The National Health Insurance Service is pushing to extend its income reconciliation system to all enrollees, targeting a blind spot in which premiums go unadjusted because enrollees do not report rising incomes to the agency. If the measure takes effect, 3.94 million regionally insured households would pay an additional 3.3 trillion won ($2.3 billion) in premiums, while 2.32 million households would receive about 1.8 trillion won ($1.3 billion) in refunds, according to estimates.
The agency plans to introduce the nationwide income reconciliation system to improve fairness in premium burdens, according to a report on major business operations submitted on the 20th to the National Assembly's Health and Welfare Committee during its parliamentary audit of government agencies. The core of the plan is a shift from the current system, under which reconciliation takes place at the enrollee's request, to one in which administrative agencies verify income and carry out the adjustment on their own authority.
Workplace enrollees currently pay premiums based on the previous year's wages, with reconciliation carried out each April according to confirmed income. Regionally insured enrollees and workplace enrollees with income outside their salaries, by contrast, have had no regular reconciliation procedure, leaving changes in income unreflected in premiums in a timely manner.
Under the new system, reconciliation would be carried out once a year on the agency's own authority, based on the National Tax Service's confirmed income data for the previous year. It would cover 9.08 million regionally insured households and 1.1 million workplace enrollees with income outside their salaries.
The agency's analysis found that 3.94 million regionally insured households would have to pay an additional 3.2911 trillion won because of income gains. Meanwhile, 2.32 million households whose income declined were estimated to receive a combined 1.8014 trillion won in refunds.