NHIS: Premium Spike for Self-Employed Results from Income Reassessment, Not a Blanket Hike

Recently, cases of self-employed individuals seeing their health insurance premiums for July increase by several dozen times compared to the previous month have been shared via social networking services (SNS) and other platforms. Some opinions have linked this to a government overhaul of the health insurance premium imposition system or blanket rate hikes. The National Health Insurance Service (NHIS) explained that the recent surge in premiums is the result of adjustments following reassessment and is unrelated to any blanket increase.

The cause of the sudden premium spike lies in the unique circumstances of self-employed business owners who have hired employees and are classified as workplace insured persons, as well as the timing of income reassessment. Business owners must pay not only their own premiums but also the employer's share of their employees' premiums. The deadline for individual business owners to report total compensation for the previous year is typically the end of May, extending to the end of June for those subject to the "faithful reporting" system. Health insurance premiums are initially levied based on reported data from the previous year, with a mechanism to settle and reflect any difference once actual income is finalized. As premiums are recalculated based on the finalized reported income, changes appear in the billing notices for June or July. If the actual income for the previous year increased significantly compared to the initial report, the outstanding premium difference is reflected all at once, leading to a sharp increase in the billed amount.

The NHIS cited the maximum monthly caps for salary-based premiums and non-salary income-based premiums as the underlying factors related to the premium structure. The monthly cap for salary-based premiums is set at 9,183,480 won, while the cap for non-salary income-based premiums is 4,591,740 won. Regarding the surge in premiums, the NHIS is reviewing the validity of the reported content through local tax offices and other channels, and has taken measures to allow insured persons to verify their individual billing details and settlement status on their premium notices.