實施高額獎金補充保費對全民健保投保金額之影響 ─以桃竹苗地區為例;Exploring the NHI premium avoidance via examing the supplementary premium with a high bonus: A case study in Taoyuan, Hsinchu, Miaoli Counties

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题名:	實施高額獎金補充保費對全民健保投保金額之影響 ─以桃竹苗地區為例;Exploring the NHI premium avoidance via examing the supplementary premium with a high bonus: A case study in Taoyuan, Hsinchu, Miaoli Counties
作者:	林逸青;Lin, Yi-Ching
贡献者:	產業經濟研究所在職專班
关键词:	健保費;投保金額;高額獎金;補充保費;迴歸分析;National Health Insurance premiums;insured amount;high bonus;supplementary premiums;regression analysis
日期:	2020-06-30
上传时间:	2020-09-02 16:55:54 (UTC+8)
出版者:	國立中央大學
摘要:	健保投保金額以經常性薪資為計算，導致以經常性薪資為主單位與高獎金低常薪單位，雖全年薪資總額相同，但健保費負擔不同。102年高額獎金補充保費實施無疑會衝擊低常薪高獎金及高薪低報單位，可能改變其薪資給付方式或被保險人投保金額。本研究以桃園市、新竹市、新竹縣、苗栗縣屬健保第一類投保單位為研究對象，以複迴歸分析次年投保金額增減、次年投保金額占薪資所得比例、高額獎金補充保費收繳情形、保險對象特性及投保單位特性，研究發現： 1.高額獎金補充保費及實施時點對投保金額增加均有正面影響。高額獎金補充保費本身及後續查核均有助於投保單位重新審視員工投保金額，增加投保單位高薪低報的成本，減少高薪低報情形發生，但當投保單位對於補充保費越來越熟悉時，正面影響會逐漸下降，可能是因為一般健保費跟補充保費間仍具有費率差距，導致投保單位選擇繳納高額獎金補充保費，讓次年投保金額占薪資所得比例下降、高額獎金補充保費對於投保金額的正面影響減少。 2.102年至106年間保險對象經常性薪資所得有逐漸往非經常性薪資所得且非獎勵性質給付的現象發生，將導致一般及補充保費費基受損，其中補充保費規定高額獎金是具獎勵性質所得，而綜所稅非按此定義區分薪資，導致有誘因更改所得名目以規避補充保費，讓健保署難以查核，如要實際確認單位有無規避健保費，需要調閱薪資清冊，進行歸類後正確申報投保金額或繳納高額獎金補充保費。 ;The insurance premium of National Health Insurance （NHI） is calculated based on regular salaries. As a result, recurring salaries are the central unit and high bonuses and lower regular salary units. Although the total annual salary is the same, the burden of health insurance premiums is different. The implementation of high bonus premiums in 102 would undoubtedly impact low-paying high-bonus units and high-paying low-reporting units and may change their salary payment methods or their insured amount. This research takes Taoyuan City, Hsinchu City, Hsinchu County, and Miaoli County as the first insured classification of health insurance units to study. Regression analysis is applied to analyze the increase and decrease of the insured amount in the following year, the proportion of insured amount to salary income in the next year, the collection of premiums, the characteristics of the insurance object and the characteristics of the insured unit, the study found that: 1. High bonus premiums and implementation timing of the supplementary premium have a positive impact on the insured amount. The high bonus supplementary premium itself and subsequent inspections would help the insured unit to re-examine the employees′ insured amount, increase the cost of high-paying and under-reporting of the insured units, and reduce the occurrence of high-paying and under-reporting. The impact would gradually decline. It may be because there is still a rate gap between general health insurance premiums and supplementary premiums. This causes the insured units to choose to pay high bonus supplementary premiums, which reduces the share of insurance premiums on the next year′s salary income and consequently reduce the positive impact. 2. During the period from 102 to 106, the recurring insured salary income gradually shifted to non-recurring salary, and non-reward payment would occur, which cause damage to the general and supplementary premium calculation base. Among them, the high bonus stipulated in the supplementary premium is a reward. The tax is not according to this definition, leading to incentives to change the income item to avoid supplementary premiums, making it difficult for the National Health Insurance Administration to check. To confirm the unit′s avoidance behavior, we should review the payroll inventory. After review, the insurance object should correctly declare the insured amount or pay a high bonus premium.
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