探討台灣健保投保薪資以多報少之現象與對策

全民健保自1995年開辦，前3年有盈餘，設置衛福部健保署為單一保險人，常住國外者得繼續參加保險，初期是一個財務健全的保險制度。約自第4年1998年起開始呈現虧損(因調降費率)，保費收入與醫療支出產生收支短絀。本文為此將基於健保費的收費、健保虧損與投保薪資以多報少做個案分析，試圖從做個案分析中找出健保費為什麼會短收，並探討健保費短收的影響因素跟投保薪資以多報少是否有關，以提供健全全民健保制度之政策參考。本文是在顧問輔導企業個案中屬於第一線資料，是用薪資表做個案分析，薪資表是勞工提供勞務，雇主給付工作報酬最直接呈現的資料，因內容記載工作期間、工資計算(勞基法第23條規定自106年起工資要有計算式明細)、保費收繳，勞工退休金提繳等這些資料數據從薪資表就可以一目了然健保費繳費情形，是照實投保，還是以多報少，選擇幾家不同行業別的薪資表作深入分析。本文在個案分析中發現幾個特徵:1、有的薪資表中的健保費扣繳額一律用最低的基本工資在扣繳(見表4-4個案一薪資單，p44)。2、有的公司是按薪資高低的比例在投保跟繳健保費。3、發現投保薪資大部份以多報少一致性的都少投保在8,000元至12,000元之間。4、再發現投保薪資以多報少平均約都約少投保在10,000元左右(見表4-8，p48)。5、各項保費計算表(見表4-5，p46)。從以上資料顯示，公司不管是繳交全民健康保險費還是繳交二代健保補充保費，各項繳費項目都會揭露在年度薪資印領清冊上，這是顧問輔導企業最主要的工作，公司想合法節稅，源頭憑證從這邊來，不誠實報稅，不但節不了稅損害反而會更大，不只是某些薪資沒報不能當費用，而是勞工的反撲會嚇死人，這是勞基法跟勞保的稅法規定。好比:勞工違反了勞基法規定雇主用勞基法12條規定解僱；但如果是雇主違反勞工法令損害到勞工權益時懂法令的勞工就會依勞基法14條規定開除雇主領了資遣費又去領失業給付。例如:(見表4-4個案一薪資單，p44)薪資合計是36,996元，應投保勞工保險38.200元但公司只投保23,100元，這樣就是公司違反了勞基法第14條第1項第6款的勞工法令；勞工就可以在知悉的一個月內以勞基法第14條第二項:「但雇主有前項第六款所定情形者，勞工得於知悉損害結果之日起，三十日內為之」。與雇主終止契約，並依勞基法第14條第四項規定請求資遣費(就是勞基法的)第十七條規定於本條終止契約準用之(除了可以跟公司領資遣費之外還可以去領失業給付)。因此規劃跟處理投保薪資以多報少，是企業當前必須面對的課題。二代健保各類所得(收入)扣繳補充保險費明細表媒體申報書，如果稍做調整改變(見表5-1本研究建議，p62)，健保署拿著申報書扣繳代號62-1〜62-5查核企業，投保薪資以多報少的情況會自動現形，薪資表上哪些項目應該投保繳交全民健康保險費與哪些項目不需要投保但需繳交二代健保補充保費(見表4-5各項保費計算表，p46)，假如公司將薪資10,000元只繳二代健保補充保費每個月繳交1.91%*12(一年)=2292元(一年保費繳這些錢)；如果公司將薪資10,000元全部都投保(包括:勞保、健保、勞退、勞保職災、積欠工資墊償)這樣一年要繳23,005元，與只繳二代健保補充保費一年只有繳2292元相較，這樣一年要多繳20,713元。相較差異這麼大，要企業不將投保薪資以多報少也難，但以多報少企業也要承擔被罰鍰的風險。企業想少繳保費不是用投保薪資以多報少，要節稅是要做憑證規劃才能節稅，更不是每個月換項目會被判定巧立名目。舉例:像年終獎金員工要繳稅雇主卻不用投保只需繳二代健保補充保費這就是實例。公司如果能正常繳交全民健保費，健保署也可以收到應收保費平衡財政。

關鍵字

全民健康保險；二代健保；健保法；勞工保險；投保單位；投保薪資；薪資以多報少

並列摘要

National Health Insurance (NHI) has been in operation since 1995. It had a surplus in the first three years. It also established the National Health Insurance Administration (NHIA) as a single insurer. Those who are resident abroad and willing to continue to pay premiums must continue to participate in insurance. The initial stage was a financially sound insurance system. For the fourth year (1998), it began to show losses, and the premium income and medical expenses have suffered from shortfalls. In this purpose, based on health insurance premiums, health insurance losses, and insured salaries, we will do a more case analysis, try to find out from the case analysis why health insurance premiums are short-collected, and discuss the impact of short-term health insurance premiums and insurance pay It is relevant to report more and less, to a provide policy reference for improving the national health insurance system. This article is the first-line information in the case of consultants and counseling companies. It is a case analysis with a salary table. The salary table is the most direct data for laborers to provide labor services and employers pay for work. The content records the working period, salary calculation, and premium collection. Therefore, the health insurance premium payment situation can be seen at a glance from the salary scale. Whether to pay the insurance premium according to the actual salary of the insured salary is more under-reported, select several salary scales in different industries for in-depth analysis. This article finds several characteristics in the case analysis: 1. The deductions for health insurance premiums in some salary tables always use the lowest basic salary for withholding is the basic salary for insurance. Of course, the health insurance premiums are the lowest. (Table 4-4, p44) 2. Some companies are insured and pay health insurance premiums in proportion to their salary. 3. It is found that the insured salary is less than NTD 8,000 to NTD 12,000 if it is reported more and less consistent. 4. Rediscovered that insured salaries are under-reported and averaged around NTD 10,000. (Table 4-8, p48) 5. Calculation table of various premiums. (Table 4-5, p46) From the above information, whether the company pays the NHI premiums or pays the 2nd Generation NHI supplementary premiums, the various payment items will be exposed to the annual salary list. This is the most important job of consultants and counseling companies. The company wants to be legal Tax savings, the source certificate comes from here, dishonest tax filing, not only can’t save taxes, but the damage will be even greater. It’s not just that certain salaries are not reported and cannot be used as expenses, and the workers’ counterattack is very horror. This is the Labor Standards Act and labor insurance tax law regulations. For example, if the worker violates the provisions of the Labor Standards Act, the employer uses Article 12 of the Labor Standards Act to dismiss; but if the employer violates the Labor Standards Act and harms the rights and interests of the workers, the workers who understand the law will expel the employer according to Article 14 of the Labor Standards Act and receive the severance payment went to receive unemployment benefits. For example: (Table 4-4, p44) the total salary is NTD 36,996, and the labor insurance should be NTD 38.200, but the company only ensures NTD 23,100. This means that the company has violated Art.14.1.6 of the Labor Standards Act. The labor law; the laborer can use the Article 14.2 of the Labor Standards Law within one month of learning: " However, the employee shall do so within 30 days of the date of the employee knowing the result of damages in the event the employer falls under any of the circumstances specified in Subparagraph 6.". Terminating the contract with the employer and requesting severance payment under Art. 14.4 of the Labor Standards Law and Article 17 of the Labor Standards Law stipulates that the termination of the contract applies to this article (except for the severance payment from the company You can also get unemployment benefits). Therefore, planning and processing the insurance salary to over-report the under-reporting is a topic that companies must face at present. The 2nd Generation NHI income withholding supplementary insurance premium detailed list media declaration form, if minor adjustments are made (Table 5-1 research proposal, p62), the NHI Department will hold the declaration form withholding code 62-1~ 62-5 check the enterprise, if the insurance salary is over-reported, it will automatically appear, which items on the salary scale should be insured to pay the national health insurance premium and which items do not need to be insured but need to pay the 2nd Generation NHI supplementary premium (Table 4-5 Various premium calculation table p46), if the company pays NTD 10,000 only to pay the 2nd Generation NHI supplementary premium, pay 1.91%*12 (one year)= NTD 2,292 (the premium for one year); if the company pays Insuring all the salary of NTD 10,000 (including labor insurance, health insurance, labor retirement, labor insurance, occupational accidents, and outstanding wages). This is a year to pay NTD 23,005, which is compared with only NTD 2,292 for 2nd Generation NHI supplementary premiums. So you have to pay NTD 20,713 more a year. Compared with such a big difference, it is difficult for companies not to over-report their insured salary, but companies that over-report less will also bear the risk of fines. Companies wanting to pay fewer insurance premiums do not use insurance salaries to report more and less. To save tax, you need to plan a voucher to save tax, and it is not those changing items every month that will be judged to be cleverly established. For example: like year-end bonus employees who have to pay taxes, employers do not need to apply for insurance and only need to pay supplementary premiums for 2nd Generation NHI. If the company can normally pay the NHI premiums, the NHI Agency can also receive premiums receivable to balance its finances.

並列關鍵字

National Health Insurance ； 2nd Generation NHI ； National Health Insurance Act ； Labor Insurance ； Group Insurance Applicant ； Insurance Salary ； Fake Salary Declaration

參考文獻

魏怡嘉、蔡孟哲(2019)。安全準備金2022年就用完 400億健保虧損擴大赤字10年新高。中國時報。https://www.chinatimes.com/newspapers/20190908000401-260102?chdtv

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