Hearings)
Where the Minister of Health and Welfare intends to make dispositions to exclude any medicine from the application of medical benefits under Article 41-2 (2) of the Act, he/she shall hold a hearing.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
 Article 18-4 (Selective Benefit)
(1) Selective benefit referred to in Article 41-4 (1) of the Act (hereinafter referred to as "selective benefit") may be provided for any of the following cases:
1. Where economic feasibility, medical treatment effects, etc. are uncertain and thus additional grounds are required to verify them;
2. Where potential advantages exist for the recovery of health of the insured or his/her dependents despite low economic feasibility;
3. Cases similar to subparagraph 1 or 2, where social demand for health care benefit exists or the Minister of Health and Welfare deems it particularly necessary to enhance national health.
(2) An assessment of the appropriateness of selective benefit referred to in Article 41-4 (2) of the Act (hereinafter referred to as "assessment of appropriateness") shall be conducted as follows:
1. Assessment period: An assessment of appropriateness shall be conducted every five years from the date selective benefit is provided: Provided, That the Minister of Health and Welfare may determine the assessment period differently, if he/she deems a prompt assessment necessary in the light of the contents, nature, effects, etc. of the relevant selective benefit;
2. Assessment items: An assessment of appropriateness shall be conducted for the following matters:
(a) Medical treatment effects and improvement of the treatment process;
(b) Cost effectiveness;
(c) Possibility of replacing selective benefit with other health care benefit;
(d) Potential benefits for national health;
(e) Any other matters similar to those specified in items (a) through (d), which are deemed by the Minister of Health and Welfare particularly necessary for the assessment of appropriateness;
3. Assessment method: An assessment of appropriateness shall be conducted in writing: Provided, That where deemed necessary by the Minister of Health and Welfare, site investigations, literature review, surveys or other methods may be added to such written assessment.
(3) Where the Minister of Health and Welfare deems that a professional and in-depth review is necessary in connection with an assessment of appropriateness, he/she may request a health care-related research institute, organization, experts, etc. to conduct such assessment.
(4) Where deemed necessary for an assessment of appropriateness, the Minister of Health and Welfare may request relevant central administrative agencies, local governments, public institutions prescribed in the Act on the Management of Public Institutions, or health care-related corporations, organizations, experts, etc. to submit necessary data or their opinions.
(5) Except as otherwise expressly provided for in paragraphs (2) through (4), matters necessary for the procedures, methods, etc. for conducting an assessment of appropriateness, shall be prescribed and publicly notified by the Minister of Health and Welfare.
[This Article Newly Inserted by Presidential Decree No. 27943, Mar. 20, 2017]
 Article 19 (Expenses Borne by Principal)
(1) The rate and amount of co-payment under Article 44 (1) of the Act (hereinafter referred to as "co-payment") shall be as set forth in attached Table 2.
(2) The amount of co-payment shall be paid by the persons who receive health care benefit to health care institutions upon claims from the health care institutions. In such cases, no health care institution shall claim expenses under pretexts other than health care benefit items or non-benefit items determined by Ordinance of the Ministry of Health and Welfare pursuant to Article 41 (3) or (4) of the Act, such as hospitalization deposits.
(3) The total amount of co-payment under Article 44 (2) of the Act, shall be an amount obtained by adding all the amount of annual co-payment borne by a person who receives health care benefit: Provided, That any of the following amounts of co-payment shall not be added:
1. An amount borne under subparagraph 3 (d) (v) and (vi) of attached Table 2;
2. An amount borne under subparagraph 3 (g) of attached Table 2;
3. An amount borne under subparagraph 4 of attached Table 2;
4. An amount borne under subparagraph 6 of attached Table 2.
(4) The co-payment ceiling referred to in Article 44 (2) of the Act (hereinafter referred to as "co-payment ceiling") means an amount computed by the calculation method specified in attached Table 3.
(5) Where the NHIS pays an amount exceeding the co-payment ceiling pursuant to Article 44 (2) of the Act, it shall pay the amount into a savings account designated by the relevant person who has received health care benefit (referring to savings accounts determined by the Minister of Health and Welfare, such as savings accounts opened at postal service agencies specified in the Postal Savings and Insurance Act or at banks specified in the Banking Act): Provided, That the NHIS may make such payment by the method determined by the Minister of Health and Welfare, if extenuating circumstances exist which make it impossible to pay the amount into the relevant savings account.
(6) Except as otherwise expressly provided for in paragraphs (2) and (5), the payment method for co-payment, the method for paying an amount exceeding the co-payment ceiling, and other necessary matters shall be prescribed and publicly notified by the Minister of Health and Welfare.
[This Article Wholly Amended by Presidential Decree No. 27943, Mar. 20, 2017]
 Article 20 (Party to Contract on Costs of Health Care Benefit)
The person who represents the medical and pharmaceutical communities and is a party to the contract on the costs of health care benefit provided for in Article 45 (1) of the Act shall be a person falling under any of the following subparagraphs:
1. For costs of health care benefit for medical clinics under Article 3 (2) 1 (a) of the Medical Service Act: The head of the association of doctors provided for in Article 28 (1) of the same Act;
2. For costs of health care benefit for dental clinics and dental hospitals under Article 3 (2) 1 (b) and 3 (b) of the Medical Service Act: The head of the association of dentists provided for in Article 28 (1) of the same Act;
3. For costs of health care benefit for oriental medical clinics or oriental medical hospitals under Article 3 (2) 1 (c) and 3 (c) of the Medical Service Act: The head of the oriental medical doctors' association provided for in Article 28 (1) of the same Act;
4. For costs of health care benefit for a midwifery clinic provided for in Article 3 (2) 2 of the Medical Service Act: One person from among the head of the midwives' association or the head of the nurses' association provided for in Article 28 (1) of the same Act;
5. For costs of health care benefit for hospitals, long-term care hospitals and general hospitals under Article 3 (2) 3 (a), (d), and (e) of the Medical Service Act: The head of an organization provided for in Article 52 of the Medical Service Act;
6. For costs of health care benefit for drugstores provided for in subparagraph 3 of Article 2 of the Pharmaceutical Affairs Act and the Korea Orphan Drug Center provided for in Article 91 of the same Act: The president of the Korean Pharmaceutical Association provided for in Article 11 (1) of the Pharmaceutical Affairs Act;
7. For costs of health care benefit for public health clinics, public health and medical care centers, branches of pubic health clinics provided for in the Regional Public Health Act and the public health and medical clinics established under the Act on the Special Measures for Public Health and Medical Services in Agricultural and Fishing Villages, Etc.: The person designated by the Minister of Health and Welfare.
 Article 21 (Terms and conditions, etc. of Contracts)
(1) Contracts provided for in Article 45 (1) of the Act shall be concluded between the president of the NHIS and persons provided for in each subparagraph of Article 20 who represent each type of health care institutions by determining a unit price per point of the relative value points of each health care benefit.
(2) The points of relative values of health care benefit referred to in paragraph (1) shall be those that have shown the values of health care benefit in the relative points between each item, computed in consideration of workload such as hours and efforts required for health care benefit, resource volumes such as human resources, facilities and equipment, the level of risk of health care benefit, social benefit in relation to health care benefit, etc.; and the Minister of Health and Welfare shall give public notice thereof after deliberation by the Deliberative Committee, as determined by Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 27943, Mar. 20, 2017>
(3) Notwithstanding paragraph (2), in any of the following cases, the points of relative values of health care benefit may be computed as classified in the following: <Amended by Presidential Decree No. 26367, Jun. 30, 2015; Presidential Decree No. 26651, Nov. 18, 2015; Presidential Decree No. 28206, Jul. 24, 2017>
1. Where the medical treatment is received by hospitalization in a long-term care hospital provided for in Article 3 (2) 3 (d) of the Medical Service Act: To be calculated by the point of relative value per day which is obtained by classifying into the degree of seriousness of patient's conditions after aggregating the points of each item of health care benefit and costs of medicines and materials for the relevant medical treatment;
2. Where the medical treatment is received by hospitalization in a medical clinic provided for in Article 3 (2) 1 (a) of the Medical Service Act, a hospital provided for in Article 3 (2) 3 (a) of the same Act, a long-term care hospital provided for in Article 3 (2) 3 (d) of the same Act, a general hospital provided for in Article 3 (2) 3 (e) of the same Act, a tertiary hospital provided for in Article 3-4 of the same Act, or a health care center provided for in Article 12 of the Regional Public Health Act for diagnosis related group (referring to the group of patients categorized by the names of diagnosis, names of medical treatments, seriousness of patients' conditions, patient's ages, etc.) determined and publicly notified by the Minister of Health and Welfare: To be calculated as one and the same point of relative value per case of hospitalization, which is comprehensive of all the points of items of health care benefit and the costs of the medicines and materials for the relevant medical treatments;
3. Where the hospice or palliative care is received under Article 24 of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life: To be calculated as the point of relative value per day, which is the total of all the points of items of health care benefit and the costs of the medicines and materials for the relevant medical treatments.
(4) In concluding a contract under paragraph (1), a contract on the expenses for new items of health care benefit for which the point of relative values is not publicly notified shall be deemed concluded on the date the point of relative values of the same item is publicly notified by the Minister of Health and Welfare under paragraph (2). In such cases, the contract shall apply, beginning with the first the health care benefit for the relevant item executed on or after the date of public notice.
[Enforcement Date : Jul. 1, 2013] A general hospital or tertiary hospital from the amendments to Article 21 (3) 2
 Article 22 (Costs of Health Care Benefit for Medicines and Materials for Medical Treatment)
(1) Health care benefit for medicines and materials for medical treatment provided for in Article 41 (1) 2 of the Act (excluding those to which the points of relative value referred to in Article 21 (2) and (3) applies; hereafter the same shall apply in this Article) under Article 46 of the Act shall be determined according to the following classifications. In such cases, if the purchase price (referring to the amount for purchasing the relevant medicines and materials for medical treatment by the health care institution; hereafter the same shall apply in this Article) exceeds the maximum amount (referring to the maximum amount publicly notified by the Minister of Health after undergoing deliberation of the Deliberative Committee; hereinafter the same shall apply), the purchase price shall be deemed the same as the maximum amount: <Amended by Presidential Decree No. 24341, Jan. 28, 2013; Presidential Decree No. 24454, Mar. 23, 2013; Presidential Decree No. 25583, Aug. 29, 2014>
1. Oriental medicines: The maximum amount;
2. Medicines other than the oriental medicines: Purchase price;
3. Deleted; <by Presidential Decree No. 25583, Aug. 29, 2014>
4. Materials for medical treatment: Purchase price.
(2) Standards and procedures for the determination of costs of health care benefit for medicines and materials for medical treatment provided for in paragraph (1) and other necessary matters shall be prescribed and publicly notified by the Minister of Health and Wealth.
 Article 22-2 (Withholding Payment, etc. of Costs of Health Care Benefit)
(1) Where the NHIS intends to withhold the payment of costs of health care benefit pursuant to Article 47-2 (1) of the Act, it shall first notify the relevant health care institution thereof in a document stating the following matters:
1. The name of the relevant health care institution, the representative, and the address thereof;
2. The fact that becomes a ground for withholding of payment, the costs of health care benefit subject to withholding of payment, and the legal grounds therefor;
3. The purport that the relevant health care institution may submit its opinion on matters referred to in subparagraph 2, and the processing method when it fails to submit its opinion.
(2) If any health care institution, in receipt of notification under paragraph (1), has an objection to the withholding of payment, it shall submit to the NHIS a written opinion on withholding of payment of the costs of health care benefit, stating the purport of and the reason for filing an objection, along with necessary documents.
(3) After examining a written opinion submitted by a health care institution under paragraph (2), the NHIS shall notify the outcomes thereof in writing to the health care institution.
(4) “Grounds prescribed by Presidential Decree, such as the final verdict of acquittal” in Article 47-2 (3) of the Act means any of the following:
1. Final verdict of acquittal;
2. Non-prosecution disposition (limited to the disposition to be cleared of suspicion or to be innocent; hereinafter the same shall apply).
(5) Where a health care institution that has received a decision to withhold the payment of costs of health care benefit under Article 47-2 (1) of the Act is found not guilty or receives a non-prosecution disposition, it shall notify the NHIS of such fact.
(6) Upon being notified pursuant to paragraph (5), the NHIS shall pay without delay the withheld costs of health care benefit and the interest for a period during which the payment of costs of health care benefit is withheld. In such cases, the amount of interest shall be calculated by multiplying the withhold costs of health care benefit by the interest rate prescribed in Article 43-3 (2) of the Enforcement Decree of the Framework Act on National Taxes for a period from the date the payment of costs of health care benefit was withheld to the date it is paid.
(7) Detailed matters, other than those prescribed in paragraphs (1) through (6), such as the form of a written opinion to be notified to the relevant health care institutions necessary for withholding of payment of costs of health care benefit, etc., and the methods of handling the opinion when it is submitted, shall be determined by the NHIS.
[This Article Newly Inserted by Presidential Decree No. 25760, Nov. 20, 2014]
 Article 23 (Additional Benefits)
(1) Additional benefits under Article 50 of the Act means medical expenses for pregnancy and delivery (including miscarriage and stillbirth; hereinafter the same shall apply). <Amended by Presidential Decree No. 28317, Sep. 19, 2017>
(2) The medical expenses for pregnancy and delivery under paragraph (1) shall be limited to the expenses incurred in medical treatment related to pregnancy and delivery (including medical treatment related to the health care of a pregnant woman before and after delivery; hereinafter the same shall apply) for the pregnant insured or her dependants (including the insured who was delivered of a baby or her dependents; hereinafter the same shall apply) in a health care institution designated pursuant to Article 24, and the amount payable shall be the amount actually borne by the pregnant insured or her dependents within the limit of the amount classified as follows: <Amended by Presidential Decree No. 27734, Dec. 30, 2016; Amended by Presidential Decree No. 28317, Sep. 19, 2017>
1. Where an embryo is in pregnancy: 500,000 won;
2. Where two or more embryos are in pregnancy: 900,000 won.
(3) Where the pregnant insured or dependant is in an area where medical treatment related to pregnancy and delivery is not available with ease, or meets any other requirements prescribed and publicly notified by the Minister of Health and Welfare, the pregnant insured or her dependents shall be paid the amount they actually spend within the limit of the amount calculated by adding the amount publicly notified by the Minister of Health and Welfare to the relevant amount specified in any subparagraph of paragraph (2), despite the amount payable under any subparagraph of paragraph (2). <Newly Inserted Presidential Decree No. 27296, Jun. 30, 2016>
(4) If the pregnant insured or her dependent intends to receive an additional benefit under paragraph (1), she shall file an application therefor with the NHIS, as prescribed by Ordinance of the Ministry of Health and Welfare.
(5) When the provision of an insurance benefit has been restricted or suspended pursuant to Article 53 or 54 of the Act at the time the pregnant insured or dependant applies for the medical expenses for pregnancy and delivery pursuant to paragraph (4), the additional benefit under paragraph (1) shall not be paid. <Amended by Presidential Decree No. 27296, Jun. 30, 2016>
(6) The NHIS shall issue, to the pregnant insured or her dependents, treatment coupons (referring to vouchers that the NHIS issues with a certain amount denoted therein (including records entered in any electronic or magnetic means), irrespective of its name or form, so that the insured or her dependents can obtain medical treatment related to pregnancy and delivery when she presents it to a health care institution designated pursuant to Article 24; the same shall apply hereinafter) in connection with the payment of the medical expenses for pregnancy and delivery under paragraphs (2) and (3). <Amended by Presidential Decree No. 27296, Jun. 30, 2016>
(7) The pregnant insured or her dependents shall not use treatment coupons issued under paragraph (6) after the lapse of 60 days from the estimated due date (referring to the date of delivery in cases of the insured who was delivered of a baby or her dependents) confirmed by a health care institution. <Amended by Presidential Decree No. 27296, Jun. 30, 2016; Amended by Presidential Decree No. 28317, Sep. 19, 2017>
(8) Except as otherwise expressly provided for in paragraphs (2) through (7), matters necessary for the procedure for and method of the payment of the medical expenses for pregnancy and delivery, the issuance and use of treatment coupons, and other relevant matters, shall be prescribed by Ordinance of the Ministry of Health and Welfare. <Amended by Presidential Decree No. 27296, Jun. 30, 2016>
 Article 24 (Health Care Institutions Accepting Treatment Coupons)
(1) The NHIS shall designate health care institutions that shall accept treatment coupons under Article 23 (6) for medical treatment related to pregnancy and delivery. <Amended by Presidential Decree No. 27296, Jun. 30, 2016>
(2) The pregnant insured or her dependent who intends to be reimbursed medical expenses for pregnancy and delivery under Article 23 (1) shall use treatment coupons in a medical institution designated pursuant to paragraph (1).
(3) Except as otherwise expressly provided for in paragraphs (1) and (2), matters necessary for the procedure for and method of designation of health care institutions and other relevant matters, shall be prescribed by Ordinance of the Ministry of Health and Welfare.
 Article 25 (Health Checkups)
(1) Health checkups (hereinafter referred to as "health checkups") provided for in Article 52 of the Act shall be conducted, classifying them into general health checkup, cancer checkup, and infant and child health checkup.
(2) Any of the following persons are eligible for health checkups: <Amended by Presidential Decree No. 25583, Aug. 29, 2014>
1. General health checkups: The employee insured, the self-employed insured who are the heads of households, the self-employed insured who are older than 40 years of age, and the dependents who are older than 40 years of age;
2. Cancer checkups: Persons falling under checkup cycle by cancer type, age standard, etc. set forth in attached Table 1 of the Enforcement Decree of the Cancer Control Act;
3. Infant and child health checkups: The insured and their dependants who are younger than 6 years of age.
(3) Health checkups shall be conducted at least once every two years, and for the employee insured who do not work at a desk, health checkups shall be conducted once a year: Provided, That cancer checkups shall be conducted as prescribed in the Enforcement Decree of the Cancer Control Act, and infant and child health checkups may be conducted according to the checkup cycle and frequency determined and publicly notified by the Minister of Health and Welfare, after taking into account the ages, etc. of the infants and children. <Amended by Presidential Decree No. 25583, Aug. 29, 2014>
(4) Health checkups shall be conducted by health care institutions designated in accordance with Article 14 of the Framework Act on Health Examination (hereinafter referred to as "checkup institutions").
(5) If the NHIS intends to conduct a health checkup, it shall notify the persons eligible for a health check of the matters concerning the conduct of their health checkups according to the following classifications:
1. General health checkups and cancer checkups: Where a health checkup is conducted for the employee insured, the relevant employers shall be notified of the health checkup and where a health checkup is conducted for the dependents of the employee insured and the self-employed insured, persons who undergo health checkups shall be notified thereof;
2. Infant and child health checkups: Where a health checkup is conducted for infants and children who are the dependants of the employee insured, the relevant employee insured shall be notified thereof and where a health checkup is conducted for infants and children of the self-employed insured, the heads of their households shall be notified thereof.
(6) Checkup institutions that have conducted the health checkups shall notify the NHIS of the outcomes of their health checkups and the NHIS shall notify persons who have undergone health checkups, of the outcomes of such health checkups: Provided, That where any checkup institution directly notifies anyone who has undergone a health checkup of the outcomes of his/her health checkup, the NHIS needs not notify him/her of the outcomes of his/her health checkup.
(7) The subject matters of health checkups, the methods of conducting health checkups, expenses incurred therefor, procedures for notifying the results of health checkups and other necessary matters concerning health checkups shall be determined and publicly notified by the Minister of Health and Welfare.
 Article 26 (Period in Arrears, etc. for Insurance Contributions)
(1) "Period prescribed by Presidential Decree" in the main sentence other than the subparagraphs of Article 53 (3) of the Act means one month.
(2) "Number of times prescribed by Presidential Decree" in the proviso to the part other than the subparagraphs of Article 53 (3) of the Act means six times.
 Article 26-2 (Methods of, Procedures for, etc. Filing Application for Accounts for Receipt of Health Care Costs)
(1) A person who intends to receive health care costs, etc. through an account opened in the name of a person eligible for health care (hereinafter referred to as "account for receipt of health care costs, etc.") under the main sentence of Article 56-2 (1) of the Act shall submit to the NHIS a request for payment of health care costs, a request for payment of insurance benefits of supportive equipment, etc., respectively, stating the account number for receipt of health care costs, etc., along with a copy of his/her deposit passbook (referring to a page where the account number is shown). The same shall also apply to the change of an account number for the receipt of health care costs, etc.
(2) When a bank where a recipient has opened an account for receipt of health care costs, etc. has discontinued its business or its normal business is impracticable due to business suspension or an information communication problem, or when an account transfer is impracticable due to an inevitable cause corresponding thereto, the NHIS shall directly pay it in cash under the proviso to Article 56-2 (1) of the Act.
[This Article Newly Inserted by Presidential Decree No. 25760, Nov. 20, 2014]
 Article 27 (Payment of Costs of Health Care Benefit to Soldiers, etc. in Active Service)
(1) "Medical care, etc. prescribed by Presidential Decree" in the former part of Article 60 (1) of the Act means any health care benefit referred to in Article 41 (1) 1 through 3 and 5 of the Act.
(2) Pursuant to the latter part of Article 60 (1) of the Act, the Minister of Justice, the Minister of National Defense, the Minister of Public Safety and Security, the Commissioner of the National Police Agency, the Administrator of the National Fire Agency, or the Commissioner of the Korea Coast Guard (hereinafter referred to as "head of an agency") shall deposit in an account designated by the NHIS, the costs of health care benefit of the relevant agency, which are expected to be incurred annually. <Amended by Presidential Decree No. 25751, Nov. 19, 2014; Presidential Decree No. 28211, Jul. 26, 2017>
(3) The NHIS shall notify the operational situation of money deposited to the Minister of Health and Welfare and the head of a relevant agency every quarter.
(4) Where the costs of health care benefit deposited by the head of an agency pursuant to paragraph (2) fall short of the costs of health care benefit to be borne by the NHIS, the NHIS shall immediately request the head of the relevant agency to pay the shortfall and the head of the agency in receipt of a request, shall pay it to the NHIS.
(5) The NHIS may use interest accruing on the costs of health care benefit deposited by the head of an agency pursuant to paragraph (2) for the costs of health care benefit it bears.
CHAPTER V HEALTH INSURANCE REVIEW AND ASSESSMENT SERVICE
 Article 28 (Services)
(1) "Services prescribed by Presidential Decree" in Article 63 (1) 7 of the Act means any of the following services: <Amended by Presidential Decree No. 24341, Jan. 28, 2013>
1. Computer processing, such as development, supply, inspection, etc. of software related to a request for the review of cost of health care benefit under Article 47 of the Act;
2. Review on the health care benefit received by the institutions as determined by Ordinance of the Ministry of Health and Welfare from among the care expense paid under Article 49 (1) of the Act;
3. Publication of evaluation results of the appropriateness of health care benefit under Article 63 (1) 2 of the Act;
4. Development and management of the patient classification system for providing the services listed in Article 63 (1) 1 through 6 of the Act and subparagraphs 1 through 3 of this paragraph;
5. Education and publicity related to the services listed in Article 63 (1) 1 through 6 of the Act and subparagraphs 1 through 4 of this paragraph.
(2) Computer processing, disclosure of the evaluation of the appropriateness, procedure, standards and method for the development and management of patient classification system under paragraph (1) 1, 3, and 4, and other necessary matters shall be determined and publicly notified by the Minister of Health and Welfare. <Amended by Presidential Decree No. 24341, Jan. 28, 2013>
 Article 29 (Executive Officers Who Are Public Officials)
The Minister of Health and Welfare shall recommend a non-standing director of the Review and Assessment Service under Article 65 (4) of the Act by designating one person from among public officials of Grade III at the Ministry of Health and Welfare or public officials belonging to the Senior Executive Service. <Amended by Presidential Decree No. 27433, Aug. 2, 2016>
 Article 30 (Delegation of Authority of President)
Matters that may be delegated by the president of the Review and Assessment Service to the head of a branch office under Article 32 of the Act applied mutatis mutandis under Article 68 of the Act, shall be the authority of health care institutions, except for the following health care institutions, on reviewing the costs of health care benefit under Article 47 (2) of the Act and on determining objections under Article 87 (2) of the Act:
1. Tertiary hospitals under Article 3-4 of the Medical Service Act;
2. Other health care institutions determined by the articles of incorporation of the Review and Assessment Service.
 Article 31 (Provisions Applied Mutatis Mutandis)
Articles 11 (excluding subparagraph 5) and 12 shall apply mutatis mutandis to matters deliberated on and resolved by the meetings of the board of directors of the Review and Assessment Service. In such cases, "NHIS" shall be construed as "Review and Assessment Service", and "president" of the NHIS as "president" of the Review and Assessment Service.
CHAPTER VI INSURANCE CONTRIBUTIONS
 Article 32 (Upper and Lowest Limits of Amount of Monthly Insurance Contribution)
The upper and lower limits of the amount of a monthly insurance contribution under Article 69 (6) of the Act shall be as classified in the following subparagraphs:
1. The upper limit of the amount of a monthly insurance contribution shall be as follows:
(a) The amount of insurance contribution based on monthly remuneration of an employee insured: The amount determined and publicly notified by the Minister of Health and Employment, taking into consideration the amount equivalent to 30 times the insurance contribution based on the average amount of monthly remuneration (hereafter referred to as “amount of insurance contribution based on the average monthly remuneration of the year before the preceding year” in this Article) of such employee in the year before the year preceding that in which the insurance contribution is imposed;
(b) The amount of insurance contribution based on monthly income of an employee insured and the amount of the monthly insurance contribution for a self-employed insured: The amount determined and publicly notified by the Minister of Health and Employment, taking into consideration the amount equivalent to 15 times the insurance contribution based on the average amount of monthly remuneration of the year before the year preceding that in which the insurance contribution is imposed;
2. The lower limit of the amount of a monthly insurance contribution shall be as follows:
(a) The amount of insurance contribution based on monthly remuneration of an employee insured: The amount determined and publicly notified by the Minister of Health and Employment, to the extent of from not less than 80/1,000 to less than 85/100 of the insurance contribution based on the average amount of monthly remuneration of the year before the preceding year;
(b) The amount of the monthly insurance contribution for a self-employed insured: The amount determined and publicly notified by the Minister of Health and Employment, to the extent of from not less than 60/1,000 to less than 65/100 of the insurance contribution based on the average amount of monthly remuneration of the year before the preceding year.
[This Article Wholly Amended by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 33 (Money and Valuables, etc. to Be Included in Remunerations)
(1) "Those determined by Presidential Decree" in the former part of Article 70 (3) of the Act means the pay, salary, remuneration, annual allowance, wage, bonus and allowances, and the money and valuables similar thereto paid in compensation for the provision of labor, other than the following: <Amended by Presidential Decree No. 26367, Jun. 30, 2015>
1. Retirement allowance;
2. Prize money, and translation or script fee;
3. Non-taxable income from labor under the Income Tax Act: Provided, That the non-taxable income under subparagraph 3 (j), (m), and (o) of Article 12 of the Income Tax Act shall be excluded.
(2) "Cases prescribed by Presidential Decree, such as no data relating to the remunerations exists or it is indistinct" in the latter part of Article 70 (3) of the Act means any of the following:
1. Where remuneration-related data is absent or indistinct;
2. Where the NHIS deems the remuneration-related data unreliable, considering the minimum wage amount provided for in Article 5 of the Minimum Wage Act.
(3) Where all or part of the remuneration is paid in kind, the amount determined by the NHIS on the basis of the current price thereof in the relevant region shall be deemed the remuneration corresponding thereto.
(4) Where the remuneration of workers in a workplace is verified during the period of applying the amount publicly notified by the Minister of Health and Welfare under the latter part of Article 70 (3) of the Act, the relevant amount publicly notified shall cease to apply, beginning with a month following the month whereto belongs the date of verification by the NHIS.
 Article 34 (Principle of Imposing Insurance Contributions on the Employee Insured)
(1) Pursuant to Article 70 (1) of the Act, amount of insurance contributions based on monthly remuneration for the employee insured shall be imposed annually on the basis of the monthly amount of remuneration computed by the following classification, and such monthly remuneration shall be recomputed under Article 39 on the basis of the amount of gross remuneration earned during the relevant year, which shall be confirmed in the following year, and settled accordingly: Provided, That as regards the employee insured subject to the amount publicly notified by the Minister of Health and Welfare under the latter part of Article 70 (3) of the Act, the settlement of contributions imposed while applying the relevant notified amount may be omitted:
1. Persons who acquire eligibility as the employee insured, or such eligibility is converted into the other employee insured, or whose eligibility as the self-employed insured is converted to the employee insured: The amount of monthly remuneration when eligibility is acquired or converted under Article 37;
2. The employee insured not falling under subparagraph 1: The amount of monthly remuneration computed under Article 36 on the basis of gross remuneration received in the preceding year.
(2) The applicable period for the monthly amount of remuneration set forth in the subparagraphs of paragraph (1) shall be as follows: <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
1. The insured under paragraph (1) 1: From the month in which falls the day when eligibility is acquired or changed (referring to the month following the month whereto belongs a day when entitlement is changed, where eligibility is changed after the second of each month) until March of the following year;
2. The insured under paragraph (1) 2: From April every year until March of the following year.
 Article 35 (Report of Remuneration, etc. for Computing Monthly Remuneration Amount)
(1) Each employer shall report to the NHIS by not later than March 10 each year of the matters required for the computation of the monthly remuneration amount under Article 70 (1) of the Act, such as the gross amount of remuneration paid in the preceding year to all the employee insured (referring to the gross amount of remuneration paid from January to December by the relevant employee insured, which is the amount computed under Article 70 of the Act and Article 33 of this Decree; hereinafter the same shall apply), and the period in which the employee insured have engaged in the relevant workplace, the State, local government, private school or its school management agency (hereinafter referred to as "workplace, etc."). In such cases, for the employee insured who are subject to the application of the latter part of Article 70 (3) of the Act, such reporting may be omitted. <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
(2) Each employer shall report to the NHIS the matters required for the computation of the monthly remuneration under Article 70 (1) of the Act, such as the gross amount of remuneration paid to all the employee insured who have been engaged, appointed, or employed until then (referring to the relevant employee insured, in cases under subparagraph 3), where the relevant workplace falls under any of the following cases:
1. Where the workplace is closed, or bankrupted, or circumstances corresponding thereto occur;
2. Where a private school is closed;
3. Where some of the employee insured retire.
 Article 36 (Confirmation, etc. on Amount of Monthly Remuneration)
(1) The NHIS shall confirm the amount obtained by dividing the gross amount of remuneration reported under Article 35 by the number of months for which the employee insured has engaged during the preceding year in the relevant workplace, etc., as the monthly remuneration: Provided, That where the employers have notified the NHIS of the average rate of increase or decrease of remunerations during the relevant business year in the relevant workplace, etc., the amount of monthly remuneration shall be determined every year by making the amount computed after reflecting the relevant average increase or decrease rate in the amount calculated as provided for in the main sentence.
(2) Where remuneration to the relevant employee insured is increased or decreased, the employers may file an application with the NHIS for the change of the amount of monthly remuneration: Provided, That the employer of a workplace to which at least 100 full-time workers belong shall file an application for change of the amount of monthly remuneration as follows: <Amended by Presidential Decree No. 26743, Dec. 22, 2015>
1. Where the remuneration of the relevant month is changed on or before the 14th day: By the 15th day of the relevant month;
2. Where the remuneration of the relevant month is changed on or after the 15th day: By the 15th day of the month following the relevant month.
(3) Where an employer fails to report under Article 35 or where the details of such report are incorrect, the NHIS may investigate the relevant facts and compute or change the monthly remuneration under Article 94 of the Act, and the NHIS in receipt of an application for changes of the amount of monthly remuneration under paragraph (2) may change the monthly remuneration from the month remuneration is increased or the month remuneration is decreased.
(4) Where any insured is being paid the remuneration by not less than two places of business to which the health insurance is available, his/her monthly remuneration is confirmed respectively taking into account the remunerations that are paid by such workplaces to him/her.
(5) Where the monthly remuneration of the employee insured is difficult to compute under Articles 33 through 38 or where no data exists to enable verify the enumerations, as well as the required matters such as an application for changes of the monthly remuneration when increasing or decreasing remuneration, the methods of computation of monthly remuneration shall be determined by the articles of incorporation of the NHIS through a resolution by the financial operation committee.
 Article 37 (Confirmation of Monthly Remuneration When Acquiring or Changing Eligibility as the Employee Insured)
Where any person acquires eligibility as the employee insured or changes into the other employee insured or changes from the self-employed insured to the employee insured, the NHIS shall confirm the amount of the monthly remuneration by making the amount based upon the following divisions for the relevant insured:
1. Where remuneration is determined annually, quarterly, monthly, weekly, or by other specified period: The amount equivalent to 30 times the amount obtained by dividing the relevant remuneration by the total number of days in the relevant period;
2. Where remuneration is determined daily, hourly, by production volume or contract: The amount obtained by averaging the remuneration of persons who receive the same remuneration by engaging in the same business as the relevant insured at the relevant workplace during the month preceding the month when acquiring eligibility as the employee insured or changing such eligibility;
3. Regarding those whose monthly remuneration is difficult to compute under subparagraphs 1 and 2: The amount obtained by taking the average remuneration received by those who engage in the same business during one month preceding the month when eligibility as the employee insured is acquired or the eligibility is converted.
 Article 38 (Confirmation on Amount of Monthly Remuneration for Employers Who Receive No Remuneration)
(1) The monthly remuneration amount for the employers who receive no remuneration under Article 70 (4) of the Act shall be computed based on the following methods. In this case, the relevant employer shall submit materials verifying the amount of their income or notify the amount of their income to the NHIS by not later than May 31 each year (in cases of employers who have submitted a certificate of faithful return to the head of the competent tax office under Article 70-2 of the Income Tax Act (hereafter referred to as "faithfully-returned employers" in this paragraph), by not later than June 30, and the monthly amount of remuneration so calculated shall be applicable from June each year to May next year (in cases of faithfully-returned employers, from July each year to June next year): <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
1. Where the income is attributable to the relevant workplace during the relevant year and is prescribed by Ordinance of the Ministry of Health and Welfare, and the amount thereof is verified by objective data;
2. Where no objective data exists to enable verification of the income, the amount reported by the employer.
(2) Articles 34 (1), 35 (2), and 36 shall apply mutatis mutandis to the procedures, etc. for confirming or changing the monthly amount of remuneration of the employers who receive no remuneration. <Newly Inserted by Presidential Decree No. 24776, Sep. 26, 2013>
(3) Notwithstanding paragraphs (1) and (2), where the amount verified or reported under paragraph (1) 1 or 2 is less than the monthly amount of remuneration of the worker who is paid the highest monthly remuneration in the relevant workplace, the amount of monthly remuneration for the relevant workers shall be the monthly remuneration of the said worker. <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
 Article 39 (Settlement of Amount of Insurance Contributions Based on Monthly Remuneration, and Payment by Installments)
(1) Where the amount of insurance contributions based on monthly remuneration that is initially computed and collected exceeds the amount of insurance contributions recomputed pursuant to Articles 34 through 38, the NHIS shall refund such overpayment to the employer, and where it falls short thereof, collect, in addition, the difference from the employer.
(2) Where the relations of employment, appointment, and engagement of the employee insured are terminated, the employer shall undergo the procedure for settling accounts with the NHIS, after settling accounts with the worker by further recomputing the insurance contributions based on monthly remuneration already paid by the relevant employee insured: Provided, That as regards the employee insured to whom the amount publicly notified by the Minister of Health and Welfare under the latter part of Article 70 (3) of the Act is applied, the calculation of the contributions imposed during the period whereto the notified amount is applied, may be omitted.
(3) Regarding the amount to be refunded to or to be borne by the employee insured among the amount that has been refunded or paid in addition under paragraph (1), the employer shall settle accounts with the relevant employee insured.
(4) Where the amount to be borne by the employee insured, among the amount to be additionally collected pursuant to paragraph (1) (hereinafter referred to as “amount to be additionally collected”), is not less than the amount of insurance contribution based on monthly remuneration amount to be borne by such employee insured (referring to the amount of insurance contribution based on monthly remuneration amount for the month to which the day of notifying the amount to be additionally collected belongs), the NHIS shall require such employee insured to pay as classified in the following subparagraphs: <Amended by Presidential Decree No. 28710, Mar. 20, 2018>
1. The amount to be additionally collected, as a result of the settlement of accounts (hereinafter referred to as the “year-end settlement”) based on the total remuneration amount of the relevant year which is finally confirmed in the next year pursuant to the main sentence of Article 34 (1): Payment in five installments: Provided, That, at the request of the user, the payment may be made in lump sum (one time) or in 10 or less installments;
2. The amount to be additionally collected, as a result of the settlement of accounts other than the year-end settlement: Payment of the whole amount in lump sum (one time): Provided, That, at the request of the user, the payment may be made in 10 or less installments.
(5) In addition to matters provided for in paragraphs (1) through (4), detailed matters necessary for the settlement of accounts of the amount of insurance contribution based on monthly remuneration, and the payment thereof in installments shall be prescribed by the articles of incorporation of the NHIS. <Newly Inserted by Presidential Decree No. 28710, Mar. 20, 2018>
 Article 40 (Payment of Insurance Contributions When Public Officials Transferred)
Where the employee insured who is a public official is transferred to other agency, the insurance contributions based on monthly remuneration for the month in which the date of transfer falls shall be paid by the head of the agency prior to such transfer by deducting it: Provided, That when the agency prior to such transfer did not pay the remuneration for the month of transfer, the moving-in agency shall pay it by deducting the same.
 Article 41 (Amount of Monthly Income)
(1) Income to be included in computing the amount of monthly income provided for in Article 71 (1) of the Act (hereinafter referred to as "amount of monthly income") shall be as follows. In such cases, the amount of non-taxable income under the Income Tax Act shall be excluded therefrom:
1. Interest income: Income prescribed in Article 16 of the Income Tax Act;
2. Dividend income: Income prescribed in Article 17 of the Income Tax Act;
3. Business income: Income prescribed in Article 19 of the Income Tax Act;
4. Earned income: Income prescribed in Article 20 of the Income Tax Act: Provided, That the earned income deduction referred to in Article 47 of the same Act shall not apply;
5. Pension income: Income prescribed in Article 20-3 of the Income Tax Act: Provided, That Articles 20-3 (2) and 47-2 of the same Act shall not be applied;
6. Other income: income prescribed in Article 21 of the Income Tax.
(2) “The amount prescribed by Presidential Decree” in the parts other than the calculation formula referred to in Article 71 (1) of the Act and in the calculation formula referred to in that paragraph means 34 million won per year. <Amended by Presidential Decree No. 28693, Mar. 6, 2018>
(3) The amount of monthly income amount shall be calculated by assessing, in the manner determined by Ordinance of the Ministry of Health and Welfare, the amount obtained by applying the calculation formula referred to in Article 71 (1) of the Act. <Amended by Presidential Decree No. 28693, Mar. 6, 2018>
(4) In addition to the matters provided for in paragraphs (1) through (3), detailed matters necessary for calculating the amount of monthly income, such as the timing of reflecting income data referred to in subpargraphs of paragraph (1), shall be prescribed by the articles of incorporation of the NHIS. <Amended by Presidential Decree No. 28693, Mar. 6, 2018>
 Article 42 (Major Factors for Calculating Contribution Points)
(1) The contribution point referred to in Article 72 (1) of the Act shall be calculated in consideration of the following matters, and the detailed methods of calculation shall be as stipulated in attached Table 4:
1. Income;
2. Property;
3. Deleted. <by Presidential Decree No. 28693, Mar. 6, 2018>
(2) Article 41 (1) shall apply mutatis mutandis to the detailed types and scope of income provided for in paragraph (1) 1.
(3) Property provided for in paragraph (1) 2 shall be as follows: <Amended by Presidential Decree No. 28693, Mar. 6, 2018>
1. Land, buildings, housing, vessels, and airplanes subject to the property tax pursuant to Article 105 of the Local Tax Act: Provided, That this shall not include family property, village property, and other buildings and land similar thereto for the purpose of common use;
2. For the self-employed insured who own no houses, the deposit money and monthly rent for the leased houses;
3. Passenger automobiles referred to in subparagraph 1 of Article 123 of the Local Tax Act, and other passenger automobiles referred to in subparagraph 2 of the same Article: Provided, That those falling under any of the following subparagraphs shall be excluded herefrom:
(a) Where the automobile has been used nine or more years;
(b) Where the engine displacement of the automobile is not less than 1,600 cc: Provided, That this shall not apply where the value of the vehicle calculated by applying to the tax base under Article 10 of the Local Tax Act the rate publicly notified by the Minister of Health and Welfare, taking into consideration the residual value rate by the number of years elapsed of an automobile under Article 4 (1) 3 of the Enforcement Decree of the Local Tax, is not less than 40 million won;
(c) Automobiles owned by persons who have rendered distinguished service to the State (including persons who have rendered distinguished service to the State under Article 73-2 of the Act on the Honorable Treatment of and Support for Persons, etc. of Distinguished Service to the State before it is amended by Act No. 11041) under Articles 4, 73, or 74 of the Act on the Honorable Treatment of and Support for Persons, etc. of Distinguished Service to the State and are judged to have suffered physical disability falling within the degree of injury under Article 6-4 of the same Act and automobiles owned by persons eligible for veteran's compensation under Article 2 of the Act on Support for Persons Eligible for Veteran's Compensation and are judged to have suffered physical disability falling within the degree of injury under Article 6 of the same Act;
(d) Automobiles owned by the disabled persons who are registered in accordance with the Act on Welfare of Persons with Disabilities;
(e) Automobiles exempted from taxation under Article 4 of the Restriction of Special Local Taxation Act;
(f) Automobiles for business use under Article 122 of the Enforcement Decree of the Local Tax Act.
(4) In addition to the matters provided for in paragraphs (1) through (3), detailed matters necessary for calculating the contribution points, such as the timing of reflecting data concerning those referred to in subpargraphs of paragraph (1) which are included in calculating the contribution points, shall be prescribed by the articles of incorporation of the NHIS. <Amended by Presidential Decree No. 28693, Mar. 6, 2018>.
 Article 42-2 (Composition, etc. of Committee on Improvement of the Insurance Contribution Imposition System)
(1) The Committee on Improvement of the Insurance Contribution Imposition System (hereinafter referred to as “System Improvement Committee") under Article 72-2 of the Act shall be composed of not less than 19 members, including one Chairperson and one Vice Chairperson, taking into consideration of gender.
(2) The Chairperson of the System Improvement Committee shall be the Vice Minister of Health and Welfare, and the Vice Chairperson shall be designated by the Chairperson from among the members.
(3) The Chairperson of the System Improvement Committee shall represent the System Improvement Committee and have general supervision and control of its affairs.
(4) The Vice Chairperson of the System Improvement Committee shall assist the Chairperson, and act on behalf of the Chairperson in any case where the Chairperson is unable to perform his/her duties due to any unavoidable cause.
(5) The members of the System Improvement Committee shall be appointed or commissioned by the Minister of Health and Welfare according to the following classifications:
1. Public officials, each one of whom is nominated by the head of an administrative agency for which he/she works, from among the public officials of Grade III who belong to the Ministry of Strategy and Finance, the Ministry of Health and Welfare, the Ministry of Employment and Labor, the Minister of Land, Infrastructure and Transport, the Office for Government Policy Coordination, the Ministry of Personnel Management, the Financial Services Commission and the National Tax Service, or public officials in general service who belong to the Senior Executive Service;
2. Not more than nine person who have abundant knowledge and experience concerning insurance contributions imposition systems, taxes, housing, finance, or pension systems;
3. One person recommended by the president of the NHIS.
(6) The term of office of the members (excluding the members under paragraph (5) 1) of the System Improvement Committee shall be two years, and may be consecutively renewed only twice.
(7) The term of office of the members (excluding the members under paragraph (5) 1) of the System Improvement Committee newly commissioned due to the resignment, etc. of an existing member shall be the remainder of his/her predecessor’s term of office.
[This Article Newly Inserted by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 42-3 (Discharge or Dismissal of System Improvement Committee)
The Minister of Health and Welfare may discharge or dismiss a member of the System Improvement Committee falling under any of the following subparagraphs:
1. Where he/she becomes unable to perform his/her duties due to any mental disorder;
2. Where he/she commits any corruption or illegality related to his/her duties;
3. Where he/she is deemed appropriate as a member due to his/her neglect of duties, injury to dignity, or other grounds;
4. Where he/she himself/herself declares that it is difficult to perform his/her duties as a member.
[This Article Newly Inserted by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 42-4 (Meetings of System Improvement Committee)
(1) The chairperson shall convene and preside over meetings of the System Improvement Committee.
(2) Meetings of the System Improvement Committee shall be convened upon request from at least one third of the total registered members, or where the chairperson deems it necessary.
(3) A majority of the member of the System Improvement Committee shall constitute a quorum, and any decision thereof shall require the concurring vote of at least a majority of those present.
(4) Where it is deemed necessary to ensure its efficient deliberation, the System Improvement Committee may establish and operate specialized committees.
(5) In addition to the matters provided for in paragraphs (1) through (4), those necessary for the operation of the System Improvement Committee and the specialized committees shall be determined by the Chairperson via a resolution by the System Improvement Committee.
[This Article Newly Inserted by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 42-5 (Administrative Secretary)
(1) The System Improvement Committee shall have one administrative secretary to handle its administrative affairs.
(2) The administrative secretary shall be nominated by the Minister of Health and Welfare, from among the public officials of Grade III or IV who belong to the Ministry of Health and Welfare.
[This Article Newly Inserted by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 42-6 (Evaluation of Appropriateness of Insurance Contribution Imposition System)
(1) The Minister of Health and Welfare may conduct investigations and research for evaluating appropriateness (hereinafter referred to as “evaluation of appropriateness”) under Article 72-3 (1) of the Act.
(2) The Minister of Health and Welfare may entrust the investigations and research conducted pursuant to paragraph (1) to a research institute, college or university, non-profit corporation, organization, etc. which has speciality in insurance contribution imposition systems.
(3) The Minister of Health and Welfare may request relevant central administrative agencies, local government, and public institutions under the Act on the Management of Public Institutions to present opinions or materials concerning the evaluation of appropriateness.
(4) Where the Minister of Health and Welfare conducts an evaluation of appropriateness under paragraph (1), he/she shall inform the System Improvement Committee of the results of such evaluation.
[This Article Newly Inserted by Presidential Decree No. 28693, Mar. 6, 2018]
 Article 43 (Separation of Household of the Self-Employed Insured)
If the self-employed insured is any of the following persons, the NHIS may separate him/her from the relevant household to form a separate household: <Amended by Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 27943, Mar. 20, 2017>
1. A person who has filed an application for the separation of household with the NHIS due to the reason of residing in a different household and maintaining a separate livelihood from the relevant household;
2. A person who is subject to the application of co-payment under subparagraph 3 (d) of attached Table 2;
3. A person servicing as full-time reserve personnel or social service personnel after call-up under Article 21 or 26 of the Military Service Act.
 Article 44 (Insurance Contribution Rates and Monetary Value per Contribution Point)
(1) The insurance contribution rate for the employee insured under Article 73 (1) of the Act shall be 624/10,000. <Amended by Presidential Decree No. 24261, Dec. 27, 2012; Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 25760, Nov. 20, 2014; Presidential Decree No. 26743, Dec. 22, 2015; Presidential Decree No. 28551, Dec. 29, 2017>
(2) The monetary value per contribution point for the self-employed insured under Article 73 (3) of the Act shall be 183.3 won. <Amended by Presidential Decree No. 24261, Dec. 27, 2012; Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 25760, Nov. 20, 2014; Presidential Decree No. 26743, Dec. 22, 2015; Presidential Decree No. 28551, Dec. 29, 2017>
 Article 45 (Areas Subject to Reduction of Insurance Contributions)
"Islands, remote areas, and agricultural and fishery communities, etc. prescribed by Presidential Decree" in Article 75 (1) 1 of the Act means any of the following areas: <Amended by Presidential Decree No. 26367, Jun. 30, 2015>
1. Island areas and isolated areas determined and publicly notified by the Minister of Health and Welfare as areas isolated from health care institutions and which entail a lengthy journey for anyone to reach health care institutions by means of public transport;
2. The following agricultural and fishing villages:
(a) Eup/Myeon area of a Gun or of a Si that takes the combined urban-rural form;
(b) Dong area of a Si or of a Gun referred to in Article 2 (1) 2 of the Local Autonomy Act, excluding residential areas, commercial areas, and industrial areas designated under Article 36 (1) 1 of the National Land Planning and Utilization Act;
3. The area recognized by the Minister of Health and Welfare in consideration of the characteristics of a workplace that has limited access to health care institutions.
 Article 45-2 (Reduction, etc. of Insurance Contributions for Account Transferors, etc.)
Where a person liable for paying insurance contributions is notified of the payment of his/her insurance contributions by means of electronic document or pays his/her insurance contributions by means of automatic account transfer under Article 75 (2) of the Act, the NHIS may reduce the insurance contributions or provide money or valuables equivalent to the reduced contributions within the limit of administrative expenses, such as postage, etc., as prescribed by the articles of incorporation of the NHIS. <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
 Article 46 (Minors Subject to Exemption from Joint Liability of the Self-Employed Insured on Payment of Insurance Contributions)
"Minors who meet the criteria prescribed by Presidential Decree" in the proviso to Article 77 (2) of the Act means any of the following: <Amended by Presidential Decree No. 26743, Dec. 22, 2015>
1. A minor who is a member of a household, which includes an adult as its member, and meets all the following requirements:
(a) The relevant minor shall not have any type of income referred to in Article 42 (2);
(b) The relevant minor shall not have property referred to in Article 42 (3) 1;
(c) The relevant minor shall not have property referred to in Article 42 (3) 3;
2. A minor whose both parents have died and who does not have any type of income referred to in Article 42 (2).
 Article 46-2 (Secondary Payment Responsibility following Transfer, or Acquisition by Transfer, of Business)
(1) A business transferee who has secondary payment responsibility pursuant to the latter part of Article 77-2 (2) of the Act shall be the person who has universally succeeded all the rights (excluding rights to receivables) to, and all the obligations (excluding obligations for accounts payable) for, the relevant business at each workplace.
(2) The value of property acquired by transfer of business, which is the limit of secondary payment responsibility under the latter part of Article 77-2 (2) of the Act, shall be any of the following: Provided, That the amount referred to in subparagraph 2 shall apply only where the amount referred to in subparagraph 1 does not exist or is unclear:
1. An amount paid or to be paid, if any, by the transferee to the transferor;
2. The value obtained by subtracting the total liabilities acquired from the total assets acquired, both of which were evaluated by the NHIS by applying mutatis mutandis Articles 60 through 66 of the Inheritance Tax and Gift Tax Act thereto.
(3) Notwithstanding paragraph (2), in any of the following cases, the value of property acquired by transfer of business shall be either an amount computed by the method referred to in paragraph (2) 1 or an amount computed by the method referred to in paragraph (2) 2, whichever is larger:
1. Where the difference between the amount referred to in paragraph (2) 1 and the market value referred to in Article 60 of the Inheritance Tax and Gift Tax Act is at least 300 million won;
2. Where the difference between the amount referred to in paragraph (2) 1 and the market value referred to in Article 60 of the Inheritance Tax and Gift Tax Act is at least an amount equivalent to 30/100 of such market value.
[This Article Newly Inserted by Presidential Decree No. 27433, Aug. 2, 2016]
 Article 46-3 (Additional Charges)
(1) "Grounds prescribed by Presidential Decree" in the main sentence of Article 78-2 (1) of the Act means any of the following:
1. Where the relevant person is not a worker, public official, or school employees;
2. Where the relevant person falls under any subparagraph of Article 6 (2) of the Act.
(2) "Cases prescribed by Presidential Decree, such as where additional charges are small sums or where it is deemed inappropriate to collect additional charges" in Article 78-2 (2) of the Act means any of the following:
1. Where the additional charges (referring to the additional charges under Article 78-2 (1) of the Act; hereinafter the same shall apply) are less than three thousand won;
2. Where there are extenuating circumstances which NHIS deems it inappropriate to collect additional charges.
[This Article Newly Inserted by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 46-4 (Payment of Insurance Contributions, etc. by Credit Cards, etc.)
(1) Deleted. <by Presidential Decree No. 27943, Mar. 20, 2017>
(2) "Institution, etc. prescribed by Presidential Decree" in Article 79-2 (1) means any of the following institutions:
1. The Korea Financial Telecommunications and Clearings Institute established under Article 32 of the Civil Act with the approval of the Financial Services Commission;
2. Institutions designated by the NHIS taking into account facilities, ability to conduct business, size of the capital, etc. among the institutions that conduct settlements by credit cards, debit cards, etc. (hereafter referred to as "credit cards, etc." in this Article) by using information and communications network.
(3) Fees for vicarious payment referred to in Article 79-2 (3) of the Act shall be approved by the NHIS after overall consideration of the operation expenses of the institutions for vicarious payment of insurance contributions. In such cases, the fees for the institutions for vicarious payment of insurance contributions, etc. shall not exceed 10/1,000 of the payment amount of the relevant insurance contributions, etc.
(4) The NHIS may determine the matters necessary for the payment of insurance contributions, etc. by credit cards, etc.
[This Article Newly Inserted by Presidential Decree No. 25583, Aug. 29, 2014]
 Article 47 (Causes for Exclusion from Provision of Data concerning Arrear or Disposition on Deficits)
"Where any other cause or event prescribed by Presidential Decree occurs" in the proviso to the main sentence of Article 81-2 (1) of the Act means any of the following cases:
1. When the payer in arrears, for whom the collection of the amount in arrears has been suspended in accordance with the determination for authorizing the rehabilitation plan under Article 243 of the Debtor Rehabilitation and Bankruptcy Act, is in the period of suspension, or when he/she is making payments of the amount in arrears pursuant to the payment schedule of the rehabilitation plan;
2. When the NHIS acknowledges that the payer in arrears is unable to pay the amount in arrears due to any of the following causes:
(a) Where a serious loss has been incurred to his/her property due to a disaster or theft;
(b) Where his/her business has suffered a remarkable loss or is in crisis.
[This Article Newly Inserted by Presidential Decree No. 24776, Sep. 26, 2013]
 Article 47-2 (Procedures for Provision of Data concerning Arrear or Disposition on Deficit)
(1) When a composite credit information collection agency under Article 25 (2) 1 of the Credit Information Use and Protection Act (hereinafter referred to as "composite credit information collection agency") requests data concerning the personal information, amount in arrears, or the amount written off, of a defaulter of insurance contributions, etc. or a person whose amount in arrears is written off (hereinafter referred to as "data concerning arrear, etc."), from the NHIS under Article 81-2 of the Act, the agency shall make such request in a document stating the following:
1. Name and address of the composite credit information collection agency;
2. Details and use of the data concerning arrear, etc. being requested.
(2) When the NHIS provides a composite credit information collection agency with data concerning arrear, etc. at a request made under paragraph (1), it may provide them by means of a document or an electronic file (referring to a magnetic tape, magnetic disc, or any other medium similar thereto, in which data concerning arrear, etc. is recorded or preserved) through an information and communications network.
(3) Where the payment of the amount in arrears, the revocation of disposal of deficit, or any other cause occurs after the NHIS has provided data concerning arrear, etc. under paragraph (2), the NHIS shall inform the composite credit information collection agency that has been provided with the data concerning arrear, etc. thereof within 15 days from the date of occurrence of such cause.
(4) Matters necessary for providing data concerning arrear, etc. other than those provided for in paragraphs (1) through (3), shall be determined by the NHIS.
[This Article Newly Inserted by Presidential Decree No. 24776, Sep. 26, 2013]
 Article 47-3 (Certification, etc. of Payment of Insurance Contributions)
(1) "Construction project, manufacture, purchase, service or any other contract prescribed by Presidential Decree" in the main sentence of Article 81-3 (1) of the Act means any of the following contracts: <Amended by Presidential Decree No. 27621, Nov. 29, 2016>
1. A contract referred to in Article 2 of the Act on Contracts to Which the State Is a Party: Provided, That any contract the price for which is paid with the operating expenses for government agencies referred to in Article 31 of the Enforcement Decree of the Management of the National Funds Act shall be excluded herefrom;
2. A contract referred to in Article 2 of the Act on Contracts to Which a Local Government Is a Party: Provided, That any contract the price for which is paid with the ordinary expenses referred to in Article 91 of the Enforcement Decree of the Local Accounting Act shall be excluded herefrom;
3. A contract concluded by a public institution under the Act on the Management of Public Institutions: Provided, That any contract the price for which is paid with the funds, which are prescribed and publicly notified by the Minister of Health and Welfare and considered to be ordinary expenses in their nature, shall be excluded herefrom.
(2) "Cases prescribed by Presidential Decree, including where a person obligated to make payment intends to pay all or some of the price for a contract with insurance contribution in arrear" in the proviso to Article 81-3 (1) of the Act means any of the following:
1. Where a person obligated to make payment intends to pay all of the price received with the insurance contributions, subsequent arrears and expenses for disposition on default, or to pay some of such price with the total amount of the insurance contributions, subsequent arrears and expenses for disposition on default;
2. Where the NHIS receives the price for the relevant contract in accordance with the disposition on default under Article 81 of the Act;
3. Where the competent court deems it impracticable to smoothly take bankruptcy procedures because a trustee in bankruptcy under the Debtor Rehabilitation and Bankruptcy Act is unable to certify the payment of insurance contributions, and the trustee in bankruptcy requests the NHIS for an exception to the certification of payment;
4. Where the relevant rehabilitation plan under the Debtor Rehabilitation and Bankruptcy Act provides that the collection of insurance contributions, subsequent arrears and expenses for disposition on default or the realization of any property under a disposition on default is deferred; and in such cases, the insurance contributions, subsequent arrears and expenses for disposition on default the certification of payment of which is not required shall be limited to the amount the collection or realization of which is deferred.
(3) Where a person obligated to pay insurance contributions under Article 77 of the Act intends to receive certification for the payment of insurance contributions, subsequent arrears and expenses for disposition on default pursuant to the main sentence of Article 81-3 (1) of the Act, he/she shall request the NHIS to certify the payment thereof, as prescribed and publicly notified by the Minister of Health and Welfare: Provided, That where a person who receives the price for a contract is not the original contractor, any of the following relevant persons shall request the certification of the payment thereof:
1. Where the claims are transferred: Transferor and transferee;
2. Where the court's assignment order is complied with: Execution creditor;
3. Where the subcontract consideration for a construction project is directly received pursuant to Article 14 (1) 1 or 2 of the Fair Transactions in Subcontracting Act: Subcontractor.
[This Article Newly Inserted by Presidential Decree No. 27433, Aug. 2, 2016]
 Article 48 (Disclosure of Personal Information of Persons in Arrear with Large Amount or in Habitual Arrears, Causes for Exclusion from Disclosure thereof, etc.)
(1) "Where any cause prescribed by Presidential Decree, such as partial payment of the amount in arrears, exists" in the proviso to Article 83 (1) of the Act means any of the following cases:
1. Where not less than 30/100 of the amount of insurance contributions in arrear, arrears, and expenses for disposition on delinquency (hereinafter referred to as the "amount in arrears") which are in default at the time a notification is issued under Article 83 (3) of the Act is paid within six months after the date of such notification;
2. Where the collection of amount in arrears is postponed by the determination to grant authorization of the rehabilitation plan made under Article 243 of the Debtor Rehabilitation and Bankruptcy Act and the case is within the grace period or the amount in arrears is being paid in accordance with payment schedule of the rehabilitation plan;
3. Where gross damage is caused to property of a person in arrear or his/her business falls into a serious crisis due to a natural disaster, for which case the Deliberative Committee on Disclosure of Insurance Contribution Information established under Article 83 (2) of the Act (hereinafter referred to as the "Deliberative Committee on Disclosure of Insurance Contribution Information") recognizes the disclosure of personal information, amount in arrears, etc. (hereinafter referred to as "personal information, etc.") of the defaulter shall not be of any practical benefit.
(2) In selecting the persons subject to the disclosure of personal information, etc. under Article 83 (3) of the Act, the NHIS and the Deliberative Committee on Disclosure of Insurance Contribution Information shall make a judgement on whether they have the ability to make payment, taking into account their property conditions and income levels, whether or not they are minors, and other circumstances comprehensively.
(3) When the NHIS informs a person in arrear under Article 83 (3) of the Act that he/she is subject to the disclosure of personal information, etc., it shall demand him/her to pay the amount in arrears, and if a defaulter falls under any cause for exclusion from the disclosure of personal information etc. under the proviso to Article 83 (1) of the Act, it shall assist him/her to submit explanatory materials for the default.
(4) When the NHIS makes a disclosure of personal information, etc. under Article 83 (4) of the Act, the name, trade name (including the name of a corporation), age, address of a person in arrear, type of the default, payment due date, amount in arrears, gist of the arrear, etc. shall be disclosed, and where a person in arrear is a corporation, the name of the representative of the corporation shall also be disclosed.
 Article 49 (Composition and Operation of the Deliberative Committee on Disclosure of Insurance Contribution Information)
(1) The Deliberative Committee on Disclosure of Insurance Contribution Information shall be comprised of 11 members, including one chairperson.
(2) From among the executive officers of the NHIS, a standing director in charge of the relevant affairs shall become the chairperson of the Deliberative Committee on Disclosure of Insurance Contribution Information, and the following persons appointed or commissioned by the president of the NHIS shall be the members thereof:
1. Four employees of the NHIS;
2. One public official of Grade III or IV belonging to the Ministry of Health and Welfare in charge of affairs related to the collection of insurance contributions;
3. One public official of Grade III or IV, belonging to the National Tax Service;
4. Four persons with extensive knowledge on and experience in law, accounting, or social insurance.
(3) The term of office of the members referred to in paragraph (2) 4 shall be two years.
(4) Meetings of the Deliberative Committee on Disclosure of Insurance Contribution Information shall open with the attendance of a majority of all the incumbent members and the resolution thereof shall require the consent of a majority of those present.
(5) Matters necessary for organizing and operating the Deliberative Committee on Disclosure of Insurance Contribution Information other than those prescribed in paragraphs (1) through (4), shall be determined by the NHIS.
 Article 50 (Disposition on Deficit)
"Cases determined by Presidential Decree" in Article 84 (1) 3 of the Act means any of the following cases:
1. Where a person in arrear possesses no assets, or is verified that the estimated value of total assets subject to dispositions on default has no residual equity for the remainder accruing after appropriating to the expenses for disposition on default;
2. Where verified that the total assets subject to dispositions on delinquency have no residual equity for the remainder accruing after appropriating to the repayment of claims secured under national taxes, local taxes, lease on deposit basis, pledge or mortgage, or security right under the Act on Security over Movable Property, Claims, Etc., etc. which take precedence over the insurance contributions and other amounts collectable under this Act;
3. Where the financial operation committee has resolved that no possibility of collection exists.
 Article 51 (Order of Appropriating Refund)
(1) The NHIS shall appropriate a refund under Article 86 (1) of the Act in the following order, pursuant to the former part of Article 86 (2) of the same Act: <Amended by Presidential Decree No. 27508, Sep. 22, 2016>
1. Where insurance contributions and subsequent arrears are overpaid or erroneously paid:
(a) Expenses for disposition on default;
(b) Insurance contributions in arrear and subsequent arrears;
(c) Insurance contributions to be paid for the next one month (limited to where a person who is able to receive the balance remaining after the appropriation under the former part of Article 86 (2) of the Act has consented thereto);
2. Where payment of collection under Article 57 of the Act (hereafter referred to as "payment of collection" in this subparagraph) and subsequent arrears are overpaid or erroneously paid:
(a) Expenses for disposition on default;
(b) Amount of collection in arrear and subsequent arrears;
3. Where additional dues and subsequent arrears are overpaid or erroneously paid:
(a) Expenses for disposition on default;
(b) Additional dues in arrear and subsequent arrears.
(2) Where a balance exists after a refund is appropriated pursuant to paragraph (1) 1 through 3, the NHIS may appropriate it in the order classified as follows: <Amended by Presidential Decree No. 27508, Sep. 22, 2016>
1. Where a balance exists after a refund is appropriated pursuant to paragraph (1) 1: It shall be appropriated in the order of each item under paragraph (1) 2, and then in the order of each item under paragraph (1) 3;
2. Where a balance exists after a refund is appropriated pursuant to paragraph (1) 2: It shall be appropriated in the order of each item under paragraph (1) 1, and then in the order of each item under paragraph (1) 3;
3. Where a balance exists after a refund is appropriated pursuant to paragraph (1) 3: It shall be appropriated in the order of each item under paragraph (1) 1, and then in the order of each item under paragraph (1) 2.
 Article 52 (Additional Interest, etc. at Time of Appropriation or Payment of Refund)
(1) "Interest prescribed by Presidential Decree" in the latter part of Article 86 (2) of the Act means the amount calculated by multiplying the refund under Article 86 (1) of the Act by the interest rate of additional payment on the refund of national tax under Article 43-3 (2) of the Enforcement Decree of the Framework Act on National Taxes for the period from the date classified in the following subparagraphs until the date the refund is appropriated to the insurance contribution, etc., arrears, or expenses for disposition on default (or the date a notice of payment is issued in cases of payment): <Amended by Presidential Decree No. 24776, Sep. 26, 2013>
1. Where insurance contributions, etc., arrears, or expenses for disposition on default (hereinafter referred to as "amount in arrears") have been paid in installments on at least two occasions, the day following the day payment in installments classified in the following items was made:
(a) Where the relevant refund does not exceed the amount paid in installments for the last time: Date of payment in installments for the last time;
(b) Where the relevant refund is more than the amount paid in installments for the last time: Date of payment in installments of each refund calculated retroactively in the order of date of recent payment in installments until the relevant refund becomes equivalent to the case under item (a);
2. Where the NHIS refunds overpayments to the employer under Article 39 (1), the day classified in the following items:
(a) The day after seven days from the due date of notification where the employer has notified the NHIS by the due date of notification of the total amount, etc. of remuneration paid to the employee insured under Articles 35 and 38: Provided, That where it is notified after the due date of notification, the day after seven days from the date of notification;
(b) The day after seven days from the date of application where the employer applied for the change of monthly remuneration to the NHIS under Article 36 (2) (including cases applicable mutatis mutandis in Article 38 (2));
3. Where the NHIS refunds the insurance contributions after settling accounts with the employer due to any cause provided for in any subparagraph of Article 35 (2) as applicable mutatis mutandis under Article 38 (2) or where it refunds the insurance contributions after resettling accounts with the employer under Article 39 (2) as the relationship of employment, appointment or engagement of the employee insured came to an end, the day classified as follows:
(a) Where eligibility changes under Article 9 (1) of the Act: The day after a lapse of seven days from the day when a report of change in eligibility was made;
(b) Where entitlement is lost under Article 10 (1) of the Act: The day after a lapse of seven days from the day when a report of loss of eligibility was made;
4. The day following the day when overpayment or erroneous payment was made in the cases other than subparagraphs 1 through 3.
(2) When the NHIS intends to appropriate the refund to the insurance contributions, etc., arrears, or expenses for disposition on default under Article 86 (2) of the Act or to pay the balance after appropriation, it shall notify the payer of the fact in writing.
CHAPTER VII APPLICATIONS FOR OBJECTION & REQUESTS FOR JUDGMENT, ETC.
 Article 53 (Objection Committees)
An objection committee shall be established in the NHIS and the Review and Assessment Service, respectively, in order to efficiently perform the affairs concerning filing of objections under Article 87 (1) and (2) of the Act.
 Article 54 (Composition, etc. of Objection Committees)
(1) Each objection committee (hereinafter referred to as "objection committee") established under Article 53 shall be comprised of 25 members including one chairperson.
(2) A standing director of the NHIS designated by the president of the NHIS shall be the chairperson of the objection committee to be established in the NHIS, and its members shall be appointed or commissioned by the president of the NHIS, from among any of the following persons:
1. One person from among the executive officers or employees of the NHIS;
2. Eight persons, namely four persons recommended by an employers' organization and four persons recommended by a workers' organization, respectively;
3. Eight persons, namely two persons recommended by civic groups, two persons recommended by consumers' organizations, two persons recommended by organizations of farmers or fishermen, and two persons recommended by organizations of the self-employed;
4. Seven persons, namely lawyers and persons of profound learning and experience in social insurance and medical services.
(3) A standing director of the Review and Assessment Service designated by the president of the Review and Assessment Service shall be the chairperson of the objection committee to be established in the Review and Assessment Service, and its members shall be appointed or commissioned by the president of the Review and Assessment Service from among any of the following:
1. One person from among executive officers or employees of the Review and Assessment Service;
2. Five persons recommended by organizations representing the insured (including the civic groups);
3. Four attorneys-at-law and persons of learning and experience in social insurance;
4. Fourteen persons recommended by medical organizations.
(4) The term of office of the members commissioned pursuant to paragraphs (2) and (3) shall be three years.
 Article 55 (Operation of Objection Committees)
(1) The chairperson of an objection committee shall convene every meeting of the objection committee and preside over such meetings. In such cases, if the chairperson is unable to perform any of his/her duties due to any extenuating circumstance, any member who is nominated by the chairperson shall act on behalf of the chairperson in performing the latter's duty.
(2) Meetings of an objection committee shall be attended by the chairperson and six members who are designated by the chairperson whenever such meetings are held.
(3) Meetings of an objection committee shall commence with the attendance of a majority of the members referred to in paragraph (2) and pass resolutions with the concurrent vote of a majority of those present.
(4) Members present at the meetings of an objection committee, other than the chairperson and executive officers and employees working for the committee, shall be paid allowances, travel expenses, and other necessary expenses within limits of budget.
(5) The scope of items put on the agenda items of an objection committee and other necessary matters concerning the operation of the committee shall be determined by the chairperson after going through the resolution thereof of the committee.
 Article 56 (Methods of Filing Objections, etc.)
The filing of objections and decisions on it under Article 87 (1) and (2) of the Act shall be based on the forms prescribed by Ordinance of the Ministry of Health and Welfare.
 Article 57 (Notification of Decisions on Objection Filed)
Where the NHIS or the Review and Assessment Service has made a decision on any objection filed, it shall notify the applicant with the original of such decision without delay, and the interested parties with copies thereof.
 Article 58 (Period for Decisions on Objection Filed)
(1) The NHIS and the Review and Assessment Service shall make a decision within 60 days from the receipt of written objection: Provided, That where any extenuating circumstances exist, it may extend the relevant period within the limit of 30 days.
(2) Where the NHIS and the Review and Assessment Service intends to extend the period for decision under the proviso to paragraph (1), notice thereof shall be served to the applicant by not later than seven days prior to the expiration of such period for determination.
 Article 59 (Submission, etc. of Request for Judgment)
(1) Those who intend to request for judgment under Article 88 (1) of the Act shall submit a request for judgment, stating the following matters to the NHIS, the Review and Assessment Service, or the Health Insurance Dispute Mediation Committee (hereinafter referred to as "Dispute Mediation Committee") under Article 89 of the Act. In such cases, when a request for judgment has been submitted to a person without justifiable authority, the request for judgment shall be sent to a person with due authority:
1. Name, resident registration number, and address of the requester and of the person subject to the disposition (in cases of a corporation, referring to the name, registration number and location of the corporation; hereafter the same shall apply in subparagraph 1 of Article 60);
2. Person who has made the original disposition (refers to the head of a relevant branch office where the head of the branch office has performed the original disposition on commission of the president of the NHIS or the president of the Review and Assessment Service; hereinafter the same shall apply);
3. Gist of disposition, and the date when he/she became aware that the original disposition was made;
4. Purport and grounds for request for judgment;
5. Where the requester is not a person subject to the disposition, relationship with him/her;
6. Indication of attached documents;
7. Whether public notice was issued on the request for judgment, and its details.
(2) Where the NHIS or the Review and Assessment Service has received a request for judgment under paragraph (1), it shall submit to the Dispute Mediation Committee the request for judgment accompanying a reply of the person who has taken the disposition and a copy of the decision on objection within ten days from the date it received the request for judgment.
(3) Where the Dispute Mediation Committee has received a request for judgment under paragraph (1), it shall send a copy or duplicate thereof to the NHIS or the Review and Assessment Service and the person who has taken the original disposition without delay, and the NHIS or the Review and Assessment Service shall submit to the Dispute Mediation Committee, the reply of the person who has taken the disposition and a copy of the written determination on objection within ten days from the date it received the copy or duplicate.
(4) When the request for judgment has been sent to a person with verifiable authority as referred to in the latter part of paragraph (1), the fact shall be notified to the requester without delay.
(5) In calculating the period of request for judgment under the latter part of Article 88 (1) of the Act, it shall be deemed that a request for judgment was raised at the time when a request for judgment was submitted to the NHIS, the Review and Assessment Service, the Dispute Mediation Committee or a person without verifiable authority.
 Article 60 (Notice of Decision on Request for Judgment)
When the chairperson of the Dispute Mediation Committee has made a decision on request for judgment, the chairperson shall affix his/her signature and seal on the written decision stating the following matters, and send without delay such written decision to the applicant and the person who has taken the dispositions and send the copy thereof to the persons interested:
1. Name, resident registration number, and address of the applicant;
2. Person who has taken the disposition;
3. Main sentence of the decision;
4. Gist of the request for judgment;
5. Grounds for the decision;
6. Date of the decision.
 Article 61 (Period for Decision on Request for Judgment)
(1) The Dispute Mediation Committee shall make a decision within 60 days from the date a request for judgment is submitted under Article 59 (1): Provided, That where any extenuating circumstance exists, the period may be extended within the extent of 30 days.
(2) If any extension of the period for decision is intended for under the proviso to paragraph (1), such fact shall be notified to the requester by not later than seven days before the period of decision finishes.
 Article 62 (Organization, etc. of Dispute Mediation Committee)
(1) The chairperson of the Dispute Mediation Committee shall be appointed by the President upon the recommendation of the Minister of Health and Welfare, and its members shall be appointed or commissioned by the Minister of Health and Welfare, from among the following persons: <Amended by Presidential Decree No. 25429, Jun. 30, 2014>
1. A current or former public official of Grade IV or higher or public official in general service belonging to the Senior Executive Service;
2. A person qualified as a judge, public prosecutor or lawyer;
3. An associate professor or a person holding a higher position in a field related to social insurances or medical treatment at a school listed in subparagraphs 1 through 3 of Article 2 of the Higher Education Act;
4. A person with extensive knowledge on and experience in social insurance or medical treatment.
(2) A public official in charge of the duty regarding requests for trials under Article 88 of the Act shall become the ex officio member prescribed in Article 89 (2) of the Act among the members referred to in paragraph (1) 1.
 Article 62-2 (Discharge or Dismissal of Dispute Mediation Committee Members)
The Minister of Health and Welfare may discharge or dismiss a member of the Dispute Mediation Committee referred to in each subparagraph of Article 62 (1), if:
1. The member becomes unable to perform his/her duties due to mental disorder;
2. The member commits misconduct in relation to his/her duties as a member;
3. The member is deemed unfit to serve as a member due to neglect of duties, injury to dignity, or any other reason;
4. The member fails to evade the relevant deliberation and resolution though he/she falls under any subparagraph of Article 65-2 (1);
5. The member voluntarily expresses his/her intention that it is impracticable to perform his/her duties.
[This Article Newly Inserted by Presidential Decree No. 26844, Dec. 31, 2015]
 Article 63 (Duty of Chairperson of Dispute Mediation Committee)
(1) The chairperson of the Dispute Mediation Committee shall represent the Dispute Mediation Committee and control overall duties of the Dispute Mediation Committee.
(2) Where the chairperson is unable to perform any of his/her duties due to any extenuating circumstance, the member designated by the chairperson shall act on his/her behalf.
 Article 64 (Term of Office for Members of Dispute Mediation Committee)
The term of office for members of the Dispute Mediation Committee shall be three years: Provided, That the term of office for public officials, from among the members set forth in Article 62 (1) 1, shall be the period of service at the relevant post.
 Article 65 (Meetings of Dispute Mediation Committee)
(1) The chairperson of the Dispute Mediation Committee shall convene and preside over meetings of the Dispute Mediation Committee.
(2) Except as otherwise expressly prescribed by this Decree, matters necessary for operating meetings of the Dispute Mediation Committee shall be determined by the chairperson via resolution by the Dispute Mediation Committee.
 Article 65-2 (Exclusion and Evasion of and Challenge to Member of Dispute Mediation Committee)
(1) Any member of the Dispute Mediation Committee (hereafter referred to as "member" in this Article) who falls under any of the following cases shall be excluded from the deliberation and resolutions of the Dispute Mediation Committee:
1. Where he/she, or his/her current or former spouse, becomes a party to the relevant agenda or holds any right or duty jointly with the party to such agenda;
2. Where he/she is a current or former relative of a party to the relevant agenda;
3. Where he/she has given any testimony, statement or advice, or conducted any research or provided service regarding the relevant agenda;
4. Where he/she or any corporation to which he/she belongs is a current or former agent of a party to the relevant agenda;
5. Where he/she is or has been involved in a disposition or nonfeasance which became the cause of the relevant agenda.
(2) If the circumstances indicate that it would be impracticable to expect fair deliberation and resolution by a member, a party to the relevant agenda may file a request for challenge to him/her with the Dispute Mediation Committee, and the Dispute Mediation Committee shall make a decision on such request by its resolution. In such cases, the member subjected to such request for challenge shall not participate in the resolution.
(3) If a member falls under any ground for exclusion stipulated in the subparagraphs of paragraph (1), he/she shall voluntarily evade the deliberation and resolution of the relevant agenda.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
 Article 66 (Administrative secretary of Dispute Mediation Committee)
(1) The Dispute Mediation Committee shall have one administrative secretary to administer offices of the Dispute Mediation Committee.
(2) The executive administrative secretary shall be appointed by the Minister of Health and Welfare, from among the public officials belonging to the Ministry of Health and Welfare.
 Article 67 (Allowances for Members of Dispute Mediation Committee)
Allowances, travel expenses, and other necessary expenses may be reimbursed to the members who attend the Dispute Mediation Committee within budgetary limits: Provided, That this shall not apply where members who are public officials attend in direct connection with their competent duties.
CHAPTER VIII SUPPLEMENTARY PROVISIONS
 Article 68 (Procedure for Delivery of Data on Reduced or Omitted Income)
(1) In any of the following cases, the NHIS shall present the relevant data to the Minister of Health and Welfare, and deliver such data to the Commissioner of the National Tax Service under Article 95 (1) of the Act, following an investigation of the income reduction and omission investigation committee pursuant to paragraph (2):
1. Where the remuneration, income, etc. (hereinafter referred to as "income, etc.") that an employer, the employee insured, or householder has reported pursuant to Article 94 (1) of the Act falls under any of the following cases:
(a) Where it differs from the income, etc. reported to the National Tax Service;
(b) Where it is below the average income, etc. of the relevant industry or type of work;
(c) Where it differs from the content of remuneration ledger, or other income-related papers, documents, etc.;
2. Any of the following cases where the reduction or omission of income, etc. is deemed exist:
(a) Where he/she fails to submit the data requested under Article 94 (1) of the Act or delays to submit them for not less than three months;
(b) Where he/she refuses, interferes with, or evades an investigation conducted under Article 94 (2) of the Act on three or more occasions.
(2) The income reduction and omission investigation committee shall be established within the NHIS to investigate reduction or omission of income, etc. referred to in Article 95 (1) of the Act (hereinafter referred to as "income reduction and omission investigation committee").
(3) The income reduction and omission investigation committee shall be comprised of five members, including a chairperson.
(4) The chairperson of the income reduction and omission investigation committee shall be appointed by the president of the NHIS from among the executive officers and employees of the NHIS.
(5) Any of the following persons appointed or commissioned by the president of the NHIS shall be the members of the income reduction and omission investigation committee:
1. One employee of the NHIS;
2. Two persons, each one of whom is respectively designated by the head of the agency where he/she belongs, from among the public officials of Grade V or higher who are under the control of the Ministry of Health and Welfare and the National Tax Service, or the public officials in general service belonging to the Senior Executive Service;
3. One certified tax accountant or one certified public accountant.
(6) Matters necessary for operating the income reduction and omission investigation committee other than those prescribed in paragraphs (3) through (5), shall be prescribed by the president of the NHIS.
 Article 69 (Reflection of Data Furnished by National Tax Service)
Upon receipt of the matters regarding remuneration or income sent by the Commissioner of the National Tax Service pursuant to Article 95 (2) of the Act, the NHIS shall apply the results to the remuneration or income of the relevant insured.
 Article 69-2 (Data, etc. Requested to Be Provided)
(1) "Data prescribed by Presidential Decree" in Article 96 (1) of the Act means the data shown in subparagraph 1 of attached Table 4-3.
(2) "Data prescribed by Presidential Decree" in Article 96 (2) of the Act means the data shown in subparagraph 2 of attached Table 4-3.
(3) Where the data referred to in paragraph (1) or (2) is stored by using a computer data recording device or computer program, such as a diskette, magnetic tape, microfilm, optical disc, etc., the State, local governments, health care institutions, insurance companies or contribution rate calculating institutions under the Insurance Business Act, public institutions under the Act on the Management of Public Institutions, other public institutions, etc. in receipt of a request for provision of data under Article 96 (1) or (2) of the Act, may provide data in the relevant form.
[This Article Newly Inserted by Presidential Decree No. 25760, Nov. 20, 2014]
 Article 70 (Criteria for Administrative Dispositions)
(1) The criteria for the business suspension of health care institutions and for the imposition of penalty surcharges under Articles 98 (1) and 99 (1) of the Act shall be as shown in attached Table 5.
(2) The procedure for collection of penalty surcharges under paragraph (1) shall be prescribed by Ordinance of the Ministry of Health and Welfare.
 Article 70-2 (Criteria for Imposition of Penalty Surcharges)
(1) Where any of the following applies to a medicine subject to suspension of, or exclusion from the application of health care benefit under Article 41-2 (1) or (2) of the Act, the Minister of Health and Welfare may impose a penalty surcharge in lieu of suspension of, or exclusion from the application of health care benefit under Article 99 (2) of the Act: <Amended by Presidential Decree No. 25583, Aug. 29, 2014; Presidential Decree No. 27433, Aug. 2, 2016>
1. Medicines that are shortage prevention drugs designated and publicly notified by the Minister of Health and Welfare and that manufacturers, manufacturers/distributor on consignment or importers avoid producing or importing, because such medicines are essential for the treatment of patients, but they are not cost-effective;
2. Medicines and medical supplies which are orphan drugs determined by the Minister of Food and Drugs Safety and which need to be introduced urgently, because they are uncommonly applied and no alternative drug exists;
3. A medicine publicly notified as eligible for health care benefit under Article 41 (3) of the Act is a single item and there exists no same medication (referring to a product which has the same administration route, ingredients, content and dosage form);
4. Any other medicine deemed by the Minister of Health and Welfare to have any special ground.
(2) Criteria for imposition of penalty surcharges under paragraph (1) shall be as set forth in attached Table 4-2.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
 Article 70-3 (Imposition and Payment of Penalty Surcharges)
(1) When the Minister of Health and Welfare intends to impose a penalty surcharge under Article 99 (1) or (2), he/she shall give written notice, stating the violation subject to the imposition of the penalty surcharge, the amount, payment due date, receiving agencies of the penalty surcharge, and other matters.
(2) A person in receipt of the notice given under paragraph (1), shall pay the penalty surcharge by a payment due date specified on the payment notice of a penalty surcharge to the receiving agency: Provided, That where it is impossible to pay the penalty surcharge within the given period due to a natural disaster or any other extenuating circumstances, he/she shall pay it within seven days from the date such cause ceases to exist.
(3) Upon receiving a penalty surcharge, a receiving agency referred to in paragraph (2) shall issue the receipt to the relevant payer, and notify the Minister of Health and Welfare of the receipt without delay.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
 Article 70-4 (Disposition for Persons Failing to Pay Penalty Surcharges)
(1) Where a person liable to pay a penalty surcharge under Article 99 (1) of the Act fails to make such payment by a due date therefor, the Minister of Health and Welfare shall issue a letter of overdue notice pursuant to the main sentence of Article 99 (4) of the Act, within 15 days after the due date therefor. In such cases, the due date for the payment shall be within ten days from the date the letter of overdue notice is issued.
(2) Where a person liable to pay a penalty surcharge has received a letter of overdue notice under paragraph (1) but fails to make such payment by a due date therefor, the Minister of Health and Welfare shall cancel the disposition of imposing the penalty surcharge under the main sentence of Article 99 (4) of the Act, and then shall take a disposition of suspending operation under Article 98 (1) of the Act or collect it in the same manner as delinquent national taxes are collected.
(3) Where the Minister of Health and Welfare cancels the disposition of imposing the penalty surcharge under the main sentence of Article 99 (4) of the Act and then takes a disposition of suspending operation under Article 98 (1) of the Act, he/she shall notify, in writing, the details thereof to the person subject to the disposition. In such cases, the written notice shall include matters necessary for the disposition of suspension of operation, such as the reason for changing the disposition and the period for the disposition of suspension of operation.
[This Article Newly Inserted by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 71 (Amounts of Support, etc. from Penalty Surcharges)
(1) Amounts of support by usage of penalty surcharges under Article 99 (7) of the Act shall be as follows: <Amended by Presidential Decree No. 25429, Jun. 30, 2014; Presidential Decree No. 27508, Sep. 22, 2016>
1. Support to the funds for costs of health care benefit paid by the NHIS under Article 47 (3) of the Act: One half of revenues of penalty surcharges;
2. Support to the funds for emergency medical services under the Emergency Medical Service Act: One half of revenues of penalty surcharges.
(2) The president of the NHIS and a person entrusted with the management and operation of the emergency medical service funds under Article 19 (2) of the Emergency Medical Service Act, shall submit to the Minister of Health and Welfare plans for operations of the penalty surcharges supported under paragraph (1) for the following year and the actual results of use during the preceding year by no later than April 30 each year.
(3) The Minister of Health and Welfare shall determine the amount of support from penalty surcharges for the following year in view of the plans for operations of penalty surcharges and the actual results of use of the penalty surcharge which he/she has received under paragraph (2), and put such amount in the budget under conditions as determined by national financial Acts.
 Article 72 (Matters of Publication)
"Matters prescribed by Presidential Decree" in the former part of the part other than subparagraphs of Article 100 (1) of the Act means the matters falling under any of the following subparagraphs:
1. Kind of the relevant health care institution and license number and gender of the representative of such health care institution;
2. Name of the head of the relevant medical institution where the founder of which is a juristic person;
3. Other matters the Health Insurance Publication Deliberation Committee established under Article 100 (2) of the Act (hereinafter referred to as the "Publication Deliberation Committee") deems necessary for the distinction from other health care institutions.
 Article 73 (Composition, Operation, etc. of Publication Deliberation Committee)
(1) The Publication Deliberation Committee shall be comprised of nine members, including one chairperson.
(2) The chairperson of the Publication Deliberation Committee shall be elected from among members set forth in subparagraphs 1 through 4, and its members shall be appointed or commissioned by the Minister of Health and Welfare, from among persons in the following subparagraphs:
1. One person recommended by consumers' organizations;
2. One journalist;
3. One legal expert, such as a lawyer;
4. Three persons recommended by organizations representing the medical and pharmaceutical industry, who have abundant knowledge and experience in health insurance;
5. One public official in general service who belongs to the Senior Executive Service of the Ministry of Health and Welfare;
6. Two persons, each of whom is recommended by the president of the NHIS and the president of the Review and Assessment Service, respectively.
(3) The term of office of members of the Publication Deliberation Committee (excluding members in paragraph (2) 5) shall be two years.
(4) The chairperson of the Publication Deliberation Committee shall represent the Publication Deliberation Committee, and shall manage overall affairs of the Publication Deliberation Committee.
(5) When the chairperson of the Publication Deliberation Committee is unable to perform his/her duty due to any extenuating circumstance, the member designated by the chairperson shall perform the duty on his/her behalf.
(6) The Publication Deliberation Committee shall open its meetings with the attendance of a majority of all the incumbent members and shall pass resolutions with concurrent votes of a majority of the members present.
(7) Matters necessary for organization, operation, etc., the Publication Deliberation Committee, other than those prescribed in paragraphs (1) through (6), shall be determined by the chairperson of the Publication Deliberation Committee after deliberation of the Publication Deliberation Committee.
 Article 73-2 (Discharge or Dismissal of Publication Deliberation Committee Members)
The Minister of Health and Welfare may discharge or dismiss a member of the Publication Deliberation Committee referred to in each subparagraph of Article 73 (2), if:
1. The member becomes unable to perform his/her duties due to any mental disorder;
2. The member commits misconduct in relation to his/her duties as a member;
3. The member is deemed unfit to serve as a member due to neglect of duties, injury to dignity, or any other reason;
4. The member voluntarily expresses his/her intention that it is impracticable to perform his/her duties.
[This Article Newly Inserted by Presidential Decree No. 26844, Dec. 31, 2015]
 Article 74 (Procedure for, Methods, etc. of Announcement)
(1) The Minister of Health and Welfare shall provide the health care institution which has been notified that it is subject to announcement under Article 100 (3) of the Act with an opportunity to submit evidence or to present itself and state opinions within 20 days from the date it received the notification.
(2) The Minister of Health and Welfare shall announce the matters of announcement under Article 100 (1) of the Act concerning the health care institutions selected as the objects of announcement under Article 100 (4) of the Act for six months on the website of the Ministry of Health and Welfare, the NHIS, the Review and Assessment Service, the competent Special Metropolitan City, Metropolitan City, Do, Special Self-Governing Province, and Si/Gun/autonomous Gu and the relevant health center, and may announce them additionally on a bulletin board, etc. of the relevant organizations.
(3) Where the Minister of Health and Welfare deems that an additional publication is necessary for such reason as a health care institution selected as the object of announcement under Article 100 (4) of the Act makes fraudulent claims falling under the subparagraphs of Article 100 (1) of the Act repeatedly or its fraudulent claims constitute a serious violation, etc., he/she may announce them in a newspaper under the Act on the Promotion of Newspapers, Etc. or may broadcast them under the Broadcasting Act in addition to the announcement in paragraph (2).
(4) When it is confirmed that the matters of announcement under Article 100 (1) of the Act are changed during the announcement period under paragraph (2) because of permission for change, report of change, etc. granted or filed under Article 33 (5) of the Medical Service Act, the Special Metropolitan City Mayor, Metropolitan City Mayor, Do governor, Special Self-Governing Province Governor, head of Si/Gun/Gu, or the head of public health clinic having jurisdiction over the relevant health care institution shall immediately notify the Minister of Health and Welfare of such fact. In such cases, the Minister of Health and Welfare shall take necessary measures so that the matters of change shall be immediately applied to the details of announcement under paragraph (2).
(5) Matters necessary for the procedure for and method of announcement, change in the matters of announcement, etc. other than those prescribed in paragraphs (1) through (4), shall be prescribed by the Minister of Health and Welfare.
 Article 74-2 (Criteria, etc. for Computing Amount Equivalent to Loss)
(1) An amount equivalent to any loss (hereinafter referred to as "amount equivalent to the loss" in this Article) that the NHIS collects from a manufacturer, operator of a manufacture by entrustment and sale business, importer or distributor of drugs under the Pharmaceutical Affairs Act or from a manufacturer, importer, repairer, distributor or lessor of medical devices under the Medical Devices Act (hereinafter referred to as "manufacturer, etc.") pursuant to Article 101 (3) of the Act, shall be the total costs of health care benefit unfairly borne by the insurer, the insured or his/her dependent due to any violation specified in subparagraphs 1 through 3 of Article 101 of the same Act.
(2) Where a manufacturer, etc. commits at least two violations specified in Article 101 (1) 1 through 3 of the Act in relation to an identical medicine or material for medical treatment, the NHIS shall collect the largest amount, out of the amounts equivalent to the loss calculated for respective violations.
(3) Where the NHIS intends to collect an amount equivalent to the loss pursuant to Article 101 (3) of the Act, it shall notify such fact to the relevant manufacturer, etc. of medicines and materials for medical treatment by written notice that includes the following:
1. The details of, and legal basis for, the relevant violation;
2. An amount to be collected, calculation details, etc.;
3. Matters necessary for payment, such as the time limit, method and place of payment.
[This Article Newly Inserted by Presidential Decree No. 27433, Aug. 2, 2016]
 Article 75 (Standards, etc. for Payment of Rewards)
(1) A person who intends to report a health care institution which is paid costs of health care benefit by fraud or other improper means shall file a report thereon to the NHIS under Article 104 (1) of the Act as determined by the NHIS. In such cases, where at least two persons file a report jointly, they shall designate a representative.
(2) Upon receiving the report under paragraph (1), after confirming the reported matter, the NHIS shall determine whether to pay a reward and notify the result thereof to the reporter (referring to the representative referred to in the latter part of paragraph (1), where the report is filed by at least two persons jointly; hereafter the same shall apply in this Article).
(3) The reporter who is notified of the decision to pay a reward under paragraph (2) shall apply for the payment of the reward to the NHIS, as determined by the NHIS.
(4) The NHIS shall pay the reporter a reward in accordance with the standards for payment of rewards stipulated in the attached Table 6 within one month from the date the application for payment of the reward is received under paragraph (3).
(5) No reward shall be paid to a person who makes a report, the details of which is the same with those already reported under paragraph (1).
(6) Matters necessary for the standards for payment of rewards, method thereof, procedure therefor, other than those prescribed in paragraphs (1) through (5), shall be determined by the NHIS.
 Article 75-2 (Payment of Incentives, etc.)
(1) The NHIS shall pay incentives under Article 104 (2) of the Act to a health care institution that has contributed to reducing the financial expenditure of the national health insurance in any of the following manners: <Amended by Presidential Decree No. 25583, Aug. 29, 2014>
1. Prescribing or preparing medicines of which costs of health care benefit are relatively low, among the medicines that can be used alternatively because their components or efficacy is the same;
2. Prescribing or preparing medicines the prices of which are low compared with other medicines and the efficacy of which is replaceable for that of other medicines due to the characteristics of the medicines, among medicines designated and publicly notified as shortage prevention drugs referred to in Article 70-2 (1) 1;
3. Purchasing medicines at a price lower than the upper price limit during a period prescribed and publicly notified by the Minister of Health and Welfare, or reducing the amount of use compared with the previous year.
(2) The amount of incentives shall not exceed 70% of the amount reduced from the financial expenditure of the national health insurance by the prescription and preparation referred to in paragraph (1).
(3) A health care institution that intends to receive incentives under paragraph (1) 1 or 2 shall request the payment of the incentives simultaneously with the filing of a request for the review of health care benefit with the Review and Assessment Service under Article 47 (2) of the Act. <Newly Inserted by Presidential Decree No. 25583, Aug. 29, 2014>
(4) The amount of incentives payable under paragraph (1) 3 shall be calculated by the Review and Assessment Service and notified to the NHIS after obtaining approval from the Minister of Health and Welfare. <Newly Inserted by Presidential Decree No. 25583, Aug. 29, 2014>
(5) Matters necessary for the criteria, method, procedures for payment of an incentive, other than those provided for in paragraphs (1) through (4) and other necessary matters, shall be determined and publicly notified by the Minister of Health and Welfare. <Amended by Presidential Decree No. 25583, Aug. 29, 2014>
[This Article Newly Inserted by Presidential Decree No. 24776, Sep. 26, 2013]
 Article 76 (Restrictions on Eligibility Acquisition as Insured or Dependents by Foreigners, etc.)
"Any ground prescribed by Presidential Decree" in Article 109 (5) 1 of the Act means any of the following:
1. Where the relevant person resides in Korea without obtaining permission to extend the period of sojourn under Article 25 of the Immigration Act or Article 10 (2) of the Act on the Immigration and Legal Status of Overseas Koreans;
2. Where the relevant person receives a written order of deportation pursuant to Article 59 (3) of the Immigration Act.
[This Article Wholly Amended by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 76-2 (Timing, etc. Eligibility Acquisition as Insured for Foreigners, etc.)
(1) An overseas Korean national or a foreigner residing in the Republic of Korea (hereinafter referred to as "foreigner, etc. residing in Korea) shall become eligible as the self-employed insured on any of the following dates, whichever is relevant, pursuant to the proviso to Article 109 (6) of the Act:
1. Where the relevant person falls under Article 109 (3) 2 of the Act and resides in Korea during the period referred to in subparagraph 1 of the same paragraph: The date the period expires;
2. Where the relevant person falls under Article 109 (3) 2 of the Act and constitutes the grounds on which he/she is expected to reside in Korea continuously pursuant to subparagraph 1 of the same paragraph: The date the person enters Korea;
3. Other cases where the Minister of Health and Welfare deems it necessary to determine the time to acquire the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea in consideration of the status, period, circumstances, etc. of sojourn, and publicly notifies such time: The date prescribed in the relevant notice.
(2) A foreigner, etc. residing in Korea shall lose the eligibility as the insured on the relevant date specified in Article 10 (1) 1, 4, or 5 of the Act, pursuant to Article 10 of the Act which is applicable mutatis mutandis under the main sentence of Article 109 (6) of the Act: Provided, That a foreigner, etc. residing in Korea shall also lose the eligibility on any of the following dates, whichever is relevant, pursuant to the proviso to Article 109 (6) of the Act:
1. The employee insured: Any of the following dates:
(b) The date following the date a written order of deportation is issued under Article 59 (3) of the Immigration Act;
(c) The date the employer requests the exclusion of the relevant person from the employee insured pursuant to Article 109 (5) 2 of the Act; Provided, That where such request is made within 14 days from the date a report on eligibility acquisition as the employee insured is made under Article 8 (2) of the Act, the relevant person shall lose the eligibility on the date of eligibility acquisition;
(d) Other cases where the Minister of Health and Welfare deems it necessary to determine the time to lose the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea in consideration of the status, period, circumstances, etc. of sojourn, and publicly notifies such time: The date prescribed in the relevant notice;
2. The self-employed insured: Any of the following dates:
(a) The date referred to in subparagraph 1 (a) or (b);
(b) Where one month has elapsed since an overseas Korean national or a foreigner whose period of sojourn has not expired departed from Korea: The date following the date of departure;
(c) Where the relevant person fails to pay insurance contributions by the end of the month in which the due date for the payment thereof under Article 109 (8) of the Act falls: The first day of the month following the month in which the due date for the payment falls;
(d) Other cases where the Minister of Health and Welfare deems it necessary to determine the time to lose the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea in consideration of the status, period, circumstances, etc. of sojourn, and publicly notifies such time: The date prescribed in the relevant notice.
[This Article Newly Inserted by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 76-3 (Time, etc. to Acquire Eligibility as Dependents for Foreigners, etc.)
(1) A foreigner, etc. residing in Korea shall acquire the eligibility as a dependent on any of the following dates, whichever is relevant, pursuant to the proviso to Article 109 (6) of the Act:
1. Where the relevant person is a newborn baby: The date he/she was born;
2. Where the relevant person files an application for the eligibility acquisition as a dependent within 90 days from the date of resident registration, reporting on his/her place of residence in Korea or alien registration under any subparagraph of Article 109 (2) of the Act (hereafter referred to as "resident registration, etc." in this Article): The date he/she makes the relevant resident registration, etc.: Provided, That where the person becomes the employee insured after the resident registration, etc., he/she shall acquire the eligibility on the date he/she becomes the employee insured;
3. Where the relevant person files an application for the eligibility acquisition as a dependent 90 days after the date of resident registration, etc.: The date he/she files an application for the eligibility acquisition: Provided, That where the person becomes the employee insured after the resident registration, etc. and files such application within 90 days from the date he/she becomes the employee insured, he/she shall acquire the eligibility on the date he/she becomes the employee insured;
4. Other cases where the Minister of Health and Welfare deems it necessary to determine the time to acquire the eligibility as dependents for foreigners, etc. differently from that for Korean nationals residing in Korea in consideration of the status, period, circumstances, etc. of sojourn, and publicly notifies such time: The date prescribed in the relevant notice.
(2) A foreigner, etc. residing in Korea shall lose the eligibility as a dependent on the date specified in Article 5 (3) of the Act (limited to where he/she is deceased; where his/her supporter loses the eligibility as the employee insured; or where he/she receives medical benefits), pursuant to Article 5 of the Act which is applicable mutatis mutandis under the main sentence of Article 109 (6) of the Act: Provided, That the relevant person shall also lose the eligibility as a dependent on any of the following dates pursuant to the proviso to Article 109 (6) of the Act:
2. The date following the date a written order of deportation is issued under Article 59 (3) of the Immigration Act;
3. Other cases where the Minister of Health and Welfare deems it necessary to determine the time to lose the eligibility as dependents for foreigners, etc. differently from that for Korean nationals residing in Korea in consideration of the status, period, circumstances, etc. of sojourn, and publicly notifies such time: The date prescribed in the relevant notice.
[This Article Newly Inserted by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 76-4 (Foreigners subject to Special Cases on Imposition and Collection of Insurance Contributions)
"Foreigners, etc. residing in Korea prescribed by Presidential Decree" in the proviso to Article 109 (9) of the Act means persons who are not granted any of the following statuses of sojourn:
1. The status of sojourn granted for cohabitation through visit under subparagraph 26, residency under subparagraph 27, permanent residency under subparagraph 28-3, or immigration through marriage under subparagraph 28-4 of attached Table 1 of the Enforcement Decree of the Immigration Act;
2. Any other status of sojourn recognized and publicly notified by the Minister of Health and Welfare because he/she deems it necessary to apply the same standards for imposing and collecting insurance contributions to such foreigners, etc. as those for Korean nationals residing in Korea, in consideration of the status, period, circumstances, etc. of sojourn.
[This Article Newly Inserted by Presidential Decree No. 27508, Sep. 22, 2016]
 Article 77 (Applicable Period for Voluntarily Continuous Insured Persons)
"Period prescribed by Presidential Decree" in the main sentence of Article 110 (2) of the Act is a period of up to 36 months reckoned from the day following the date employment relationship comes to an end. <Amended by Presidential Decree No. 24520, May 3, 2013; Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 28551, Dec. 29, 2017>
 Article 78 (Entrustment of Service)
Where the NHIS intends to entrust service under each subparagraph of Article 112 (1) of the Act to postal service agencies, financial institutions, or other persons pursuant to Article 112 (1) of the Act, it shall obtain a resolution by the board of directors of the NHIS regarding the selection of agencies to be entrusted and the details of entrustment contract.
 Article 79 (Allocation, etc. of Insurance Contributions and Insurance Contributions, etc. Entrusted with Collection)
Where the NHIS collects insurance contributions and insurance contributions entrusted with collection through one integrated written notification for payment upon request from a person liable for payment (excluding where the NHIS collects such contributions by the means of delinquent dispositions according to Article 81 of the Act and applicable law to entrustment with collection), if the amount of insurance contributions collected, and subsequent fees or insurance contributions entrusted to the NHIS for collection is smaller than the amount the NHIS has to collect, it shall collect the payment in installments in the proportion of the amount by insurance (referring to the amount excluding arrears and additional charges under the Act and applicable law to the entrustment with collection) that the NHIS intends to collect pursuant to the main sentence of Article 113 (1) of the Act, unless the person liable for payment states otherwise by the payment date.
 Article 80 (Management of Contributions)
The NHIS shall keep and manage separate accounts for contributions received from each respective Fund under Article 93-4 (1) of the Act.
 Article 81 (Management of Sensitive Information and Personally Identifiable Information)
(1) Where it is inevitable to perform the following affairs, the NHIS (including those entrusted with the services of the NHIS under Article 112 of the Act) may manage information on health under Article 23 of the Personal Information Protection Act, information falling under criminal records under subparagraph 2 of Article 18 of the Enforcement Decree of the same Act, and data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under the subparagraphs of Article 19 of the same Decree: <Amended by Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 25760, Nov. 20, 2014>
1. Affairs related to reporting on a workplace under Article 7 of the Act;
2. Affairs related to the services set forth in Article 14 (1) of the Act;
3. Affairs related to the payment of costs of health care benefit to soldiers, etc. in active service under Article 60 of the Act;
4. Affairs related to the settlement of costs of health care benefit under Article 61 of the Act;
4-2. Affairs related to the provision of data under Article 81-2 of the Act;
5. Affairs related to the disclosure of personal information, etc. of persons in arrear under Article 83 of the Act;
6. Affairs related to filing of objections and administrative proceedings under Articles 87 and 90 of the Act;
7. Affairs related to reporting, etc. under Article 94 of the Act;
8. Affairs related to forwarding of data on the reduction or omission of incomes under Article 95 of the Act;
8-2. Affairs related to a request for provision of data under Article 96 of the Act;
9. Affairs related to the payment of rewards under Article 104 of the Act;
10. Affairs related to the entrustment of services under Article 112 of the Act.
(2) Where performing the following affairs is inevitable, the Review and Assessment Service may deal with information on health under Article 23 of the Personal Information Protection Act and data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under Article 19 of the Enforcement Decree of the same Act: <Amended by Presidential Decree No. 24776, Sep. 26, 2013; Presidential Decree No. 25760, Nov. 20, 2014; Presidential Decree No. 27960, Mar. 27, 2017>
1. Affairs related to reporting on the current status of facilities, equipment, human resource, etc. of health care institutions under Article 43 of the Act;
1-2. Affairs related to the verification of entitlement to health care benefit, etc. under Article 48 of the Act;
2. Affairs related to the services set forth in Article 63 (1) of the Act;
3. Affairs related to filing of objections and administrative litigations under Articles 87 and 90 of the Act;
4. Affairs related to a request for provision of data under Article 96 of the Act.
(3) Where performing the following affairs is inevitable, health care institutions (including organizations authorized by health care institutions pursuant to Article 47 (6) of the Act, in the case of subparagraph 2) may deal with information on health under Article 23 of the Personal Information Protection Act and data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under Article 19 of the Enforcement Decree of the same Act: <Newly Inserted by Presidential Decree No. 27960, Mar. 27, 2017>
1. Affairs related to the provision of health care benefit referred to in Article 41 (1) of the Act;
2. Affairs related to claims for costs of health care benefit referred to in Article 47 (1) or (2) of the Act.
(4) Where performing the following affairs is inevitable, the Minister of Health and Welfare (including those delegated or entrusted with the authority of the Minister of Health and Welfare under Article 111 of the Act) may manage information referred to in paragraph (1): <Amended by Presidential Decree No. 27960, Mar. 27, 2017>
1. Affairs related to approval for disposition on default under Article 81 (3) of the Act;
2. Affairs related to a request for a trial under Article 88 of the Act;
3. Affairs related to reports and inspections, etc. under Article 97 of the Act;
4. Affairs related to the disposition of suspension of operation under Article 98 of the Act;
5. Affairs related to the imposition and collection of penalty surcharges under Article 99 of the Act;
6. Affairs related to the publication of the fact of violation.
 Article 81-2 (Re-Examination of Regulation)
The Minister of Health and Welfare shall examine the appropriateness of the attached Table 4-2 every five years from July 2, 2014 (referring to the period that ends on the day before the base date of every fifth year) and take measures for improvement, etc.
[This Article Newly Inserted by Presidential Decree No. 25429, Jun. 30, 2014]
CHAPTER IX PENALTY PROVISIONS
 Article 82 (Standards for Imposition of Administrative Fines)
Standards for imposition of administrative fines under Article 119 of the Act shall be as listed in attached Table 7.
ADDENDA
Article 1 (Enforcement Date)
This Decree shall enter into force on September 1, 2012: Provided, That the part concerning general hospitals and tertiary general hospitals in the amended provisions of Article 21 (3) 2 shall enter into force on July 1, 2013.
Article 2 (General Transitional Measures)
In calculating insurance benefit, such as costs of health care benefit (including co-payment and amount borne by the NHIS) and health care benefit, and monthly insurance contributions provided before this Decree enters into force shall be governed by the former provisions.
Article 3 (Transitional Measures concerning Deliberation and Resolution on Points of Relative Values on Health Care Benefit)
From among the points of relative value on health care benefit and costs of medicines and materials for medical treatment which have been publicly notified after undergoing the deliberation by the Review and Assessment Committee under former provisions as of January 1, 2007, the day on which partially amended Enforcement Decree of the National Health Insurance Act (Presidential Decree No. 19818) entered into force, matters which have not been amended until the enforcement date of this Decree shall be deemed to have undergone deliberation and resolution by the Review and Assessment Committee under the amended provisions of Articles 21 (2) and 22.
Article 4 (Transitional Measures concerning Restriction on Insurance Benefits of Defaulters of Insurance Contributions)
Where a person obligated to pay insurance contributions had received from the NHIS a disposition of restriction on insurance benefits under former Article 27 for reason of failure to pay insurance contributions for not less than three times but less than six times before September 29, 2008, the date the partially amended Enforcement Decree of the National Health Insurance Act (Presidential Decree No. 20986) entered into force, such disposition of restriction shall be deemed revoked on September 29, 2008: Provided, That the restriction on insurance benefits imposed by such disposition of restriction for period until September 29, 2008, shall remain effective.
Article 5 (Transitional Measures concerning Areas Subject to Reduction of Insurance Contributions)
The areas subject to the reduction of insurance contributions under subparagraph 3 of Article 32 of the former Enforcement Decree of the National Health Insurance Act (referring to the same Enforcement Decree before it was amended by Presidential Decree No. 20190) as of July 1, 2007, shall be deemed areas subject to reduction of insurance contributions which are recognized by the Minister of Health and Welfare under the amended provisions of subparagraph 3 of Article 45.
Article 6 (Special Cases concerning Provision of Medical Treatment by Hospitalization for Diagnosis Related Group Subject to Comprehensive Medical Treatment)
General hospitals and tertiary general hospitals may provide medical treatment by hospitalization for diagnosis-related group which is subject to comprehensive medical treatment under subparagraph 2 of the attached Table 2 of the former Enforcement Decree of the National Health Insurance Act (referring to the same Enforcement Decree before it was amended by Presidential Decree No. 23851) until June 30, 2013.
Article 7 (Transitional Measures concerning Recognition of Persons Subject to Reduction of Co-Payment)
Those who had been receiving medical aid under subparagraphs 3 and 3-2 of Article 2 of the former Enforcement Decree of the Medical Care Assistance Act (referring to the same Act before it was amended by Presidential Decree No. 21313) as of April 1, 2009, the date the partially amended Enforcement Decree of the National Health Insurance Act (Presidential Decree No. 21314) entered into force shall be deemed recognized by the NHIS as those subject to the reduction of shares borne by principals under the amended provisions of subparagraph 3 (d) of attached Table 2.
Article 8 Omitted.
Article 9 (Relationship with Other Statutes)
Where a statute cites the former provisions of the Enforcement Decree of the National Health Insurance Act at the time this Decree enters into force, it shall be deemed to have cited the relevant provisions of this Decree in lieu of the former provisions, if provisions corresponding thereto exist in this Decree.
ADDENDA <Presidential Decree No. 24128, Sep. 28, 2012>
Article 1 (Enforcement Date)
This Decree shall enter into force on October 1, 2012.
Article 2 (Applicability)
The amended provisions of subparagraph 1 (a) (i) of attached Table 2 shall apply to the health care benefit for dental treatment for disabled persons furnished on or after the date this Decree enters into force.
ADDENDUM <Presidential Decree No. 24247, Dec. 21, 2012>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Articles 2 and 3 Omitted.
ADDENDUM <Presidential Decree No. 24261, Dec. 27, 2012>
This Decree shall enter into force on January 1, 2013.
ADDENDUM <Presidential Decree No. 24341, Jan. 28, 2013>
This Decree shall enter into force on the date of its promulgation.
ADDENDA <Presidential Decree No. 24454, Mar. 23, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation. (Proviso Omitted.)
Articles 2 through 4 Omitted.
ADDENDA <Presidential Decree No. 24520, May 3, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Applicable Period for Voluntarily Continuous Insured Persons)
The amended provisions of Article 77 shall also apply to persons who are voluntarily continuous insured persons as at the time this Decree enters into force.
ADDENDA <Presidential Decree No. 24588, Jun. 11, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2013.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefit for Dentures)
The amended provisions of subparagraphs 3 (d) (iii) and (iv), and 3 (f) shall apply to the health care benefit provided on or after the date this Decree enters into force.
ADDENDA <Presidential Decree No. 24776, Sep. 26, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended provisions of subparagraph 1 (a) (i) of attached Table 2 and subparagraph 3 (d) of the same Table shall enter into force on October 1, 2013; the amended provisions of Articles 47, 47-2, and 75-2 on November 23, 2013; and the amended provisions of Articles 43 and 44 on January 1, 2014, respectively.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of subparagraph 1 (a) (i) of attached Table 2 and subparagraph 3 (d) of the same Table shall apply to the health care benefit that comes into effect on and after October 1, 2013.
ADDENDA <Presidential Decree No. 25015, Dec. 18, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended provisions of attached Table 3 shall enter into force on January 1, 2014.
Article 2 (Applicability to Amounts of Co-Payment out of Costs of Health Care Benefit)
The amended provisions of subparagraph 4 of attached Table 2 shall begin to apply from health care benefit provided after this Decree enters into force.
Article 3 (Special Cases, etc. concerning Co-Payment Ceiling)
(1) Notwithstanding the amended provisions of subparagraph 2 of attached Table 3, co-payment ceiling by each insurance contribution based on upper limit amount classified in the following shall be applied from January 1, 2014 to December 31, 2014:
1. In cases of the self-employed insured
ClassificationCo-Payment Ceiling
(a) Where the insurance contributions based on upper limit amount is equivalent to hat of 10/100 of the low-level of all the self-employed insured, and does not exceed the amount determined and publicly notified by the Minister of Health and Welfare1,200,000 won
(b) Where the insurance contributions based on upper limit amount is equivalent to 10/100 of the low-level of all the self-employed insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 30/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare1,500,000 won
(c) Where the insurance contributions based on upper limit amount is equivalent to 30/100 of the low-level of all the self-employed insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 50/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare2,000,000 won
(d) Where the insurance contributions based on upper limit amount is equivalent to 50/100 of the low-level of all the self-employed insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 70/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare2,500,000 won
(e) Where the insurance contributions based on upper limit amount is equivalent to 70/100 of the low-level of all the self-employed insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 80/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare3,000,000 won
(f) Where the insurance contributions based on upper limit amount is equivalent to 80/100 of the low-level of all the self-employed insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 90/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare4,000,000 won
(g) Where the insurance contributions based on upper limit amount is equivalent to 90/100 of the low-level of all the self-employed insured, exceeding the amount determined and publicly notified by the Minister of Health and Welfare5,000,000 won
2. In cases of the employee insured or his/her dependents
ClassificationCo-Payment Ceiling
(a) Where the insurance contributions based on upper limit amount is equivalent to 10/100 of the low-level of all the employee insured, not exceeding the amount determined and publicly notified by the Minister of Health and Welfare1,200,000 won
(b) Where the insurance contributions based on upper limit amount is equivalent to 10/100 of the low-level of all the employee insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 30/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare1,500,000 won
(c) Where the insurance contributions based on upper limit amount is equivalent to 30/100 of the low-level of all the employee insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 50/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare2,000,000 won
(d) Where the insurance contributions based on upper limit amount is equivalent to 50/100 of the low-level of all the employee insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 70/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare2,500,000 won
(e) Where the insurance contributions based on upper limit amount is equivalent to 70/100 of the low-level of all the employee insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 80/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare3,000,000 won
(f) Where the insurance contributions based on upper limit amount is equivalent to 80/100 of the low-level of all the employee insured exceeding the amount determined and publicly notified by the Minister of Health and Welfare, and is equivalent to 90/100 of the low-level not exceeding the amount determined and publicly notified by the Minister of Health and Welfare4,000,000 won
(g) Where the insurance contributions based on upper limit amount is equivalent to 90/100 of the low-level of all the employee insured, exceeding the amount determined and publicly notified by the Minister of Health and Welfare5,000,000 won
(2) Paragraph (1) shall begin to apply from the first health care benefit provided on or after January 1, 2014.
ADDENDA <Presidential Decree No. 25044, Dec. 30, 2013>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2014.
Article 2 (Applicability)
The amended provisions of attached Table 4 shall apply with the calculation of insurance contributions for January 2014.
ADDENDA <Presidential Decree No. 25429, Jun. 30, 2014>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 2, 2014: Provided, That the amended provisions of Article 19 (2) and subparagraph 3 of attached Table 2 shall enter into force on July 1, 2014.
Article 2 (Applicability to Suspension and Exclusion of Medicines from Health Care Benefit and Criteria for Imposition of Penalty Surcharges)
The amended provisions of Article 18-2 and attached Table 4-2 shall begin to apply beginning with the first violation of Article 47 (2) of the Pharmaceutical Affairs Act committed after this Decree enters into force.
Article 3 (Applicability to Amount of Co-Payment for Artificial Dental Implants)
The amended provisions of Article 19-2 and subparagraph 3 (d) (v) and (vi) and (g) of attached Table 2 shall apply beginning with the first health care benefit provided on or after July 1, 2014.
Article 4 (Transitional Measures concerning Chairperson of Dispute Mediation Committee)
The chairperson of the Dispute Mediation Committee appointed under the former Article 62 (1) as at the time this Decree enters into force shall be deemed appointed under this Decree until the chairperson is appointed under the amended provisions of Article 62 (1).
ADDENDA <Presidential Decree No. 25583, Aug. 29, 2014>
Article 1 (Enforcement Date)
This Decree shall enter into force on September 1, 2014: Provided, That the amended provisions of Article 46-2 shall enter into force on September 25, 2014.
Article 2 (Applicability to Payment of Incentives)
The amended provisions of Article 75-2 shall apply to health care benefit provided after this Decree enters into force.
Article 3 (Applicability to Calculation of Expenses to be Borne by Principal)
The amended provisions of attached Table 2 shall also apply where expenses to be borne by the principal for the health care benefit provided after this Decree enters into force are calculated for a person who has been receiving medical treatment by hospitalization as at the time this Decree enters into force.
Article 4 (Applicability to Payment of Monetary Rewards)
The amended provisions of attached Table 6 shall apply to a person who files a report after this Decree enters into force on that a health care institution has received insurance benefit costs by deceit or any other wrongful means.
Article 5 (Applicability to Calculation of Costs of Health Care Benefit)
Notwithstanding the amended provisions of the latter part of Article 19 (1) and Article 22 (1) 2 and 3, the calculation of costs of health care benefit done before this Decree enters into force shall be governed by the former provisions.
ADDENDA <Presidential Decree No. 25751, Nov. 19, 2014>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended parts of the Presidential Decrees which were promulgated before this Decree enters into force, but the enforcement dates of which have not arrived yet among the Presidential Decrees amended pursuant to Article 5 of the Addenda, shall respectively enter into force on the enforcement dates of such Presidential Decrees.
Articles 2 through 5 Omitted.
ADDENDUM <Presidential Decree No. 25760, Nov. 20, 2014>
This Decree shall enter into force on November 21, 2014: Provided, That the amended provisions of Article 44 shall enter into force on January 1, 2015, and the amended provisions of Article 76 (1) and (2) 3 (a) shall enter into force on January 22, 2015, respectively.
ADDENDA <Presidential Decree No. 26302, Jun. 1, 2015>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 4, 2015.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 26367, Jun. 30, 2015>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2015: Provided, That the amended provisions of Article 21 (3) 3 shall enter into force on July 15, 2015, and the amended provisions of Article 76 (2) 2 on October 1, 2015.
Article 2 (Applicability to Palliative Care Received by Hospitalization)
The amended provisions of Article 21 (3) 3 shall apply to the health care benefit provided on or after July 15, 2015.
Article 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of attached Table 2 shall apply to the health care benefit provided on or after July 1, 2015.
Article 4 (Transitional Measures concerning the Insured Who Are Foreigners, etc.)
Notwithstanding the amended provisions of Article 76 (2) 2, those who have entered the Republic of Korea before this Decree enters into force shall be governed by the former provisions.
ADDENDA <Presidential Decree No. 26651, Nov. 18, 2015>
Article 1 (Enforcement Date)
This Decree shall enter into force on November 19, 2015.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 26743, Dec. 22, 2015>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2016: Provided, That the amended provisions of subparagraph 5 of attached Table 2 shall enter into force on July 1, 2016.
Article 2 (Applicability to Raising Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of subparagraph 3 (d) (vii) of attached Table 2 shall apply from a medicine which is prepared based on a prescription issued after January 1, 2016.
Article 3 (Applicability to Raising Co-Payment Rate for Costs of Health Care Benefit for Long-Term Inpatient)
The amended provisions of subparagraph 5 of attached Table 2 shall apply from a patient who is hospitalized after the enforcement date under the proviso to Article 1 of the Addenda.
ADDENDUM <Presidential Decree No. 26844, Dec. 31, 2015>
This Decree shall enter into force on the date of its promulgation.
ADDENDA <Presidential Decree No. 27296, Jun. 30, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2016.
Article 2 (Applicability to Medical Expenses for Pregnancy and Delivery)
The amended provisions of Article 23 (3) and (6) shall apply from the medical expenses for pregnancy and delivery for which an application is filed with the NHIS after July 1, 2016.
Article 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of subparagraph 1 (a) (i), subparagraph 3 (a) (iii), subparagraph 3 (d) (iii) through (vi), subparagraph 3 (d) (viii), and subparagraph 3 (f) through (h) of attached Table 2 shall apply from the health care benefit provided after July 1, 2016.
ADDENDA <Presidential Decree No. 27433, Aug. 2, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on August 4, 2016.
Article 2 Omitted.
ADDENDA <Presidential Decree No. 27508, Sep. 22, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on September 23, 2016.
Article 2 (Applicability to Disposition for Persons Failing to Pay Penalty Surcharges)
The amended provisions of Article 70-4 shall also apply to persons who have received a letter of overdue notice before this Decree enters into force but fail to pay penalty surcharges by the due date for the payment thereof.
Article 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of subparagraph 1 (a) (i) of attached Table 2, subparagraph 4 in the remarks column of the table under subparagraph 3 (d) (ii) of the same Table, and subparagraph 3 (d) (viii) of the same Table shall apply, starting from the health care benefit provided after this Decree enters into force.
Article 4 (Transitional Measures concerning Standards for Imposition of Administrative Fines)
Where a person, subjected to a disposition of administrative fines for a violation committed before this Decree enters into force, commits an identical violation for the first time after this Decree enters into force, such identical violation shall be construed as a violation committed first, for the purposes of applying the amended provisions of subparagraph 2 (a), (c), (e), and (g) of attached Table 7.
ADDENDA <Presidential Decree No. 27616, Nov. 29, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on December 2, 2016.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 27621, Nov. 29, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on November 30, 2016.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 27734, Dec. 30, 2016>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2017.
Article 2 (Transitional Measures concerning Medical Expense for Pregnancy or Delivery)
Where treatment coupon is issued or in the process of issuance after an application for medical expense for pregnancy or delivery is filed with NHIS under Article 23 (4) or (6) before this Decree enters into force, the previous provisions shall apply notwithstanding Article 23 (2) 2.
Article 3 (Applicability to Co-Payment Rate of Health Care Benefits)
The amended provisions of the table under subparagraph 1 (b) of attached Table 2, subparagraph 6 in the remarks column of the table under the same subparagraph 1 (b), subparagraph 3 (b) (iv) of the same table, table (d) (ii) of the same subparagraph, paragraph 2 or 5 of the remarks column of the table of the same (ii) shall apply, starting from the health care benefits provided after this Decree enters into force.
ADDENDA <Presidential Decree No. 27853, Feb. 7, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
The amended provisions of subparagraph 1 (b) of attached Table 2 shall begin to apply to the health care benefit that comes into effect on and after January 1, 2017.
ADDENDA <Presidential Decree No. 27943, Mar. 20, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on March 23, 2017: Provided, That the amended provisions of Article 46-4 (1) shall enter into force on the date of its promulgation.
Article 2 (Applicability to Computation, Adjustment, etc. of Points of Relative Values)
The amended provisions of Article 21 (2) shall also apply to the health care benefit, for which the procedures for computing or adjusting the points of relative values are underway as at the time this Decree enters into force.
Article 3 (Transitional Measures concerning Designation of Selective Benefit and Assessment of Appropriateness)
(1) Health care benefit publicly notified by the Minister of Health and Welfare pursuant to the former provisions of subparagraph 4 of attached Table 2, shall be deemed selective benefit designated pursuant to Article 41-4 (1) of the Act.
(2) Where the period for an assessment of appropriateness referred to in the amended provisions of Article 18-4 (2) 1 is applied to the health care benefit deemed selective benefit pursuant to paragraph (1), the date health care benefit has been provided pursuant to the former provisions of subparagraph 4 of attached Table 2, shall be deemed the date selective benefit has been provided.
ADDENDA <Presidential Decree No. 27959, Mar. 27, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on March 28, 2017.
Articles 2 through 4 Omitted.
ADDENDUM <Presidential Decree No. 27960, Mar. 27, 2017>
This Decree shall enter into force on March 30, 2017. (Proviso Omitted.)
ADDENDA <Presidential Decree No. 28107, Jun. 13, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2017.
Article 2 (Applicability to Co-Payment of Costs of Health Care Benefit)
The amended provisions of subparagraph 3 (a) 4) of attached Table 2 shall apply, beginning with the health care benefit that comes into effect after this Decree enters into force.
ADDENDA <Presidential Decree No. 28206, Jul. 24, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on August 4, 2017. (Proviso Omitted.)
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 28211, Jul. 26, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended parts of the Presidential Decrees, which were promulgated before this Decree enters into force but the enforcement dates of which have not arrived yet, among the Presidential Decrees amended pursuant to Article 8 of the Addenda, shall enter into force on the enforcement dates of the respective Presidential Decrees.
Articles 2 through 8 Omitted.
ADDENDA <Presidential Decree No. 28222, Aug. 1, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on August 9, 2017.
Article 2 (Transitional Measures concerning Computation of Monthly Insurance Contributions of the Self-Employed Insured)
In cases of computing monthly insurance contributions for August 2017 of the self-employed insured, the previous provisions shall apply, notwithstanding the amended provisions of the former part of the table of subparagraph 1 (d) of attached Table 4.
ADDENDA <Presidential Decree No. 28317, Sep. 19, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Payment of Medical Expenses for Pregnancy and Delivery)
The amended provisions of paragraph (1), the main sentence of paragraph (2), and paragraph (7) of Article 23 shall apply, beginning with the insured who is delivered of a baby after this Decree enters into force or her dependents.
ADDENDA <Presidential Decree No. 28348, Sep. 29, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on October 1, 2017: Provided, That the amended provisions of subparagraph 3 (d) 3) and 4) and (f) of attached Table 2 shall enter into force on November 1, 2017.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefit)
(1) The amended provisions of subparagraph 3 (b) 1), (d) 2), (i) and (j) of attached Table 2 shall apply, beginning with the health care benefit that comes into effect on and after October 1, 2017.
(2) The amended provisions of subparagraph 3 (d) 3) and 4) and (f) of attached Table 2 shall apply, beginning with the health care benefit that comes into effect on and after November 11, 2017.
ADDENDA <Presidential Decree No. 28551, Dec. 29, 2017>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2018.
Article 2 (Transitional Measures concerning Applicable Period for Voluntarily Continuous Insured Persons)
The amended provisions of Article 77 shall also apply to a voluntarily continuous insured person who retains the eligibility of the employee insured pursuant to Article 110 (2) of the Act as at the time this Decree enters into force.
ADDENDA <Presidential Decree No. 28602, Jan. 23, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Co-Payment Rate for Costs of Medical Care Benefits)
The amended provisions of subparagraph 3 (l) of attached Table 2 shall also apply to the medical care benefits, which was either implemented before this Decree enters into force or are under implementation as at the time this Decree enters into force, according to the notification of the result of the general health checkup of the year 2018.
ADDENDA <Presidential Decree No. 28693, Mar. 6, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2018.
Article 2 (Special Cases concerning Adjustment of Insurance Contributions)
(1) The “self-employed insured determined by Presidential Decree” in subparagraph 1 of Article 4 of the addenda to the National Health Insurance Act (Act No. 14776) means the persons whose the amount of income is not more than five million won per year, which was calculated pursuant to the former provisions each month when an insurance contribution was imposed, including the month to which the previous day of the enforcement date of this Decree belongs and whose property grade under the amended provisions of subparagraph 3 of attached Table 4 is 34 or below.
(2) When reducing an insurance contribution pursuant to Article 4 of the addenda to the National Health Insurance Act (Act No. 14776), the amount referred to in any of the following subparagraphs shall be reduced from such insurance contribution: Provided, That where it is impossible to reduce it pursuant to paragraph 1 or 2, due to any change in household composition, such amount shall be reduced, as determined and publicly announced by the Minister of Health and Welfare:
1. The self-employed insured under subparagraph 1 of Article 4 of the addenda to the National Health Insurance Act (Act No. 14776): The amount increased after comparing an insurance contribution calculated pursuant to the former provisions with an insurance contribution calculated pursuant to the amended provisions;
2. The self-employed insured under subparagraph 2 of Article 4 of the addenda to the National Health Insurance Act, (Act No. 14776): The amount equivalent to 30/100 of an insurance contribution calculated pursuant to the amended provisions.
(3) Pursuant to Article 4 of the addenda to the National Health Insurance Act (Act No. 14776), the insurance contributions shall be reduced by the amount under paragraph (2) until an insurance contribution of June 2022 is imposed: Provided, That in cases falling under any of the following subparagraphs, the insurance contributions shall be reduced until an insurance contribution is imposed in the month to which the date specified in each of the following subparagraphs belongs (referring to the previous month where such date is the first day of any month):
1. Where there has occurred any eligibility conversion of the self-employed insured to whom the amount reduction has been applied pursuant to subparagraphs 1 and 2 of Article 4 of the addenda to the National Health Insurance Act (Act No. 14776): The date when the eligibility conversion has occurs;
2. Where since there has increased the income or property of the self-employed insured to whom the amount reduction has been applied pursuant to subparagraph 1 of Article 4 of the addenda to the National Health Insurance Act (Act No. 14776), he/she comes to fail to meet the requirements under paragraph (1): The date when he/she comes to fail to meet such requirements;
3. Where, since there has increased the income or property of the self-employed insured to whom the amount reduction has been applied pursuant to subparagraph 2 of Article 4 of the addenda to the National Health Insurance Act (Act No. 14776), he/she comes to fail to meet the requirements for the eligibility as the dependent even under the former provisions: The date when the NHIS confirms he/she fails to meet such requirements.
ADDENDUM <Presidential Decree No. 28710, Mar. 20, 2018>
This Decree shall enter into force on the date of its promulgation.