全 民 健 康 保 險 年 報
National Health Insurance In Taiwan
2013-2014
ANNUAL REPORT
為穩固健保財源，使健保永續經營，
二代健保採「量能負擔」原則，也就是所得
較高的民眾有能力多繳保險費，故對現行
一般保險費計費基礎過度依賴經常性薪資
所得的情形予以適度調整。為了擴大保險費
基，「二代健保」的保費收入，除了現行
以經常性薪資對照投保金額所計算出的「一
般保險費」之外，再加上「補充保險費」，
把以往沒有列入投保金額計算的高額獎金、
兼職所得、執行業務收入、股利所得、利息
所得或租金收入等項目，納入「補充保險
費」的計費基礎，計收補充保險費。希望藉
由擴大保險費基，拉近相同所得者之保險
費，達到負擔之公平性（圖
2
）。
補充保險
費的收取對象以第一類至第四類及第六類
保險對象為主，第五類低收入戶之保險對
象則不列為補充保險費之收取對象。另外，
投保單位
(
雇主
)
每月所支付薪資總額與其
受僱者當月投保金額總額間之差額，亦增
列為計費基礎，收取補充保險費，以落實
量能負擔的精神，提升保費負擔的公平性。
The second-generation NHI system was adopted to
broaden and solidify the NHI revenue base and ensure the
program’s long-term sustainability. The previous system
collected premiums solely on the basis of regular wages, but
that put an excessive and unfair burden on wage earners in
an age when irregular and unearned income have become
increasingly prevalent in Taiwan. Embracing the “ability to
pay” principle, which asks higher income earners to pay more
in premiums, the second-generation systemadds to the existing
base of “standard premiums” based on monthly salaries by
collecting “supplementary premiums” on other forms of
income not considered under the previous system, such as
large bonuses, wages from part-time jobs, ad hoc professional
fees, and interest, dividend and rental income.
The hope is that broadening the system’s premium base
will narrow the gap in the NHI premiums paid by individuals
with similar total incomes and more equitably share the
premium burden (Chart 2). The individuals insured under
categories 1-4 and 6 in Table 1 are subject to supplementary
premiums, while Category 5 low-income households are not.
Supplementary premiums are also collected on the
difference between the total salaries (not including bonuses
or subsidies) insurance registration organizations (employers)
actually pay their employees in a month and the total “salary
basis” (Table 4) for the organization’s employees. This also
reflects the “ability to pay” principle and promotes a more
equitable distribution of the program’s financial burden.