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NATIONAL HEALTH INSURANCE ACT

NATIONAL HEALTH INSURANCE

ACT

ReproducedfromStatutesoftheRepublicofKorea

1. the term "worker" means a person who, regardless of the type of his occupation, lives on remunerations received as compensation for his work (including a director or other officer of a corporation), except for a public officialoraschoolemployeeundersubparagraphs4and5,respectively;

2. the term "employer" means a person who falls under one of the fol- lowing items:

(a) the owner of the workplace to which a worker in question belongs; (b) the head of the organ to which a public official in question belongs and who is determined by the Presidential Decree; and (c) the person who establishes and operates a private school to which a school employee in question belongs (referring to a private school referred to in Article 3 of the Pension for Private School Teachers and Staff Act; hereafter the same shall apply in this Article);

3. the term "workplace" means a place of business or office;

4. the term "public official" means a person who is a regular employee of the State or a local government performing civil services; and

5. the term "school employee" means a teacher at or an employee of a private school or the organization that manages the school. AArrttiiccllee 44 ((HHeeaalltthh IInnssuurraannccee PPoolliiccyy DDeelliibbeerraattiivvee CCoommmmiitttteeee)) (1) The Health Insurance Policy Deliberative Committee (hereinafter referred to the "Deliberative Committee") mandated to deliberate and vote on the matters concerning the health insurance policy, which fall under each of the following subparagraphs, shall be set up under the Minister of Health and Welfare:

1. The standards for medical care benefits provided for in the provisions of Article 39 (2);

2. The matters concerning expenses necessary for the medical care ben- efits provided for in the provisions of Article 42 (3); NATIONAL HEALTH INSURANCE ACT

Act No. 5854, Feb. 8, 1999

Amended by Act No. 6073, Dec. 31, 1999

Act No. 6093, Dec. 31, 1999

Act No. 6124, Jan. 12, 2000

Act No. 6320, Dec. 29, 2000

Act No. 6474, May 24, 2001

Act No. 6618, Jan. 19, 2002

Act No. 6799, Dec. 18, 2002

Act No. 6951, Jul. 29, 2003

Act No. 6981, Sep. 29, 2003

Act No. 7144, Jan. 29, 2004

Act No. 7347, Jan. 27, 2005

Act No. 7377, Jan. 27, 2005

Act No. 7590, Jul. 13, 2005

Act No. 8034, Oct. 4, 2006

Act No. 8153, Dec. 30, 2006

AArrttiiccllee 11 ((PPuurrppoossee))

The purpose of this Act is to improve the citizens' health and promote social security by providing the citizens with insurance benefits for, prevention of disease and injury, medical examination, medical treatment, rehabilitation and childbirth, death, and improvement of health. AArrttiiccllee 22 ((CChhaarrggee))

The Minister of Health and Welfare shall be in charge of the national health insurance program prescribed by this Act.

AArrttiiccllee 33 ((DDeeffiinniittiioonnss))

For the purpose of this Act,Amended by Act No. 6124, Jan. 12, 2000; Act No. 8034, Oct. 4, 2006

CHAPTER GENERAL PROVISIONS

ReproducedfromStatutesoftheRepublicofKorea

(5) The terms of office of the members of the Deliberative Committee shall be three years: Provided, That the terms of office for the members who are public officials shall be the period during which they hold their offices and the term of office for any member filling a vacancy shall be the remainder of the term of office for his predecessor. (6) Matters necessary for the operation, etc. of the Deliberative Committee shall be prescribed by the Presidential Decree.

[This Article Wholly Amended by Act No. 8153, Dec. 30, 2006]

3. The insurance premium rates of the employee insured provided for in the provisions of Article 65 (1);

4. The monetary value per contribution point of the self employed insured provided for in the provisions of Article 65 (3); and

5. Other major matters concerning the health insurance, which are prescribed by the Presidential Decree.

(2) The Deliberative Committee shall be composed of 25 members in- cluding one chairman and one vice chairman.

(3) The chairman of the Deliberative Committee shall be the Vice Minister of Health and Welfare and the vice chairman shall be nominated by the chairman from among the members referred to in paragraph (4) 3. (4) The following persons shall be appointed or commissioned by the Minister of Health and Welfare as the members of the Deliberative Committee:

1. Two persons who are each recommended by workers' organizations and employers' organizations and eight persons who are each recommended by civil organizations (referring to the non-profit civil organizations provided for in the provisions of Article 2 of the Assistance for Non-Profit, Non-governmental Organizations Act; hereinafter the same shall apply), consumers' organizations, the organizations of farmers and fishermen, andtheorganizationoftheself-employed;

2. Eight persons who are recommended by the organization represent- ing the medical profession and the organization representing the manufacturers of medicines; and

3. Eight persons falling under each of the following items: (a) Two public officials who work for central administrative agencies, who are prescribed by the Presidential Decree;

(b) Two person who are each recommended by the president of the National Health Insurance Corporation and the director of the Health Insurance Review Board; and

ReproducedfromStatutesoftheRepublicofKorea

subparagraphs, who are supported mainly by the employee insured and do not have other remunerations or income:

1. Spouses of the employee insured;

2. Lineal ascendants of the employee insured (including lineal ascendants of their spouses);

3. Lineal descendants (including lineal descendants of their spouses) and their spouses of the employee insured; and

4. Brothers/sisters of the employee insured. (3) The standards for determination of the dependent eligibility referred to in paragraph (2), time of acquisition or loss of such eligibility, and other necessary matters shall be prescribed by the Ordinance of the Ministry of Health and Welfare.

AArrttiiccllee 66 ((CCaatteeggoorriieess ooff tthhee iinnssuurreedd)) (1) The insured shall be divided into the employee insured and the self- employed insured.

(2) The workers and employers of all workplaces and the public officials and school employees shall become the employee insured: Provided, That the persons who fall under one of the following subparagraphs shall be excluded:Amended by Act No. 6320, Dec. 29, 2000; Act No. 7144, Jan. 29, 2004; Act No. 8034, Oct. 4, 2006

1. Day-to-day workers who are employed for the period of less than one month;

2. Soldiers in the active service underthe provisions of the Military Service Act (including staff sergeants appointed without volunteer- ing), secondment personnel and candidates for military officers;

3. Public officials who take their office through election, and who do not receive monthly remuneration or salary equivalent thereto; and

4. Workers and employers of the workplaces as prescribed by the AArrttiiccllee 55 ((EElliiggiibbllee PPeerrssoonnss,, eettcc..)) (1) Korean nationals who reside within the country, excluding those who fall under one of the following subparagraphs, shall become the insured (hereinafter referred to as "the insureds") of the health insurance referred to in this Act (hereinafter referred to as the "health insurance") or their dependents:Amended by Act No. 6474, May 24, 2001; Act No. 8034, Oct. 4, 2006

1. Persons who receive medical benefits under the provisions of the Medical Care Assistance Act (hereinafter referred to as "medical care eligible persons"); and

2. Persons who receive medical care under the provisions of the Act on the Honorable Treatment of Persons of Distinguished Services to In- dependence and the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State (hereinafter re- ferred to as "medical care eligible persons for distinguished service"): Provided, That this shall not apply to the persons who fall under one of the following items:

(a) Persons, from among the medical care eligible persons for distinguished service, who request the insurer that they be under the coverage of the health insurance; and

(b) Where persons who were under the coverage of the health insur- ance become medical care eligible persons for distinguished ser- vice, persons who do not request the insurer that they be excluded from the coverage of the health insurance.

(2) Dependents of the insured referred to in paragraph (1) refer to the persons, from among the persons falling under one of the following CHAPTER THE INSURED

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 88 ((CChhaannggee ooff EElliiggiibbiilliittyy)) (1) The employer of the employee insured concerned, if there is a change of eligibility in that the self-employed insured becomes the employee insured or the head of the household of the self-employed insured concerned, if there is a change of eligibility in that the employee insured or his dependent becomes the self-employed insured, shall each report the particulars to the insurer as prescribed by the Ordinance of the Ministry of Health and Welfare within fourteen days from the date of the change in eligibility.

(2) Where the self-employed insured or the employee insured fall under the provisions of subparagraphs 3 and 4 of Article 49, the Minister of National Defense and the Minister of Justice shall notify the insurer under the conditions as provided by the Ordinance of the Ministry of Health and Welfare within one month from the date of the change.Newly Inserted by Act No. 7590, Jul. 13, 2005

AArrttiiccllee 99 ((TTiimmee ooff LLoossss ooff EElliiggiibbiilliittyy)) (1) An insured shall lose his eligibility on the day he falls under one of the following subparagraphs:Amended by Act No. 6474, May 24, 2001; Act No. 7144, Jan. 29, 2004

1. Day after the day he dies;

2. Day after the day he loses his nationality;

3. Day after the day he ceases to reside within the country;

4. Thedayhebecomesadependentof theemployeeinsured;

5. The day he becomes a medical care eligible person; and

6. The day a request for exclusion from coverage of the health insurance is made by a person who was formerly under the coverage of the health insurance but became a medical care eligible person for dis- tinguished service.

Presidential Decree in view of the peculiarity of workplace, forms of employment and kinds of business, and public officials and school employees.

(3) The self-employed insured shall be the insured other than the employee insured and their dependents.

(4) Workers and employers under paragraph (2) 4 may either become the employee insured or secede under the conditions as prescribed by the Presidential Decree.Newly Inserted by Act No. 6320, Dec. 29, 2000 AArrttiiccllee 77 ((TTiimmee ooff AAccqquuiissiittiioonn ooff EElliiggiibbiilliittyy)) (1) An insured shall acquire the eligibility of the employee insured or the self- employed insured on the day he takes residence in the country: Provided, That a person who falls under one of the following subparagraphs shall acquire each applicable eligibility on the applicable day:Amended by Act No. 6474, May 24, 2001

1. For a formerly medical care eligible person, on the day when he be- comes excluded from such eligibility;

2. The day on which a former dependent of the employee insured loses his eligibility;

3. For a formerly medical care eligible person for distinguished service, on the day when he is excluded from such eligibility; and

4. For a medical care eligible person for distinguished service who re- quests the insurer for coverage under the health insurance under the provisions of Article 5 (1) 2 (a), on the day when the request is made. (2) If eligibility is acquired under the provisions of paragraph (1), the employer of the employee insured concerned or the head of the household of the self-employed insured concerned shall report the particulars to the insurer as prescribed by the Ordinance of the Ministry of Health and Welfare within fourteen days after the date of acquisition of the eligibility.

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 1122 ((IInnssuurreerr))

The insurer of the national health insurance shall be the National Health Insurance Corporation (hereinafter referred to as the "Corporation"). AArrttiiccllee 1133 ((OOppeerraattiioonnss,, eettcc..)) (1) The Corporation shall be in charge of the following operations:

1. Supervision of the eligibility of the insured and their dependents;

2. Assessment and collection of insurance premiums and other fees re- ferred to in this Act;

3. Administration of insurance benefits;

4. Prevention programs necessary for maintenance and improvement of health of the insured and their dependents;

5. Payment of the insurance benefit costs;

6. Programs for managing, employing and increasing its assets;

7. Operation of medical facilities;

8. Educationaltrainingandpublicityinconnectionwiththehealthinsurance;

9. Investigative research and international cooperation in connection with the health insurance;

10. Operations delegated to it under the provisions of this Act or other Acts and subordinate statutes; and

11. Other operations that the Minister of Health and Welfare determines to be necessary in connection with the health insurance. (2) Matters necessary with regard to the kinds and scope of the programs for managing, employing, and increasing assets as referred to in paragraph (1) 6 shall be prescribed by the Presidential Decree. CHAPTER NATIONAL HEALTH INSURANCE

CORPORATION

(2) If eligibility is lost under the provisions of paragraph (1), the employer of the employee insured concerned or the head of the household of the self- employed insured concerned shall report the particulars to the insurer as prescribed by the Ordinance of the Ministry of Health and Welfare within fourteen days after the date of loss of the eligibility. AArrttiiccllee 1100 ((CCoonnffiirrmmaattiioonn ooff AAccqquuiissiittiioonn oorr LLoossss ooff EElliiggiibbiilliittyy)) (1) Acquisition, change, or loss of the eligibility of an insured shall take effect retroactively from the time of acquisition, change or loss of the eligibility as referred to in Articles 7 through 9. In such a case, the insurer may confirm the fact thereof.

(2) an insured or a former the insured may make a request for the confirmation referred to in paragraph (1).

AArrttiiccllee 1111 ((HHeeaalltthh IInnssuurraannccee CCaarrdd)) (1) The National Health Insurance Corporation shall issue health insurance cards to the insured

(2) When an insured or his dependent receives a medical care benefit, he shall present the insurance card referred to in paragraph (1) to a medical care institution referred to in Article 40 (1) (hereinafter referred to as "medical care institution"): Provided, That this shall not apply if an unavoidable circumstance such as a force majeure exists. (3) Matters necessary with regard to the form of the health insurance card referred to in paragraph (1) and issuing and using it shall be prescribed by the Ordinance of the Ministry of Health and Welfare.

ReproducedfromStatutesoftheRepublicofKorea

6. Matters concerning its financial operation committee;

7. Matters concerning insurance premiums and insurance benefits;

8. Matters concerning its budget and settlement of accounts;

9. Matters concerning its assets and accounting;

10. Matters concerning modification of the articles of incorporation; and

11. Matters concerning public announcement. (2) When the Corporation intends to modify its articles of incorporation, it shall obtain authorization of the Minister of Health and Welfare. AArrttiiccllee 1177 ((RReeggiissttrraattiioonn))

The registration for establishment of the Corporation shall include the following matters:

1. Objectives;

2. Its name;

3. Seat of the principal office and branch offices; and

4. Name, address and resident registration number of the chairman of the board of directors.

AArrttiiccllee 1188 ((DDiissssoolluuttiioonn))

MattersregardingthedissolutionoftheCorporationshallbeprescribedbyActs. AArrttiiccllee 1199 ((OOffffiicceerrss))

(1) TheCorporationshallhaveasitsofficersonechairmanoftheboardofdirectors, 17directorsandoneauditor.AmendedbyActNo.7144,Jan. 29,2004 (2) The chairman of the board of directors shall be appointed or dismissed by the President upon recommendation of the Minister of Health and Welfare.Amended by Act No. 7144, Jan. 29, 2004

(3) As directors, eight persons recommended, two each, by the labor unions, an employer organization, an agricultural and fishery organization, and a (3) If a service in question is being provided for, or the use of the facilities is for, a specific person, the Corporation may collect a service charge or a use fee for the provision of the service or the use of the facilities under the conditions as prescribed by the Corporation's articles of incorporation.

(4) The Corporation shall disclose to the public the information that it maintains and manages in connection with the health insurance as prescribed by the Official Information Disclosure Act.Amended by Act No. 8034, Oct. 4, 2006

AArrttiiccllee 1144 ((LLeeggaall PPeerrssoonnaalliittyy ooff CCoorrppoorraattiioonn)) (1) The Corporation shall be a juristic person.

(2) The Corporation shall come into existence by registering its establishment at the seat of its principal office. AArrttiiccllee 1155 ((OOffffiiccee))

(1) Location of the principal office of the Corporation shall be determined by the articles of incorporation.Amended by Act No. 7144, Jan. 29, 2004 (2) When necessary, the Corporation may establish branch offices pursuant to its articles of incorporation.

AArrttiiccllee 1166 ((AArrttiicclleess ooff IInnccoorrppoorraattiioonn)) (1) The articles of incorporation of the Corporation shall state the following matters:

1. Objectives;

2. Its name;

3. Seat of the office;

4. Matters concerning its officers and employees;

5. Matters concerning the board of directors;

ReproducedfromStatutesoftheRepublicofKorea

2. A person falling under any subparagraph of Article 33 of the State Public Officials Act.

[This Article Wholly Amended by Act No. 7144, Jan. 29, 2004] AArrttiiccllee 2222 ((OObblliiggaattoorryy RReettiirreemmeenntt//DDiissmmiissssaall ooff OOffffiicceerr)) (1) When an officer is confirmed to fall under one of the subparagraphs of Article 21, the officer in question shall be obligated to retire. (2) When an officer falls under one of the following subparagraphs, the person with the power to appoint or dismiss may dismiss the officer in question:Amended by Act No. 7144, Jan. 29, 2004

1. When he is determined to be unable to perform his duties due to a physical or mental disability;

2. When he violates an official duty;

3. When he causes a loss to the Corporation, either intentionally or through gross negligence;

4. When he commits an act that is damaging to his dignity, regardless of whether while on duty or off duty; and

5. When he violates an order of the Minister of Health and Welfare re- ferred to in this Act.

AArrttiiccllee 2233 ((PPrroohhiibbiittiioonn aaggaaiinnsstt OOffffiicceerr''ss HHoollddiinngg CCoonnccuurrrreenntt OOffffiiccee)) The chairman of the board of directors, permanent directors, and permanent auditors of the Corporation may not engage themselves in another, for profit businessor,withoutpermissionofthepersonwiththepowertoappointordismiss, holdanotherofficeconcurrently.AmendedbyActNo.7144,Jan.29,2004 AArrttiiccllee 2244 ((BBooaarrdd ooff DDiirreeccttoorrss)) (1) The Corporation shall have a board of directors in order to deliberate on and resolve important matters of the Corporation. consumer organization, five persons recommended by the chairman of the board of directors of the Corporation, and four relevant public officials determined by the Presidential Decree shall be appointed or dismissed by the MinisterofHealthandWelfare.AmendedbyActNo.7144,Jan.29,2004 (4) The auditor shall be appointed or dismissed by the Minister of Health and Welfare.Amended by Act No. 7144, Jan. 29, 2004

(5) Posts of the chairman of the board of directors, five of the directors and the auditor shall be permanent: Provided, That the non-permanent members may receive reimbursements for actual expenses as prescribed by the articles of incorporation.Amended by Act No. 7144, Jan. 29, 2004 (6) The term of the office of an officer shall be three years: Provided, That the term of the office of an officer who is a public official shall be the term of that office.Amended by Act No. 7144, Jan. 29, 2004 AArrttiiccllee 2200 ((DDuuttiieess ooff OOffffiicceerrss)) (1) The chairman of the board of directors shall represent the Corporation and supervise its duties and affairs at large.

(2) The permanent directors shall execute the operations of the Corporation under the order of the chairman of the board of directors, and when the chairman of the board of directors is unable to perform his duties due to an unavoidable circumstance, a permanent director determined by the articles of incorporation shall act for the chairman. (3) The auditor shall audit the accounting of the Corporation, the circumstances ofexecutionofitsoperations,andthecircumstancesofitsassets. AArrttiiccllee 2211 ((GGrroouunnddss ffoorr DDiissqquuaalliiffiiccaattiioonn ooff OOffffiicceerr)) A person who falls under one of the following subparagraphs may not be- come an officer of the Corporation:Amended by Act No. 8034, Oct. 4, 2006

1. A person who is not a national of the Republic of Korea; and

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 2299 ((LLiimmiittaattiioonn oonn RReepprreesseennttaattiivvee PPoowweerr)) (1) In connection with the matters with regard to which the interests of the Corporation and the interests of the chairman of the board of directors are in conflict with each other, the chairman of the board of directors may not represent the Corporation, but the permanent auditor shall represent the Corporation.

(2) The provisions of paragraph (1) shall apply mutatis mutandis to any litigation between the Corporation and the chairman of the board of directors.

AArrttiiccllee 3300 ((DDeelleeggaattiioonn ooff PPoowweerrss ooff CChhaaiirrmmaann ooff BBooaarrdd ooff DDiirreeccttoorrss)) From among the powers of the chairman of the board of directors referred to in this Act, those prescribed by the Presidential Decree, such as restriction of benefits and notice to pay insurance premium, may be delegated to the heads of the branch offices pursuant to the articles of incorporation. AArrttiiccllee 3311 ((FFiinnaanncciiaall OOppeerraattiioonn CCoommmmiitttteeee)) (1) The Corporation shall have a financial operation committee in order to deliberate on and resolve the matters related to the insurance finance, such as the contract of the medical care benefit cost provided for in the provisions of Article 42 (5), the deficit disposal of insurance premiums provided for in theprovisionsofArticle72.AmendedbyActNo.8153,Dec.30,2006 (2) Deleted.by Act No. 8153, Dec. 30, 2006

(3) The chairman of the financial operation committee shall be elected by the committeefromamongthecommitteemembersreferredtoinArticle32(1)3. AArrttiiccllee 3322 ((CCoommppoossiittiioonn,, eettcc.. ooff FFiinnaanncciiaall OOppeerraattiioonn CCoommmmiitttteeee)) (1) The financial operation committee shall be composed of the members referred to in the following subparagraphs:

(2) The board of directors shall be composed of the chairman and directors. (3) The auditor may come before the board of directors and speak. (4) Matters necessary with regard to the issues to be resolved by the board of directors and the operation of the board of directors shall be prescribed by the Presidential Decree.

AArrttiiccllee 2255 ((AAppppooiinnttmmeenntt aanndd DDiissmmiissssaall ooff OOffffiicceerrss)) The chairman of the board of directors shall appoint and dismiss em- ployees pursuant to the articles of incorporation. AArrttiiccllee 2266 ((LLeeggaall FFiiccttiioonn ooff PPuubblliicc OOffffiicciiaall iinn AApppplliiccaattiioonn ooff PPeennaall PPrroovviissiioonnss))

The officers and the employees of the Corporation shall be considered to be public officials in applying the provisions of Articles 129 through 132 of the Criminal Act.Amended by Act No. 8034, Oct. 4, 2006 AArrttiiccllee 2277 ((RRuulleess,, eettcc..))

Rules relevant to the organization, human resource related affairs, remunerations, and accounting of the Corporation shall be determined with approval of the Minister of Health and Welfare after being passed through a resolution of the board of directors.

AArrttiiccllee 2288 ((SSeelleeccttiioonn aanndd AAppppooiinnttmmeenntt ooff AAggeenntt)) The chairman of the board of directors may select and appoint an agent from among the officers or employees of the Corporation in order to have the agent act for him in all judicial or extra-judicial acts relevant to the affairs of the Corporation.

ReproducedfromStatutesoftheRepublicofKorea

(3) The Corporation shall keep its accounting related with the health insurance program separately from other accounting. AArrttiiccllee 3344 ((BBuuddggeett))

The Corporation shall compile a proposed budget for each fiscal year by separating the contents thereof by their nature and obtain approval of the Minister of Health and Welfare. The same shall apply when the budget is being modified.

AArrttiiccllee 3355 ((LLooaannss))

The Corporation may borrow funds when there is a shortage of cash in making disbursements: Provided, That approval of the Minister of Health andWelfareisnecessaryforanylong-termloanwiththetermofatleastoneyear. AArrttiiccllee 3366 ((RReesseerrvvee FFuunndd))

(1) From the surplus funds at the settlement of accounts for each fiscal year, the Corporation shall accumulate as its reserve funds an amount equivalent to at least five hundredths of the expenses required for pay- ment of insurance benefits for that fiscal year until the funds reach fifty hundredths of the expenses required for that fiscal year. (2) The reserve funds referred to in paragraph (1) may not be used except to meet the shortage in the expenses required for payment of insurance benefitsorwhenthereisashortageofcashinmakingdisbursements;when the shortage of cash in making disbursements is met out of the reserve funds,theamountshallbemadeupforwithinthefiscalyearconcerned. (3) Matters necessary with regard to the method of managing or employing the reserve funds referred to in paragraph (1) shall be prescribed by the Ordinance of the Ministry of Health and Welfare.

1. Ten members representing the the employee insured;

2. Ten members representing the self employed insured; and

3. Ten members representing the public interest. (2) As the members referred to in paragraph (1), the Minister of Health and Welfare shall appoint or commission the following persons:

1. As the committee members referred to in paragraph (1) 1, persons recommended, five each, by the labor unions' organization and the employers' organization;

2. As the committee members referred to in paragraph (1) 2, persons recommended severally by the agricultural and fishery organization, the urban self-employed persons' organization and the citizens' organization as prescribed by the Presidential Decree; and

3. As the committee members referred to in paragraph (1) 3, relevant public officials and persons with extensive knowledge on and experience in healthinsurancewhoaredeterminedbythePresidentialDecree. (3) The term of the office of the members of the financial operation com- mittee shall be two years: Provided, That the term of the office of an officer who is a public official shall be the term of that office, and the term of the office of an officer who is filling a vacancy shall be the remaining term of his predecessor.

(4) Matters necessary with regard to the operation, etc. of the financial operation committee shall be prescribed by the Presidential Decree. AArrttiiccllee 3333 ((AAccccoouunnttiinngg))

(1) The fiscal year of the Corporation shall be based on the fiscal year of the Government.

(2) The Corporation shall administrate the financial affairs relevant to the the employee insured in coordination with those relevant to the self employed insured.

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 3399 ((MMeeddiiccaall CCaarree BBeenneeffiittss)) (1) Medical care benefits referred to in the following subparagraphs shall be provided for diseases, injuries, childbirths, etc. of the insured and their dependents:

1. Diagnosis, medical examinations;

2. Supply of medicine, materials for medical treatment;

3. Emergency aid, operation or other types of medical treatments;

4. Prevention, rehabilitation;

5. Hospitalization;

6. Nursing; and

7. Transfers. (2) Criteria for the medical care benefits referred to in paragraph (1) (hereinafter referred to as "medical care benefits"), such as the method, procedure, scope, and maximum limit of medical care benefits shall be prescribed by the Ordinance of the Ministry of Health and Welfare. (3) In prescribing the criteria for medical care benefits under the provisions of paragraph (2), the Minister of Health and Welfare may exclude the ailments that do not cause difficulties at work or in daily life and other items determined by the Ordinance of the Ministry of Health and Welfare from the medical care benefit eligible items.

AArrttiiccllee 4400 ((MMeeddiiccaall CCaarree IInnssttiittuuttiioonn)) (1) Medical care benefits (excluding nursing and transfers) shall be pro- vided by the medical care institutions referred to in the following subparagraphs. In this case, the Minister of Health and Welfare may exclude the medical facilities determined by the Presidential Decree, such CHAPTER INSURANCE BENEFITSAArrttiiccllee 3377 ((SSeettttlleemmeenntt ooff AAccccoouunnttss)) (1) The Corporation shall prepare a statement of accounts and a business report for each fiscal year and report to the Minister of Health and Welfare thereon by the end of February in the next year.

(2) When the Corporation reports to the Minister of Health and Welfare on it statement of accounts and business report under the provisions of paragraph (1), it shall publicly announce the contents thereof as pre- scribed by the Ordinance of the Ministry of Health and Welfare. AArrttiiccllee 3388 ((MMuuttaattiiss MMuuttaannddiiss AApppplliiccaattiioonn ooff CCiivviill AAcctt)) Unless otherwise prescribed by this Act, the provisions of the Civil Act that are relevant to an incorporated foundation shall apply mutatis mutandis in regard to the Corporation.

ReproducedfromStatutesoftheRepublicofKorea

therefor.Amended by Act No. 7144, Jan. 29, 2004

AArrttiiccllee 4411 ((PPaarrttiiaall RReessppoonnssiibbiilliittyy ffoorr EExxppeennsseess)) A person who receives medical care benefits referred to in Article 39 (1) shall be individually responsible for a part of their costs (hereinafter referred to as "individual co-payment") under the conditions as prescribed by the Presidential Decree.

AArrttiiccllee 4422 ((CCaallccuullaattiioonn,, eettcc.. ooff MMeeddiiccaall CCaarree BBeenneeffiitt CCoosstt)) (1) The costs of medical care benefits shall be determined by contract between the chairman of the board of directors of the Corporation and a person determined by the Presidential Decree who represents the med- ical and pharmaceutical communities. In such a case, the term of the contract shall be one year.Amended by Act No. 6093, Dec. 31, 1999 (2) If a contract is concluded under the provisions of paragraph (1), the contract shall be considered to be between the Corporation and each individual medical care institution.

(3) The contract referred to in paragraph (1) shall be concluded 75 days prior to the date on which its term expires and if no contract is concluded within that period, an amount determined by the Minister of Health and Welfare after going through a resolution thereon of the Deliberative Committee shall be the medical care benefit cost. In such a case the medical care benefit cost determined by the Minister of Health and Welfare shall be considered to be the medical care benefit cost de- termined by contract under the provisions of paragraphs (1) and (2). Amended by Act No. 8153, Dec. 30, 2006

(4) If the cost of a medical care benefit is being determined under the provisions of paragraph (1) or (3), the Minister of Health and Welfare shall give a notice oftheparticularsofthemedicalcarebenefitcost withoutanydelay. as those deemed to be unfit as medical care institutions for public interest or national policy reasons, from medical care institutions: Amended by Act No. 6981, Sep. 29, 2003

1. Medical facilities that are established under the provisions of the Med- ical Service Act;

2. Pharmacies that are registered under the provisions of the Pharma- ceutical Affairs Act;

3. The Korea Orphan Drug Center that is established under the provi- sions of Article 72-12 of the Pharmaceutical Affairs Act;

4. Public health clinics, public health and medical care centers, and branches of public health clinics referred to in the Regional Public Health Act; and

5. Public health clinics installed under the provisions of the Act on the Special Measures for Public Health and Medical Services in Agricul- tural and Fishing Villages, etc.

(2) If necessary for efficiently providing medical care benefits, the Minister of Health and Welfare may recognize the medical care institutions that meet the standards prescribed by the Ordinance of the Ministry of Health and Welfare, such as facilities, equipment, manpower, and areas of specialization, as specialized general medical care institutions or specialized medical care institutions under the conditions as prescribed by the Ordinance of the Ministry of Health and Welfare. (3) Medical care institutions that are recognized to be specialized general medical care institutions or specialized medical care institutions under the provisions of paragraph (2) may set the medical care benefit procedure referred to in Article 39 (2) and medical care benefit costs re- ferred to in Article 42 differently from other medical care institutions. (4) Medical care institutions referred to in paragraphs (1) and (2) may not refuse to provide medical care benefits unless there is a proper reason

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to the medical care institution and shall be paid to the insured concerned. (4) The Corporation may, for accounting, offset the amount to be paid to an insured under the provisions of paragraph (3) against the insurance premiums and other collections referred to in this Actwhich the insured concernedshouldpay(hereinafterreferredtoas"insurancepremiums,etc."). (5) In paying the cost of a medical care benefit, if the Health Insurance Review Board referred to in paragraph (2) evaluates the reasonableness of a medical care benefit as referred to in Article 56 and notifies it to the Corporation, the Corporation shall adjust the payment by increasing or reducing the cost of the medical care benefit in accordance with the results of the evaluation. In this case, matters relevant to the standards for increased or reduced payment of medical care benefit costs shall be prescribed by the Ordinance of the Ministry of Health and Welfare. (6) A medical care institution may get any organization falling under each of the following subparagraphs to vicariously claim for review referred to in the provisionsofparagraph(2):NewlyInsertedbyActNo.8153,Dec.30,2006

1. The association of doctors, the association of dentists, the associa- tion of Oriental doctors and the association of midwives provided for in the provisions of Article 26 (1) of the Medical Service Act or a branch office or a branch of each of those associations, which each makes a report pursuant to the provisions of paragraph (6) of the same Article;

2. The organization of medical institutions provided for in the provisions of Article 45-2 of the Medical Service Act; and

3. The association of pharmacists provided for in the provisions of Ar- ticle 11 of the Pharmaceutical Affairs Act and a branch office or a branch of the association, which makes a report pursuant to the pro- visions of Article 12-2 of the same Act.

(7) Medical supplies manufacturers, medical supplies wholesalers and other persons determined by the Ordinance of the Ministry of Health and (5) When the chairman of the board of directors of the Corporation enters into the contract referred to in paragraph (1), he shall put it up for deliberation and resolution of the Financial Operation Committee re- ferred to in Article 31.

(6) When the chairman of the board of directors of the Corporation requests for materials that are necessary in order to conclude the contract referred to in paragraph (1), the Health Insurance Review Board referred to in Article 55 shall sincerely comply therewith.

(7) Details of the contract referred to in paragraph (1) and other necessary matters shall be prescribed by the Presidential Decree.Amended by Act No. 6093, Dec. 31, 1999

AArrttiiccllee 4433 ((CCllaaiimm ffoorr aanndd PPaayymmeenntt ooff MMeeddiiccaall CCaarree BBeenneeffiitt CCoosstt)) (1) A medical care institution may claim the cost of a medical care benefit from the Corporation. In such a case a request for review referred to in paragraph (2) shall be considered to be a claim to the Corporation for the cost of a medical care benefit.

(2) A person who intends to claim the cost of a medical care benefit as referred to in paragraph (1) shall request the Health Insurance Review Board referred to in Article 55 for a review of the medical care benefit cost, and the Health Insurance Review Board which receives the request shall review the matter and notify the Corporation and the medical care institution the details of its review without any delay. (3) The Corporation which receives notification of the review details under the provisions of paragraph (2) shall pay the medical care benefit cost to the medical care institution in accordance with such details and without any delay. In such a case, if the individual co-payment already paid is in excess of the amount notified under the provisions of paragraph (2), the difference of the excess payment subtracted from the amount to be paid

ReproducedfromStatutesoftheRepublicofKorea

has excessively collected to the person who requested the confirmation (hereinafter referred to as the "excessively collected medical expenses"): Provided, That in the event that the relevant medical care institution fails to refund the excessively collected medical expenses, the Corporation may refund such excessively collected medical expenses to the person who requested for confirmation after deducting them from the medical care benefits it is liable to pay such medical care institution. [This Article Newly Inserted by Act No. 6799, Dec. 18, 2002] AArrttiiccllee 4444 ((MMeeddiiccaall CCaarree CCoosstt)) (1) When an insured or his dependent, because of emergency or other unavoidable circumstances determined by the Ordinance of the Ministry of Health and Welfare, receives medical care for disease, injury, child- birth, etc. at an institution that is determined by the Ordinance of the Ministry of Health and Welfare and performs functions similar to those of a medical care institution (including a medical care institution placed under a period of suspension of operation under the provisions of Article 85 (1)) or undergoes a childbirth at a place other than a medical care institution, the Corporation shall disburse an amount equivalent to the medical care benefit concerned to the insured or his dependent as the cost of the medical care as prescribed by the Ordinance of the Ministry of Health and Welfare.

(2) An institution that has provided medical care under the provisions of paragraph (1) shall issue to the person who received the medical care a detailed medical care statement or a receipt stating the particulars of the medical care as prescribed by the Ordinance of the Ministry of Health and Welfare, and the person who received the medical care shall submit this to the Corporation.

Welfare may establish a medical supplies logistics cooperative asso- ciation in order to improve the medical supplies distribution system and to provide storage, transportation, and other logistics services for medical supplies to medical care institutions. In this case, matters regarding the organization and operation of the medical supplies logistics cooperative association and guidance for and supervision of the said cooperative association shall be prescribed by the Presidential Decree by applying mutatis mutandis the provisions of the Small and Medium Enterprise Cooperatives Act that concern cooperatives and business cooperatives. Amended by Act No. 6799, Dec. 18, 2002; Act No. 8034, Oct. 4, 2006 (8) Matters necessary with regard to the method and procedure of the claim, review, and payment of the costs of medical care benefits referred to in paragraphs (1) through (6) shall be prescribed by the Ordinance of the Ministry of Health and Welfare.Amended by Act No. 6799, Dec. 18, 2002; Act No. 8153, Dec. 30, 2006

AArrttiiccllee 4433--22 ((CCoonnffiirrmmaattiioonn ooff EEnnttiittlleemmeenntt ttoo MMeeddiiccaall CCaarree BBeenneeffiittss)) (1) Any insured or any dependent may ask the Health Insurance Review Board established pursuant to Article 55 to confirm whether part of the medical expenses he has borne other than individual co-payment is excluded from his entitlement to medical care benefits in accordance with Article 39 (3). (2) The Health Insurance Review Board shall, upon receiving the request for confirmation under paragraph (1), notify the person who requested the confirmation of its confirmation. In this case, if part of the medical expenses for which the confirmation is requested is confirmed to be subject to the medical care benefits, the Health Insurance Review Board shall notify the Corporationandtherelevantmedicalcareinstitutionofsuchfacts. (3) The medical care institution shall, upon receiving the notice under the latter part of paragraph (2), shall refund without delay the amount that it

ReproducedfromStatutesoftheRepublicofKorea

medical care related instructions of the Corporation or the medical care institution;

3. When he has intentionally or through gross negligence refused to submit the documents referred to in Article 50 or other items or evaded questions or medical checkups; and

4. When he receives or is eligible to receive insurance benefits or compensations under other Acts and subordinate statutes due to a dis- ease,aninjuryoradisasterthatisrelatedtohisbusinessorinlineofduty. (2) When a person who is eligible to receive a medical care benefit has received from the State or a local government an amount equivalent to the medical care benefit or become eligible to receive an amount equiva- lent to the cost of the medical care benefit under the provisions of other Acts and subordinate statutes, the Corporation shall withhold the in- surance benefit up to the limit of the amount.

(3) The Corporation may withhold insurance benefits from a locally pro- vided the insured who has been delinquent in paying the per household insurance premium referred to in Article 62 (4) for at least the time period determined by the Presidential Decree until such a time as when the insurance premium is paid in full.Amended by Act No. 7144, Jan. 29, 2004; Act No. 8153, Dec. 30, 2006

(4) If there is a delinquency of payment of the insurance premium referred to in Article 68 (1), the Corporation shall apply the provisions of paragraph (3), only if there is a ground for putting the responsibility for the payment delinquency on the employee insured himself. In such a case, the provisions of paragraph (3) shall apply also to the dependents of the employee insured in question.

(5) Notwithstanding the provisions of paragraphs (3) and (4), where the approved insurance premium is provided not less than one time after obtaining approval for the installment payment from the Corporation AArrttiiccllee 4455 ((OOppttiioonnaall BBeenneeffiitt)) In addition to the medical care benefits prescribed in this Act, the Corporation may provide funeral costs, sickness allowances, and other ben- efits under the conditions as prescribed by the Presidential Decree. AArrttiiccllee 4466 ((SSppeecciiaall CCaassee ffoorr DDiissaabblleedd PPeerrssoonn)) (1) The Corporation may provide insurance benefits of supportive equip- ment for an insured who is a disabled person registered under the provisions of the Welfare of Disabled Persons Act and his dependents. Amended by Act No. 8034, Oct. 4, 2006

(2) The scope, method, and procedure of the insurance benefits for supportive equipment as referred to in paragraph (1) and other necessary matters shall beprescribedbytheOrdinanceoftheMinistryofHealthandWelfare. AArrttiiccllee 4477 ((HHeeaalltthh CChheecckkuupp)) (1) The Corporation shall provide health checkups for the insured and their dependents in order to facilitate early detection of diseases and subsequent medical care benefits.

(2) Candidates for, frequency of, and procedure of the health checkup referred to in paragraph (1) and other necessary matters shall be pre- scribed by the Presidential Decree.

AArrttiiccllee 4488 ((RReessttrriiccttiioonn ooff BBeenneeffiittss)) (1) When a person who is eligible to receive insurance benefits falls under one of the following subparagraphs, the Corporation shall not provide any insurance benefit:

1. When he has intentionally or through gross negligence caused a criminal conductorintentionallycontributedtotheoccurrenceofanaccident;

2. When he has intentionally or through gross negligence failed to follow

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 4499 ((SSuussppeennssiioonn ooff BBeenneeffiittss)) When a person who is eligible to receive insurance benefits falls under one of the following subparagraphs, no insurance benefit shall be provided during that period: Provided, That in the cases of subparagraphs 3 and 4, the medical care benefits under the provisions of Article 54-2 shall be provided: Amended by Act No. 7144, Jan. 29, 2004; Act No. 7590, Jul. 13, 2005

1. When he is travelling abroad;

2. When he is engaged in business operations abroad;

3. When he comes to fall under Article 6 (2) 2; and

4. When he is committed to a correctional institution or other equivalent facilities.

AArrttiiccllee 5500 ((VVeerriiffiiccaattiioonn ooff BBeenneeffiittss)) When it is determined to be necessary in providing insurance benefits, the Corporation may demand that a person who receives insurance benefits submit documents and other items or be subject to questioning or diagnosis by relevant personnel.

AArrttiiccllee 5511 ((DDiissbbuurrsseemmeenntt ooff MMeeddiiccaall CCaarree CCoossttss,, eettcc..)) When there is a claim for disbursement of medical care costs or for optional benefits which the Corporation has an obligation to provide under this Act, the Corporation shall pay or provide them without any delay. AArrttiiccllee 5522 ((CCoolllleeccttiioonn ooff UUnnjjuusstt EEnnrriicchhmmeenntt)) (1) The Corporation shall collect all or part of the amount equivalent to the insurance benefits or the insurance benefit costs from a person who has received insurance benefits or a medical care institution that has received insurance benefit costs by deceit or other improper methods.Amended by Act No. 6799, Dec. 18, 2002

pursuant to the provisions of Article 70-2, the insurance benefits may be paid: Provided, That the same shall not apply to a case where anyone who has obtained approval for the installment payment provided for in the provisions of Article 70-2 fails to pay the approved insurance pre- mium not less than two times without any justifiable grounds therefor. Newly Inserted by Act No. 8153, Dec. 30, 2006

(6) With respect to insurance benefits that are provided in the period during which such insurance benefits are not provided pursuant to the provisions of paragraphs (3) and (4) (hereafter referred to as the "ben- efit restriction period" in this paragraph), the insurance benefits shall be recognized only in the case falling under any of the following subpar- agraphs:Newly Inserted by Act No. 8153, Dec. 30, 2006

1. Where the insurance premium in arrears is fully paid within the deadline for its payment in the month to which the date on which two months lapse from the date on which the Corporation serves a notice that insurance benefits are received during the benefit restriction period belongs; and

2. Where the insurance premium that is approved pursuant to the provisions of Article 70-2 is paid not less than once within the deadline for its payment in the month to which the date on which two months lapse from the date on which the Corporation serves a notice that insurance benefits are paid during the benefit restriction period be- longs: Provided, That where anyone who has obtained approval for the installment payment pursuant to the provisions of Article 70-2 fails to pay the approved insurance premium not less than two times without any justifiable grounds therefor, his insurance benefits shall not be recognized.

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 5544 ((PPrrootteeccttiioonn ooff RRiigghhtt ttoo BBeenneeffiittss)) Therighttoreceiveinsurancebenefitsshallbeunalienableandunseizable. AArrttiiccllee 5544--22 ((PPrroovviissiioonn ooff MMeeddiiccaall CCaarree BBeenneeffiittss ttoo SSoollddiieerrss eettcc.. iinn AAccttiivvee SSeerrvviiccee))

(1) Where any person who falls under subparagraphs 3 and 4 of Article 49 has received a medical care, etc. prescribed by the Presidential Decree (hereafter in this Article, referred to as the "medical care benefit") at the medical care institution, the Corporation may pay the expenses necessary therefor (hereafter in this Article, referred to as the "medical care benefit expenses") which are to be borne by it, after receiving a deposition from the Minister of Justice, Minister of National Defense, Administrator of the National Emergency Management Agency, Commissioner of the National Police Agency or Commissioner of the National Maritime Police Agency. In this case, the Minister of Justice, Minister of National Defense, Administrator of the National Emergency Management Agency, Commissioner of the National Police Agency or Commissioner of the National Maritime Police Agency shall, under the conditions as prescribed by the Presidential Decree, deposit in advance the medical care benefit expenses which are expected to be annually required, except for the inevitable cases in their budgets.Amended by Act No. 7590, Jul. 13, 2005 (2) Provisions of Articles 39 through 43, 43-2, 50 and 51 shall apply mutatis mutandis to the matters concerning the medical care benefits and medical care benefit expenses.

[This Article Newly Inserted by Act No. 7144, Jan. 29, 2004] (2) In such a case as one referred to paragraph (1), when insurance benefits have been provided because of false reports or testimonies of the employer or the insured or because of false diagnosis by a medical care institution, the Corporation may require payment of the collection referred to in the same paragraph from such person/entity jointly with the person who received the insurance benefits.

(3) In such a case as one referred to paragraph (1), the Corporation may require payment of the collection referred to in the same paragraph from an insured who belongs to the same household as the person who received insurance benefits by deceit or other improper methods (referring to the employee insured if the person who received the insurance benefits by deceit or other improper methods is a dependent) jointly with the person who received the insurancebenefitsbydeceitorotherimpropermethods.

(4) In such a case as one referred to in paragraph (1), when a medical care institution has received the cost of a medical care benefit from the insured or his dependent by deceit or other improper methods, the Corporation shall collect the amount from the medical care institution concerned and disburse it to the insured or his dependent without any delay. AArrttiiccllee 5533 ((RRiigghhtt ttoo IInnddeemmnniittyy)) (1) When the Corporation has provided an insurance benefit to the insured because the grounds for the insurance benefit have arisen through the act of a third party, the Corporation shall have the right to claim for compensation against the third party up to the amount of the expenses required for the benefit concerned.

(2) In such a case as one referred to in paragraph (1), when the person who receives the insurance benefit has already received compensation for the loss from the third party, the Corporation shall withhold the insurance benefit up to the amount of the compensation.

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 5577 ((LLeeggaall PPeerrssoonnaalliittyy,, eettcc..)) (1) The Review Board shall be a juristic person.

(2) The Review Board shall come into existence with the registration of its establishment at the seat of its principal office. AArrttiiccllee 5588 ((OOffffiicceerrss))

(1) The Review Board shall have as its officers the director, sixteen trustees and one auditor.

(2) The director and the auditor shall be appointed or dismissed by the Minister of Health and Welfare.Amended by Act No. 7144, Jan. 29, 2004 (3) As trustees, five persons recommended by a medicine related organization, three persons recommended by the Corporation, three persons recommended by the director of the Review Board, four persons recom- mended, one each, by the labor unions' group, the employers' organization, the agricultural and fishing organization, and the consumer organization, and one person from among the relevant public officials determined by the PresidentialDecreeshallbeappointedordismissedbytheMinisterofHealth andWelfare.AmendedbyActNo.7144,Jan.29,2004

(4) Posts of the director, three of the trustees and the auditor shall be permanent: Provided, That the non-permanent officers may receive re- imbursements for actual expenses under the conditions as prescribed by the articles of incorporation.Amended by Act No. 7590, Jul. 13, 2005 (5) The term of office of the officers shall be three years: Provided, That the term of office of an officer who is a public official shall be the term of his office.Amended by Act No. 7144, Jan. 29, 2004

AArrttiiccllee 5599 ((MMeeddiiccaall TTrreeaattmmeenntt RReevviieeww CCoommmmiitttteeee)) (1) In order to efficiently conduct the operations of the Review Board, a medical treatment review committee (hereinafter referred to as the "re- AArrttiiccllee 5555 ((EEssttaabblliisshhmmeenntt)) In order to review the costs of medical care benefits and evaluate the reasonableness of medical care benefits, the Health Insurance Review Board (hereinafter referred to as the "Review Board") shall be established. AArrttiiccllee 5566 ((OOppeerraattiioonnss,, eettcc..)) (1) The Review Board shall be in charge of the operations referred to in the following subparagraphs:

1. Review of the costs of medical care benefits;

2. Evaluation of the reasonableness of medical care benefits;

3. Development of the criteria for review and evaluation;

4. Investigative research and international cooperation related with the operations referred to in subparagraphs 1 through 3;

5. Operations delegated to it in connection with review of the costs of benefits or evaluation of the reasonableness of medical care that are provided under the provisions of other Acts;

6. Operations determined by the Minister of Health and Welfare to be necessary in connection with the health insurance program; and

7. Other operations prescribed by the Presidential Decree in connection with review of the costs of insurance benefits and evaluation of the reasonableness of insurance benefits.

(2) The criteria, procedures, and methods relevant to the evaluation of the reasonableness of medical care benefits as referred to in paragraph (1) 2, 5, and 7, and other necessary matters shall be prescribed by the Or- dinance of the Ministry of Health and Welfare.

CHAPTER HEALTH INSURANCE

REVIEW BOARD

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 6622 ((IInnssuurraannccee PPrreemmiiuumm)) (1) In order to meet the expenses required for the health insurance pro- gram, the Corporation shall collect insurance premiums from the persons obligated to pay insurance premium referred to in Article 68. (2) The insurance premium referred to in paragraph (1) shall be collected from the month next to the month whereto belongs the day on which the eligibility of an insured has been obtained until the month which in- cludes the day before the day on which the insured loses his eligibility: Provided, That where the eligibility of the insured has been obtained on the first day of each month, it shall be collected from the relevant month. Amended by Act No. 8034, Oct. 4, 2006

(3) In collecting the insurance premium under the provisions of paragraphs (1) and (2), where the eligibility of an insured has been altered, the insurance premium of the month whereto belongs the altered day shall be collected on the basis of eligibility prior to such alteration: Provided, That where the eligibility of the insured has been altered on the first day of each month, it shall be collected on the basis of altered eligibility. Newly Inserted by Act No. 8034, Oct. 4, 2006

(4) The amount of the insurance premium per month for the employee insured shall be the product of the monthly wage amount calculated under the provisions of Article 63 multiplied by the insurance premium rate referred to in Article 65 (1) or (2).Amended by Act No. 8153, Dec. 30, 2006 (5) The amount of insurance premium per month forthe self employed insured shall be calculated for per unit of household, but the insurance premium per month for the household to which a locally provided the insured belongs shall be the amount obtained by multiplying the CHAPTER INSURANCE PREMIUMview committee") shall be established under the Review Board. (2) The review committee shall be composed of no more than thirty full- time review members, including the chairman of the committee, and no more than six hundred part-time review members, and it may have a subcommittee for each area of medical specializations. (3) Matters necessary for the qualification and the term of office of the members of the review committee and the operation of the committee, etc. shall be prescribed by the Ordinance of the Ministry of Health and Welfare. AArrttiiccllee 6600 ((RRaaiissiinngg,, eettcc.. ooff FFuunnddss)) (1) The Review Board may collect a special assessment from the Corpo- ration in order to conduct the operations referred to in Article 56 (1) (excluding the operations referred to in subparagraph 5 of the same paragraph of the same Article).

(2) When operations related with review of the costs of benefits or evalua- tion of the reasonableness of medical care are delegated to the Review Board under the provisions of Article 56 (1) 5, the Review Board may receive a fee from the delegator.

(3) The amount and collection method of the special assessment and fee referred to in paragraphs (1) and (2) and other necessary matters shall be prescribed by the Ordinance of the Ministry of Health and Welfare. AArrttiiccllee 6611 ((PPrroovviissiioonnss AApppplliieedd MMuuttaattiiss MMuuttaannddiiss)) Provisions of Articles 13 (4), 15, 16 (excluding paragraph (1) 6 and 7), 17, 18, 20 through 22, 23, 24 through 30, 33 (1), 34, 35, 37 and 38 shall apply mutatis mutandis in regard to the Review Board. In such cases, the "Corporation" and "chairman of the board of directors," shall be considered the "Review Board" and "director," respectively.Amended by Act No. 7144, Jan. 29, 2004; Act No. 7590, Jul. 13, 2005

ReproducedfromStatutesoftheRepublicofKorea

circumstances shall be calculated on the basis of the monthly remuner- ation amount for the month before the occurrence of the circumstance in question.Amended by Act No. 8153, Dec. 30, 2006

(3) Remunerations referred to in paragraph (1) shall mean money and other valuables (excluding anything of expense compensatory nature) that workers, public officials and school employees receive from employers, the State or local governments for providing their labor, which are determined by the Presidential Decree. In this case, if it falls under the cases prescribed by the Presidential Decree, such as there are no data relating to the remunerations or they are indistinct, the amount determined and publicly notified by the Minister of Health and Welfare shall be regarded as the remunerations.AmendedbyActNo.6320,Dec.29,2000

(4) Matters necessary with regard to the calculation of the monthly re- muneration amount referred to in paragraph (1) and the calculation of the monthly remuneration amount for the employers who are not remu- nerated shall be prescribed by the Presidential Decree.Amended by Act No. 8153, Dec. 30, 2006

AArrttiiccllee 6644 ((CCoonnttrriibbuuttiioonn PPooiinntt)) (1) The contribution point provided for in the provisions of Article 62 (5) shall be set taking into account the income, the property, the living standard and the participation rate of economic activities, etc. of each of the self employed insured and the upper limit and the lowest limit thereof may be set according to the standards that are set by the Presidential Decree. Amended by Act No. 8153, Dec. 30, 2006

(2) In determining the method and criteria for calculating the contribution point under the provisions of paragraph (1), assets for which excercise of property rights is restricted under the provisions of other Acts and subordinate statutes may be treated differently from other assets. monetary value per contribution point under the provisions of Article 65 (3) by the contribution point calculated under the provisions of Article 64. Amended by Act No. 6093, Dec. 31, 1999; Act No. 8153, Dec. 30, 2006 (6) If an insured falls under one of the following subparagraphs, insurance premium for the insured or the household to which the insured belongs may be reduced partly in accordance with the ar- ticles of incorporation of the Corporation:Amended by Act No. 8034, Oct. 4, 2006

1. Persons who reside in the areas prescribed by the Presidential De- cree, such as islands, remote places, agricultural and fishing villages, etc.: Provided, That the persons residing in agricultural and fishing villages shall be limited to the persons prescribed by the Ordinance of the Ministry of Health and Welfare, such as persons who are engaged in agricultural or fishing activities;

2. Persons who are at least sixty five years of age;

3. Disabled persons who are registered under the provisions of the Wel- fare of Disabled Persons Act; and

4. Persons of distinguished services to the State who are determined in Article 4 (1) 4, 6, 10, 12, or 14 of the Act on the Honorable Treatment and Support of Persons, etc. of Distinguished Services to the State. (6) Deleted.byActNo.8153,Dec.30,2006EnforcementDate:Jul.1,2007 AArrttiiccllee 6633 ((MMoonntthhllyy RReemmuunneerraattiioonn AAmmoouunntt)) (1) The monthly remuneration amount provided for in the provisions of Article 62 (4) shall be calculated on the basis of the remuneration amount that is paid to each of the employee insured and the upper limit and the lowest limit thereof may be set according to the standards that are set by the Presidential Decree.Amended by Act No. 8153, Dec. 30, 2006 (2) Insurance premium for an insured to whom a part or all of his remuneration is not paid due to temporary retirement from office or other

ReproducedfromStatutesoftheRepublicofKorea

2. When it is clearly recognized that he is enrolled in any level of school of below college level or otherwise not engaged in any income pro- ducing activity; and

3. When he meets the criteria prescribed by the Ordinance of the Ministry of Health and Welfare, which are comparable to subparagraphs 1 and 2. (3) For the exemption of insurance premium under the provisions of paragraph (1) or the income to be exempted from the computation of insurance premium under the provisions of paragraph (2) 1, it shall ap- ply from the month next to the month whereto belongs the day on which the reasons for allowance suspension falling under any of subparagraphs 2 through 4 of Article 49 have occurred to the month whereto belongs the day on which the reasons have been settled: Provided, That where the reasons for allowance suspension have been solved on the first day of each month, the insurance premium of relevant month shall not be exempted, or the income shall not be exempted from the computation of insurance premiums.Newly Inserted by Act No. 8034, Oct. 4, 2006 AArrttiiccllee 6666--22 ((RReedduuccttiioonn ooff IInnssuurraannccee PPrreemmiiuummss)) (1) With respect to the insured prescribed by the Ordinance of the Ministry of Health and Welfare from among the insured falling under any of the following subparagraphs, part of the insurance premiums of the insured or the households to which the insured belong may be reduced:

1. Persons who reside on islands, in remote areas and agricultural and fishery communities, etc. that are prescribed by the Presidential Decree;

2. Persons who are at least 65 years old;

3. Disabled persons who are registered pursuant to the Welfare of Dis- abled Persons Act;

4. Persons who have rendered distinguished services for the State provided for in the provisions of Article 4 (1) 4, 6, 10, 12 or 14 of the Act on the Honorable Amended by Act No. 8153, Dec. 30, 2006

(3) Ways and standards for calculating the contribution point and other necessary matters shall be prescribed by the Presidential Decree.Newly Inserted by Act No. 8153, Dec. 30, 2006

[This Article Wholly Amended by Act No. 6093, Dec. 31, 1999] AArrttiiccllee 6655 ((IInnssuurraannccee PPrreemmiiuumm RRaattee,, eettcc..)) (1) Insurance premium rate of the employee insured shall be determined by the Presidential Decree, within the limit of eighty thousandths after going through a resolution of the Deliberative Committee.Amended by Act No. 8153, Dec. 30, 2006

(2) Insurance premium rate of the employee insured who is engaged outside of Korea for business operations shall be fifty hundredths of the insurance premium rate determined under the provisions of paragraph (1). (3) The monetary value per contribution point of each of the locally pro- vided the insured shall be determined by the Presidential Decree after going through the deliberation of the Deliberative Committee.Newly In- serted by Act No. 8153, Dec. 30, 2006

AArrttiiccllee 6666 ((EExxeemmppttiioonn ffrroomm IInnssuurraannccee PPrreemmiiuumm)) (1) When the employee insured falls under one of subparagraphs 2 through 4 of Article 49, the Corporation shall exempt the insured concerned from his insurance premium: Provided, That when the employee insured falls under subparagraph 2 of Article 49, this shall apply only if he does not have any dependent who resides within Korea.

(2) Whenthe self employed insured falls under one of the following subparagraphs, income of that the insured shall be excluded from calculation oftheinsurancepremiumforthehouseholdtowhichthattheinsuredbelongs:

1. When he falls under one of subparagraphs 2 through 4 of Article 49;

ReproducedfromStatutesoftheRepublicofKorea

(3) Deleted.by Act No. 8153, Dec. 30, 2006

AArrttiiccllee 6688 ((RReessppoonnssiibbiilliittyy ffoorr PPaayymmeenntt ooff IInnssuurraannccee PPrreemmiiuumm)) (1) Insurance premium of the employee insured shall be paid by his employer. (2) Insurance premium of the self-employed insured shall be paid jointly by all the self-employed insured who belong to the same household as the said the insured. In such cases, notice or demand to one the insured shall be considered to be effective against all the self-employed insured who belong to the said household.

(3) An employer shall pay the portion of the insurance premium for the month to be borne by the employee insured by deducting it from his remunerations. In such cases, the employer shall notify the amount of deduction to the employment provided the insured. AArrttiiccllee 6699 ((DDeeaaddlliinnee ffoorr PPaayymmeenntt ooff IInnssuurraannccee PPrreemmiiuumm)) A person who has responsibility for payment of insurance premium under the provisions of Article 68 (1) and (2) shall pay the insured's insurance premium for theapplicablemonthbythetenthdayofthenextmonth:Provided,Thatinsurance premiums of the self-employed insured may be paid quarterly pursuant to the provisionsoftheOrdinanceoftheMinistryofHealthandWelfare. AArrttiiccllee 7700 ((DDeemmaanndd ffoorr IInnssuurraannccee PPrreemmiiuumm,, eettcc.. aanndd DDiissppoossiittiioonn oonn DDeeffaauulltt)) (1) When a person who has responsibility for payment of insurance pre- mium as referred to in Article 68 fails to pay the insurance premium, etc. the Corporation may determine a time period and demand payment. (2) a demand is being made under the provisions of paragraph (1), a payment period of at least ten days but no more than fifteen days shall be determined and a letter of demand issued.

(3) When a person who receives the demand referred to in paragraph (1) fails TreatmentandSupportofPersons,etc.ofDistinguishedServicestotheState;

5. Persons on leaves of absence; and

6. Other persons who are published by the Minister of Health and Wel- fare as the persons whose insurance premiums need to be reduced on the grounds of their difficult lives and natural disaster, etc. (2) Ways and procedures for reducing the insurance premiums referred to in the provisions of paragraph (1) and other necessary matters shall be determined and published by the Minister of Health and Welfare. [This Article Newly Inserted by Act No. 8153, Dec. 30, 2006] Enforcement Date: Jul. 1, 2007

AArrttiiccllee 6677 ((BBuurrddeenn ooff IInnssuurraannccee PPrreemmiiuumm)) (1) The insurance premium for the employee insured shall be borne, fifty hundredths each, by the employee insured and the person referred to in the following classifications: Provided, That if the employee insured is a school employee, fifty hundredths, thirty hundredths, and twenty hundredths of the amount of the insurance premium shall be borne by the said employment provided the insured, the person prescribed in subparagraph 2 (c) of Article 3, and the State, respectively, but if the person prescribed in subparagraph 2 (c) of Article 3 cannot bear the whole of his burden, the deficient amount may be borne by the accounts of a school:Amended by Act No. 6799, Dec. 18, 2002

1. If the employee insured is a worker, then the person prescribed in subparagraph 2 (a) of Article 3; and

2. If the employee insured is a public official, then the State or the local government to which that public official belongs. (2) The insurance premium for the self employed insured shall be borne jointly by all the self-employed insured who belong to the same household as the said the insured.

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fiable grounds thereof, the Corporation shall revoke its approval to pay his insurance premium in installment.

(3) Necessary matters concerning procedures, ways and standards, etc. for the approvalandtherevokeofapprovaltopaytheinsurancepremiumininstallment shallbeprescribedbytheOrdinanceoftheMinistryofHealthandWelfare. [This Article Newly Inserted by Act No. 8153, Dec. 30, 2006] AArrttiiccllee 7711 ((AAddddiittiioonnaall CChhaarrggee)) (1) When a person who has a responsibility to pay an insurance premium, etc. fails to make the payment by the payment deadline, the Corporation shall collect an additional charge equivalent to five hundredths of the insurance premium,etc.inarrearssincethedateofexpirationofthepaymentperiod. (2) When a person who has a responsibility to pay an insurance premium, etc. fails to make payment of the insurance premium, etc. in arrears within three months after the expiration of the payment period, the Corporation shall add another additional charge equivalent to five hundredths of the insurance premium, etc. in arrears since expiration of the three months to the additional charge referred to in paragraph (1) and collect both. (3) When a person who has a responsibility to pay an insurance premium, etc. fails to make payment of the insurance premium, etc. in arrears within six months after the expiration of the payment period, the Corporation shall add another additional charge equivalent to five hundredths of the insurance premium, etc. in arrears since expiration of the six months to the additional chargesreferredtoinparagraphs(1)and(2)andcollectallofthem. (4) If there has been a force majeure or another unavoidable circumstance determined by the Ordinance of the Ministry of Health and Welfare, collection of the additional charges referred to paragraphs (1) through (3) may be forgone,notwithstandingtheprovisionsofparagraphs(1)through(3). to pay the insurance premium, etc. by the deadline for payment, the Corporation may collect it in accordance with the examples of dis- position of the national tax in arrears, after obtaining approval of the Minister of Health and Welfare.

(4) When the Corporation determines that an asset that is seized in accordance with the example of disposition on the national tax in arrears as referred to in paragraph (3) is not appropriate to be auctioned off di- rectly by it because expert knowledge is necessary for the auction or because of other special circumstances, the Corporation may have the Korea Asset Management Corporation established under the Act on the Efficient Disposal of Non-Performing Assets, etc. of Financial Institutions and the Establishment of Korea Asset Management Corporation (herein- after referred to as the "Korea Asset Management Corporation") conduct the auction for the Corporation, and in this case the auction shall be con- sidered to have been conducted by the Corporation.Amended by Act No. 6073, Dec. 31, 1999; Act No. 8034, Oct. 4, 2006 (5) If the Korea Asset Management Corporation conducts an auction for the Corporation under the provisions of paragraph (4), the Corporation may pay a fee pursuant to the provisions of the Ordinance of the Ministry of Health and Welfare.Amended by Act No. 6073, Dec. 31, 1999 AArrttiiccllee 7700--22 ((IInnssttaallllmmeenntt PPaayymmeennttss ooff IInnssuurraannccee PPrreemmiiuummss iinn AArrrreeaarrss)) (1) With respect to anyone who has defaulted in his insurance premium not less than three times, the Corporation may approve him to pay his insurance premium in installment under the conditions as prescribed by the Ordinance of the Ministry of Health and Welfare. (2) When anyone who is approved to pay his insurance premium in installment pursuant to the provisions of paragraph (1) fails to pay the approved insurance premium not less than two times without any justi-

ReproducedfromStatutesoftheRepublicofKorea

1. Category of the insurance premium, etc. to be collected;

2. Amount to be paid; and

3. Deadline for and place of payment. (2) In making a payment notice under the provisions of paragraph (1), the Corporationmaymakeanoticebyanelectronicdocumentundertheexchange mode, etc. of electronic documents where the person who has a responsibility topayhasapplied.NewlyInsertedbyActNo.8034,Oct.4, 2006 (3) Where the Corporation has made a notice by electronic documents under the provisions of paragraph (2), it shall be deemed to have arrived to the person who has a responsibility to pay when it has been stored to the information and communication networks provided by the Ordinance of the Ministry of Health and Welfare, or inputted in the electronic mail address designated by the person who has a responsibility to pay. Newly Inserted by Act No. 8034, Oct. 4, 2006

(4) The application method for the electronic document notice under the provisions of paragraph (2), procedures therefor, and other necessary matters shall be provided by the Ordinance of the Ministry of Health and Welfare.Newly Inserted by Act No. 8034, Oct. 4, 2006 AArrttiiccllee 7755 ((AApppprroopprriiaattiioonn ffoorr aanndd RReettuurrnn ooff IInnssuurraannccee PPrreemmiiuumm,, eettcc..)) (1) When a part of the amount paid as insurance premium, additional charge or default disposition charge by a person who has a responsibility to pay is paid in mistake, the Corporation shall immediately determine the excess payment or the mistaken payment to be an insurance premium refund. (2) The insurance premium refund referred to in paragraph (1) shall be appropriated for any insurance premium, etc. yet to be paid or default disposition charges, and any balance remaining after the appropriation shall be disbursed to the payer within thirty days after the date of the determination referred to in paragraph (1).

AArrttiiccllee 7722 ((DDiissppoossiittiioonn aass LLoossss)) (1) When there is a circumstance that falls under one of the following subparagraphs, the Corporation may dispose of insurance premiums, etc. as loss after obtaining a resolution of the financial operation committee:

1. A case where the disposition on default is concluded and the portion to be appropriated for the amount in arrears is insufficient for meeting the amount in arrears;

2. A case where the extinctive prescription for the claim concerned has run out; and

3. A case determined by the Presidential Decree where the possibility of collection is recognized not to exist.

(2) When the Corporation discovers the existence of other seizable assets after the disposition on loss under the provisions of paragraph (1) 3, it shall immediately cancel the disposition and effect a default disposition. AArrttiiccllee 7733 ((PPrreecceeddeennccee ooff CCoolllleeccttiioonn ooff IInnssuurraannccee PPrreemmiiuumm,, eettcc..)) Insurance premium, etc. shall be collected before other claims except for national taxes and local taxes: Provided, That this shall not apply to the claims that are secured by a lease on a deposit basis, the right of pledge or a mortgage if the insurance premium is assessed against the proceeds from the sale of an asset for which the fact of establishment of a lease on a deposit basis, the right of pledge or a mortgage having been registered prior to the payment period for the insurance premium, etc. is proved. AArrttiiccllee 7744 ((NNoottiiccee ttoo PPaayy IInnssuurraannccee PPrreemmiiuumm,, eettcc..)) (1) When the Corporation intends to collect an insurance premium, etc., it shall determine the amount thereof and give to the person who has a responsibility to pay a notice to pay by a writing that states the details referred to in the following subparagraphs:

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twenty members who are appointed or commissioned by the Minister of Health and Welfare from among persons with extensive knowledge on and experience in the health-insurance-related legal or medical fields. (4) Matters necessary with regard to the decision on a request for review, notice of the decision, and organization and operation of the Dispute Mediation Committee shall be prescribed by the Presidential Decree. AArrttiiccllee 7788 ((AAddmmiinniissttrraattiivvee LLiittiiggaattiioonn)) A person who has an objection to a decision of the Corporation or the Review Board or a person who protests against the decision on a formal objection referred to in Article 76 or a request for review referred to in Article 77 may institute an administrative litigation pursuant to the provisions of the Administrative Litigation Act.Amended by Act No. 8034, Oct. 4, 2006 AArrttiiccllee 7766 ((AApppplliiccaattiioonn ooff OObbjjeeccttiioonn)) (1) A person who has an objection to the decisions of the Corporation on the qualification, insurance premium, etc., insurance benefits, and insurance benefit costs for an insured or his dependent may formally raise the objection to the Corporation.

(2) The Corporation, a medical care institution, or other entity that has an objection to the decisions of the Review Board on evaluation, etc. of the reasonableness of the medical care benefit costs and medical care benefits may formally raise the objection to the Review Board. (3) The formal objections referred to in paragraphs (1) and (2) shall be made in writing within ninety days after the date of the decision: Provided, That this shall not apply when an explanation is made that the formal objection could not be raised due to a legitimate reason. (4) Matters necessary with regard to the decision on a formal objection, notice of the decision, etc. shall be prescribed by the Presidential Decree. AArrttiiccllee 7777 ((RReeqquueesstt ffoorr RReevviieeww)) (1) A person who protests against the decision on a formal objection referred to in Article 76 may request the Health Insurance Dispute Me- diation Committee (hereinafter referred to as the "Dispute Mediation Committee") for a review. In such a case, provisions of Article 76 (3) shall apply mutatis mutandis with regard to the request for review. (2) The Dispute Mediation Committee shall be under the command of the Minister of Health and Welfare.

(3) The Dispute Mediation Committee shall be composed of no more than CHAPTER FORMAL OBJECTION

AND REQUEST FOR REVIEW, ETC.

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fall under any subparagraph of Article 6 (2) may not prevent those employed workers from becoming the employee insured as referred to in this Act or take a measure that is injurious to the workers, such as denial of a worker's promotion or wage increase or the dismissal of a worker, for the purpose of evading an increase of the employer's share to be borne by the employer in question and without any reasona- ble ground therefor.Amended by Act No. 7144, Jan. 29, 2004

AArrttiiccllee 8822 ((RReeppoorrttiinngg,, eettcc..)) (1) The Corporation may require an employer or the head of a household to report an insured's change of residence, remunerations, income, and other matters necessary for the health insurance program or to submit relevant documents.

(2) When the Corporation recognizes a necessity for factual verification of the materials that are reported or submitted under the provisions of paragraph (1), the Corporation may require the employees under its charge to investigate the matters in question.

(3) In a case of paragraph (2), the Corporation employees shall be in possession of certificates that indicate their authority and show them to relevant persons.

AArrttiiccllee 8822--22 ((FFoorrwwaarrddiinngg,, eettcc.. ooff IInnccoommee RReedduuccttiioonn,, OOmmiissssiioonn DDaattaa)) (1) Where the Corporation recognizes that there exists reduction or omission in the remuneration or income, etc. reported under the provisions of Article 82 (1), it may forward in writing the matters on income reduction or omission to the Commissioner of the National Tax Service through the Minister of Health and Welfare.

(2) Where the Commissioner of the National Tax Service conducts any tax investigation under the provisions of related Acts, such as the Frame- AArrttiiccllee 7799 ((PPrreessccrriippttiioonn))

(1) The rights referred to in the following subparagraphs shall be barred by prescription if not exercised for three years:

1. The right to collect an insurance premium (including additional charge on an insurance premium) or to receive an insurance premium refund;

2. The right to receive an insurance benefit;

3. The right to receive the cost of an insurance benefit; and

4. The right to receive a refund of excess individual co-payment under the provisions of Article 43 (3).

(2) The prescription referred to in paragraph (1) shall be interrupted by the occurrence of one of the events referred to in the following subparagraphs:

1. Notice of or demand for insurance premium; and

2. Claim for insurance benefit or insurance benefit cost. (3) Except for the matters prescribed in this Act, the extinctive prescription and interruption of prescription referred to in paragraphs (1) and (2) shall be in accordance with the provisions of the Civil Act.Amended by Act No. 8034, Oct. 4, 2006

AArrttiiccllee 8800 ((CCaallccuullaattiioonn ooff TTiimmee PPeerriioodd)) Except as otherwise provided by this Act, the provisions of the Civil Act that are relevant to time periods shall apply mutatis mutandis to calculation of the time periods prescribed by this Act or by the orders referred to in this Act. Amended by Act No. 8034, Oct. 4, 2006

AArrttiiccllee 8811 ((PPrrootteeccttiioonn ooff RRiigghhttss aanndd IInntteerreessttss ooff WWoorrkkeerrss)) An employer who employs the workers of all business places which do not CHAPTER SUPPLEMENTARY PROVISIONS

ReproducedfromStatutesoftheRepublicofKorea

officials under his charge to question relevant persons or inspect relevant documents.

(2) The Minister of Health and Welfare may require a medical care institution (including any medical care institution that has provided medical care under the provisions of Article 44) to report on the matters relevant to insurance benefits, such as the provision of a medical care and medicine, or submit relevant documents or require public officials under his charge to question the relevant personnel or inspect the relevant documents. (3) The Minister of Health and Welfare may require a person who has received an insurance benefit to report on the details of the insurance benefit concernedorrequirepublicofficialsunderhischargetoquestiontheperson. (4) TheMinisterofHealthandWelfaremayorderanorganizationthatisassigned to vicariously file claims for examining medical care benefit cost pursuant to the provisions of Article 43 (6) (hereinafter referred to as the "vicarious claim organization") to submit necessary material and require public officials under his charge to check and confirm the material, etc. pertaining to the vicarious claims.NewlyInsertedbyActNo.8153,Dec.30,2006

(5) In cases of paragraphs (1) through (4), the public officials under the Ministry of Health and Welfare shall be in possession of certificates that show their authority and show them to relevant persons.Amended by Act No. 8153, Dec. 30, 2006

AArrttiiccllee 8855 ((PPeennaallttyy SSuurrcchhaarrggee,, eettcc..)) (1) When a medical care institution falls under one of the following subparagraphs, the Minister of Health and Welfare may determine a time period within the limit of one year and order the medical care institution to suspend its operation:

1. Whenitplacestheburdenofthecostofamedicalcarebenefitontheinsurer, aninsured,oradependentbydeceitorotherillegitimatemethods;and work Act on National Taxes, on the matters forwarded under the pro- visions of paragraph (1), he shall forward the matters on the remunera- tion or income from among the results of relevant investigation to the Corporation.Amended by Act No. 8034, Oct. 4, 2006 (3) Forwarding procedures under the provisions of paragraphs (1) and (2) and other necessary matters shall be prescribed by the Presidential Decree. [This Article Newly Inserted by Act No. 7377, Jan. 27, 2005] AArrttiiccllee 8833 ((FFuurrnniisshhiinngg ooff MMaatteerriiaallss)) (1) The Corporation and the Review Board may request the State, local governments, medical care institutions, insurance business operators and insurance rate computing organizations under the Insurance Busi- ness Act, and other public organizations to furnish the materials that are necessary for the health insurance program.Amended by Act No. 6951, Jul. 29, 2003; Act No. 8034, Oct. 4, 2006

(2) Those that have received the request to furnish materials under the provisions of paragraph (1) shall sincerely comply therewith.Amended by Act No. 6951, Jul. 29, 2003

(3) Fees, commissions, etc. shall be exempted for the materials furnished to the Corporation or the Review Board by the State, local governments, medical care institutions, insurance rate computing organizations under the Insurance Business Act and other public organizations under the provisions of paragraph (1).Newly Inserted by Act No. 6951, Jul. 29, 2003; Act No. 8034, Oct. 4, 2006

AArrttiiccllee 8844 ((RReeppoorrtt aanndd IInnssppeeccttiioonn)) (1) The Minister of Health and Welfare may order an employer or the head of a household to report or submit materials on an insured's moving, remuneration, income and other necessary matters or require public

ReproducedfromStatutesoftheRepublicofKorea

paragraph (2) fails to make the payment by the payment deadline, it shall be collected in accordance with the examples of disposition on the national tax in arrears.

AArrttiiccllee 8866 ((KKeeeeppiinngg SSeeccrreett)) A person who had been engaged in the operations of the Corporation or the Review Board, the vicarious claim organization or a person who is so engaged presently shall not disclose any secrets that he has acquired ex officio.Amended by Act No. 8153, Dec. 30, 2006

AArrttiiccllee 8877 ((SSuuppeerrvviissiioonn ooff CCoorrppoorraattiioonn,, eettcc..)) The Minister of Health and Welfare may take measures that are necessary for supervision of the Corporation and the Review Board, such as an order to report on their programs or an order to modify the articles of incorporation or regulations or to take other necessary actions after inspecting the conditions of their programs and assets.

AArrttiiccllee 8888 ((AAssssiiggnnmmeenntt aanndd EEnnttrruussttmmeenntt ooff AAuutthhoorriittyy)) (1) The authority of the Minister of Health and Welfare referred to in this Act may be assigned in part to the Special Metropolitan City Mayor, Metropolitan City Mayors, or Do governors under the conditions as pre- scribed by the Presidential Decree.

(2) The authority of the Minister of Health and Welfare referred to in Article 84 (2) may be entrusted to the Corporation or the Review Board under the conditions as prescribed by the Presidential Decree. AArrttiiccllee 8899 ((DDeelleeggaattiioonn ooff OOppeerraattiioonnss)) (1) The Corporation may delegate its operations relevant to receipt of insurance premiums, payment of insurance benefit costs or verification of

2. When it violates the order referred to in Article 84 (2), makes a false report, or refuses, obstructs or evades an inspection or questioning by the publicofficialsunderthechargeoftheMinistryofHealthandWelfare. (2) Where a medical care institution is subject to the order of suspension of operation by falling under paragraph (1) 1, when the Minister of Health and Welfare determines that the order of suspension of operation causes serious inconvenience to the persons who use the medical care institution in question, or that there exist other special circumstances, the Minister of Health and Welfare may assess and collect a penalty surcharge in the amount not exceeding five times of the amount that was borne due to deceit or other illegitimate methods in lieu of the order of suspension of operation. In such a case, the amount of penalty surcharge on the basis of the category and degree of the violating conduct that is subject to assessment of a penalty surcharge and other necessary matters shall be prescribed by the Presidential Decree. (3) A person who has been ordered to suspend operation under the pro- visions of paragraph (1) may not provide medical care benefits during the period of suspension of operation in question.

(4) Penalty surcharges collected under the provisions of paragraph (2) shall not be put to uses other than those referred to in the following subparagraphs:Amended by Act No. 8034, Oct. 4, 2006

1. Support for funds necessary for medical care benefit costs paid by the insurer under the provisions of the main sentence of Article 43 (3); and

2. Support for the emergency medical service fund referred to in the Emergency Medical Service Act.

(5) Sizes of support from penalty surcharges referred to in paragraph (4) for different uses, procedure of their use, and other necessary matters shall be prescribed by the Presidential Decree.

(6) When a person who shall pay a penalty surcharge as referred to in

ReproducedfromStatutesoftheRepublicofKorea

to the provisions of paragraph (1) for the businesses of the following subparagraphs:

1. Insurance benefits for the insured and their dependents;

2. Operational expenses for the health insurance business; and

3. Subsidies needed to reduce insurance premiums pursuant to the provisions of Articles 66-2 and 93-2 (3).

(4) The Corporation shall use the funds that are provided pursuant to the provisions of paragraph (2) for the businesses of the following subparagraphs:

1. The project undertaken to enhance and check up the people's health; 2.The insurance benefits that are paid to treat the diseases of the insured and their dependents, which are caused by their smoking; and

3. The insurance benefits that are paid to the aged who are at least 65 years old from among the insured and their dependents. [This Article Wholly Amended by Act No. 8153, Dec. 30, 2006] AArrttiiccllee 9933 ((SSppeecciiaall CCaassee ffoorr FFoorreeiiggnneerr,, eettcc..)) (1) The Government may arrange for a separate health insurance for the workers at a workplace where a foreign government is the employer in consultation with the foreign government.

(2) The overseas Korean nationals or the foreigners who sojourn in the country and who are prescribed by the Presidential Decree shall become the insured or dependents who are subject to the application of this Act, notwithstanding the provisions of Article 5.Amended by Act No. 7590, Jul. 13, 2005

AArrttiiccllee 9933--22 ((SSppeecciiaall CCaassee ffoorr UUnneemmppllooyyeedd PPeerrssoonnss)) (1) Where any person who is prescribed by the Ordinance of the Ministry of Health and Welfare from among the employee insured whose employment payment of insurance premiums to postal service agencies or financial institutions under the conditions as prescribed by the Presidential Decree. (2) The Corporation may delegate part of its operations to state organs, local governments, corporations that conduct social insurance operations under other Acts and subordinate statutes, or other persons. (3) The scope of the operations that the Corporation may delegate under the provisionsofparagraph(2)andofthepersonstowhomtheymaybedelegated shallbeprescribedbytheOrdinanceoftheMinistryof HealthandWelfare. AArrttiiccllee 9900 ((DDiissppoossaall ooff SSmmaallll SSuumm)) If an amount to be collected or an amount to be returned is less than two thousand won per case (excluding the individual co-payment refunds which may be disposed of by offsetting under the provisions of Article 43 (4)), the Corporation shall not collect or return it.

AArrttiiccllee 9911 ((DDiissppoossaall ooff FFrraaccttiioonnaall SSuumm)) In calculating the expenses related to insurance premiums, etc. and insurance benefits, fractional sums under the provisions of Article 47 of the Management of the National Funds Act shall not be included in the calculation.Amended by Act No. 7347, Jan. 27, 2005 AArrttiiccllee 9922 ((GGoovveerrnnmmeenntt''ss SSuubbssiiddiieess ffoorr IInnssuurraannccee FFiinnaannccee)) (1) The State shall subsidize an amount equivalent to 14/100 of the amount of anticipated revenues from insurance premiums for the year concerned to the CorporationfromtheNationalTreasuryeveryyearwithinlimitsofbudget (2) The Corporation may be provided with funds from the National Health Promotion Fund provided for in the National Health Promotion Act under the conditions as prescribed by the same Act.

(3) The Corporation shall spend financial resources that are raised pursuant

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 9944 ((PPeennaall PPrroovviissiioonnss)) (1) Any person who works for a vicarious claim organization and has filed a claim for the medical care benefit cost by means of false and illegality shall be punished by imprisonment with prison labor for not more than three years or by a fine not exceeding 30 million won. (2) A person who falls under any of the following subparagraphs shall be punished by imprisonment with prison labor for not more than one year or by a fine not exceeding ten million won:

1. A person who has gotten any other person who is not a vicarious claim organization to vicariously examine such claims in violation of the provisions of Article 43 (6);

2. An employer who has violated the provisions of Article 81;

3. A founder of any medical care institution, who has violated the pro- visions of Article 85 (3); and

4. A person who has violated the provisions of Article 86. [This Article Wholly Amended by Act No. 8153, Dec. 30, 2006] AArrttiiccllee 9955 ((PPeennaall PPrroovviissiioonnss)) A person who fails to report or submit documents, a person who makes a false report or submits false documents, or a person who refuses, obstructs or evades inspection or questioning in violation of the provisions of Article 84 (2) shall be punished by a fine of not more than ten million won. AArrttiiccllee 9966 ((PPeennaall PPrroovviissiioonnss)) A person who violates the provisions of Article 40 (4) or the former part of Article 44 (2) shall be punished by a fine of not more than five million won. CHAPTER PENAL PROVISIONSrelationship has expired files an application with the Corporation for retaining his qualification as the employee insured within the deadline for the payments of insurance premiums of the self employed insured who are first notified pursuant to the provisions of Article 74, he shall retain his qualification as the employee insured for a period set by the Presidential Decree notwithstanding the provisions of Article 8: Provided, That the same shall not apply to a case where the applicant fails to pay his insurance premium that he has to pay for the first time after he files the application on or before the deadline for its payment. (2) an insured who files the application with the Corporation pursuant to the provisions of paragraph (1) (hereinafter referred to as a "voluntarily and continuously the insured person") shall calculate his monthly wage amount based on the average amount of his wages that are paid for immediately preceding three months with the exception of the month that belongs to the date on which the employment relationship expires. (3) Part of the insurance premiums of the voluntarily and continuously insured persons may be reduced under the conditions as published by the Minister of Health and Welfare.

(4) Total amount of the insurance premiums of voluntarily and continuously the insured persons shall be borne and paid by them notwithstanding the provisions of Articles 67 (1) and 68 (1).

(5) Ways and procedures for fling applications for voluntarily and continuously the insured persons and other necessary matters shall be prescribed by the Ordinance of the Ministry of Health and Welfare. [This Article Newly Inserted by Act No. 8153, Dec. 30, 2006] Enforcement date: Jul. 1, 2007

ReproducedfromStatutesoftheRepublicofKorea

provisions of Article 82 (1) and (2) or 84 (1), (3) and (4). AArrttiiccllee 110000 ((PPrroocceedduurree ffoorr AAsssseessssmmeenntt aanndd CCoolllleeccttiioonn ooff FFiinnee ffoorr NNeegglliiggeennccee))

(1) The fine for negligence referred to in Articles 98 and 99 shall be assessed and collected by the Minister of Health and Welfare under the conditions as prescribed by the Presidential Decree.

(2) A person who protests against the disposition by fine for negligence referred to in paragraph (1) may raise a formal objection to the Minister of Health and Welfarewithinthirtydaysafterhereceivesthenoticeofsuchdisposition. (3) When a person who is subject to the disposition by a fine for negligence as referred to in paragraph (1) raises a formal objection under the provisions of paragraph (2), the Minister of Health and Welfare shall without any delay notify the competent court of this fact, and the competent court so notified shall hold a trial of negligence fine as re- ferred to in the Non-Contentious Case Litigation Procedure Act. Amended by Act No. 8034, Oct. 4, 2006

(4) When a fine for negligence is not paid without any objection being raised within the time period referred to in paragraph (2), it shall be collected in accordance with the examples of disposition on the national tax in arrears. ADDENDA

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on July 1, 2000: Provided, That Articles 4 and 5 of the Addenda shall enter into force on the date of its promulgation. Amended by Act No. 6093, Dec. 31, 1999

AArrttiiccllee 22 ((RReeppeeaall ooff OOtthheerr AAccttss)) TheMedicalInsuranceActandtheNationalMedicalInsuranceActshallberepealed. AArrttiiccllee 9977 ((JJooiinntt PPeennaall PPrroovviissiioonnss)) When the representative of a corporation or an agent, employee or other employed person of a corporation or an individual commits an offense referred to in Articles 94 through 96 in connection with the duties of the said corporation or individual, in addition to punishing the offender, the said corporation or individual shall also be subject to the punishment by fine as referred to in each applicable Article.

AArrttiiccllee 9988 ((FFiinnee ffoorr NNeegglliiggeennccee)) (1) When an insured or his dependent, or a person who was formerly an insured or his dependent, receives an insurance benefit by using a document that proved his eligibility after losing that eligibility, he shall be punished by a fine for negligence of not more than the amount equivalent to the said benefit.

(2) When a person who is eligible to receive insurance benefits effects another person's receipt of an insurance benefit by deceit or other illegitimate methods, he shall be punished by a fine for negligence of not more than the amount equivalent to the said insurance benefit. The same shall apply to a person who receives an insurance benefit by same method. AArrttiiccllee 9999 ((FFiinnee ffoorr NNeegglliiggeennccee)) A person who falls under any of the following subparagraphs shall be punished by a fine for negligence of not more than one million won: Amended by Act No. 8153, Dec. 30, 2006

1. A person who violates an order referred to in Article 87; and

2. A person who fails to submit documents, state his opinions, or make a declaration or report, a person who makes false statements, declaration, or report, or a person who refuses, obstructs or evades investigation or inspection without a justifiable ground therefor, in violation of the

ReproducedfromStatutesoftheRepublicofKorea

rations for enforcement of this Act.

(2) A person who receives the request for submission of materials referred to in paragraph (1) shall sincerely comply therewith. AArrttiiccllee 66 ((DDiissssoolluuttiioonn ooff IInnccoorrppoorraatteedd BBooddiieess)) The Medical Insurance Association and the Medical Insurance Federation in existence at the time when this Act enters into force which were estab- lished under the provisions of the previous Medical Insurance Act shall each be dissolved at the same time as when this Act enters into force. AArrttiiccllee 77 ((SSuucccceessssiioonn ooff RRiigghhttss bbyy UUnniivveerrssaall TTiittllee,, eettcc..)) (1) The Corporation shall succeed, by a universal title, to the rights and duties of the Medical Insurance Association and Medical Insurance Fed- eration referred to in the previous Medical Insurance Act existing at the time when this Act enters into force: Provided, That the Review Board shall succeed, by a universal title, to the rights and duties of the Medical Insurance Federation related with its review operations. (2) Assets of the Medical Insurance Association referred to in the previous Medical Insurance Act at the time when this Act enters into force shall be considered as assets of the Corporation, and the assets of the Medical Insurance Federation shall be considered as assets of the Review Board. AArrttiiccllee 88 ((EEmmppllooyymmeenntt,, eettcc.. ooff EEmmppllooyyeeeess)) Employees of the previous Medical Insurance Association and Medical Insurance Federation at the time when this Act enters into force shall be considered to have been employed by the Corporation: Provided, That the employees, from among the employees of the Medical Insurance Federation, who are engaged in the review operations as determined by the Minister of Health and Welfare shall be consideredtohavebeenemployedbytheReviewBoard.

AArrttiiccllee 33 ((EEssttaabblliisshhmmeenntt ooff CCoorrppoorraattiioonn)) The National Health Insurance Corporation in existence at the time when this Act enters into force which was established under the National Medical Insurance Act shall be considered as the Corporation which is established under the provisions of this Act: Provided, That the officers of the Corporation shall be appointed in accordance with the provisions of Article 19, and in this case, the term of the office of the officers of the previous National Health Insurance Corporation shall be considered to have terminated. AArrttiiccllee 44 ((PPrreeppaarraattiioonn ffoorr EEssttaabblliisshhmmeenntt ooff RReevviieeww BBooaarrdd)) (1) The Minister of Health and Welfare shall commission six establishment committeemen within thirty days from the date on which this Act is promulgated and have them take charge of the affairs related with the establishment of the Review Board.

(2) The establishment committeemen shall prepare the Articles of Incorporation, obtain approval therefor from the Minister of Health and Welfare, and then register the establishment of the Review Board. (3) When the director of the Review Board is appointed, the establishment committeemen shall hand over the affairs, and, when handing over of the affairs is completed, they shall be considered dismissed. (4) Expenses, etc. that are necessary for the preparation for establishment of the Review Board shall be born by the state.

AArrttiiccllee 55 ((AAcctt ooff PPrreeppaarraattiioonn ffoorr EEnnffoorrcceemmeenntt ooff TThhiiss AAcctt)) (1) The Minister of Health and Welfare and the chairman of the board of directors or establishment committeemen of the National Health Insurance Corporation may request the Medical Insurance Federation, the Medical Insurance Association, the National Health Insurance and other relevant persons to submit the materials that are necessary for prepa-

ReproducedfromStatutesoftheRepublicofKorea

Medical Insurance Act or National Medical Insurance Act at the time when this Act enters into force shall be considered to be requests for and hearings on insurance benefits or insurance benefit costs referred to in this Act.

AArrttiiccllee 1100 ((TTrraannssiittiioonnaall MMeeaassuurreess rreeggaarrddiinngg CCoooorrddiinnaattiioonn ooff FFiinnaanncciiaall AAffffaaiirrss))

(1) Notwithstanding the provisions of Article 33 (2), the Corporation shall keep the accounting for the financial affairs related with the employment provided the insured and those related with the locally provided the insured (excluding the financial affairs necessary for the management and operation of the Corporation) separately from each other until June 30, 2003.Amended by Act No. 6618, Jan. 19, 2002

(2) As for the employee insured as referred to in paragraph (1), accounting for the financial affairs related with the employee insured who are workers at work-places referred to in Article 6 (2) 1 and their employers and accounting for the financial affairs related with the employee insured who are public officials or school employees as referred to in Article 6 (2) 2 shall be kept separately from each other until December 31, 2000. [This Article Wholly Amended by Act No. 6093, Dec. 31, 1999] AArrttiiccllee 1100--22

Deleted.by Act No. 6618, Jan. 19, 2002

AArrttiiccllee 1100--33 ((SSppeecciiaall CCaassee ffoorr IInnssuurraannccee RRaattee FFoolllloowwiinngg SSeeppaarraattee AAccccoouunnttiinngg ooff FFiinnaanncciiaall AAffffaaiirrss)) (1) Notwithstanding the provisions of Article 65 (1), insurance premium rates for the employee insured may be set differently for different employment provided the insured classes referred to in Article 6 (2) 1 and 2 under the AArrttiiccllee 99 ((TTrraannssiittiioonn MMeeaassuurreess rreeggaarrddiinngg AAccqquuiissiittiioonn,, eettcc.. ooff EElliiggiibbiilliittyy ooff tthhee iinnssuurreedd aanndd DDeeppeennddeenntt)) (1) A person who becomes an insured or his dependent under the provisions of the previous Medical Insurance Act or National Medical Insurance Act at the time when this Act enters into force shall be considered to have acquired the eligibility of an insured or dependent referred to in this Act. (2) A request for medical insurance review that is presented and being examined under the provisions of the previous Medical Insurance Act or National Medical Insurance Act at the time when this Act enters into force shall be considered the formal objection referred to in this Act, and a request for reexamination of medical insurance shall be considered to have been made to, and being examined by, the Dispute Mediation Committee.

(3) Matters concerning collection of insurance premiums, etc. for which the payment period has expired at the time when this Act enters into force under the provisions of the previous Medical Insurance Act or National Medical Insurance Act shall be in accordance with the previous provisions. (4) A medical care institution for which the term of suspension of operation has not yet terminated at the time when this Act enters into force, from among the medical care institutions that were subject to suspension of operation under the provisions of the previous Medical Insurance Act or National Medical Insurance Act, shall be considered to have been subject to suspension of operation for the remaining term (referring to the shorter term of the two if the remaining term of suspension of operation referred to in the Medical Insurance Act and the one referred to in the National Medical Insurance Act overlap each other) under the provisions of this Act.

(5) Requests for and hearings on insurance benefits or insurance benefit costs that are made or conducted under the provisions of the previous

ReproducedfromStatutesoftheRepublicofKorea

the person representing the medical and pharmaceutical communities under the provisions of Article 42 (1) for the duration of six months commencing on the date of the promulgation of this Act.

AArrttiiccllee 1122 ((TTrraannssiittiioonnaall MMeeaassuurreess rreeggaarrddiinngg PPeennaall PPrroovviissiioonnss,, eettcc..)) Application of penal provisions or fine for negligence for an offense in vio- lation of the previous Medical Insurance Act or National Medical Insurance Act that is committed before this Act enters into force shall be subject to the provisions of the previous Medical Insurance Act or National Medical Insurance Act.

AArrttiiccllee 1133 ((RReellaattiioonn ttoo OOtthheerr AAccttss aanndd SSuubboorrddiinnaattee SSttaattuutteess)) (1) In cases where the provisions of the previous Medical Insurance Act or National Medical Insurance Act are cited in other Acts and subordinate statutes at the time when this Act enters into force, if there are corresponding provisions in this Act, this Act or the corresponding provisions of this Act shall beconsideredtohavebeencitedinlieuofthepreviousprovisions. (2) In cases where the Medical Insurance Association or the Medical Insurance Federation referred to in the previous Medical Insurance Act or the National Health Insurance Corporation referred to in the National Medical Insurance Act is cited in other Acts and subordinate statutes at the time when this Act enters into force, the Corporation referred to in this Act shall be considered to have been cited.

AArrttiiccllee 1144 ((TTrraannssiittiioonnaall MMeeaassuurreess rreeggaarrddiinngg EExxttiinnccttiivvee PPrreessccrriippttiioonn)) Right to collect or receive refund of insurance premium, right to receive an insurance benefit, or right to receive refund of excess payment of individual co-payment for which extinctive prescription has occurred before this Act enters into force shall be pursuant to the previous provisions. conditions as provided by the Presidential Decree during the separate financial accounting period referred to in Article 10 (2) of the Addenda. In such a case, the different insurance premium rates shall each be determined within the limit of eighty thousandths. (2) Notwithstanding the provisions of Article 65 (2), insurance premium rates for the employee insured engaged in operations outside of Korea shall be fifty hundredths of the applicable insurance premium rate referred to in paragraph (1) during the separate financial accounting period referred to in Article 10 (2).

[This Article Newly Inserted by Act No. 6093, Dec. 31, 1999] AArrttiiccllee 1100--44 ((SSppeecciiaall CCaassee ffoorr AAddjjuussttmmeenntt ooff IInnssuurraannccee RRaattee ffoorr EEmmppllooyymmeenntt PPrroovviiddeedd tthhee iinnssuurreedd)) Insurance rate of a person whose rate has increased by at least the ratio determined by the Presidential Decree, from among the employee insured whose insurance premium has increased due to the enforcement of this Act at least twenty hundredths of the insurance premium for the month to which the day before the enforcement date of this Act belongs, may be adjusted under the conditions as prescribed by the Presidential Decree within the limit of the separate financial accounting period referred to in Article 10 (1) of the Addenda.

[This Article Newly Inserted by Act No. 6093, Dec. 31, 1999] AArrttiiccllee 1111 ((MMeeddiiccaall CCaarree BBeenneeffiitt CCoosstt)) The criteria for calculation of the costs of medical care benefits determined by the Minister of Health and Welfare under the provisions of the previous Medical Insurance Act and National Medical Insurance Act at the time when this Act enters into force shall be considered to have been determined by contract with the chairman of the board of directors of the Corporation and

ReproducedfromStatutesoftheRepublicofKorea

ADDENDAAct No. 6124, Jan. 12, 2000

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on the date of its promulgation. AArrttiicclleess 22 tthhrroouugghh 66

Omitted.

ADDENDAAct No. 6320, Dec. 29, 2000

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on July 1, 2001.

AArrttiiccllee 22 ((PPrreeppaarraattoorryy AAccttss ffoorr EEnnffoorrcceemmeenntt ooff tthhiiss AAcctt)) (1) The Minister of Heath and Welfare or the president of the National Health Insurance Corporation may request the State, local governments, corporations and public organizations dealing with the social insurance affairs under other Acts and subordinate statutes, workers and employers of the workplaces and other relevant persons to submit the data necessary for the preparation for enforcement of this Act. (2) Persons in receipt of the request for submission of data under para- graph (1) shall faithfully comply with it.

ADDENDAAct No. 6474, May 24, 2001

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on October 1, 2001. AArrttiicclleess 22 tthhrroouugghh 1133

Omitted.

AArrttiiccllee 1155 ((TTrraannssiittiioonnaall MMeeaassuurreess rreeggaarrddiinngg PPrriioorr CCoonndduucctt,, eettcc..)) (1) Punishment for an offense in violation of the Medical Insurance Act or National Medical Insurance Act that is committed before this Act enters into force shall be pursuant to the previous provisions. (2) Various actions, such measures, taken by the insurer, insurer organization, or an administrative agency under the provisions of the pre- vious Medical Insurance Act or National Medical Insurance Act at the time when this Act enters into force shall be considered to be their corresponding actions of the Corporation, Review Board or an administrative agency referred to in this Act, and if actions, such as measures, taken by the insurer or the insurer organization overlap each other, minor measures therefrom shall be considered to be actions of the Corporation or Review Board referred to in this Act. (3) A specialized general medical care institution or a specialized medical care institution that is recognized by the Minister of Health and Welfare at the time when this Act enters into force under the provisions of the previous Medical Insurance Act or National Medical Insurance Act shall be considered to be a specialized general medical care institution or a specialized medical care institution referred to in this Act. ADDENDAAct No. 6073, Dec. 31, 1999

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on the date of its promulgation. AArrttiicclleess 22 aanndd 33

Omitted.

ADDENDUMAct No. 6093, Dec. 31, 1999

This Act shall enter into force on the date of its promulgation.

ReproducedfromStatutesoftheRepublicofKorea

amended provisions of Articles 19 (6), 21 and 58 (5) shall apply to the officers first appointed after the enforcement of this Act. (3) (Applicable Cases concerning Exceptions from Restriction on Benefits following Delinquency of Insurance Premiums) The amended provisions of Article 48 (3) may be applicable to the persons who have already received insurance benefits in the status of delinquency of insurance pre- miums during the period under the previous provisions. ADDENDAAct No. 7347, Jan. 27, 2005

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on July 1, 2005.

AArrttiicclleess 22 tthhrroouugghh 44

Omitted.

ADDENDUMAct No. 7377, Jan. 27, 2005

This Act shall enter into force six months after the date of its promulgation. ADDENDUMAct No. 7590, Jul. 13, 2005

This Act shall enter into force on January 1, 2006. ADDENDAAct No. 8034, Oct. 4, 2006

(1) (Enforcement Date) This Act shall enter into force on the first day of the month next to that whereto belongs the date of promulgation: Provided, That the amended provisions of Article 74 (2) and (3) shall enter into force six months after the date of its promulgation.

(2) (Application Example concerning Collection and Exemption of Insurance Premiums) The amended provisions of Articles 62 (2) and 66 (3) shall apply to the person who acquires or loses the eligibility of insurance the ADDENDAAct No. 6618, Jan. 19, 2002

(1) (EnforcementDate)ThisActshallenterintoforceonthedateofitspromulgation. (2) (Transitional Measures following Amendment of Article 10 (1) of Ad- denda of National Health Insurance Act; Act No. 5854) The Corporation shall take the measures to restore the financial affairs of employment provided the insured and the self-employed insured accounted compre- hensively at the time of enforcement of this Act, to the financial affairs status of the employee insured and the self-employed insured accounted separately at the time of December 31, 2001.

ADDENDUMAct No. 6799, Dec. 18, 2002

This Act shall enter into force on the date of its promulgation. ADDENDUMAct No. 6951, Jul. 29, 2003

This Act shall enter into force on the date of its promulgation. ADDENDAAct No. 6981, Sep. 29, 2003

(1) (Enforcement Date) This Act shall enter into force six months after the date of its promulgation.

(2) (Applicable Cases) Medical care benefits provided by the Korea Orphan Drug Center under the amended provisions of Article 40 (1) 3 shall apply with respect to the medicines which are offered to patients on or after the enforcement date of this Act.

ADDENDAAct No. 7144, Jan. 29, 2004

(1) (Enforcement Date) This Act shall enter into force on the date of its promulgation: Provided, That the amended provisions of Article 54-2 shall enter into force three months after the date of its promulgation. (2) (Applicable Cases concerning Term of Office, etc. of Officers) The

ReproducedfromStatutesoftheRepublicofKorea

AArrttiiccllee 55 ((TTrraannssiittiioonnaall MMeeaassuurreess ccoonncceerrnniinngg VViiccaarriioouuss CCllaaiimm ffoorr MMeedd-- iiccaall CCaarree BBeenneeffiitt CCoosstt))

The medical care benefit cost for which a claim is vicariously filed pursuant to the provisions of Article 10 of the previous Special Act on Sound Finance of National Health Insurance at the time of enforcement of this Act shall be deemed the medical care benefit cost for which a claim is vicariously filed pursuant to the provisions of Article 43 (6).

AArrttiiccllee 66 ((TTrraannssiittiioonnaall MMeeaassuurreess ccoonncceerrnniinngg AApppprroovvaall ffoorr IInnssttaallllmmeenntt PPaayymmeenntt ooff IInnssuurraannccee PPrreemmiiuumm iinn AArrrreeaarrss)) The approval or the revocation of the approval for the installment payment of the insurance premium in arrears provided for in the provisions of Article 11 of the previous Special Act on Sound Finance of National Health Insurance at the time of enforcement of this Act shall be deemed the approval or the revocation of the approval provided for in the amended provisons of Article 70-2.

AArrttiiccllee 77

Omitted.

insured first after the enforcement of this Act, or the portion of occurrence or termination of reasons for the allowance suspension. ADDENDAAct No. 8153, Dec. 30, 2006

AArrttiiccllee 11 ((EEnnffoorrcceemmeenntt DDaattee)) This Act shall enter into force on January 1, 2007: Provided, That the amended provisionsofArticles62(6),66-2and93-2shallenterintoforceonJuly1,2007. AArrttiiccllee 22 ((VVaalliidd PPeerriioodd))

The amended provisions of Article 92 shall have their validity on or before December 31, 2011.

AArrttiiccllee 33 ((AApppplliiccaattiioonn EExxaammppllee ccoonncceerrnniinngg IInnssuurraannccee PPrreemmiiuummss)) The amended provisions of Article 62 (4) and (5) shall apply to the in- surance premiums for which a publication of notice is first made after the enforcement of this Act.

AArrttiiccllee 44 ((TTrraannssiittiioonnaall MMeeaassuurreess ccoonncceerrnniinngg HHeeaalltthh IInnssuurraannccee PPoolliiccyy DDeelliibbeerraattiivvee CCoommmmiitttteeee))

(1) The Health Insurance Policy Deliberative Committee provided for in the previous Special Act on Sound Finance of National Health Insurance shall be deemed the Health Insurance Policy Deliberative Committee provided for in the amended provisions of Article 4.

(2) The matters that go through the deliberation and the resolution of the Health Insurance Policy Deliberative Committee provided for in the previous Special Act on Sound Fiance of National Health Insurance shall be deemed the matters that go through the deliberation and the resolution of the Health Insurance Policy Deliberative Committee pro- vided for in the amended provisions of Article 4.

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