History

These Rules are drawn up in accordance with Article 77 of the Labor
Insurance Act (hereinafter referred to as the Act).

Pursuant to Article 3 of the Act, the following shall have tax exemption
status:
1.Bills and receipts generated from labor insurance transactions between
insurer and insured units shall be exempt from the stamp duty.
2.Insurance premium payments, late fee payments, incomes from compulsory
enforcement, and other sources of incomes, such as management of foundations
and miscellaneous incomes shall be exempt from business and income taxes.
3.Buildings, medical supplies and equipment, emergency response vehicles used
by insurer providing labor insurance and benefits received by the insured or
others beneficiaries shall be exempt from taxation in accordance with the
existing tax law.

The calculation of the duration of the insurance coverage period, unless
specified elsewhere in the Statute, shall be in accordance with the Civil
Code.
The ages of the insured persons and their dependents shall be calculated
according to information contained in the household registry.

Insurer shall compile an annual report at the end of each year, and submit the
following documents at monthly intervals to the central competent authority
for registration and examination:
1.The statistical records showing insured units, number of insured persons
and insurance wages.
2.The statistical records showing all insurance benefits payments.
3.The accounting records showing all transactions involving insurance incomes
and expenditures.
4.The insurance fund utilization status.
The above records shall be submitted to the Labor Insurance Supervisory
Commission.

The Labor Insurance Supervisory Commission shall compile quarterly supervisory
records, examinations of disputes, and financial audit reports, and submit a
final report at the end of each year to the central competent authority for
registration and examination.

Insurer or members of the Labor Insurance Supervisory Commission, when
conducting the labor insurance inspections in accordance with Article 28 of
the Statute, shall display their identification documents.

The competent authorities referred to in Paragraph 2 to Article 6 of the
statute are the municipalities or county (or city) governments where the
workers' worksites are located.

The persons employed outside of the industries mentioned in Item 1 of
Paragraph 1 to Article 8 of the Statute, refer to the workers approved and
recognized by the central competent authority for insurance coverage from
other businesses or civil organizations.

Employed persons with no definite employer or are self-employed and
participate in two or more professional labor unions shall select the major
union as their basis for insurance coverage.

The insured unit should prepare employee or membership name lists (cards),
attendance and working records, wage tables and wage accounting records.
Employee or membership name lists (cards) shall separately contain the
following items:
1.Name, sex, birthrate (year/month/day), address, serial number of the
national identification card.
2.Year/month/day of the commencement of employment, union membership or
receiving professional training.
3.Type of work.
4.Work hours and amount of wage.
5.Period of leave without pay due to injury or illness.
The attendance and working records, wage tables, wage accounting records
contained in Paragraph 1 and Items 4 to 5 to Paragraph 2 of this Article shall
not apply to professional unions, fishermen’s associations, associations of
the captains of the ships and seamen’s general union.
The records and tables referred to in Paragraph 1 shall be preserved for
five years by the insured unit after the date the insured person leaves his (
or her) job, withdraws from membership or finishes or drops out of training
program.

Workers without definite employers referred to in Items 7 to 8 of Paragraph
1 to Article 6 of the Statute are those who are always employed by over two
employers that are not belong to the categories of Items 1 to 5 of the same
Article of the Statute in the past three months, and whose job
opportunities, working times, quantities of work, workplaces and
remuneration are not steady.
Self-employed persons referred to in Items 7 to 8 of Paragraph 1 to Article
6 of the Statute are those who perform their job or technique independently
and obtain remuneration accordingly, and do not hire persons help them to do
the work with payments.

When units apply for coverage of insurance and undertake insurance procedures,
they shall fill out application forms for insurance coverage and joining
insurance coverage, and submit each of them to the insurer.
The joining application forms referred to in the preceding Paragraph shall
be filled out in detail in accordance with household registry or other related
information.

When employers, associations or affiliated authorities hiring workers referred
to in Article 6 of the Statute apply for coverage of insurance, except for
governmental authorities or public schools, they shall submit the xeroxed
copies of the front and back pages of the national identification cards of the
persons in charge and the copies of the following related documents issued
by other related business competent authorities:
1.Factories shall submit the factory registration certificates.
2.Minefields shall submit the minefield registration certificates,
minefield excavating or prospecting certificates.
3.Saltpits, ranges, pastures, forest and tea plantations shall submit
registration certificates.
4.Transportation entities shall submit transportation permits or other
related documents.
5.Public utilities shall submit business licenses or other related
documents.
6.Companies and business entities shall submit company licenses, registration
certificates for entities for profit or business registration certificates.
7.Private schools, news media, cultural entities, public-interest entities,
cooperative entities, fishieries, occupational training institutions and civil
organizations for various business shall submit their accredited or
registration certificates.

When employers, associations or affiliated authorities hiring personnel
referred to in Article 8 of the Statute apply for coverage of insurance,
they shall submit the documents in the same manner pursuant to the preceding
article.

The insurer shall fill out and make one copy of certificate of insurance in
accordance with the application forms for insurance coverage and two copies of
insurance card for the insured persons in accordance with the application
forms for joining insurance coverage and give them to the insured units. The
certificate of insurance shall be displayed in a conspicuous place. One copy
of the insurance card for the insured persons shall be safekept by the insured
units and the other copy shall be signed and safekept by the insured person.

For those workers qualified under Article 6 of the Statute, when the insured
units inform the insurer with a name-list on the dates their employees
formally report to work, become a member of their associations or receive
the professional training, the effective dates of the insurance shall be
commenced from the zero hour of the dates when the application forms for
joining insurance coverage from the insured united reached the insurer or when
they are mailed; when the insured units did not inform the insurer with a
name-list on the dates their employees formally report to work, become a
member of their associations or receive professional training, the effective
dates of the insurance shall be commenced from the zero hour of the next dates
when the application forms for joining insurance coverage from the insured
units reached the insurer or when they are mailed.
When the insured units withdraw from insurance coverage on the dates after
their employees leave their jobs, withdraw memberships from their associations
or finish (or withdraw from) professional training programs, the effectiveness
of the insurance shall be terminated from the 24th hour of the dates when
the application forms for withdrawing from insurance coverage from the insured
units reached the insurer or when they are mailed; when the insured units
did not withdraw from the insurance coverage on the dates after their
employees leave their jobs, withdraw memberships from their associations or
finish (or withdraw from) professional training programs, the effectiveness of
the insurance shall be terminated on the 24th hour of the dates when employees
leave their jobs, withdraw their memberships or finish (or withdraw from)
professional training programs.
The dates of the mails are posted referred to in the preceding paragraphs
are set in accordance with the post-marks of the original sending post
offices.

When the insurer received the application forms for joining or transferring
insurance, forms for adjusting insurance wages submitted by the insured units,
except for those without names shall be immediately rejected, it shall
notify the insured units in writing to correct the errors such as missing of
the seals of the insured units, the persons in charge, or the bithdates of the
insured persons, serial numbers of the national identification cards and the
mistaken insurance wages. The insured units shall make the necessary
corrections within 10 days upon receipt of the said notification.
When the application forms for joining or transferring insurance are corrected
by the insured units on time, they shall take effect on the dates of their
submission. When the corrections are overdue, they shall take effect on the
next date upon correction. When no correction after overdue in made, they
shall not take effect.
When forms for adjusting insurance wages are corrected by the insured units on
time, they shall take effect on the first day of the next month from the
date of submission. When the correction are overdue, they shall take effect on
the first day of the next month from the date of correction. When no
correction after overdue is made, they shall not take effect.
The submission of the corrections referred in the preceding three paragraphs
shall be set on the date which they reach the insurer. When the corrections
are mailed, they shall be set in accordance with the post-marks of the
original sending post offices.
When the insured units make an overdue correction or make no correction at all
after overdue, they shall be liable for any loss incurred to workers.

In case the insured units are suspended, disbanded or bankrupted, or the
premiums payable remain unpaid and after the proceedings of compulsory
execution the late fees for overdue premiums still cannot be paid, the insurer
may notify them in writing to withdraw from insurance coverage. The
termination of the effectiveness of insurance, the calculation of the premiums
payable and the added penalties for overdue premiums shall be set on the dates
the above-mentioned facts are ascertained; if the facts cannot be ascertained,
the dates shall be set by the insurer after investigations.
In case the insured units are overdue in the payment of premiums or late
fees for overdue premiums, and after the notification to pay within a set
time-limit but still cannot pay, and there are apparent facts to indicate that
the possibility of payment is none, the insurer may withdraw insurance
coverage immediately. The termination of the effectiveness of insurance, the
calculation of the premiums payable and the added penalties for overdue
premiums shall be set on the dates the notifications for payment within a
set time-limit are arrived.

The insured units shall submit the application forms for the changes in the
insured units and other related documents to the insurer within so days
after the occurance of the following:
1.The changes of names, addresses or other corresponding addresses of the
insured units.
2.The changes of persons in charge of the insured units.
3.The changes of seals of the insured units or the persons in charge.
In case the name of the insured unit is changed, the original insurance
certificate shall be returned to the insurer and a new insurance certificate
shall be issued.
The insurer shall make the change referred to in the preceding paragraph
within 30 days.

When the persons in charge of the insured units are changed, the unpaid
premiums or the penalities for overdue premiums owed by the original persons
shall be individually and jointly assumed by the new persons.
When the insured units are terminated after merger and acquisition, their
unpaid premiums or penalities shall be assumed by the remaining insured
units after merger and acquisition or the new insured units.

When the insurance wages are adjusted or other related contents are changed,
the insured units shall duely fill them out on the insurance cards of the
insured persons safekept by them to reflect such changes. When the original
cards are totally filled out, the insured units shall notify the insurer to
issue new blank cards. They shall put these cards together and used and
safekept them accordingly.

In the event of employing persons under the age of 15 to perform the work, the
insured units shall submit xeroxed copies of their certificates of
graduating from national middle high schools or xeroxed copies of approval
certificates issued by the municipal or county (city) governments at the
worksites when apply for joining insurance coverage.

Foreign workers refered to in Paragraph 3 to Article 6 of the Statute applying
for joining insurance coverage shall submit xeroxed copies of work permits
approved and issued by the central competent authority or other related
business competent authorities.
The national identification cards referred to in these Regulations shall be
applicable to the foreign workers mentioned in the preceding paragraph, who
shall present their residence permits for foreign nationals or foreign
passports.

When the insured persons referred to in Article 9 of the Statute intend to
continue to join insurance coverage, the insured units shall not deny them.
When the insured persons referred to in Article 9 of the Statute continue to
join insurance coverage, the insured units they affiliated with shall continue
to pay premiums for them, and except under the circumstances of Items 2 and
4 of the same Article, shall notify in writing to the insurer about their
names, birthdates, serial numbers of their national identification cards,
the dates of their national military service, unpaid leaves, suspension from
the job because of pending lawsuits or detention. The same procedure shall
apply when the insured persons are discharged from national military
service, reinstated to the former positions or their detention are revoked
or stopped.
When the insured persons referred to in Item 3 of Article 9 of the Statute
continue to join insurance coverage, in addition to processing according to
the procedures stipulated in the preceding paragraph, they shall also submit
medical records issued by the hospitals or clinics.

When insured persons leave their employment and withdrew from insurance
coverage without receiving old-age benefits resuming employment after reaching
the age of 60, if their suspension of insurance seniority have not exceeded
two years, the insured unit they affiliated with may apply for rejoining
insurance coverage for them.

In the event that the insured person’s death, termination of employment,
withdrawal from membership of associations, conclusion (or withdrawal) of
vocational training programs, or disability after medical evaluations, the
insured units shall, on the dates on which death, termination of employment,
withdrawal from membership of associations, conclusion (or withdrawal) of
vocational training programs occurred or upon receipt of the notification of
disability, fill out the application forms for withdrawal of insurance
coverage and submit them to the insurer.
In the event that the insured persons are on the leave of absence due to
injuries or illness, the insured units may not withdraw their insurance
coverage.

In the event that the insured persons are transferred in the insured units
with the same affiliation, the tranferring units shall fill out the tranfer-
out part of the application forms for transfer of insurance coverage and
forward them directly to the receiving units. The receiving units shall fill
out the receiving part of the forms and submit both parts to the insurer.
The effectiveness of the transfer of insurance coverage shall be set on the
date when the application forms for tranfer of insurance coverage reach the
insurer. In case of mailing, they shall be set in accordance with the post-
marks of the original sending post offices.

In the event that there are changes to or errors in the insured persons’
name, birthdates, serial numbers of the national identification cards, the
insured units shall fill out the application forms for change in items of
the insured persons and submit the xerexed copies of the front and back
pages of the national identification cards or other related documents to the
insurer to process the changes.

All related insurance files and records shall be safekept and regularly
maintained by the insurer.

Persons who have the option to select and receive labor insurance coverage
or civil service insurance concurrently may only be permitted to select one
for insurance coverage.

For those insured persons who are qualified under Item 7 of Paragraph 1 to
Article 6 of the Statute, in the event that their insured units are those
professional labor unions not affiliated with their own specialties, or
those who have changed their own specialties but have not transferred to the
professional labor unions with their own specialties, the insurer, after
knowing the facts, shall notify the original insured units to transfer
insurance coverage within a set time-limit. Nevertheless, their insurance
seniority before and after the transfer shall be calculated in combine.

The total monthly wages referred to in Paragraph 1 to Article 14 of the
Statute shall be set in accordance with the wages stipulated in Item 3 of
Article 2 of the Labor Standards Law. For those without fixed or steady
monthly incomes, they shall be set according to the average monthly incomes in
the recent three months. For those who are paid in kind, they shall be
calculated in cash pursuant to the prices publicly announced by the
Government.
In the event the insured units filing application forms for joining
insurance coverage for their newly employed workers and their total monthly
wages are not ascertained, they shall be set at the total monthly wages
received by the workers with the same working grades in the insured units
and apply pursuant to the requirements contained in the Insurance Wages
Grading Table.

In the event that the insured persons’ insurance wage reported by the insured
units are not correct, the insurer shall adjust them immediately in accordance
with the insurance wages of the same professions with identical grades and
notify the insured units. If the adjusted insurance wages are not equivalent
to the actual wages, the amount shall be set in accordance with the actual
wages.
The immediately adjusted insurance wages referred to in the preceding
paragraph shall take effect from the first day of the month following the said
adjustments.

In the event that the insured persons are hospitalized because of injuries
or illness and those continue to join insurance coverage in accordance with
Items 1, 3, 5 of Article 9 and Part One of Article 9 of the Statute, their
insurance wages may not be adjusted during the period of joining insurance
coverage. When the Insurance Wages Grading Table is adjusted, their
insurance wages may not be set below the grades applicable to the basic
wages.

For those who joining insurance coverage prusuant to Item 3 of Paragraph 1
to Article 8 of the Statute, in the event that their incomes have not
reached the highest grade on the Injurance Wages Grading Table, they may apply
for reporting their insurance wages by themselves with proof. However, the
lowest grade may not below the fifteenth grade of the Insurance Wages
Grading Table and the highest grades of the applicable insurance wages
reported by their affiliated employees.

The insurer shall separately calculate payable insurance premiums in
accordance with the insured persons’ insurance wages reported by the
insured units each month and prepare insurance premium payment bills with
the statements of mothods of calculation regularly. The bills shall be sent to
the insured units before the 25th day of the next month and request them to
pay the premiums.

When the insured units received the premium payment bills with the
statements of methods of calulation sent by the insurer, they shall pay the
premiums immediately to the banks or post offices especially designated by the
insurer. When the payments are made through deposit accounts of the post
offices, the insured units shall fill out their names, serial number of
their insurance certificates, the monthly payments are made and the amounts of
payments on the correspondence part of the depocit bills and keep the
receipt as the proof the insurance premium payments.
In the event that the insured units have not received the premium payment
bills referred to in the preceding paragraph by the end of month the insurer
shall send them, they shall notify the insurer in writing to resend them
within five days. Under this circumstance, the insured units shall pay the
premiums within the grace period (fifteen days) or pay to the special labor
insurance accounts in the banks or post offices in accordance with the amounts
of premiums set in last month temporarily and set the amounts straight later
when they pay the premiums of the next month.

If the insured units object to the amounts of premiums stated in the premium
payment bills, they shall pay the said amounts first and then list the reasons
to file a formal objection to the insurer. When the insurer discovers errors
after investigation, it shall set the amounts straight later when it
calculates premiums of the next month.

In the event that the insured units are overdue in the payment of premiums
or late fees for overdue premiums, and after the insurer suspend insurance
payments temporarily in accordance with Paragraph 3 to Article 17 of the
Statute, they shall pay insurance premiums continuely during this temporary
suspension period. After the payment of these owed fees, the insured persons
can file their applications for their insurance payments.

The insurer shall calculate the amounts of insurance premiums payable by the
insured units in yuan (N.T.$1) and to count five and higher fractions as units
and disregard the rest when calculating a tenth of a yuan (N.T.$0.1).

In the event that the insured units cannot set-off or receive insurance
premiums within the time-limits set by Article 16 of the Statute due to
various reasons, they shall pay them first.

In the event that the insured persons are recruited to assume national
military service, take unpaid leaves, are suspended from the job because of
pending lawsuits or are detained and continue to join insurance coverage,
the portion of their premiums payable by the insured units shall be paid by
the insured units during the period. As for the portion of premiums payable by
the insured persons, those have already been paid shall be deducted from the
payments and those have not already paid shall be paid by the insured units
first and recover from the insured persons later.

In the event that the central and the provincial (city) governments shall be
responsible to pay or subsidize insurance premiums pursuant to Article 15 of
the Statute, the insurer shall prepare and issue insurance premium payment
bills each month and send them to the central and the city governments by
the end of the next month and request them to pay in accordance with the
related regulations.
After the insurer discovers that insurance premiums payable by the governments
refered to in the preceding paragraph are inadequate after investigation, it
shall set the accounts straight later when it calculates premiums of the
next month.

When employers or persons in charge of the insured units deduct insurance
premiums payable by the insured persons pursuant to Item 1 of Paragraph 1 to
Article 16 of the Statute, they shall explain them clearly on the insured
persons’ wage bills (bages) or issue receipts to them.

The insurer shall determine the applicable categories of occupations and
premium rates of the occupational incident insurance for the insured units
in accordance with the applicability list concening categories of
occupations and premium rates for the occupational incident insurance, and
after assessing the following principles, notify the insrued units in
writing:
1.The same category of occupations shall use the same premium rates of the
occupational incident insurance.
2.In the event that the same insured unit uses the same premium rates of
the occupational incident insurance and its line of business includes
various occupations, premium rates of the occupational incident insurance
shall be decided by its most principal or representative business.
If the insured units object to the categories of occupations and premium rates
referred to in the preceding paragraph, they shall prepare and submit
necessary documents or materials, and file an application for reexamination to
the insurer within fifteen days after the next day of receiving the
notification.
After the applicable categories of occupations and premium rates of the
occupational incident insurance are determined and ascertained, the insured
units are not allowed to request for readjustment except in the event of
changing their business.

The insured units with employees above a certain number referred to in
Paragraph 2 to Article 13 of the Statute, the standard of the number of
persons shall be determined by the central competent authority.

Late fees payable by the insured units referred to in Paragraph 2 to Article
47 of the Statute shall be calculated by the insurer and notify them to pay to
the designated banks or post offices.

For the purpose of letting the insured person pay their insurance premiums
by transfer of money or to deposit accounts of the post offices, the insured
units that the insured persons are affiliated with and referred to in Items 7,
8 of Paragraph 1 to Article 6 and Item 4 of Paragraph 1 to Article 8 of the
Statute may establish special “labor insurance” accounts in the financial
institutions or post offices and notify the insurer.
The insured units the insured persons are affiliated with and referred to in
the preceding paragraph, after receiving approvals from the insured persons or
the general meeting of the members, may take three-or-six months’ insurance
premiums in advance and issue receipts to the insured persons and pay to the
insurer monthly. Those insurance premiums received in advance and not yet
payable to the insurer shall be deposited in special accounts in the financial
institutions or post offices. The interests thus accumulated shall be used
within the scope of the insurance transactions referred to in the Statute.
The insured units which are receiving insurance premium in advance referred to
in the preceding paragraph may join the insurance programs for their chiefs or
personnel in charge of the business for the purpose of quaranteeing their
honesty and credibility.
The management of insurance premium received in advance referred in
Paragraph 2 to the Article shall be pursuant to the related regulations
concerning financial transactions of the groups affiliated with the insured
units.

In the event that the insurance premiums payable by the insured persons are
exempt from payment pursuant to Paragraph 1 to Article 18 of the Statute,
the insurer shall calculate the amounts in accordance with the approved
documents of payment and issue the insurance premium exemption bills, and
subtract the amounts from the total insurance premiums payable by the
insured units.

The insured units shall process the application of insurance benefit payment
procedures for their affiliated insured persons or their beneficiaries and
shall not receive any form of monetary compensation.

Persons continuing to apply for receiving injury or sickness benefits or
hospital care benefits referred to in Article 20 of the Statute are those
insured persons who have already received injury or sickness benefits or
hospital care benefits due to the incidents of injury and sickness before
withdrawing from insurance coverage, and continue to apply for receiving
such benefits after withdrawing from insurance coverage.
In the event that the insured persons apply for the payments of insurance
benefits after the termination the effectiveness of insurance pursuant to
Article 20 of the Statute, the procedures shall be processed by the original
insured units. However, if the original insured units are suspended, disbanded
or bankrupted as provided in Article 18 of these Regulations, the insured
persons or their beneficiaries may apply for these payments by themselves.

The “average monthly insurance wages” referred to in Paragraph 2 to
Article 19 of the Statute shall be calculated by dividing by six the insured
persons’ total monthly insurance wages in the most current six months prior
to the occurrence of the insurance incidents. For those who have joined
insurance coverage less than six months, their average monthly insurance wages
shall be calculated by their actual seniority in joining insurance coverage.
However, the old-age benefit payments shall be calculated by dividing by
thirty-six the insured persons’ total month insurance wages in the most
current three years prior to the retirement.
The “six months” or “three years” referred to in the preceding paragraph
shall include the month when the insruance incidents occur.
In the event that before the occurance of the insurance incidents the
insured persons have more than two insurance wages in the same month for
calculating their insurance wages in the most recent six months or the most
recent three years before their retirement, the highest wages shall be used as
a standard and calculated on average along with the monthly insurance wages of
the other months.

When applying for the payments of missing person allowance in accordance
with Paragraph 3 to Article 19 of the Statute, the following documents must be
prepared:
1.Application forms for missing person allowances.
2.Receipts of benefits payments.
3.Copies of whole household registration form (with the date of disappearance
listed).
The order for receiving missing person allowance shall be executed pursuant to
Article 65 of the Statute.
In the event that beneficiaries of missing person allowances are
grandchildren, brothers or sisters, they shall be limited to those who have
been specially raised and supported by the missing persons.

In the event that death benefits are paid pursuant to Paragraph 4 to Article
19 of the Statute but the insured persons are in fact alive, if they return
the paid death benefits and rejon labor insurance, their prior insurance
senority shall be restored and recognized.

In case insurance benefits are payable in cash in accordance with the Statute,
upon calculation by the insurer, they shall be transferred directly to the
insured persons or their beneficiaries. The insured units they are
afiliated with shall be notified and record the facts on the insurance
cards safekept by them.

Upon request by the insured persons or their beneficiaries, the insurance
benefit payments payable to them may be paid in advance by the insured units
in portion or in whole. After the insured units make the payments and
receive the proofs from the insured persons or their beneficiaries, while they
are in the process of applying for the payments of insurance benefits, they
may request the insurer to transfer the paid amounts to them directly. Under
such circumstances, the insurer shall record the facts on the benefit
payment notification bills.
The advance payments made by the insured units referred to in the preceding
paragraph shall be paid to the insured persons or their beneficiaries directly
and in persons.

After reviewing the applications for cash payments filed by the insured
persons or their beneficiaries and all procedures are deemed complete, the
insurer shall make the payments within ten days after receiving the
application forms.

The intentional criminal activities referred to in Article 26 of the Statute
shall be determined by the final decisions of the civil judicial authorities
or the military adjudication authorities.

All categories of insurance benefit payment application forms, receipts,
diagnostic documents and certificates used by the insured persons, insured
units, hospitals, clinics or licensed doctors or midwives shall be filled
out according to related written instructions.

With the exception of those stipulated in Articles 76 and 78 of these
Regulations, the medical diagnosis or birth certificates used in applying
for all kinds of insurance benefit payments shall be valid only after they are
prepared and issued by the hospitals, clinics or licensed doctors.
Birth certificates prepared and issued by licensed midwives shall also be
valid.

In the event that the Labor Insurance Supervisory Committee is evaluating
cases of insurance dispute or the insurer is examining insurance benefit
payments, if they deem necessary, may request the insured persons,
beneficiaries, insured units, hospitals, clinics, licensed doctors or midwives
to submit related reports. They may also send persons to examine and
investigate the medical histories, account, physical examination and
chemical test results or x-rays of the conerned hospitals, clinics and insured
units. The insured persons, beneficiaries, insured units, hospitals,
clinics, licensed doctors or midwives are not allowed to reject these
requests.

For those insurance benefit payments that are calculated on a daily or
instance basis, they shall be calculated to the tenth of a yuan. If the
total amount of payments are calculated on a yuan basis, five and higher
fractions shall be counted as units and disregard the rest when calculating
a tenth of a yuan.

When applying for the payments of birth benefits in accordance with Article 31
of the Statute, the following documents must be prepared:
1.Application forms for birth benefit payments.
2.Receipt of benefits payments.
3.Birth certificate of the newborn babies or copies of valid household
registration form with the names of the mothers and the birth dates, months
and years of the newborn babies listed. In the event of miscarriage, the
certificates of miscarriage prepared and issued by the hospitals, clinics,
or licensed doctors or midwives.

When applying for the payments of injury or sickness benefits in accordance
with Article 33 or 34 of the Statute, the following documents must be
prepared:
1.Application forms for injury or sickness benefit payments.
2.Receipt of benefit payments.
3.Written medical diagnosis of the injury or sickness. In the event that
hospitalization is required, the documents prepared and issued by the
hospitals concerned which contain the names of the injury and sickness and the
dates of entry and release can be served as substitutes.
For those persons infected with dust-lung diseases and apply for the
payments of occupational diseases compensation diseases, copies of x-rays
and the reports of dust-related operation employment history shall be attached
and submitted. However, if the insurer has verified that the applicants have
been hospitalized and registered for dust-lung diseases, the aforementioned
required documents can be waived.

A term for the insured persons to apply for the payments of injury or sickness
benefits is set at every fifteen days and the applications shall be made at
the end of the term.

After the approval of the central competent authority, the insurer may
delegate the management of the payments of occupational injury and disease
medical benefits to the central health insurance board. The contract of
delegation shall be drawn up by the insurer and the central health insurance
board and submit to the central competent authority and the central health
competent authority for review and approval.
After the insurer delegates the management of the payments of occupational
injury and disease medical benefits to the central health insurance board,
if the insured persons suffering from occupational injuries or occupational
diseases, they shall apply to the medical service institutions affiliated with
the National Health Insurance Program for treatment and diagnosis. With the
exception of other regulations provided for by the Statute and these
Regulations, the medical payments paid by the insurer shall be executed
pursuant to the related regulations of the national health insurance program.

When the insured persons applying for outpatient medical treatments or
hospitalization for occupational injuries or diseases, they shall submit the
occupational injury or disease outpatient medical treatment bills or
hospitalization application forms prepared and issued by the insured units
they are affiliated with, as will as the national health insurance cards and
national identification cards or other related documents that can verify the
identities of the insured persons for review. In the event of failing to
submit these documents or the required documents are not suitable, the medical
service institutions affiliated with the national health insurance program
shall deny their registration and medical treatment as patients with the
status of the insured persons.
In the event that the insured persons suffering from occupational injuries
or occupational diseases and the insured units they are affiliated with do not
issue occupational injury or disease medical treatment bills or forms for
them, they may apply them directly to the insurer. After the insurer reviews
and discovers the facts are true, the bills or forms shall be issued.

In the event that the insured persons cannot submit or submit for review the
related required documents due to the facts that they have not received the
occupational injury or disease outpatient medical treatment bills, or
hospitalization application forms, or national health insurance cards, or
are seeking emergency treatments for injuries or diseases, they shall
prepare and submit other related documents that can verify their identities
and proclaim they are in the possession of labor insurance status, and proceed
to register and receive medical treatments. Under such circumstances, the
medical service institutions affiliated with the national health insurance
programs shall provide medical services, receive insurance medical expenses
and issue receipts to the persons seeking medical treatments. In case the
insured persons obtain and submit the required documents within seven days (
excluding regular days off) after the date they are admitted for medical
treatments, the medical service institutions affiliated with the national
health insurance program shall refund the paid insurance medical expenses.

In the event that the insured persons are unable to provide the necessary
documents within the seven days after receiving medical treatments as
stipulated in the preceding article as the result of any circumstances not
of their own faults, they shall prepare and submit the occupational injury
or disease outpatient medical treatment bills or hospitalization application
forms and the receipts of medical expenses prepared and issued by the
medical service institutions affiliated with the national health insurance
programs, within six months from the date of receiving outpatient medical
treatment or the date of releasing from hospitalization, to the branch offices
Central Health Insurance Board responsible for the jurisdictional districts to
apply for reimbursement of the paid medical expenses.

The instructions for receipt, issuance and usage of bills and forms for
medical treatments of occupational injuries and diseases shall be drawn up the
insurer and submitted to the central competent authority for review and
approval.

Upon receipt of the insured persons’ occupational injury or disease
outpatient medical treatment bills, the medical service institutions
affiliated with the national health insurance program shall attach them to the
medical histories of the insured persons and preserve them for review and
examination. Upon receipt of the occupational injury or disease
hospitalization application forms, they shall fill out in detail the
verification portions of the application forms and submit them within three
days to the insurer for review and examination.
After the insurer review the applications for hospitalization referred to in
the preceding paragraph and decides that they are not qualified as
occupational injuries or diseases, it shall notify the Central Health
Insurance Board, the medical service institutions affiliated with the National
Health Insurance Program, insured units and the insured persons.

In the event that the insured persons are hospitalized several times with
the same occupational injuries or diseases, the total number of days used to
calculated the amount of benefits for coverage of food expenses as provided
for in Item 4 of Paragraph 1 to Article 43 of the Statute shall be counted
from the first day of hospitalization and calculated in combine every six
months.
The standards for payments of the food expenses referred to in the preceding
paragraph shall be drawn up by the central competent authority with the
central health competent authority.

In the event that the occupational injury or disease hospitalization
application forms issued by the insured unit contain any incomplete
information, errors, or the whole procedure is not complete. After two
notifications from the insurer to make the necessary corrections within
certain timelimits but to no avail without due causes, thus creating a
situation that the insurer cannot make proper assessments and payments medical
benefits, the insurer shall not pay the benefits.

After the implementation of the National Health Insurance Program, the
hospital rooms belong to the Government Employees’ Insurance Programs
referred to in Item 5 of Paragraph 1 to Article 43 of the Statute shall be
designated as the insurance rooms belong to the National Health Insurance
Program.

In the event that the insured persons are stricken with occupational
injuries or diseases outside of the jurisdictional ares which this Statute
is implemented and require outpatient medical services or hospitalization,
they may retain the documents of proof and bills of expenses issued by the
hospitals or clinics where they received medical treatments and present
them, within six months from the dates they received chinical services or
the dates they are released from the hospitals, to the insured units they
are affiliated with. The insured units shall apply to the branch offices of
the Central Health Insurance Board responsible for the jurisdictional
districts for reimbursement of the outpatient or hospitalization expenses.
The insurer shall pay the outpatient or hospitalization expenses referred to
in the preceding paragraph in accordance with the real and true fees. However,
if the amoutns applied for exceed the average standardized fees payable to the
outpatient and hospitalization expenses as compiled by the medical research
centers under special contracts with the National Health Insurance Program
three months prior to the dates the contingercies occurred or the dates the
insured persons were released from the hospitals, the excessive portions of
the expenses shall not be paid by the insurer.
If the insured persons received emergency injury or sickness treatments but
not at the medical service institutions affiliated with the National Health
Insurance Program, their time-limits for applying benefit payments and the
standards of payments of the insruer shall be executed pursuant to the related
regulations contained in the Measures for the Reimbursement of Emergency
Injury or Sickness Medical Expenses Paid by the Patients Themselves in the
National Health Insurance Program.

When applying for the payments of disability benefits in accordance with
Article 53 or 54 of the Statute the following documents must be prepared:
1.Application forms for disability benefits payments.
2.Receipt of benefits payments.
3.Written medical diagnosis of the disabilities.
4.For persons examined with x-rays shall supply the x-rays taken.
The written medical diagnosis of the disabilities rererred to in the preceding
paragraph shall be prepared and issued by the hospitals or clinics
performing the treatments under special contracts with the national health
insurance program. For those disabilities stricken outside of the
jurisdicational area which this Statute is implemented, they shall be prepared
and issued by the original hospitals or clinics performing the treatments.
While reviewing disability benefit payments, the insurer, in addition to
designating hospitals, clincis or doctors under special contracts with the
national health insurance program to perform re-examinations pursuant to
Article 56 of the Statute, may also notify the hospitals or clinics which
prepared and issued the written medical diagnosis and request them to submit
any necessary records of examinations or other related medical history
records.

The term “termination of medical treatments” referred to in Paragraph 1 to
Article 53 and Paragraph 1 to Article 54 of the Statute means after medical
treatments, the injuries or sickness suffered by the insured persons remain
stable and unchanged and are not expected to improve even resume medical
treatments.

When applying for the payments of disability benefits in accordance with
Article 53 and 54 of the Statue, the dates for applying the payments of the
benefits pursuant to Article 30 of the Statute shall be set on the dates on
which the hospitals or chinics under special contracts with the national
insurance disabilities or will never recover.
In the event that the insured persons request the issuance of the written
medical diagnosis referred to in the preceding paragraph, the hsopitals or
chinics under special contracts with the National Health Insurance Program
shall issue the documents within three days.

The term “on the same part” referred to in Items 8 and 9 of Article 55 of
the Statute means the same portions that are paysically on or linked to the
disabled system of the insured persons’ bodies.

For those subject-matters not that are not covered by Article 55 of the
Statute and the Chart of Payment Standards for Disability Benefits of Labor
Insurance Program, may be supplemented by the regulations issued by the
central competent authority.

In the event that the insured persons who was unable to perform work due to
physical disabilities and apply for disability benefit payments in
accordance with the Chart of Payment Standards for Disability Benefits of
Labor Insurance Program and die afterwards, their beneficiaries may select
to receive death benefits or disability benefits.

In the event that insured persons apply for the payments of old-age
benefits, the insured units they are affiliated with shall at the same time
proceed to the procedures of with drawing from insurance coverage.

The term “joining insurance program in the samn insured units” referred to
in Item 3 of Paragraph 1 to Article 58 of the Statute means any one of the
following situations:
1.The insured persons join insurance coverage with their affiliated
employers, institutions or groups.
2.The insured persons join insurance coverage with the employers,
institutions or groups that are merged or reorganized in accordance with
related statutes and administrative regulations.
3.The insured persons join insurance coverage with the employers,
institutions or groups that are transferred from public enterprises to private
enterprises in accordance with the Statute for Transferving Public Enterprises
to Private Enterprises.

When apply for the payments of old-age benefits in accordance with Article
58 of the Statute, the following documents must be prepared:
1.Application forms for old-age benefit payments.
2.Receipt of benefit payments.
3.Copies of household registration form or xereoed copies of the front and
back pages of the national identification cards. The xereoed copies of the
national identification cards shall be stamped by the insured units to
verify that they are authentic to the original documents.
4.For those persons qualified under Item 4 of Paragraph 1 to Article 58 of
the Statute, related certificates of employment shall also be submitted.

The grandchildren, brothers or sisters who are specially raised and
supported referred to in Articles 63 and 64 of the Statute are those persons
who do not have abilities to earn their own living and cannot maintain their
own life, and are raised and supported by the deceased insured persons prior
to their death.

When the parents, spouses or children of the insured persons are legally
proclaimed death, the time of their death shall be set by the count’s
formal decisions, and the time shall be regarded as the time of death referred
to in Article 62 of the Statute. The amounts of their burial subsidies shall
be calculated in accordance with the following stipulations:
1.If the time of death and the count’s decision fall during the insurance
coverage period of the insured persons, they shall be calculated according
to the monthly insurance wages in the six months prior to the month the
related decision is rendered by the court.
2.If the time of death falls during the insruance coverage period of the
insured persons, and when the related decision is redenered by the court the
insruance coverage is with drawn, they shall be calculated according to the
monthly insurance wages in the sic months prior to the month the insurance
coverage is withdrawn.

In the event that when the applications for the payments of death benefits are
submitted and the insured units affiliated fail to proceed with the process of
withdrawing from insurance coverage, the insurer shall terminate insurance
coverage directly and immediately.

When the insured persons applying for burial subsidies referred to in
Article 62 of the Statute, the following documents must be prepared:
1.Application forms for burial subsidies.
2.Receipt of subsidy payments.
3.Death certificates or written autopsy reports issued by the public
prosecutors, and in the event of legally proclaiming death, the related
court decisions.
4.Copies of valid household registration form with the dates of death listed.
In case the deceased are adopted children, the dates of their adoption and
registration shall also be listed.

When applying for burial subsidies and survivors’ subsidies referred to
Article 63 or Article 64 of the Statute, the following documents must be
prepared:
1.Application forms for burial subsidy and survivor’s subsidies.
2.Receipt of subsidy payments.
3.Death certificates or written autopsy reports issued by the public
prosecutors, and in the event of legally proclaiming death, the related
court decisions.
4.Copies of whole household registration form with the dates of death listed.
In case the deceased are adopted children, the dates of their adoption and
registration shall also be listed.

In the event that when the applications for the payments of death benefits are
submitted and the applications and the deceased are not belong to the same
household, they shall submit separate copies of the household registration
forms at the same time.

In the event that the insured persons do not have any survivors referred to in
Articles 63 and 64 of the Statute, those responsible for their burials shall
submit relevant documents and apply to the insurer for the payments of
burial subsidies.

In the event that the beneficiaries of the payments of survivors’ subsidies
are minors, their submitted application forms and receipts shall be signed and
stamped with the seals of their legal guardians.

In the event that the beneficiaries of the payments of survivors’ subsidies
with the same order as referred to in Article 65 of the Statute and there
are more than two persons, they shall jointly apply and receive these
payments. In the event that there are still other beneficiaries exist and do
not file their applications, those beneficiaries applied and received the
payments shall be responsible for paying them later their entitled shares.

In the event that after the insured persons died and their beneficiaries are
minors and cannot apply for the payments of insurance benefits as referred
to in Article 92 of these Regulations, the insured units they are afflilated
with shall notify the insurer immediately. Under such circumstances, except
the payments of burial subsidies may be processed in accordance with Article
91 of these Regulations, their survivors’ subsidies shall be deposited by the
insurer and receive interests. The subsidies shall be paid by the tiem their
beneficiaries are qualified to apply and received.

The expenses referred to in Article 68 of the Statute shall include all
costs needed for handling personnel and business affairs of the insurance
program.

The forms, lists and charts of the various documents provided for in the
Statute and these Regulations shall be designed and determined by the
insurer.
The forms and lists referred to in the preceding paragraph, with the exception
of those required by the medical service institutions under special
contracts with the National Health Insurance Program to implement medical
service for labor insurance matters, shall be produced and issued by the
insurer.

These Regulations shall become effective on the day of promulgation.