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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

Presidential Decree No. 28861, May 1, 2018

Presidential Decree No. 29002, Jun. 26, 2018

Presidential Decree No. 29163, Sep. 18, 2018

Presidential Decree No. 29196, Sep. 28, 2018

Presidential Decree No. 29383, Dec. 18, 2018

Presidential Decree No. 29409, Dec. 24, 2018

Presidential Decree No. 29545, Feb. 12, 2019

Presidential Decree No. 29675, Apr. 2, 2019

Presidential Decree No. 29830, Jun. 11, 2019

Presidential Decree No. 30143, Oct. 22, 2019

Presidential Decree No. 30287, Dec. 31, 2019

Presidential Decree No. 30747, Jun. 2, 2020

Presidential Decree No. 30807, Jun. 30, 2020

Presidential Decree No. 30824, Jul. 7, 2020

Presidential Decree No. 31096, Oct. 7, 2020

Presidential Decree No. 31321, Dec. 29, 2020

Presidential Decree No. 31337, Dec. 29, 2020

Presidential Decree No. 31453, Feb. 17, 2021

Presidential Decree No. 31614, Apr. 6, 2021

Presidential Decree No. 31846, Jun. 29, 2021

Presidential Decree No. 32047, Oct. 14, 2021

Presidential Decree No. 32097, Nov. 1, 2021

Presidential Decree No. 32190, Dec. 7, 2021

Presidential Decree No. 32528, Mar. 8, 2022

Presidential Decree No. 32748, Jun. 30, 2022

Presidential Decree No. 32894, Aug. 31, 2022

Presidential Decree No. 33128, Dec. 27, 2022

Presidential Decree No. 33382, Apr. 11, 2023

Presidential Decree No. 33553, Jun. 20, 2023

Presidential Decree No. 33593, Jun. 27, 2023

Presidential Decree No. 33913, Dec. 12, 2023

Presidential Decree No. 34091, Jan. 2, 2024

Presidential Decree No. 34217, Feb. 13, 2024

Presidential Decree No. 34423, Apr. 19, 2024

Presidential Decree No. 34497, May 7, 2024

Presidential Decree No. 34844, Aug. 20, 2024

CHAPTER I GENERAL PROVISIONS
 Article 1 (Purpose)
The purpose of this Decree is to prescribe matters mandated by the National Health Insurance Act and those necessary for the enforcement thereof.
 Article 2 (Head of Organ Who is Employer)
"Who is prescribed by Presidential Decree" in subparagraph 2 (b) of Article 3 of the National Health Insurance Act (hereinafter referred to as the "Act") means heads of organizations referred to in Appendix 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 Appendix 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 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 paragraph (3) of that Article (hereinafter referred to as "implementation plan"), he or 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 or 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 or 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 or she shall reflect results of the evaluation in both the comprehensive plan and implementation plan to be formulated thereafter.
(5) Except as provided in paragraphs (1) through (4), details necessary for the formulation, implementation, evaluation, etc. of comprehensive plans or implementation plans, shall be determined and publicly notified by the Minister of Health and Welfare.
[This Article Added on 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 Added on 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 the following matters: <Amended on Aug. 2, 2016; Jan. 2, 2024>
1. The relative point value of each item of health care benefits provided for in Article 21 (2);
2. The upper-limit on the costs of the health care benefits of each medicine and materials for medical treatment provided for in Article 22;
3. Other important matters regarding health insurance including the matters regarding additional benefits under Article 23, which are placed on the agenda of the meetings of the Health Insurance Policy Deliberative Committee provided 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 or she works, from among the public officials of Grade III who belong to the Ministry of Economy 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 or her duties due to any mental or physical disability;
2. The member commits misconduct in relation to his or 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 or her intention that it is impracticable to perform his or her duties.
[This Article Added on Dec. 31, 2015]
 Article 5 (Chairperson 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 Chairperson of the Deliberative Committee shall assist the Chairperson and act on behalf of the Chairperson, where the Chairperson is unable to perform his or her duties due to any unavoidable reasons.
 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 the members of the Deliberative Committee shall constitute a quorum, and any decision thereof shall require the concurring vote of 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) Except as provided in paragraphs (1) through (5), necessary matters concerning the operation of the Deliberative Committee and the subcommittees 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 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 the budget: Provided, That this shall not apply where any member who is a public official attends in direct connection with his or her duties.
CHAPTER II THE INSURED
 Article 9 (Persons Excluded from the Employee Insured)
"Workers and employers of workplaces prescribed by Presidential Decree, ... public officials, and school employees" 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 dependents;
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 subparagraph 1 of Article 2 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 dependents.
[This Article Added on Aug. 1, 2017]
 Article 10 (Executive Officer Who Is Public Official)
Pursuant to Article 20 (4) 2 of the Act, the Minister of Economy 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 on Mar. 23, 2013; Nov. 19, 2014; 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, any of the following matters shall undergo deliberation and resolution at meetings of the board of directors of the NHIS (hereinafter referred to as "board of directors"): Provided, That matters subject to deliberation and resolution by the Deliberative Committee under Article 4 (1) of the Act and those subject to deliberation and resolution by the Financial Operation Committee under Article 33 of the Act (hereinafter referred to as the "Financial Operation Committee") 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 loans 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 prescribed 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 contributions, employment insurance contributions, industrial accident compensation insurance contributions, contributions, and other charges entrusted (hereinafter referred to as "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 delinquency disposition of insurance contributions;
10. Other authority prescribed 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 classifications:
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 prescribed by Presidential Decree" in Article 34 (2) 3 of the Act means each person designated by the Minister of Economy 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 prescribed 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 a majority of the members shall constitute a quorum, and any decision thereof shall require the concurring vote of at least 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 prescribed 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.
 Article 17-2 (Upper Limit on Contributions to Catastrophic Health Expenditure Support Programs)
The upper limit of the amount the NHIS contributes to the catastrophic health expenditure support program prescribed in the Act on the Support for Catastrophic Health Expenditure pursuant to Article 39-2 of the Act, shall be 1/1,000 of the revenues from insurance premiums for the year immediately preceding the previous year.
[This Article Added on Oct. 14, 2021]
CHAPTER IV INSURANCE BENEFITS
 Article 18 (Medical Facilities Excluded from Health Care Institution)
(1) "Medical facilities, etc. prescribed by Presidential Decree" in the latter part, with the exception of the subparagraphs, of Article 42 (1) of the Act means the following medical institutions or drugstores: <Amended on 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 to suspend business, etc. due to activities of inducing the insured or his or 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 (Reduction of Upper Limit Amount of Costs of Health Care Benefits for Medicines and Criteria for Suspension of Application of Health Care Benefits)
(1) Where the Minister of Health and Welfare reduces the upper limit amount of costs of health care benefits for medicines (referring to the amount set as the upper limit of health care benefits of each kind of medicine pursuant to Article 41 (3) of the Act; hereinafter referred to as "upper limit amount") or suspends any medicine from the application of health care benefits pursuant to Article 41-2 of the Act, he or she shall notify the NHIS and the Review and Assessment Service of such fact to record and manage the details of reduction of the upper limit amount and suspension of the application of health care benefits.
(2) "Period prescribed by Presidential Decree" in Article 41-2 (2) and (3) of the Act means five years, respectively. <Amended on Jun. 11, 2019>
(3) The Minister of Health and Welfare need not reduce the upper limit amount for any of the following medicines, among medicines subject to reduction of the upper limit amount prescribed in Article 41-2 (1) or (2) of the Act:
1. Shortage prevention drugs (referring to medicines designated and publicly notified by the Minister of Health and Welfare, which a manufacturer, contract manufacturing business entity, or importer under the Pharmaceutical Affairs Act avoids their production or import, because such medicines are essential for the treatment of patients but are not cost-effective; hereinafter the same shall apply);
2. Orphan drugs (referring to medicines determined by the Minister of Food and Drug Safety, which should be urgently produced or imported because no alternative drug exists; hereinafter the same shall apply);
3. Low-cost drugs (referring to medicines determined and publicly notified by the Minister of Health and Welfare, whose upper limit amount does not exceed the basic amount determined and publicly notified by the Minister of Health and Welfare).
(4) The criteria for reducing the upper limit amount for medicines and suspending the application of health care benefits under Article 41-2 (1) through (3) of the Act shall be as specified in Appendix 4-2.
[This Article Wholly Amended on Sep. 28, 2018]
 Article 18-3 Deleted. <Sep. 28, 2018>
 Article 18-4 (Selective Benefits)
(1) Selective benefits referred to in Article 41-4 (1) of the Act (hereinafter referred to as "selective benefits") 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 or her dependents despite low economic feasibility;
3. Cases equivalent to subparagraph 1 or 2, where social demand for health care benefits exists or the Minister of Health and Welfare deems it particularly necessary to enhance national health.
(2) An assessment of the appropriateness of selective benefits 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 benefits are provided: Provided, That the Minister of Health and Welfare may determine the assessment period differently, if he or 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 benefits with other health care benefits;
(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 or 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 provided in paragraphs (2) through (4), matters necessary for the procedures, methods, etc. for conducting an assessment of appropriateness, shall be determined and publicly notified by the Minister of Health and Welfare.
[This Article Added on Mar. 20, 2017]
 Article 19 (Expenses Borne by Beneficiaries)
(1) The rate and amount of co-payment prescribed in Article 44 (1) of the Act (hereinafter referred to as "co-payment") shall be as set forth in Appendix 2.
(2) The amount of co-payment shall be paid by the persons who receive health care benefits 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 prescribed by Ministerial Decree 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 prescribed in Article 44 (2) 1 of the Act shall be an amount obtained by adding up the amounts of annual co-payment borne by a person who receives health care benefits: Provided, That none of the following amounts of co-payment shall be added: <Amended on Jun. 26, 2018; Apr. 2, 2019; Jun. 11, 2019; Oct. 22, 2019; Oct. 7, 2020; Jun. 29, 2021; Jun. 20, 2023; Nov. 7, 2023; Apr. 19, 2024; Aug. 20, 2024>
1. In cases of using two-bed or three-bed rooms of general inpatient units and two-bed or three-bed rooms of inpatient units of the departments of psychiatry, of tertiary care hospitals, general hospitals, hospitals, oriental medical clinics, and intermediate care hospitals (limited to long-term care hospitals that are medical institutions satisfying the requirements prescribed in Article 3-2 of the Medical Service Act among the medical rehabilitation facilities referred to in Article 58 (1) 4 of the Act on Welfare of Persons with Disabilities), and mental hospitals prescribed in subparagraph 1 (a) (i) of Appendix 2, an amount borne as hospitalization costs;
1-2. An amount borne in accordance with subparagraph 1 (b) or 3 (p) of Appendix 2 for outpatient treatment received at a tertiary hospital for a disease determined and publicly notified by the Minister of Health and Welfare as a main disease or injury pursuant to subparagraph 1 (c) (iii) of that Table: Provided, That the amount borne by any of the following persons shall be excluded herefrom:
(a) A pregnant woman;
(b) A person under six years of age;
(c) A patient excluded from separation of prescribing and dispensing under subparagraph 1 (b) of Appendix 2;
(d) A person who receives infertility treatment determined and publicly notified by the Minister of Health and Welfare pursuant to subparagraph 3 (k) of Appendix 2;
(e) A person eligible for medical assistance who receives medical assistance under the following statutes:
(v) Article 50 of the Act on Support for Persons Eligible for Veteran's Compensation;
2. An amount borne as prescribed in subparagraph 3 (d) (v), (vi), (ix) and (x) of Appendix 2;
3. An amount borne as prescribed in subparagraph 3 (g) and (o) of Appendix 2;
4. An amount borne as prescribed in subparagraph 4 of Appendix 2;
4-2. An amount borne as prescribed in subparagraph 5-2 of Appendix 2;
5. An amount borne as prescribed in subparagraph 6 of Appendix 2.
(4) The co-payment ceiling referred to in the former part, with the exception of the subparagraphs, of Article 44 (2) of the Act (hereinafter referred to as "co-payment ceiling") means an amount computed by the calculation method specified in Appendix 3. <Amended on Nov. 7, 2023; Aug. 20, 2024>
(5) Where the NHIS pays an amount exceeding the co-payment ceiling pursuant to the latter part, with the exception of the subparagraphs, of Article 44 (2) of the Act, it shall pay the amount into a savings account designated by the relevant party (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, where it is unable to pay the amount into the relevant savings account due to any unavoidable cause. <Amended on Jun. 11, 2019; Nov. 7, 2023; Aug. 20, 2024>
(6) Except as provided 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 determined and publicly notified by the Minister of Health and Welfare.
[This Article Wholly Amended on Mar. 20, 2017]
 Article 20 (Party to Contract on Costs of Health Care Benefits)
The person who represents the medical and pharmaceutical communities and is a party to the contract on the costs of health care benefits provided for in Article 45 (1) of the Act shall be any of the following persons: <Amended on Jun. 26, 2018; Jun. 29, 2021>
1. For costs of health care benefits for medical clinics prescribed in Article 3 (2) 1 (a) of the Medical Service Act: The head of the association of doctors provided for in Article 28 (1) of that Act;
2. For costs of health care benefits for dental clinics and dental hospitals prescribed in 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 that Act;
3. For costs of health care benefits for oriental medical clinics or oriental medical hospitals prescribed in 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 that Act;
4. For costs of health care benefits 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 that Act;
5. For costs of health care benefits for hospitals, long-term care hospitals, mental hospitals, and general hospitals prescribed in 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 benefits for drugstores provided for in subparagraph 3 of Article 2 of the Pharmaceutical Affairs Act and the Korea Orphan and Essential Drug Center provided for in Article 91 of that 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 benefits for public health clinics, public health and medical care centers, branches of public health clinics provided for in the Regional Public Health Act and the public health and medical clinics established under the Act on Special Measures for Health and Medical Services in Agricultural and Fishing Villages: The person designated by the Minister of Health and Welfare.
 Article 21 (Terms and Conditions 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 benefits referred to in paragraph (1) shall be those that have shown the values of health care benefits in the relative points between each item, computed in consideration of workload such as hours and efforts required for health care benefits, resource volumes such as human resources, facilities and equipment, the level of risk of health care benefits, social benefits in relation to health care benefits, etc.; and the Minister of Health and Welfare shall give public notice thereof after deliberation by the Deliberative Committee, as prescribed by Ministerial Decree of Health and Welfare. <Amended on Mar. 20, 2017>
(3) Notwithstanding paragraph (2), in any of the following cases, the points of relative values of health care benefits may be computed as classified in the following: <Amended on Jun. 30, 2015; Nov. 18, 2015; Jul. 24, 2017; Jul. 2, 2019; Jun. 29, 2021>
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 (excluding long-term care hospitals that are medical institutions satisfying the requirements prescribed in Article 3-2 of the Medical Service Act among the medical rehabilitation facilities referred to in Article 58 (1) 4 of the Act on Welfare of Persons with Disabilities): To be calculated by the point of relative value per day which is obtained by classifying into the degree of seriousness of patients' conditions after aggregating the points of each item of health care benefits 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 that Act, a long-term care hospital provided for in Article 3 (2) 3 (d) of that Act, a general hospital provided for in Article 3 (2) 3 (e) of that Act, a tertiary hospital provided for in Article 3-4 of that Act, or a health care center provided for in Article 12 of the Regional Public Health Act for a 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 includes all the points of items of health care benefits and the costs of the medicines and materials for the relevant medical treatments;
3. Where the hospice or palliative care is received under Article 28 of the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients 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 benefits and the costs of the medicines and materials for the relevant medical treatments.
(4) In concluding a contract prescribed in paragraph (1), a contract on the expenses for new items of health care benefits for which the point of relative values is not publicly notified shall be deemed concluded on the date the point of relative values of that 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 benefits for the relevant item executed on or after the date when a public notice is given.
 Article 22 (Costs of Health Care Benefits for Medicines and Materials for Medical Treatment)
(1) Health care benefits 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) apply; hereafter in this Article the same shall apply) 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 in this Article the same shall apply) 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 on Jan. 28, 2013; Mar. 23, 2013; Aug. 29, 2014>
1. Oriental medicines: The maximum amount;
2. Medicines other than the oriental medicines: Purchase price;
3. Deleted; <Aug. 29, 2014>
4. Materials for medical treatment: Purchase price.
(2) Standards and procedures for the determination of costs of health care benefits for medicines and materials for medical treatment provided for in paragraph (1) and other necessary matters shall be determined and publicly notified by the Minister of Health and Wealth.
 Article 22-2 (Withholding Payment of Costs of Health Care Benefits)
(1) Where the NHIS intends to withhold the payment of costs of health care benefits pursuant to the former part of Article 47-2 (1) of the Act, it shall first notify the relevant health care institution thereof in a document stating the following matters: <Amended on Jun. 29, 2021>
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 benefits 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 benefits, 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) "Reasons prescribed by Presidential Decree, such as where a court's judgment of acquittal becomes final and conclusive" in the former part of Article 47-2 (4) of the Act means any of the following: Provided, That this shall not apply in the case of subparagraph 2 or 3 where a health institution is found guilty through the ruling of the court after it was reinvestigated and an indictment was brought, though non-transfer decision or non-prosecution disposition had been rendered: <Amended on Dec. 29, 2020; Aug. 20, 2024>
1. Final judgment of acquittal;
2. Non-transfer decision (limited to the disposition to be cleared of suspicion or to be innocent; hereinafter the same shall apply);
3. 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 benefits under the former part of Article 47-2 (1) of the Act receives a judgment of acquittal, non-transfer decision, or non-prosecution disposition, it shall notify the NHIS of such fact. <Amended on Dec. 29, 2020; Jun. 29, 2021>
(6) Upon being notified pursuant to paragraph (5), the NHIS shall pay without delay the withheld health care benefits costs and the interest accrued during the period in which the payment of health care benefits costs has been withheld. <Amended on Aug. 20, 2024>
(7) Except as provided in paragraphs (1) through (6), details 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 benefits, etc., and the methods of handling the opinion when it is submitted, shall be determined by the NHIS.
[This Article Added on Nov. 20, 2014]
 Article 23 (Additional Benefits)
(1) Additional benefits prescribed in Article 50 of the Act mean medical expenses for pregnancy and delivery (including miscarriage and stillbirth; hereinafter the same shall apply). <Amended on Sep. 19, 2017>
(2) A person eligible for the medical expenses for pregnancy and delivery prescribed in paragraph (1) shall be as follows: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. An insured person who is pregnant or gave birth to a baby, or her dependents;
2. Legal representative (limited to where the insured person gave birth to a baby or her dependents died) of the insured or his or her dependents under two years of age (hereinafter referred to as "infants and young children under two years of age").
(3) The NHIS may issue a person falling under any subparagraph of paragraph (2) with treatment coupons for medical expenses for pregnancy and delivery which can be used to pay any of the following expenses: <Amended on Dec. 24, 2018; Jun. 2, 2021; Jun. 29, 2021>
1. Expenses incurred in relation to medical treatment related to an insured person who is pregnant or gave birth to a baby;
2. Expenses incurred in purchasing medicines or materials for medical treatment for an insured person who is pregnant or gave birth to a baby or her dependents;
3. Expenses incurred in relation to medical treatment for infants and young children under two years of age;
4. Expenses incurred in purchasing medicines or materials for medical treatment prescribed for infants and young children under two years of age.
(4) A person who intends to be issued with treatment coupons (hereafter in this Article referred to as "applicant") shall submit an application for issuance prescribed by Ministerial Decree of Health and Welfare, along with a certificate verifying that the applicant falls under any subparagraph of paragraph (2). <Amended on Dec. 24, 2018>
(5) Upon receipt of an application for issuance of treatment coupons prescribed in paragraph (4), the NHIS shall issue the applicant with the coupons after verifying that he or she falls under any subparagraph of paragraph (2). <Amended on Dec. 24, 2018>
(6) The period of using treatment coupons shall be from the date of being issued with the treatment coupons pursuant to paragraph (5) until any of the following days: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. The insured who is pregnant or gave birth to a baby, or her dependents: A date when two years have elapsed from the date of childbirth (in cases of miscarriage and stillbirth, the relevant date);
2. Legal representative of infants and young children under two years of age: A date when two years have elapsed from the date of birth of infants and young children under two years of age.
(7) The upper limit of payable amount of a treatment coupon shall be as follows: Provided, That if deemed necessary and publicly notified by the Minister of Health and Welfare, the payable amount may exceed the following upper limits: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. In cases of being pregnant with or giving birth to a fetus: 1 million won;
2. In cases of being pregnant with or giving birth to at least two fetuses: 1.4 million won.
(8) Except as provided in paragraphs (2) through (7), matters necessary for the procedures for and methods 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 Ministerial Decree of Health and Welfare. <Amended on Jun. 30, 2016>
 Article 24 Deleted. <Dec. 24, 2018>
 Article 25 (Health Checkups)
(1) Health checkups prescribed in Article 52 of the Act (hereinafter referred to as "health checkups") shall be conducted at least once every two years, and for the employees 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 by 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, in consideration of the ages, etc. of infants and young children.
(2) Health checkups shall be conducted by health examination institutions designated in accordance with Article 14 of the Framework Act on Health Examination (hereinafter referred to as "examination institutions").
(3) If the NHIS intends to conduct a health checkup, it shall notify the persons eligible for a health check of the matters concerning conducting 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 dependents of the employee insured, the relevant employee insured shall be notified thereof, and where a health checkup is conducted for infants and children who are the self-employed insured, the heads of their households shall be notified thereof.
(4) Examination institutions that have conducted health checkups shall notify the NHIS of the outcomes of health checkups, and the NHIS shall notify persons who have undergone health checkups, of the outcomes of such health checkups: Provided, That where any examination institution directly notifies anyone who has undergone a health checkup of the outcomes of his or her health checkup, the NHIS needs not notify him or her of such outcomes.
(5) The subject matters of health checkups, the methods for conducting health checkups, expenses incurred therein, procedures for notifying the outcomes of health checkups, and other necessary matters concerning health checkups shall be determined and publicly notified by the Minister of Health and Welfare.
[This Article Wholly Amended on Dec. 24, 2018]
 Article 26 (Restrictions of Benefits)
(1) "Period prescribed by Presidential Decree" in the main clause, with the exception of the subparagraphs, of Article 53 (3) of the Act means one month.
(2) "Number of ... prescribed by Presidential Decree" in the proviso, with the exception of the subparagraphs, of Article 53 (3) of the Act means six times.
(3) "Where ... is below the standard prescribed by Presidential Decree" in the proviso, with the exception of the subparagraphs, of Article 53 (3) of the Act means where all of the following requirements are met; in such cases, income means income referred to in Article 41 (1), and property means property referred to in Article 42 (1) 1: <Added on Jun. 11, 2019; Dec. 31, 2021; May 7, 2024>
1. The income of a household to which the insured who fails to pay the insurance contributions under Article 53 (3) 2 of the Act belongs shall be below 3.36 million won, and the tax base under Articles 10-2 through 10-6 of the Local Tax Act (hereinafter referred to as "tax base") on property of the household shall be below 4.5 million won: Provided, That in cases of minors, persons of 65 years of age or over, or persons with disabilities registered pursuant to the Act on Welfare of Persons with Disabilities, the tax base on their income and property shall be below the amount determined by the NHIS, respectively;
2. The insured who fails to pay the insurance contributions under Article 53 (3) 2 of the Act shall have no income occurring from business for which he or she was registered as a business entity pursuant to Article 168 (1) of the Income Tax Act.
(4) Detailed matters relating to the procedures, methods, and timing for identifying incomes and property under paragraph (3) shall be determined by the NHIS. <Added on Jun. 11, 2019>
[Title Amended on Jun. 11, 2019]
 Article 26-2 (Methods of and Procedures for 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 the recipient of health care under the main clause of Article 56-2 (1) of the Act (hereinafter referred to as "account for receipt of health care costs, etc.") shall submit to the NHIS a request for payment of health care costs, a request for payment of insurance benefits for assistive devices, etc., respectively, stating the account number of account for receipt of health care costs, etc., along with a copy of his or her deposit passbook (referring to a page where the account number is shown). The same shall also apply to the change of an account for receipt of health care costs, etc. <Amended on Jun. 11, 2019; Aug. 31, 2022>
(2) When a financial institution where a recipient has opened an account for receipt of health care costs, etc. is unable to operate its business as usual due to closure or suspension of its business or an information and communication disruption, etc. or when an account transfer is impracticable due to any unavoidable cause corresponding thereto, the NHIS shall directly pay such amount in cash under the proviso of Article 56-2 (1) of the Act.
[This Article Added on Nov. 20, 2014]
 Article 26-3 (Disclosure of Personal Details on Persons in Arrears of Payment of Unjust Enrichment or Unjust Profit Collectable and Causes for Exclusion from Disclosure Thereof)
(1) "Information prescribed by Presidential Decree" in the main clause of Article 57-2 (1) of the Act means the violation that has given rise to the money collectable, the name of the person in arrears (including the name of the representative of a corporation), his or her trade name (including the name of a corporation), age, address, and type of the amount in arrears (referring to the amount of collection in arrears, subsequent arrears, and delinquency disposition expenses; hereafter in this Article the same shall apply), payment due date, amounts, and summary of the arrears.
(2) "Where there is a compelling reason prescribed by Presidential Decree not to do so, such as partial payment of an amount in arrears" in the proviso of Article 57-2 (1) of the Act means any of the following cases:
1. Where at least 10/100 of the amount in arrears as at the time of notification under Article 57-2 (3) of the Act is paid within six months from the date of notification;
2. Where the defaulter is in the grace period of collection after the collection of the amount in arrears is deferred following a decision to grant authorization for a rehabilitation plan referred to in Article 243 of the Debtor Rehabilitation and Bankruptcy Act; or pays the amount in arrears according to the payment schedule specified in the rehabilitation plan;
3. Where an investigation is being conducted or a criminal trial is underway due to a violation giving rise to the money collectable;
4. Where gross damage is caused to property of a person in arrears or other similar cases due to a natural disaster, for which case the Deliberative Committee on Disclosure of Unjust Enrichment and Unjust Profit in Arrears established under Article 57-2 (2) of the Act (hereinafter referred to as the "Deliberative Committee on Disclosure of Unjust Enrichment and Unjust Profit in Arrears") recognizes the disclosure of personal details, etc. under paragraph (1) of that Article shall not be of any practical benefit.
(3) When the NHIS serves on a person in arrear a notice under Article 57-2 (3) of the Act, it shall demand him or her to pay the amount in arrears, and in cases falling within the proviso of paragraph (1) of that Article, it shall inform him or her to submit explanatory materials for the default.
[This Article Added on Jun. 2, 2020]
 Article 26-4 (Establishment and Operation of Deliberative Committee on Disclosure of Information on Unjust Enrichment and Unjust Profit in Arrears)
(1) The Deliberative Committee on Disclosure of Information on Unjust Enrichment and Unjust Profit in Arrears shall be comprised of nine 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 Information on Unjust Enrichment and Unjust Profit in Arrears, and the following persons appointed or commissioned by the president of the NHIS shall be the members thereof:
1. One staff member of the NHIS;
2. One public official of Grade IV or V belonging to the Ministry of Health and Welfare in charge of affairs related to the collection of unjust enrichment or unjust profit for the costs of insurance benefits;
3. Four persons that have much knowledge and experience in law, accounting or social insurance.
(3) A member referred to in paragraph (2) 3 shall serve a two-year term and may be reappointed or recommissioned only once.
(4) Meetings of the Deliberative Committee on Disclosure of Information on Unjust Enrichment and Unjust Profit in Arrears shall open with the attendance of a majority of all incumbent members and resolutions shall be passed with the consent of a majority of those present.
(5) Except as provided in paragraphs (1) through (4), matters necessary for organizing and operating the Deliberative Committee on Disclosure of Information on Unjust Enrichment and Unjust Profit in Arrears shall be determined by the NHIS.
[This Article Added on Jun. 2, 2020]
 Article 27 (Payment of Costs of Health Care Benefits to Soldiers 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 benefits 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 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 benefits of the relevant agency, which are expected to be incurred annually, and health care costs under Article 49 of the Act (hereinafter referred to as "health care costs"). <Amended on Nov. 19, 2014; Jul. 26, 2017; Jun. 11, 2019>
(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 benefits deposited by the head of an agency pursuant to paragraph (2) fall short of the costs of health care benefits and health care costs 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 such request shall pay them to the NHIS. <Amended on Jun. 11, 2019>
(5) The NHIS may use interest accruing on the costs of health care benefits and health care costs deposited by the head of an agency pursuant to paragraph (2) for the costs of health care benefits it bears. <Amended on Jun. 11, 2019>
[Title Amended on Jun. 11, 2019]
CHAPTER V HEALTH INSURANCE REVIEW AND ASSESSMENT SERVICE
 Article 28 (Services)
(1) "Services prescribed by Presidential Decree" in Article 63 (1) 8 of the Act means the following: <Amended on Jan. 28, 2013; Dec. 27, 2022>
1. Computer processing, such as development, supply, inspection, etc. of software related to a request for the review of costs of health care benefits under Article 47 of the Act;
2. Disclosure of the results of evaluation of the appropriateness of health care benefits under Article 47-4 of the Act;
3. Review of the health care costs received by the institutions prescribed by Ministerial Decree of Health and Welfare out of the health care costs paid under Article 49 (1) of the Act;
4. Development and management of patient classification systems, and disease and injury classification systems related to health care benefits for providing the services listed in Article 63 (1) 1 through 7 of the Act and subparagraphs 1 through 3 of that paragraph;
5. Education and publicity related to the services listed in Article 63 (1) 1 through 7 of the Act and subparagraphs 1 through 4 of that paragraph.
(2) Computer processing, disclosure of the results of evaluation of the appropriateness, the procedure, standards and method for the development and management of patient classification systems, and disease and injury classification systems related to health care benefits under paragraph (1) 1, 2, and 4, and other necessary matters shall be determined and publicly notified by the Minister of Health and Welfare. <Amended on Jan. 28, 2013; Dec. 27, 2022>
 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 on Aug. 2, 2016>
 Article 29-2 (Dual Office Holding by Members of Medical Treatment Review Committee)
(1) Professors, associate professors, or assistant professors (hereinafter referred to as "professor, etc.") intending to concurrently serve as members of the Medical Treatment Review Committee (hereafter in this Article referred to as the "Review Committee") pursuant to Article 66-2 (1) of the Act shall file an application for permission to concurrently hold office with the president of the university where they currently serve as professor. Upon receipt of the application, the president shall notify the relevant professor, etc. of whether to grant permission without delay.
(1) Except as provided in paragraph (1), necessary details for ensuring that professors, etc. concurrently serve as members of the Review Committee, such as working conditions and remuneration, shall be prescribed by the articles of incorporation of the Review and Assessment Service.
[This Article Added on Nov. 7, 2023]
 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 benefits 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 prescribed 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 Lower Limits of Amount of Monthly Insurance Contributions)
The upper and lower limits of the amount of monthly insurance contributions under Article 69 (6) of the Act shall be as classified in the following subparagraphs: <Amended on Aug. 31, 2022; Dec. 27, 2022; Jan. 2, 2024; May 7, 2024>
1. The upper limit of the amount of monthly insurance contributions shall be as follows:
(a) Insurance contributions based on monthly remuneration of the employee insured: The amount determined and publicly notified by the Minister of Health and Welfare, taking into consideration the amount equivalent to 30 times the insurance contributions based on the average amount of monthly remuneration (hereafter in this Article referred to as "amount of insurance contributions based on the average monthly remuneration of the year before the preceding year") of such employee in the year before the year preceding that in which the insurance contributions are imposed;
(b) Insurance contributions based on extra monthly income other than remuneration for the employee insured and the amount of the monthly insurance contributions of the self-employed insured: The amount determined and publicly notified by the Minister of Health and Welfare, taking into consideration the amount equivalent to 15 times the insurance contributions based on the average amount of monthly remuneration of the year before the year preceding that in which the insurance contributions are imposed;
2. The lower limit of the amount of monthly insurance contributions shall be as follows:
(a) The amount of insurance contributions based on monthly remuneration of the employee insured: The amount determined and publicly notified by the Minister of Health and Welfare, of at least 50/1000 but less than 85/1000 of the amount of insurance contributions based on the average monthly remuneration of the year preceding that in which the insurance contributions are imposed;
(b) The amount of the monthly insurance contributions of the self-employed insured: The amount determined and publicly notified by the Minister of Health and Welfare, of at least 90/100 but less than 100/100 of the amount of insurance contributions based on monthly remuneration prescribed in item (a).
[This Article Wholly Amended on Mar. 6, 2018]
 Article 33 (Money and Valuables to Be Included in Remunerations)
(1) "Which are prescribed 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 of nature similar thereto paid in compensation for the provision of labor, other than the following: <Amended on 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 there are no data relating to the remunerations or they are 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 amount of monthly remuneration computed according to the following classifications, 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 amount of monthly remuneration set forth in the subparagraphs of paragraph (1) shall be as follows: <Amended on 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 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 on 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.
(3) Notwithstanding the former part of paragraph (1), if an employer has already submitted a simplified statement of payment regarding the total amount of remuneration paid to the employee insured for the preceding year to the head of the tax office having jurisdiction over withholding tax, the commissioner of a regional tax office, or the Commissioner of the National Tax Service pursuant to Article 164-3 (1) of the Income Tax Act, the reporting under the former part of paragraph (1) shall be deemed made: Provided, That this shall not apply where the NHS is unable to verify information necessary for calculating the amount of monthly remuneration due to omissions, errors, etc. in the relevant simplified statement of payment. <Added on Aug. 20, 2024>
 Article 36 (Confirmation 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 clause.
(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 on 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 an employee insured is being paid the remuneration by not less than two workplaces to which the health insurance is available, his or her monthly remuneration is confirmed respectively taking into account the remunerations that are paid by such workplaces to him or 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 prescribed 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 an employer who receives no remuneration under Article 70 (4) of the Act shall be computed based on the following methods; in such cases, the relevant employer shall submit data verifying the amount of his or her income or notify the amount of his or her 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 in this paragraph referred to as "faithfully-returned employers"), by not later than June 30], and the amount of monthly remuneration so calculated shall be applicable from June of each year to May of the following year (in cases of faithfully-returned employers, from July of each year to June of the following year): <Amended on Sep. 26, 2013>
1. Where the income is attributable to the relevant workplace during the relevant year and is prescribed by Ministerial Decree 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 amount of monthly remuneration of the employers who receive no remuneration. <Added on Sep. 26, 2013>
(3) Notwithstanding paragraphs (1) and (2), the amount of monthly remuneration of such employer shall be a relevant amount specified in the following subparagraphs: <Amended on Dec. 29, 2020>
1. Where the amount of monthly remuneration calculated based on the amount verified or the amount reported under paragraph (1) 1 or 2 is less than the amount of monthly remuneration of a worker who is paid the highest amount of monthly remuneration in the relevant workplace (excluding cases falling under subparagraph 2 (b)): The amount of monthly remuneration of the worker who is paid the highest amount of monthly remuneration in the relevant workplace;
Where it falls under any of the following categories: The amount obtained by averaging the monthly remuneration of workers in the relevant workplace:
(a) Where the employer has failed to submit data and notify the amount of his or her income under the latter part, with the exception of the subparagraphs, of paragraph (1) or he or she has no objective data to enable verification of his or her income under the subparagraph 1 of that paragraph;
(b) Where an amount verified under paragraph (1) 1 is 0 won or less.
[Title Amended on Dec. 29, 2020]
 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 re-computing 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, out of the amount to be additionally collected pursuant to paragraph (1) (hereinafter referred to as "amount to be additionally collected"), is greater than the amount of insurance contributions based on monthly remuneration (referring to the amount of insurance contributions based on monthly remuneration for the month which includes the date of notifying the amount to be additionally collected), the NHIS may, upon the request of an employer, allow such employee insured to make payments in up to 12 installments.<Amended on May 7, 2024>
(5) Except as provided in paragraphs (1) through (4), details necessary for the settlement of accounts of the amount of insurance contributions based on monthly remuneration, and the payment thereof in installments shall be prescribed by the articles of incorporation of the NHIS. <Added on Mar. 20, 2018>
 Article 40 (Payment of Insurance Contributions When Public Officials Are 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 included in the calculation of the amount of monthly income (referring to the amount of extra monthly income other than remuneration under Article 71 (1) of the Act for the employee insured, and referring to the amount of monthly income under paragraph (2) of that Article for the self-employed insured; hereinafter the same shall apply) shall be as follows; in such cases, non-taxable income under the Income Tax Act shall be excluded: <Amended on Oct. 7, 2020; Jun. 30, 2022; May 7, 2024>
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;
5. Pension income: Income prescribed in Article 20-3 of the Income Tax Act: Provided, That in cases of public pension incomes provided in paragraph (1) 1 of that Article, paragraph (2) of that Article shall not apply, and the entirety of pension incomes accrued during the relevant taxable period shall be deemed the pension income;
6. Other income: Income prescribed in Article 21 of the Income Tax Act.
(2) Detailed methods for calculating the income referred to in each subparagraph of paragraph (1) shall be prescribed by Ministerial Decree of Health and Welfare. <Added on Oct. 7, 2020>
(3) The timing to reflect income data specified in the subparagraphs of paragraph (1) in calculating the amount of monthly income shall be classified as follows: Provided, That where any unavoidable reason exists such as a natural disaster, the timing to reflect the income data may be adjusted, as prescribed by the articles of incorporation of the NHIS: <Added on Aug. 31, 2022; May 7, 2024>
1. When calculating the amount of monthly income from January to October each year: Data for the year before the preceding year in which insurance contributions based on monthly income (referring to insurance contributions based on extra monthly income other than remuneration for the employee insured, and monthly insurance contributions for income for the self-employed insured; hereinafter the same shall apply) are imposed: Provided, That data on pension income under paragraph (1) 5 shall be data for the year before the year in which insurance contributions based on monthly income are imposed;
2. When calculating the amount of monthly income for November and December each year: Data for the year preceding the year when insurance contributions based on monthly income are imposed.
(4) "Amount prescribed by Presidential Decree" in the provisions, 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 20 million won per year. <Amended on Mar. 6, 2018; Oct. 7, 2020; Aug. 31, 2022>
(5) Except as provided in paragraphs (1) through (4), details necessary for the calculation of the amount of monthly income, such as the specific types of income data, shall be prescribed by the articles of incorporation of the NHIS. <Added on Aug. 31, 2022; May 7, 2024>
 Article 41-2 (Adjustment of Amount of Monthly Income)
(1) Where an insured witnesses an increase or decrease in income under any subparagraph of Article 41 (1) (hereafter in this Article, referred to as "business income, etc.") due to reasons prescribed by the NHIS's articles of incorporation, such as business closure and changes in business performance, he or she may file an application with the NHIS for the adjustment of the amount of monthly income accompanied by documents evidencing the cause of the income change, thus allowing the NHIS to reflect data regarding business income, etc. earned at the time of the imposition of the insurance contributions based on monthly income in calculating the amount of monthly income.
(2) Notwithstanding Article 41 (3), the NHIS, upon receipt of an application for adjustment under paragraph (1), may adjust the amount of monthly income by reflecting such data regarding business income, etc. earned at the time of imposing the insurance contributions based on monthly income in the calculation of the amount of monthly income, and the insurance contributions based on monthly income imposed subsequently in the relevant year shall be calculated based on the adjusted amount of monthly income.
(3) Where the business income, etc. for the relevant year accrues to the insured who has filed an application for the adjustment of the amount of monthly income under paragraph (1) after such adjustment is made pursuant to paragraph (2), he or she shall report the fact of accrual of business income, etc. and the amount thereof to the NHIS within one month from the first day of the month following the month in which such business income, etc. accrues, and thereafter the amount of insurance contributions based on the monthly income for the relevant year imposed by the NHIS shall be calculated based on the adjusted amount of monthly income reflecting the reported business income, etc. <Added on Jun. 20, 2023; May 7, 2024>
(4) Where the business income, etc. for the relevant year are verified following the adjustment of the amount of monthly income pursuant to paragraph (2) or (3), the NHIS may settle the insurance contributions based on monthly income by calculating again the amount of monthly income for the relevant year based on the verified business income, etc. <Amended on Jun. 20, 2023>
(5) Where the amount of insurance contributions based on monthly income calculated following the adjustment of the amount of monthly income pursuant to paragraph (2) or (3) is less than the amount of insurance contributions based on monthly income settled again pursuant to paragraph (4), the NHIS shall additionally collect the shortfall from the insured. <Amended on Jun. 20, 2023; May 7, 2024>
(6) The NHIS may allow insurance contributions based on monthly income which are additionally collected pursuant to paragraph (5) to be paid in up to 12 installments. <Amended on Jun. 20, 2023; May 7, 2024>
(7) Where the amount of insurance contributions based on monthly income recalculated after adjustment of the amount of monthly income pursuant to paragraph (2) or (3) exceeds the amount recalculated pursuant to paragraph (4), the NHS shall pay the excess amount to the insured. In such cases, the NHS may offset the amount to be paid to the insured against the insurance contributions, etc. to be paid by the insured. <Added on Aug. 20, 2024>
(8) Except as provided in paragraphs (1) through (7), details necessary for the procedures for applying for the adjustment of the amount of monthly income, the procedures for reporting accrual of business income, etc. after the adjustment, the calculation and settlement of insurance contributions based on monthly income, the payment thereof in installments, and other relevant matters shall be prescribed by the NHIS's articles of incorporation. <Amended on Jun. 20, 2023; Aug. 20, 2024>
[This Article Added on Aug. 31, 2022]
 Article 42 (Criteria for Calculating Contribution Points based on Property)
(1) The contribution points based on property under Article 72 (1) of the Act (hereinafter referred to as "contribution points based on property") shall be calculated in consideration of the following properties, and the specific calculation method shall be as specified in Appendix 4:
1. Land, buildings, housing, ships, and aircraft, which are subject to property tax under Article 105 of the Local Tax Act: Provided, That this shall not apply to family property, village property, and other buildings and land similar thereto used for common purposes;
2. For the self-employed insured who own no houses, the security deposit and monthly rent for the leased houses.
(2) Except as provided in paragraph (1), details necessary for calculating the contribution points based on property shall be prescribed by the articles of incorporation of the NHIS.
[This Article Wholly Amended on May 7, 2024]
 Article 42-2 (Exclusion from Contribution Points based on Property of Housing-Related Loan Amounts)
(1) "Self-employed insured prescribed by Presidential Decree" in the proviso of Article 72 (1) of the Act means any of the following self-employed insured: <Amended on Dec. 27, 2022; Nov. 7, 2023>
1. A self-employed insured who belongs to such household that owns one house per household as determined and publicly notified by the Minister of Health and Welfare, while meeting all the following requirements (hereinafter referred to as "member of a family owning one house per household"):
(a) The owner (including his or her spouse or lineal ascendant or descendant who constitutes the same household as the owner according to resident registration) of the house shall take out a loan determined and publicly notified by the Minister of Health and Welfare (hereafter in this Article referred to as "housing mortgage loan, etc."), including a loan secured by housing (where a new loan is taken out and secured against the relevant housing for the purpose of lowering the interest rate on the loan or extending the term of the loan, and with which the existing loan is paid off on the same day as the date when the new loan is taken out, including the new loan (hereafter in this Article referred to as "mortgage refinance loan"), from a financial company, etc. defined in the Act on Real Name Financial Transactions and Confidentiality (hereinafter referred to as "financial company, etc.");
(b) The relevant household shall take out a housing mortgage loan, etc. (excluding a mortgage refinance loan) for the first time within three months before or after the date of acquisition of ownership of a house;
2. A self-employed insured person who belongs to a household that has no housing ownership as determined and publicly notified by the Minister of Health and Welfare (hereinafter referred to as "member of a household without housing ownership"), while meeting all the following requirements:
(a) A lessee (including a spouse or lineal ascendant or descendant who constitutes the same household as the lessee according to resident registration) shall take out a loan determined and publicly notified by the Minister of Health and Welfare, (hereafter in this Article, referred to as "loan secured by security deposit, etc.") including a loan secured by housing deposit for leased housing (where a new loan is taken out and secured against the security deposit for the relevant leased housing for the purpose of lowering the interest rate on the loan or extending the term of the loan, and with which the existing loan is paid off on the same day as the date when the new loan is taken out, including the new loan (hereafter in this Article referred to as "security deposit refinance loan") from a financial company, etc. to live in the house leased by the relevant household;
(b) The relevant household shall take out a loan secured by a security deposit, etc. (excluding a mortgage refinance loan) for the first time within three months before or after (referring to three months before and after the date of modification, extension, or renewal of a lease contract, where the loan is taken out for such purposes) the earlier of the date of moving into the house or the move-in date specified in the lease contract documents under Article 3-2 (2) of the Housing Lease Protection Act (in the case of an alien, referring to the date of registering the place of stay as indicated in the alien registration card or the date of reporting changes therein under the Immigration Act, or the date of reporting the place of residence in the Republic of Korea or the date of reporting changes thereof under the Act on the Immigration and Legal Status of Overseas Koreans).
(2) "House that does not exceed the standards prescribed by Presidential Decree" in the proviso of Article 72 (1) of the Act means a house that meets the following requirements: <Amended on Aug. 31, 2022>
1. In cases of a member of a family owning one house per household: The tax base amount for property tax on a house purchased with a housing mortgage loan, etc. shall not exceed the amount obtained by multiplying the assessed value of the house under the main clause of Article 52 (5) of the Income Tax Act by the fair market price rates prescribed in Article 109 of the Enforcement Decree of the Local Tax Act;
2. In cases of a member of a household without housing ownership: The amount appraised by the standards prescribed by Ministerial Decree of Health and Welfare, of the security deposit and monthly rents of the house leased with a loan secured by security deposit, etc., shall not exceed 30 percent of the assessed value of the house under the main clause of Article 52 (5) of the Income Tax Act.
(3) The assessed value of the amount of loan under the proviso of Article 72 (1) of the Act shall be the amount classified as follows; in such cases, where the amount of mortgage refinance loan or the amount of security deposit refinance loan is greater than the amount of existing loan, the difference shall be subtracted when assessing the amount of loan: <Amended on Aug. 31, 2022; Dec. 27, 2022>
1. In cases of a member of a family owning one house per household: An amount obtained by multiplying the aggregate amount of housing mortgage loans, etc. (excluding the amount paid off) by the fair market price rates prescribed in Article 109 of the Enforcement Decree of the Local Tax Act. In such cases, if the amount exceeds the tax base amount for the property tax of the relevant house, it shall be the amount of property tax base, and if such amount exceeds 50 million won, it shall be 50 million won;
2. In cases of a member of a household without housing ownership: 30 percent of the aggregate amount of the loans secured by security deposit, etc. (excluding the amount paid off). In such cases, if the amount is greater than the amount equivalent to 30 percent of the amount of security deposit, it shall be 30 percent of the security deposit.
(4) "Data or information prescribed by Presidential Decree, including those on the amount of loans" in Article 72 (3) of the Act means the following data or information: <Amended on May 7, 2024>
1. The name and resident registration number of a person who has obtained a housing mortgage loan, etc. or loan secured by security deposit, etc.;
2. Information on the current status of a housing mortgage loan, etc. or loan secured by security deposit, etc., including the kind, period, amount, and security;
3. Other data or information determined and publicly notified by the Minister of Health and Welfare as necessary for calculating contribution points based on property.
(5) Except as provide in paragraphs (1) through (4), details necessary for assessing the amount of loan under the proviso of Article 72 (1) of the Act shall be determined and publicly notified by the Minister of Health and Welfare.
[This Article Added on Jun. 30, 2022]
[Title Amended on May 7, 2024]
[Previous Article 42-2 moved to Article 42-3 <Jun. 30, 2022>]
 Article 42-3 Deleted. <May 7, 2024>
 Article 42-4 Deleted. <May 7, 2024>
 Article 42-5 Deleted. <May 7, 2024>
 Article 42-6 Deleted. <May 7, 2024>
 Article 42-7 (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 specialty 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 the evaluation of appropriateness under paragraph (1), he or she shall notify the Deliberative Committee of the results thereof. <Amended on May. 7, 2024>
[This Article Added on Mar. 6, 2018]
[Moved from Article 42-6 <Jun. 30, 2022>]
 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 or her from the relevant household to form a separate household: <Amended on Sep. 26, 2013; Mar. 20, 2017; Jun. 30, 2020; Oct. 7, 2020>
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 has suffered from a rare incurable disease or such referred to in subparagraph 3 (d) of Appendix 2 and is eligible for co-payment reduction;
3. A person who serves as a member of full-time reserve personnel or social service personnel after having been called up under Article 21 or 26 of the Military Service Act;
4. A person who serves as a member of alternative service personnel after having been called up under Article 17 of the Act on the Assignment and Performance of the Alternative Service.
 Article 44 (Insurance Contribution Rates and Monetary Value per Contribution Point based on Property)
(1) The insurance contribution rate for the employee insured under Article 73 (1) of the Act and the insurance contribution rate for the self-employed insured under paragraph (3) of that Article shall be 709/10,000 each. <Amended on Dec. 27, 2012; Sep. 26, 2013; Nov. 20, 2014; Dec. 22, 2015; Dec. 29, 2017; Dec. 24, 2018; Dec. 31, 2019; Dec. 29, 2020; Dec. 7, 2021; Dec. 27, 2022; May 7, 2024>
(2) The monetary value per contribution point based on property for the self-employed insured under Article 73 (3) of the Act shall be 208.4 won. <Amended on Dec. 27, 2012; Sep. 26, 2013; Nov. 20, 2014; Dec. 22, 2015; Dec. 29, 2017; Dec. 24, 2018; Dec. 31, 2019; Dec. 29, 2020; Dec. 7, 2021; Dec. 27, 2022; May 7, 2024>
[Title Amended on May 7, 2024]
 Article 44-2 (Period of Stay Abroad to Be Excluded from Payment of Insurance Contributions)
"Period ... prescribed by Presidential Decree" in the main clause of Article 74 (1) of the Act means three months: Provided, That in cases deemed by the NHIS as staying abroad for business operations, the period means one month. <Amended on Oct. 14, 2021>
[This Article Added on Jul. 7, 2020]
 Article 45 (Areas Subject to Reduction of Insurance Contributions)
"On islands, or in remote areas, or agricultural and fishery communities, etc. prescribed by Presidential Decree" in Article 75 (1) 1 of the Act means any of the following areas: <Amended on 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 of Insurance Contributions for Account Transferors)
Where a person obliged to pay insurance contributions is notified of the payment of his or her insurance contributions by means of an electronic document or pays his or her insurance contributions by means of automatic transfer from a bank account or credit card prescribed in 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 on Sep. 26, 2013; Oct. 22, 2019>
[Moved from Article 47 <Sep. 26, 2013>]
 Article 46 (Minors Subject to Exemption from Joint Liability of the Self-Employed Insured from Payment of Insurance Contributions)
"Minors who meet the criteria prescribed by Presidential Decree" in the proviso of Article 77 (2) of the Act means any of the following: Provided, That a minor with income generated from business for which he or she was registered as a business entity pursuant to Article 168 (1) of the Income Tax Act, as dividend income prescribed in Article 41 (1) 2 or business income prescribed in Article 41 (1) 3 shall be excluded herefrom: <Amended on Dec. 22, 2015; Dec. 24, 2018; Feb. 13, 2024; May 7, 2024>
1. A minor who meets all of the following requirements:
(a) The aggregate of his or her income referred to in Article 41 (1) 1 shall be not more than 1 million won per year;
(b) He or she shall have no property falling under Article 42 (1) 1;
2. A minor whose both parents have died and who meets the requirements prescribed in subparagraph 1 (a).
 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 Added on Aug. 2, 2016]
[Previous Article 46-2 moved to Article 46-3 <Aug. 2, 2016>]
 Article 46-3 (Additional Charges)
(1) "Grounds prescribed by Presidential Decree" in the provisions, with the exception of the subparagraphs, 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 3,000 won;
2. Where there are unavoidable reasons which NHIS deems it inappropriate to collect additional charges.
[This Article Added on Sep. 22, 2016]
[Previous Article 46-3 moved to Article 46-4 <Sep. 22, 2016>]
 Article 46-4 (Payment of Insurance Contributions by Credit Card)
(1) Deleted. <Mar. 20, 2017>
(2) "Institution, etc. prescribed by Presidential Decree" in Article 79-2 (1) of the Act 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 in this Article referred to as "credit cards, etc.") 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 Added on Aug. 29, 2014]
[Moved from Article 46-3 <Sep. 22, 2016>]
 Article 46-5 (Exception to Notification before Making Delinquency Disposition on Insurance Contributions)
"Cases prescribed by Presidential Decree" in the proviso of Article 81 (4) of the Act means where a person who fails to pay insurance contributions, etc. falls under any of the following cases: <Amended on Jun. 20, 2023>
1. Where the person is subjected to a delinquency disposition due to delinquency in the payment of national taxes;
2. Where the person is subjected to a delinquency disposition due to delinquency in the payment of local taxes or public charges (referring to public charges defined in subparagraph 8 of Article 2 of the Framework Act on National Taxes or Article 2 (1) 26 of the Framework Act on Local Taxes; hereinafter the same shall apply);
3. Where the person is subjected to compulsory execution;
4. Where the person is subjected to a disposition to suspend transactions at a clearing-house prescribed in the Bills of Exchange and Promissory Notes Act or the Check Act;
5. Where an auction commences;
6. Where a corporation is dissolved;
7. Where it is deemed that there exists any act to avoid the execution of delinquency disposition through concealment, omission, or false contracts, or by other improper means.
[This Article Added on Sep. 28, 2018]
 Article 46-6 (Seizure of Unjust Enrichment or Unjust Profit Collectible)
(1) "Compulsory execution, compulsory collection of national taxes because any cause prescribed by Presidential Decree" in Article 81-2 (1) 2 of the Act means any of the following:
1. Where compulsory collection or delinquency disposition commences due to delinquency of a national tax, local tax, or public charge;
2. Where compulsory execution commences;
3. Where a disposition to suspend transactions is issued at a clearing-house under the Bills of Exchange and Promissory Notes Act or the Check Act;
4. Where an auction commences;
5. Where a corporation is dissolved;
6. Where it is deemed that there exists any act to evade money collectible through concealment, omission, or false contracts, or by other improper means;
7. Where the commencement of rehabilitation procedures or of simplified rehabilitation procedures, or a decision of declaration of bankruptcy is issued under the Debtor Rehabilitation and Bankruptcy Act;
8. Where a person has no address or place of residence in the Republic of Korea;
9. Where the amount of money collectible under Article 57 (1) or (2) of the Act is at least 500 million won.
(2) "Any ground prescribed by Presidential Decree such as the judgment of acquittal by a court becoming final and conclusive" in Article 81-2 (3) 2 of the Act means any of the following:
1. If the court’s judgment of acquittal becomes final and conclusive;
2. If a prosecutor withdraws a prosecution.
[This Article Added on Jun. 20, 2023]
 Article 47 (Causes for Exclusion from Provision of Data concerning Delinquency or Write-off of Deficits)
(1) "In cases prescribed by Presidential Decree occurs" in the proviso, with the exception of the subparagraphs, of Article 81-3 (1) of the Act means cases where at least one installment payment of insurance contributions is made after obtaining approval for installment payments from the NHIS pursuant to Article 82 (1) of the Act: Provided, That this shall not apply where approval for installment payments is revoked pursuant to Article 82 (3) of the Act. <Added on Jan. 2, 2024>
"Where any other cause or event prescribed by Presidential Decree occurs" in the proviso, with the exception of the subparagraphs, of Article 81-3 (1) of the Act means any of the following: <Amended on Jun. 20, 2023; Jan. 2, 2024>
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 or 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 or her property due to a disaster or theft;
(b) Where his or her business has suffered a remarkable loss or is in crisis.
[This Article Added on Sep. 26, 2013]
[Previous Article 47 moved to Article 45-2 <Sep. 26, 2013>]
 Article 47-2 (Procedures for Provision of Data concerning Delinquency or Write-off of Deficits)
(1) Deleted; <Nov. 7, 2023>
(2) When the NHIS provides a centralized credit information collection agency provided in Article 25 (2) 1 of the Credit Information Use and Protection Act (hereinafter referred to as "centralized credit information collection agency") with data concerning delinquency, etc. (referring to data concerning delinquency, etc. under the main clause, with the exception of the subparagraphs, of Article 81-3 (1) of the Act; hereafter in this Article the same shall apply) pursuant to Article 81-3 (1) of the Act, such data may be provided by means of a document or in electronic form (referring to a magnetic tape, magnetic disc, or any other medium similar thereto, in which data concerning delinquency, etc. is recorded or stored) through information and communications networks. <Amended on Nov. 7, 2023>
(3) Where the payment of the amount in arrears, the revocation of write-off of deficits, or any other cause occurs after the NHIS has provided data concerning delinquency, etc. under paragraph (2), the NHIS shall inform the credit information collection agency that has been provided with the data concerning delinquency, etc. thereof within 15 days from the date of occurrence of such cause.
(4) Except as provided in paragraphs (2) and (3), matters necessary for providing data concerning delinquency, etc. shall be determined by the NHIS. <Amended on Nov. 7, 2023>
[This Article Added on Sep. 26, 2013]
 Article 47-3 (Certification of Payment of Insurance Contributions)
(1) "Construction project, manufacture, purchase, service, or any other contract prescribed by Presidential Decree" in the main clause of Article 81-4 (1) of the Act means any of the following contracts: <Amended on Nov. 29, 2016; Jun. 20, 2023>
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 38 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 contributions in arrears" in the proviso of Article 81-4 (1) of the Act means any of the following: <Amended on Jun. 20, 2023>
1. Where a person obligated to make payment intends to pay all of the price received with the insurance contributions, subsequent arrears and delinquency disposition expenses, or to pay some of such price with the total amount of the insurance contributions, subsequent arrears and delinquency disposition expenses;
2. Where the NHIS receives the price for the relevant contract in accordance with the delinquency disposition 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 delinquency disposition expenses or the realization of any property under a delinquency disposition is deferred. In such cases, the insurance contributions, subsequent arrears and delinquency disposition expenses 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 delinquency disposition expenses pursuant to the main clause of Article 81-4 (1) of the Act, he or she shall request the NHIS to certify the payment thereof, as determined 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, the following persons shall request the certification for the payment thereof: <Amended on Jun. 20, 2023>
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 Added on Aug. 2, 2016]
 Article 47-4 (Service by Mail)
Where the NHIS serves documents under Articles 79 and 81 of the Act by mail pursuant to the proviso of Article 81-5 of the Act, it may serve such documents by regular mail. <Amended on Jun. 20, 2023>
[This Article Added on Oct. 22, 2019]
 Article 48 (Disclosure of Personal Details of Persons in Arrear with Large Amount or in Habitual Arrears and Causes for Exclusion from Disclosure Thereof)
(1) "Where any cause prescribed by Presidential Decree, such as partial payment of the amount in arrears, exists" in the proviso of Article 83 (1) of the Act means any of the following cases: <Amended on Jun. 2, 2020>
1. Where not less than 30/100 of the amount of insurance contributions in arrear, arrears, and expenses for disposition on delinquency (hereafter in this Article referred to as "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 or 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 details, etc.") of the defaulter shall not be of any practical benefit.
(2) In selecting the persons subject to the disclosure of personal details, etc. under Article 83 (3) of the Act, the NHIS and the Deliberative Committee on Disclosure of Insurance Contribution Information shall make a judgment 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 or she is subject to the disclosure of personal details, etc., it shall demand him or her to pay the amount in arrears, and if a defaulter has any reason for exclusion from the disclosure of personal details, etc. under the proviso of Article 83 (1) of the Act, it shall inform him or her to submit explanatory materials for the default.
(4) When the NHIS makes a disclosure of personal details, etc. under Article 83 (4) of the Act, it shall also disclose the name of a person in arrears, his or her trade name (including the name of a corporation), age, type of business he or she engages in, occupation, address, type of the amount in arrears, payment due date, amount due, gist of the arrear, etc., and where a person in arrears is a corporation, the name of the representative of the corporation shall also be disclosed. <Amended on Jun. 20, 2023>
 Article 49 (Composition and Operation of 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) A majority of the members of the Deliberative Committee on Disclosure of Insurance Contribution Information shall constitute a quorum, and any decision thereof shall require the concurring vote of a majority of those present.
(5) Except as provided in paragraphs (1) through (4), matters necessary for organizing and operating the Deliberative Committee on Disclosure of Insurance Contribution Information shall be determined by the NHIS.
 Article 50 (Write-off of Deficits)
"Cases prescribed by Presidential Decree" in Article 84 (1) 3 of the Act means any of the following cases:
1. Where a person in arrears 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 delinquency disposition expenses;
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 and Claims, 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 Overpayment or Erroneous Payment)
(1) The NHIS shall appropriate overpayment or erroneous payment under Article 86 (1) of the Act (hereinafter referred to as "overpayment or erroneous payment") in the following order: <Amended on Sep. 22, 2016; Jun. 2, 2020>
1. Where insurance contributions and subsequent arrears are overpaid or erroneously paid:
(a) Delinquency disposition expenses;
(b) Insurance contributions in arrear and subsequent arrears;
(c) Insurance contributions to be paid for the next one month (limited to where a person obliged to make payment has consented thereto);
2. Where payment of collection under Article 57 of the Act (hereafter in this subparagraph referred to as "payment of collection") and subsequent arrears are overpaid or erroneously paid:
(a) Delinquency disposition expenses;
(b) Amount of collection in arrear and subsequent arrears;
3. Where additional dues and subsequent arrears are overpaid or erroneously paid:
(a) Delinquency disposition expenses;
(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 on 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.
[Title Amended on Jun. 2, 2020]
 Article 52 (Additional Interest at Time of Appropriation or Payment of Overpayment or Erroneous Payment)
(1) When the NHIS intends to appropriate the overpayment or erroneous payment to the insurance contributions, etc., arrears, or delinquency disposition expenses under Article 86 (1) of the Act or to refund the balance after appropriation pursuant to paragraph (2), it shall notify the payer of the fact in writing. <Added on 2020. 6. 2>
(2) "Interest prescribed by Presidential Decree" in Article 86 (3) of the Act means the amount calculated by multiplying the overpayment or erroneous payment by the interest rate of additional payment on the refund of national tax under the main clause of 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 overpayment or erroneous payment is appropriated to the insurance contributions, etc., arrears, or delinquency disposition expenses (or until the date a notice of refund is issued in cases of refund): <Amended on Sep. 26, 2013; Jun. 2, 2020>
1. Where insurance contributions, etc., arrears, or delinquency disposition expenses (hereinafter referred to as "amount in arrears") have been paid in installments on at least two occasions, the day following the date 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.
[Title Amended on Jun. 2, 2020]
CHAPTER VII APPLICATIONS FOR OBJECTION AND REQUESTS FOR JUDGMENT
 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 the filing of objections under Article 87 (1) and (2) of the Act.
 Article 54 (Composition 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 or her duties due to any unavoidable reason, any member who is nominated by the chairperson shall act on behalf of the chairperson in performing the latter's duty.
(2) Meetings of the objection committee shall be attended by the chairperson and six members who are designated by the chairperson whenever such meetings are held.
(3) A majority of the members of the objection committee under paragraph (2) shall constitute a quorum, and any decision thereof shall require the concurring vote of a majority of those present.
(4) Members present at the meetings of the 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 the 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)
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 Ministerial Decree 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 unavoidable 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 of 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 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 the "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 in subparagraph 1 of Article 60 the same shall apply);
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 or 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 or 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 10 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 10 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 under paragraph (1).
 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 or 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 unavoidable 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 of 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 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 on 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) in any of the following cases:
1. The member becomes unable to perform his or her duties due to any mental or physical disability;
2. The member commits misconduct in relation to his or 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 or she falls under any subparagraph of Article 65-2 (1);
5. The member voluntarily expresses his or her intention that it is impracticable to perform his or her duties.
[This Article Added on 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 or her duties due to any unavoidable reason, the member designated by the Chairperson shall act on his or 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 provided in 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 in this Article referred to as "member") who falls under any of the following cases shall be excluded from the deliberation and resolutions of the Dispute Mediation Committee:
1. Where he or she, or his or 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 or she is a current or former relative of a party to the relevant agenda;
3. Where he or she has given any testimony, statement or advice, or conducted any research or provided service regarding the relevant agenda;
4. Where he or she or any corporation to which he or she belongs is a current or former agent of a party to the relevant agenda;
5. Where he or 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 or 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 or she shall voluntarily evade the deliberation and resolution of the relevant agenda.
[This Article Added on 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 the budget: 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 to exist:
(a) Where he or 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 or 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 the "Income Reduction and Omission Investigation Committee").
(3) The Income Reduction and Omission Investigation Committee shall be comprised of five members, including one 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 or 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) Except as provided in paragraphs (3) through (5), matters necessary for operating the Income Reduction and Omission Investigation Committee shall be determined 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 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 Appendix 4-3.
(2) "Data prescribed by Presidential Decree" in Article 96 (2) of the Act means the data shown in subparagraph 2 of Appendix 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 Added on Nov. 20, 2014]
 Article 69-3 (Support for Inquiry, Inspection, Examination, Investigation, and Verification)
If the Minister of Health and Welfare, pursuant to Article 97 (7) of the Act, intends to require the NHIS or the Review and Assessment Service to provide support for inquiries, inspections, investigations, and verification under paragraphs (1) through (5) of that Article, the Minister shall notify the NHIS or the Review and Assessment Service of the following matters in advance:
1. Names and positions of public officials who perform the relevant business affairs;
2. Details and methods of support for business affairs of the NHIS or the Review and Assessment Service;
3. Scale of human resources to be assigned to support the business affairs of the NHIS or the Review and Assessment Service, and operational plans;
4. Other matters deemed necessary by the Minister of Health and Welfare to provide support to the NHIS or the Review and Assessment Service.
[This Article Added on May 7, 2024]
 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 Appendix 5.
(2) The procedure for collection of penalty surcharges under paragraph (1) shall be prescribed by Ministerial Decree of Health and Welfare.
 Article 70-2 (Criteria for Imposition of Penalty Surcharges)
(1) Where a medicine subject to suspension of the application of health care benefits under Article 41-2 (3) of the Act is a medicine for which costs of health care benefits are claimed by a health care institution in the year in which the date of the suspension of the application of health care benefits falls or the year immediately preceding the year (excluding medicines referred to in the subparagraphs of paragraph (2)), the Minister of Health and Welfare may impose penalty surcharges in lieu of the suspension of the application of health care benefits under Article 99 (2) 1 of the Act or paragraph (3) 1 of that Article. <Added on Dec. 7, 2021>
(2) Where any of the following applies to a medicine subject to suspension of the application of health care benefits prescribed in Article 41-2 (3) of the Act, the Minister of Health and Welfare may impose penalty surcharges in lieu of the suspension of the application of health care benefits prescribed in Article 99 (2) 2 of the Act or paragraph (3) 2 of that Article: <Amended on Aug. 29, 2014; Aug. 2, 2016; Sep. 28, 2018; Dec. 7, 2021>
1. Shortage prevention drugs;
2. Orphan drugs;
3. A medicine publicly notified as eligible for health care benefits prescribed in Article 41 (3) of the Act which is a single item, for which the same medication does not exist (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.
(3) "Period prescribed by Presidential Decree" in Article 99 (3) of the Act means five years. <Added on Sep. 28, 2018; Dec. 7, 2021>
(4) Criteria for imposition of penalty surcharges prescribed in paragraphs (1) and (2) shall be as specified in Appendix 4-2. <Amended on Sep. 28, 2018; Dec. 7, 2021>
[This Article Added on 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 prescribed in Article 99 (1) through (3), he or 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. <Amended on Sep. 28, 2018>
(2) A person who receives a notice under paragraph (1) shall pay the penalty surcharge to a receiving agency by a due date for payment stated in the payment notice of the penalty surcharge. <Amended on Dec. 12, 2023>
(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 Added on Jun. 30, 2014]
 Article 70-4 (Disposition for Persons Failing to Pay Penalty Surcharges)
(1) Where a person liable to pay a penalty surcharge prescribed in 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 clause of Article 99 (5) of the Act, within 15 days after the due date therefor. In such cases, the due date for the payment shall be within 10 days from the date the letter of overdue notice is issued. <Amended on Sep. 28, 2018>
(2) Where a person liable to pay a penalty surcharge has received a letter of overdue notice prescribed in 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 prescribed in the main clause of Article 99 (5) of the Act, and then shall take a disposition of suspending operation prescribed in Article 98 (1) of the Act or collect it in the same manner as delinquent national taxes. <Amended on Sep. 28, 2018>
(3) Where the Minister of Health and Welfare cancels the disposition of imposing the penalty surcharge prescribed in the main clause of Article 99 (5) of the Act and then takes a disposition of suspending operation prescribed in Article 98 (1) of the Act, he or 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 ground for changing the disposition and the period for the disposition of suspension of operation. <Amended on Sep. 28, 2018>
[This Article Added on Sep. 22, 2016]
 Article 71 (Amounts of Support from Penalty Surcharges)
(1) Amounts of support by use of penalty surcharges prescribed in Article 99 (1) of the Act, paragraph (2) 2 of that Article, or paragraph (3) 2 of that Article shall be as follows: <Amended on Jun. 30, 2014; Sep. 22, 2016; May 1, 2018; Sep. 28, 2018; Dec. 7, 2021; Nov. 7, 2023>
1. Support for catastrophic health expenditure support programs prescribed in the Act on the Support for Catastrophic Health Expenditure: 65/100 of revenues of penalty surcharges.
2. Support for the funds for emergency medical services prescribed in the Emergency Medical Service Act: 35/100 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 prescribed in Article 19 (2) of the Emergency Medical Service Act shall submit to the Minister of Health and Welfare plans on operation 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 or she has received under paragraph (2), and put such amount in the budget under conditions as prescribed by national finance-related statutes or regulations.
 Article 72 (Matters to Be Published)
"Matters prescribed by Presidential Decree" in the former part, with the exception of the subparagraphs, of Article 100 (1) of the Act means the matters falling under any of the following subparagraphs: <Amended on Jan. 2, 2024>
1. Kind of the relevant health care institution and license number 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 and Operation 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 or her duty due to any unavoidable reason, the member designated by the Chairperson shall perform the duty on his or 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) Except as provided in paragraphs (1) through (6), matters necessary for organization, operation, etc., the Publication Deliberation Committee 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 or her duties due to any mental or physical disability;
2. The member commits misconduct in relation to his or 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 or her intention that it is impracticable to perform his or her duties.
[This Article Added on Dec. 31, 2015]
 Article 74 (Procedure for and Methods 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 publicly announce the matters of publication under Article 100 (1) of the Act concerning the health care institutions selected as the objects of publication 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, Special Self-Governing City, Do, Special Self-Governing Province, and Si/Gun/autonomous Gu and the relevant health center, and may publicly announce them additionally on a bulletin board, etc. of the relevant organizations. <Amended on Jun. 2, 2020>
(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 or she may announce them in a newspaper under the Act on the Promotion of Newspapers or may broadcast them under the Broadcasting Act in addition to the public announcement in paragraph (2).
(4) When it is confirmed that the matters of publication under Article 100 (1) of the Act are changed during the period of public announcement 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, Special Self-Governing Province Mayor, Do Governor, Special Self-Governing Province Governor, head of the Si/Gun/Gu, or the head of the public health clinic having jurisdiction over the relevant health care institution subject to public announcement under paragraph (2) shall notify, without delay, 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 public announcement under paragraph (2). <Amended on Jun. 2, 2020>
(5) Except as provided in paragraphs (1) through (4), matters necessary for the procedure for and method of announcement, change in the matters of announcement, etc. shall be determined by the Minister of Health and Welfare.
 Article 74-2 (Criteria for Computing Amount Equivalent to Loss)
(1) An amount equivalent to any loss (hereafter in this Article referred to as "amount equivalent to the loss") 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 benefits unfairly borne by the insurer, the insured or his or her dependent due to any violation specified in subparagraphs 1 through 3 of Article 101 (1) of that 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 Added on Aug. 2, 2016]
 Article 74-3 (Calculation of Additional Charges in Cases of Litigation involving Medicines)
"Interest prescribed by Presidential Decree" in Article 101-2 (5) of the Act means an amount calculated by multiplying the amount calculated pursuant to Article 101-2 (3) or (4) of the Act by the interest rate prescribed in the main clause of Article 43-3 (2) of the Enforcement Decree of the Framework Act on National Taxes.
[This Article Added on Nov. 7, 2023]
 Article 75 (Standards for Payment of Monetary Awards)
(1) A person who falls under any subparagraph of Article 104 (1) of the Act or who intends to report any concealed property shall file a report thereon with the NHIS as determined by the NHIS. In such cases, when at least two persons file a report jointly, they shall designate a representative. <Amended on Jun. 20, 2023>
(2) Upon receiving the report under paragraph (1), after confirming the reported matter, the NHIS shall determine whether to pay a monetary award 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 in this Article the same shall apply).
(3) The reporter who is notified of the decision to pay a monetary award under paragraph (2) shall apply for the payment of the monetary award to the NHIS, as determined by the NHIS.
(4) The NHIS shall pay the reporter a monetary award in accordance with the standards for payment of monetary awards stipulated in Appendix 6 within one month from the date the application for payment of the monetary award is received under paragraph (3).
(5) No monetary award shall be paid to a person who files a report, the details of which is the same with those already reported under paragraph (1).
(6) "Property prescribed by Presidential Decree" in Article 104 (3) 3 of the Act means property registered or recorded in the name of a person liable to pay the money collectible under Article 57 of the Act, which is located in the Republic of Korea. <Added on Jun. 20, 2023>
(7) Except as provided in paragraphs (1) through (6), matters necessary for the standards, methods, procedures, etc. for the payment of monetary awards and others shall be determined by the NHIS. <Amended on Jun. 20, 2023>
 Article 75-2 (Payment of Incentives)
(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 on Aug. 29, 2014; Dec. 7, 2021>
1. Prescribing or preparing medicines of which costs of health care benefits 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 effect of which is potent enough to replace 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 (2) 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 70/100 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 benefits with the Review and Assessment Service under Article 47 (2) of the Act. <Added on 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. <Added on Aug. 29, 2014>
(5) Except as provided in paragraphs (1) through (4), matters necessary for the criteria, method, procedures for payment of an incentive and others shall be determined and publicly notified by the Minister of Health and Welfare. <Amended on Aug. 29, 2014>
[This Article Added on Sep. 26, 2013]
 Article 76 (Restrictions on Eligibility Acquisition as Insured or Dependents by Foreigners)
"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 stay 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 on Sep. 22, 2016]
 Article 76-2 (Time to Acquire Eligibility as the Insured for Foreigners)
(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 insured on any of the following dates, whichever is relevant, pursuant to the proviso of Article 109 (6) of the Act: <Amended on Jul. 16, 2019>
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 that 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 or she is expected to reside in Korea continuously pursuant to subparagraph 1 of that paragraph: The date the person enters Korea;
3. Other cases where the Minister of Health and Welfare deems it necessary to determine the timing for acquiring the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea, based on the status, period, circumstances, etc. of stay, and publicly notifies such timing: The date prescribed in the relevant public 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 clause 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 of Article 109 (6) of the Act: <Amended on Jun. 11, 2019; Jul. 16, 2019>
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 timing for losing the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea, based on the status, period, circumstances, etc. of stay, and publicly notifies such timing: The date prescribed in the relevant public 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 stay has not expired departed from Korea: The date following the date of departure;
(c) The date the self-employed insured requests the exclusion of him or her from the insured pursuant to Article 109 (5) 2 of the Act: Provided, That where the self-employed insured who has failed to pay insurance contributions or the self-employed insured for whom 14 days have not passed since the first payment of insurance contributions requests the exclusion of him or her from the insured after meeting the requirements determined and publicly notified by the Minister of Health and Welfare, it shall be the date of acquisition of the eligibility;
(d) Other cases where the Minister of Health and Welfare deems it necessary to determine the timing for losing the eligibility as the insured for foreigners, etc. differently from that for Korean nationals residing in Korea, based on the status, period, circumstances, etc. of stay, and publicly notifies such timing: The date prescribed in the relevant public notice.
[This Article Added on Sep. 22, 2016]
 Article 76-3 (Timing to Acquire Eligibility as Dependents for Foreigners)
(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 of Article 109 (6) of the Act: <Amended on Apr. 19, 2024>
1. In cases of a newborn baby defined in subparagraph 4 of Article 2 of the Mother and Child Health Act, who is a child of the employee insured (including the child of his or her spouse): The date of birth;
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 or her place of residence in Korea, or alien registration under any subparagraph of Article 109 (2) of the Act (hereafter in this Article referred to as "resident registration, etc."):
(a) Where he or she meets all the requirements prescribed in the subparagraphs of Article 109 (4) of the Act as of the date of filing an application for eligibility acquisition as a dependent: The date of the relevant resident registration, etc.: Provided, That where he or she becomes the employee insured after the resident registration, etc., the date on which he or she becomes the employee insured;
(b) Where he or she fails to meet only the requirements prescribed in Article 109 (4) 3 of the Act as of the date of filing an application for eligibility acquisition as a dependent: The date on which he or she meets the requirements prescribed in Article 109 (4) 3 of the Act;
3. Where he or she files an application for eligibility acquisition as a dependent after 90 days have elapsed from the date of resident registration, etc.;
(a) Where he or she meets all the requirements prescribed in the subparagraphs of Article 109 (4) of the Act as at the date of filing an application for eligibility acquisition as a dependent: The date of filing an application for eligibility acquisition: Provided, That where he or she becomes the employee insured after resident registration, etc. and files an application for eligibility acquisition as a dependent within 90 days from the date he or she becomes the employee insured, the date he or she becomes the employee insured;
(b) Where he or she fails to meet only the requirements prescribed in Article 109 (4) 3 of the Act as of the date of filing an application for eligibility acquisition as a dependent: The date on which he or she meets the requirements prescribed in Article 109 (4) 3 of the Act;
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 stay, and publicly notifies such time: The date prescribed in the relevant public 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 or she is deceased; where his or her supporter loses the eligibility as the employee insured; or where he or she receives medical benefits), pursuant to Article 5 of the Act which is applicable mutatis mutandis under the main clause 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 of Article 109 (6) of the Act: <Amended on Jun. 11, 2019>
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 stay, and publicly notifies such time: The date prescribed in the relevant public notice.
[This Article Added on 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 of Article 109 (9) of the Act means persons who are not granted any of the following statuses of stay, among foreigners, etc. residing in Korea who are the self-employed insured:
1. A person who has the status of stay granted for immigration through marriage (F-6) specified in Appendix 1-2 of the Enforcement Decree of the Immigration Act;
2. A person who has the status of stay granted for permanent residency (F-5) specified in Appendix 1-3 of the Enforcement Decree of the Immigration Act;
3. A person who has any other status of stay publicly notified by the Minister of Health and Welfare, as deemed necessary for applying 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 circumstances, objective, period, etc. of stay.
[This Article Wholly Amended on Dec. 24, 2018]
 Article 77 (Applicable Period for Voluntarily Continuous Insured Persons)
(1) "Period prescribed by Presidential Decree" in the main clause of Article 110 (2) of the Act means any of the following periods within the scope not exceeding 36 months reckoned from the day following the date employment relationship comes to an end:
1. A period that ends on the day before the eligibility of the insured who files an application with the NHIS pursuant to Article 110 (1) of the Act (hereinafter referred to as "voluntarily continuous insured person") changes pursuant to Article 9 (1) 2 of the Act;
2. A period that ends on the day before a voluntarily continuous insured person loses his or her eligibility pursuant to Article 10 (1) of the Act.
(2) Where a voluntarily continuous insured person who lost his or her eligibility pursuant to Article 10 (1) 5 of the Act as becoming an eligible recipient prescribed in Article 3 (1) 2 of the Medical Care Assistance Act re-acquires the eligibility of the insured pursuant to Article 8 (1) 1 of the Act and where the date when the eligibility is re-acquired is within 36 months from the day following the date employment relationship comes to an end under paragraph (1), he or she may file a reapplication for the eligibility of the voluntarily continuous insured person within the period determined by the NHIS. In such cases, the applicator shall retain his or her eligibility during the period prescribed in paragraph (1) from the date when such eligibility is re-acquired.
(3) Except as provided in paragraph (2), the period, procedures, methods, etc. necessary for re-application for the eligibility of a voluntarily continuous insured person shall be determined by the NHIS.
[This Article Wholly Amended on Jun. 26, 2018]
 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 of Insurance Contributions and Insurance Contributions 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 obliged to make 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 clause 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 114 (1) of the Act.
 Article 81 (Processing of Sensitive Information and Personally Identifiable Information)
(1) Where unavoidable to perform the following business affairs, the NHIS (including those entrusted with the business affairs of the NHIS under Article 112 of the Act) may process information on health under Article 23 of the Personal Information Protection Act, data that constitutes a criminal history under subparagraph 2 of Article 18 of the Enforcement Decree of that Act, and data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under the subparagraphs of Article 19 of that Decree: <Amended on Sep. 26, 2013; Nov. 20, 2014; Jun. 30, 2022; Jun. 20, 2023>
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 benefits to soldiers, etc. in active service under Article 60 of the Act;
4. Affairs related to the settlement of costs of health care benefits under Article 61 of the Act;
4-2. Affairs related to the provision of financial information, etc. under Articles 72 and 96-2 of the Act;
4-3. Affairs related to the provision of data under Article 81-3 of the Act;
5. Affairs related to the disclosure of personal details, etc. of persons in arrears under Article 83 of the Act;
6. Affairs related to the 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 the 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 monetary awards under Article 104 of the Act;
10. Affairs related to the entrustment of services under Article 112 of the Act.
(2) Where unavoidable to perform the following business affairs, the Review and Assessment Service may process 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 that Act: <Amended on Sep. 26, 2013; Nov. 20, 2014; Mar. 27, 2017>
1. Affairs related to reporting on the current status of facilities, equipment, human resources, etc. of health care institutions under Article 43 of the Act;
1-2. Affairs related to the verification of entitlement to health care benefits, 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 the 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 unavoidable to perform the following business affairs, health care institutions (including organizations authorized by health care institutions to act on their behalf pursuant to Article 47 (7) of the Act, in the case of subparagraph 2) may process 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 that Act: <Added on Mar. 27, 2017; Jun. 20, 2023>
1. Affairs related to the provision of health care benefits referred to in Article 41 (1) of the Act;
2. Affairs related to claims for costs of health care benefits referred to in Article 47 (1) or (2) of the Act.
(4) Where unavoidable to perform business affairs regarding claims for the payment of health care costs under Article 49 (3) of the Act, a quasi-health care institution under Article 49 (1) of the Act (hereinafter referred to as "quasi-health care institution") may process information on health under Article 23 of the Personal Information Protection Act or data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under Article 19 of the Enforcement Decree of that Act. <Added on Jun. 29, 2021; Jun. 20, 2023>
(5) Where unavoidable to perform business affairs regarding claims for the payment of insurance benefits under the former part of Article 51 (2) of the Act, a person who sells assistive devices under Article 51 (2) of the Act (hereinafter referred to as "assistive device seller") may process information on health under Article 23 of the Personal Information Protection Act or data containing resident registration numbers, passport numbers, driver's license numbers, or alien registration numbers under Article 19 of the Enforcement Decree of that Act. <Added on Jun. 29, 2021; Jun. 20, 2023>
(6) 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 process data referred to in paragraph (1) where unavoidable to perform the following: <Amended on Mar. 27, 2017; Jun. 29, 2021>
1. Affairs related to approval for delinquency disposition 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 under Article 100 of the Act.
 Article 81-2 (Re-Examination of Regulation)
(1) The Minister of Health and Welfare shall examine the appropriateness of the criteria for reducing the upper limit amount for medicines and suspending the application of health care benefits under Article 18-2 (4) and subparagraph 2 of Appendix 4-2 every five years, counting from July 1, 2019 (referring to the period that ends on the day before the base date of every fifth year) and shall take measures, such as making improvements.
(2) The Minister of Health and Welfare shall examine the appropriateness of the rate and amount of co-payment under Article 19 (1) and Appendix 2 every three years, counting from January 1, 2022 (referring to the period that ends on the day before January 1 of every third year), and shall take measures, such as making improvements.
[This Article Wholly Amended on Mar. 8, 2022]
CHAPTER IX PENALTY PROVISIONS
 Article 82 (Criteria for Imposition of Administrative Fines)
Criteria for imposition of administrative fines under Article 119 of the Act shall be as listed in Appendix 7.
ADDENDA <Presidential Decree No. 24077, Aug. 31, 2012>
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 benefits, such as costs of health care benefits (including co-payment and amount borne by the NHIS) and health care benefits, 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 Benefits)
From among the points of relative value on health care benefits 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 Appendix 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 Appendix 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 Appendix 2 shall apply to the health care benefits for dental treatment for disabled persons furnished on or after the date this Decree enters into force.
ADDENDA <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 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 Benefits for Dentures)
The amended provisions of subparagraphs 3 (d) (iii) and (iv), and 3 (f) shall apply to the health care benefits 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 Appendix 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 Benefits)
The amended provisions of subparagraph 1 (a) (i) of Appendix 2 and subparagraph 3 (d) of the same Table shall apply to the health care benefits that come 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 Appendix 3 shall enter into force on January 1, 2014.
Article 2 (Applicability to Amounts of Co-Payment out of Costs of Health Care Benefits)
The amended provisions of subparagraph 4 of Appendix 2 shall begin to apply from health care benefits 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 Appendix 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 or 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 to cases where health care benefits are provided 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 Appendix 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 Appendix 2 shall enter into force on July 1, 2014.
Article 2 (Applicability to Suspension and Exclusion of Medicines from Health Care Benefits and Criteria for Imposition of Penalty Surcharges)
The amended provisions of Article 18-2 and Appendix 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 Appendix 2 shall apply beginning with the first health care benefits 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 benefits provided after this Decree enters into force.
Article 3 (Applicability to Calculation of Expenses to be Borne by Principal)
The amended provisions of Appendix 2 shall also apply where expenses to be borne by the principal for the health care benefits 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 Appendix 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 Benefits)
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 benefits 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 benefits provided on or after July 15, 2015.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of Appendix 2 shall apply to the health care benefits provided on or after July 1, 2015.
Article 4 (Transitional Measures concerning the Insured Who Are Foreigners)
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 Appendix 2 shall enter into force on July 1, 2016.
Article 2 (Applicability to Raising Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of subparagraph 3 (d) (vii) of Appendix 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 Benefits for Long-Term Inpatient)
The amended provisions of subparagraph 5 of Appendix 2 shall apply from a patient who is hospitalized after the enforcement date under the proviso of 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.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
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 Appendix 2 shall apply from the health care benefits 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.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of subparagraph 1 (a) (i) of Appendix 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 benefits 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 Appendix 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.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of the table under subparagraph 1 (b) of Appendix 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 Benefits)
The amended provisions of subparagraph 1 (b) of Appendix 2 shall begin to apply to the health care benefits 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 of Points of Relative Values)
The amended provisions of Article 21 (2) shall also apply to the health care benefits, 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 Benefits and Assessment of Appropriateness)
(1) Health care benefits publicly notified by the Minister of Health and Welfare pursuant to the former provisions of subparagraph 4 of Appendix 2, shall be deemed selective benefits 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 benefits deemed selective benefits pursuant to paragraph (1), the date health care benefits have been provided pursuant to the former provisions of subparagraph 4 of Appendix 2, shall be deemed the date selective benefits have 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 Benefits)
The amended provisions of subparagraph 3 (a) 4) of Appendix 2 shall apply, beginning with the health care benefits that come 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 Appendix 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), with the exception of its subparagraphs, 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 Appendix 2 shall enter into force on November 1, 2017.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
(1) The amended provisions of subparagraph 3 (b) 1), (d) 2), (i) and (j) of Appendix 2 shall apply, beginning with the health care benefits that come into effect on and after October 1, 2017.
(2) The amended provisions of subparagraph 3 (d) 3) and 4) and (f) of Appendix 2 shall apply, beginning with the health care benefits that come 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 Health Care Benefits)
The amended provisions of subparagraph 3 (l) of Appendix 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.
Articles 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 Appendix 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): <Amended by Presidential Decree No. 30013, Jul. 30, 2019>
1. Where there has occurred any eligibility conversion (excluding cases where such conversion has occurred on grounds of Article 3 (1) 2 of the Medical Care Assistance Act) 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 occurred;
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.
ADDENDA <Presidential Decree No. 28861, May 1, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2018.
Article 2 (Applicability to Amounts of Support by Usage of Penalty Surcharges)
The amended provisions of Article 71 (1) shall apply, beginning with support by usage of penalty surcharges of 2019.
ADDENDA <Presidential Decree No. 29002, Jun. 26, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2018.
Article 2 (Applicability to Re-Application of Eligibility of Voluntarily Continuous Insured Persons)
The amended provisions of Article 77 shall also apply to a person for whom 36 months have not elapsed, counting from the day following the date employment relationship comes to an end pursuant to Article 77 (1) as of July 1, 2018.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of Appendix 2 shall apply, beginning with health care benefits provided after July 1, 2018.
ADDENDA <Presidential Decree No. 29163, Sep. 18, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on September 21, 2018.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 29196, Sep. 28, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on September 28, 2018: Provided, That the amended provisions of Appendix 5 shall enter into force on November 1, 2018.
Article 2 (Transitional Measures concerning Changing Criteria for Disposition of Business Suspension and Imposition of Penalty Surcharges)
(1) Notwithstanding the amended provisions of Appendix 5, the previous provisions shall apply to a disposition of business suspension or the imposition of penalty surcharges for violations committed during an investigation period that ends before November 1, 2018.
(2) The amended provisions of Appendix 5 shall apply to a disposition of business suspension or the imposition of penalty surcharges for violations committed during an investigation period that commences before and ends after November 1, 2018: Provided, That the previous provisions shall apply where the application of the same amended provisions is more disadvantageous to health care institutions than the application of the previous provisions, during an investigation period until October 31, 2018.
(3) Notwithstanding Article 2 (1) and the proviso of Article 2 (2) of the Addenda, the amended provisions of subparagraph 4 of Appendix 5 shall also apply to reduction and exemption regarding violations committed during an investigation period until October 31, 2018.
ADDENDA <Presidential Decree No. 29383, Dec. 18, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on December 20, 2018.
Article 2 Omitted.
ADDENDA <Presidential Decree No. 29409, Dec. 24, 2018>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2019: Provided, That the amended provisions of Appendixs 4-3 and 7 shall enter into force on the date of its promulgation.
Article 2 (Applicability to Medical Expenses for Pregnancy and Delivery)
The amended provisions of Article 23 shall apply, beginning with an application for issuing medical expenses for pregnancy and delivery filed with the NHIS after this Decree enters into force.
Articles 3 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of subparagraphs 1 and 3 of Appendix 2 shall apply, beginning with health care benefits provided after this Decree enters into force.
ADDENDA <Presidential Decree No. 29545, Feb. 12, 2019>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Co-Payment Ceiling)
The amended provisions of Appendix 3 shall apply, beginning with health care benefits provided after January 1, 2019.
ADDENDA <Presidential Decree No. 29675, Apr. 2, 2019>
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 Benefits of Chuna Manual Therapy)
The amended provisions of Article 19 (3) and subparagraph 3 (d) (ix) and (x) and subparagraph 3 (o) of Appendix 2 shall apply, beginning with health care benefits provided after April 8, 2019.
ADDENDA <Presidential Decree No. 29830, Jun. 11, 2019>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 12, 2019: Provided, That the following amended provisions shall enter into force on the dates specified as follows:
1. The amended provisions of Articles 18-2, 19 (5), 76-2 (2) 1 (a) and 76-3, subparagraph 1 (aj) of Appendix 4-3, and Appendix 7: Date of promulgation;
2. The amended provisions of Article 19 (3) 1 and subparagraphs 1 and 3 of Appendix 2: July 1, 2019;
3. The amended provisions of Article 26-2 (1) and subparagraph 1 (q) and (y) of Appendix 4-3: October 24, 2019;
4. The amended provisions of subparagraph 5 of Appendix 2: January 1, 2020.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of Article 19 (3) 1 and subparagraphs 1 and 3 of Appendix 2 shall apply, beginning with health care benefits provided after the enforcement date under subparagraph 2 of Article 1 of the Addenda.
Article 3 (Transitional Measures concerning Co-Payment Rate for Costs of Health Care Benefits)
Notwithstanding the amended provisions of subparagraph 5 of Appendix 2, the previous provisions shall apply to health care benefits of the insured or his/her dependent who is hospitalized as at the time of the enforcement date under subparagraph 4 of Article 1 of the Addenda.
ADDENDUM <Presidential Decree No. 29950, Jul. 2, 2019>
This Decree shall enter into on the date of its promulgation. (Proviso Omitted.)
ADDENDUM <Presidential Decree No. 29985, Jul. 16, 2019>
This Decree shall enter into force on July 16, 2019.
ADDENDA <Presidential Decree No. 30013, Jul. 30, 2019>
Article 1 (Enforcement Date)
This Decree shall enter into force on August 1, 2019.
Article 2 (Applicability to Adjustment of Insurance Contributions)
The amended provisions of Article 2 (3) 1 of the Addenda to the Enforcement Decree of the National Health Insurance Act, Presidential Decree No. 28693, shall apply, beginning with insurance contributions for August, 2019 of those who became eligible recipients of medical benefits on grounds of Article 3 (1) 2 of the Medical Care Assistance Act and then became the self-employed insured again before this Decree enters into force.
ADDENDA <Presidential Decree No. 30143, Oct. 22, 2019>
Article 1 (Enforcement Date)
This Decree shall enter into force on October 24, 2019: Provided, That the amended provisions of Article 19 (3) 1 and subparagraphs 1 (a) (i) and 3 of Appendix 2 shall enter into force on November 1, 2019, and the amended provisions of subparagraphs 2 and 3 (d) and (n) of Appendix 2, with the exception of its items, shall enter into force on January 1, 2020.
Article 2 (Applicability to Co-Payment Rate for Costs of Health Care Benefits)
The amended provisions of Article 19 (3) 1 and subparagraphs 1 (a) (i) and 3 of Appendix 2, with the exception of its items, shall apply to health care benefits provided on or after November 1, 2019.
Article 3 (Applicability to Calculation of Co-Payments)
The amended provisions of subparagraph 2 of Appendix 2 shall apply, beginning with cases where co-payments are calculated for health care benefits provided for patients who are hospitalized on or after the enforcement date pursuant to the proviso to Article 1 of the Addenda.
ADDENDUM <Presidential Decree No. 30287, Dec. 31, 2019>
This Decree shall enter into force on January 1, 2020.
ADDENDA <Presidential Decree No. 30747, Jun. 2, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 4, 2020: Provided, That the amended provisions of Article 23 (3) 2 subparagraph 2 (l) of Appendix 6 and subparagraph 2 of Appendix 6 shall enter into force on July 1, 2019.
Article 2 (Applicability to Co-Payment of Costs of Health Care Benefits)
The amended provisions of subparagraph 3 (l) (ii) of Appendix 2 shall begin to apply to the health care benefits that come into effect on and after January 1, 2020.
Article 3 (Transitional Measures concerning Standards for Payment of Monetary Rewards)
The amended provisions of subparagraph 2 of Appendix 6 shall begin to apply to reporting of a health care institution that has received insurance benefit costs by fraud or other improper means on or after July 1, 2020.
ADDENDA <Presidential Decree No. 30807, Jun. 30, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into on the date of its promulgation. (Proviso Omitted.)
Articles 2 through 5 Omitted.
ADDENDA <Presidential Decree No. 30824, Jul. 7, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 8, 2020.
Article 2 (Applicability to Period of Stay Abroad Excluded from Payment of Insurance Contributions)
The amended provisions of Article 44-2 shall begin to apply to the insured who depart from the Republic of Korea after this Decree enters into force.
ADDENDA <Presidential Decree No. 31096, Oct. 7, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended provisions of Article 41 shall enter into force on November 1, 2020.
Article 2 (Applicability to Co-Payment of Costs of Health Care Benefits)
The amended provisions of Article 19 (3) 3, and subparagraphs 3 (l) (iii) and 3 (p) shall apply to health care benefits provided on or after the date this Decree enters into force.
Article 3 (Applicability to Calculation of Insurance Contributions)
The amended provisions of Article 41 (1) and (2) shall begin to apply to the calculation of the insurance contributions for November 2020.
ADDENDA <Presidential Decree No. 31321, Dec. 29, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2021.
Article 2 (Applicability to Expansion of Persons Eligible for Exemption from Co-Payment of Costs of Health Care Benefits)
The amended provisions of subparagraph 3 (l) (i) of Appendix 2 shall apply to the health care benefits provided according to the results of general health examinations for the year 2021.
ADDENDA <Presidential Decree No. 31337, Dec. 29, 2020>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2021.
Article 2 (General Applicability)
This Decree shall also apply to cases under investigation by judicial police officers as at the time this Decree enters into force.
ADDENDA <Presidential Decree No. 31453, Feb. 17, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Articles 2 through 8 Omitted.
ADDENDA <Presidential Decree No. 31614, Apr. 6, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on April 6, 2021.
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 31846, Jun. 29, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 30, 2021: Provided That the amended provisions of Article 23 shall enter into force on January 1, 2022.
Article 2 (Transitional Measures concerning Subsidization of Medical Expenses for Pregnancy and Delivery)
Notwithstanding the amended provisions of Article 23, the previous provisions shall apply to applications for medical expenses for pregnancy and delivery filed before the enforcement date prescribed in the proviso to Article 1 of the Addenda.
Article 3 Omitted.
ADDENDA <Presidential Decree No. 32047, Oct. 14, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Upper Limit on Contributions to Catastrophic Health Expenditure Support Programs)
The amended provisions of Article 17-2 shall begin to apply from the fiscal year following the fiscal year in which the enforcement date of this Decree falls.
Article 3 (Applicability to Change of Period of Stay Abroad to Be Excluded from Payment of Insurance Contributions)
The amended provisions of Article 44-2 shall also apply to the insured who are staying abroad as at the time this Decree enters into force.
ADDENDA <Presidential Decree No. 32097, Nov. 1, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Co-Payment of Costs of Health Care Benefits)
(1) The amended provisions of subparagraph 2 (a) of Appendix 2, with the exception of its formula, shall also apply where a person is hospitalized after this Decree enters into force.
(2) The amended provisions of the main clause of subparagraph 2 (d) of Appendix 2 and subparagraph 3 (d) (ii) of that Table shall begin to apply where a person receives medical treatment using medical equipment determined by the Minister of Health and Welfare after this Decree enters into force.
Article 3 (Applicability to Calculation of Contribution Points for Self-Employed Insured)
The amended provisions of subparagraph 1 (b) (ii) of Appendix 4 shall begin to apply to the calculation of contribution points after this Decree enters into force.
Article 4 (Transitional Measures concerning Co-Payment of Costs of Health Care Benefits)
Notwithstanding the amended provisions of the proviso of subparagraph 2 (c) of Appendix 2 and the proviso of subparagraph 3 of the column of remark of subparagraph 3 (d) (ii) of that Table, the previous provisions shall apply where a person is hospitalized before this Decree enters into force.
ADDENDA <Presidential Decree No. 32190, Dec. 7, 2021>
Article 1 (Enforcement Date)
This Act shall enter into force on December 9, 2021: Provided, That the amended provisions of Articles 44 and 81-2, and the amended provisions of Appendix 5 shall enter into force on January 1, 2022.
Article 2 (Applicability to Insurance Contribution Rates and Monetary Value per Contribution Point)
The amended provisions of Article 44 shall begin to apply the calculation of monthly insurance contributions for the month in which the enforcement date prescribed in the proviso of Article 1 of the Addenda falls.
Article 3 (Transitional Measures concerning Changing Criteria for Disposition of Business Suspension and Imposition of Penalty Surcharges)
(1) Notwithstanding the amended provisions of Appendix 5, the previous provisions shall apply to a disposition of business suspension or the imposition of penalty surcharges for violations committed during an investigation period that ends before January 1, 2022.
(2) The amended provisions of Appendix 5 shall also apply to a disposition of business suspension or disposition of the imposition of penalty surcharges for violations committed during an investigation period beginning before January 1, 2022 and ending after January 1, 2022: Provided, That where it is more disadvantageous to a health care institution to apply the amended provisions of Appendix 5 than the previous provisions, the previous provisions shall apply.
ADDENDA <Presidential Decree No. 32293, Dec. 31, 2021>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2022: Provided, That the following amended provisions shall enter into force on the dates specified as follows:
1. ··· <omitted> ··· The amended provisions of Article 7 of the Addenda (excluding paragraphs (3) and (4) of that Article): January 1, 2023;
2. Omitted.
Articles 2 through 7 Omitted.
ADDENDUM <Presidential Decree No. 32528, Mar. 8, 2022>
This Decree shall enter into force on the date of its promulgation.
ADDENDA <Presidential Decree No. 32635, May 9, 2022>
Article 1 (Enforcement Date)
This Decree shall enter into force on May 18, 2022: Provided, That ··· <omitted> ··· Article 4 of the Addenda shall enter into force on August 18, 2022, and ··· <omitted> ··· shall enter into force.
Articles 2 through 4 Omitted.
ADDENDUM <Presidential Decree No. 32748, Jun. 30, 2022>
This Decree shall enter into force on July 1, 2022.
ADDENDA <Presidential Decree No. 32894, Aug. 31, 2022>
Article 1 (Enforcement Date)
This Decree shall enter into force on September 1, 2022: Provided, That the amended provisions of Article 42-2 (2) 1 and (3) 1 shall enter into force on November 1, 2022, and Article 8 of the Addenda shall enter into force on January 1, 2023.
Article 2 (Applicability to Criteria for Calculating Amount of Monthly Income of the Employee Insured)
The amended provisions of Article 41 (4) shall begin to apply to the insurance contributions based on monthly income of the employee insured for September 2022.
Article 3 (Applicability to Adjustment of Amount of Monthly Income and Contribution Points)
The amended provisions of Article 41-2 (including cases applicable mutatis mutandis in the amended provisions of Article 42 (2)) shall begin to apply to the insurance contributions based on monthly income of the employee insured and the amount of monthly insurance contributions of the self-employed insured for September 2022.
Article 4 (Applicability to Methods of Calculation of Contribution Points for Automobiles)
The amended provisions of Article 42 (3) 3 (b) and subparagraph 4 of Appendix 4 shall begin to apply to monthly insurance contributions for the self-employed insured for September 2022.
Article 5 (Applicability to Exclusion from Contribution Points of Housing-Related Loan Amounts of the Self-Employed Insured)
The amended provisions of Article 42-2 (2) 1 and (3) 1 shall begin to apply to monthly insurance contributions of the self-employed insured for November 2022.
Article 6 (Applicability to Calculation of Contribution Points for Income)
The amended provisions of subparagraphs 1 (excluding item (c)) and 2 of Appendix 4 shall begin to apply to monthly insurance contributions of the self-employed insured for September 2022.
Article 7 (Special Cases concerning Increase in Amount of Monthly Insurance Contributions of the Self-Employed Insured)
(1) Insurance contributions (referring to an amount obtained by subtracting insurance contributions imposed pursuant to subparagraph 2 (b) of the previous Article 32, the proviso, with the exception of the items, of subparagraph 1 of Appendix 4, and Article 2 of the Addenda of the partially amended Enforcement Decree of the National Health Insurance Act (Act No. 28693) from insurance contributions imposed pursuant to subparagraph 2 (b) of Article 32, the proviso, with the exception of the items, of subparagraph 1 of Appendix 4) shall be reduced by 100 percent of the amount of increases from September 2022 to October 2024 and reduced by 50/100 from November 2024 to August 2026: Provided, That where such reductions in accordance with the main clause are impracticable due to any change in household composition of the self-employed insured, etc., the insurance contributions shall be reduced as determined and publicly notified by the Minister of Health and Welfare:
1. Insurance contributions for August 2022, calculated pursuant to the previous provisions, shall be less than the amount of the monthly insurance contributions under the amended provisions of subparagraph 2 (b) of Article 32;
2. The amount of income under subparagraph 1 (a) of Appendix 4 shall not exceed 3.36 million won a year and no points shall be imposed on property and automobile pursuant to items (b) and (c) of that subparagraph.
(2) Notwithstanding paragraph (1), insurance contributions shall be reduced until the month in which the date specified in the relevant subparagraph falls (or the preceding month, if the relevant date is the first day of each month) in any of the following cases:
1. Where the eligibility of a self-employed insured changes (excluding where such change occurs by falling under Article 3 (1) 2 of the Medical Benefit Act): The date the eligibility changes;
2. Where a self-employed insured ceases to satisfy the requirements under paragraph (1) 2: The date the relevant requirements are not satisfied;
Article 8 Omitted.
ADDENDA <Presidential Decree No. 33128, Dec. 27, 2022>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 1, 2023: Provided, That the amended provisions of Article 28 (1), and 42-2 (1) and (3) shall enter into force on the date of its promulgation.
Article 2 (Applicability to Insurance Contribution Rates and Monetary Value per Contribution Point)
The amended provisions of Article 44 (1) and (2), and subparagraph 1 (a) of Appendix 4 shall begin to apply to the calculations of insurance contributions for January 2023.
ADDENDA <Presidential Decree No. 33382, Apr. 11, 2023>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 5, 2023.
Articles 2 through 5 Omitted.
ADDENDA <Presidential Decree No. 33553, Jun. 20, 2023>
Article 1 (Enforcement Date)
This Decree shall enter into force on June 28, 2023.
Article 2 (Applicability to Reporting on Accrual of Business Income following Adjustment of Amount of Monthly Income and Contribution Points)
The amended provisions of Article 41-2 (3) through (7) shall begin to apply where an employee insured files an application for the adjustment of the amount of monthly income with the NHIS pursuant to Article 41-2 (1) (including cases applied mutatis mutandis pursuant to Article 42 (2)) or where a self-employed insured files an application for the adjustment of contribution points with the NHIS after this Decree enters into force.
Article 3 (Applicability to Co-Payment Ceiling)
The amended provisions of Appendix 3 shall begin to apply to health care benefits provided after January 1, 2023.
ADDENDA <Presidential Decree No. 33593, Jun. 27, 2023>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2023. (Proviso Omitted.)
Articles 2 and 3 Omitted.
ADDENDA <Presidential Decree No. 33844, Nov. 7, 2023>
Article 1 (Enforcement Date)
This Decree shall enter into force on November 20, 2023: Provided, That the amended provisions of Article 71 (1) 1 and 2 and subparagraph 3 (a) (ii) of Appendix 2 shall enter into force on January 1, 2024.
Article 2 (Applicability to Co-Payment of Costs of Health Care Benefits)
The amended provisions of subparagraph 3 (a) (ii) of Appendix 2 shall begin to apply to the health care benefits that come into effect after January 1, 2024.
Article 3 (Transitional Measures concerning Dual Office Holding by Members of Medical Treatment Review Committee)
Professors, etc. who concurrently serve as members of the Medical Treatment Review Committee after obtaining permission for dual office before this Decree enters into force shall be deemed to have obtained such permission under the amended provisions of Article 29-2 (1).
ADDENDUM <Presidential Decree No. 33913, Dec. 12, 2023>
This Decree shall enter into force on the date of its promulgation.
ADDENDA <Presidential Decree No. 34091, Jan. 2, 2024>
Article 1 (Enforcement Date)
This Decree shall enter into force on January 12, 2024.
Article 2 (Applicability to Adjustment of Scope of Amount of Insurance Contributions Based on Monthly Remuneration of the Employee Insured)
The amended provisions of subparagraph 2 (a) of Article 32 shall begin to apply to insurance contributions calculated for January 2024.
Article 3 (Applicability to Calculation of Contribution Points for Income)
The amended provisions of subparagraph 1 (a) of Appendix 4 shall begin to apply to insurance contributions calculated for January 2024.
ADDENDA <Presidential Decree No. 34217, Feb. 13, 2024>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation.
Article 2 (Applicability to Calculation of Contribution Points for Insurance Contributions on Property)
The amended provisions of Article 42 (3) 3 and subparagraphs 1 and 4 of Appendix 4 shall begin to apply to cases where the insurance contributions for February 2024 of the self-employed insured are calculated.
Article 3 Omitted.
ADDENDA <Presidential Decree No. 34423, Apr. 19, 2024>
Article 1 (Enforcement Date)
This Decree shall enter into force on July 1, 2024: Provided, That the amended provisions of Article 76-3 shall enter into force on the date of the promulgation.
Article 2 (Applicability to Timing to Acquire Eligibility for Foreigners Residing in the Republic of Korea)
(1) The amended provisions of Article 76-3 (1) 1 shall begin to apply to newborn babies born in the Republic of Korea after April 3, 2024.
(2) The amended provisions of Article 76-3 (1) 2 and 3 shall begin to apply to foreigners, etc. residing in the Republic of Korea who entered the country after April 3, 2024.
ADDENDA <Presidential Decree No. 34497, May 7, 2024>
Article 1 (Enforcement Date)
This Decree shall enter into force on the date of its promulgation: Provided, That the amended provisions of Appendix 7 shall enter into force on May 20, 2024; the amended provisions of Article 69-3 shall enter into force on July 3, 2024; and the amended provisions of Articles 42-3 through 42-7 shall enter into force on July 10, 2024.
Article 2 (Applicability to Criteria for Exceptions to Restrictions on Insurance Benefits)
The amended provisions of the main clause of Article 26 (3) 1 shall also apply to persons whose insurance benefits are restricted as at the time this Decree enters into force in accordance with the standards for restrictions on insurance benefits under the previous provisions.
Article 3 (Applicability to Installment Payment of Amount to Be Additionally Collected of Insurance Contributions based on Monthly Remuneration)
The amended provisions of Article 39 (4) shall begin to apply to cases where the NHIS recalculates the amount of insurance contributions based on monthly remuneration under Articles 34 through 38 and additionally collects the shortfall after this Decree enters into force.
Article 4 (Applicability to Methods of Calculating Monthly Income of Self-Employed Insured)
The provisions regarding the calculation of monthly income of the self-employed insured in the amended provisions of Article 41 shall begin to apply to calculations of insurance contributions for May 2024 for the self-employed insured.
Article 5 (Applicability to Installment Payment of Amount to Be Additionally Collected of Insurance Contributions based on Monthly Income)
The amended provisions of Article 41-2 (6) shall begin to apply to cases where the NHIS recalculates insurance contributions based on monthly income pursuant to paragraph (4) of that Article and additionally collects the shortage after this Decree enters into force.
Article 6 Omitted.
ADDENDA <Presidential Decree No. 34844, Aug. 20, 2024>
Article 1 (Enforcement Date)
This Decree shall enter into force on August 21, 2024: Provided, That the amended provisions of Articles 35 (3) and 41-2 (1) shall enter into force on January 1, 2025.
Article 2 (Applicability to Rate and Amount of Co-Payment by Persons with Chronic Diseases)
The amended provisions of subparagraph 3 (q) of Appendix 2 shall begin to apply to health care benefits provided after this Decree enters into force.
Article 3 (Applicability to Methods for Calculating Co-Payment Ceiling)
The amended provisions of subparagraph 1 of Appendix 3 shall begin to apply to cases involving the receipt of health care benefits and the receipt of health care and childbirth under Article 49 (1) of the Act after January 1, 2024.