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Art. 5 Ordinance on the Reduction of Health Insurance Premiums (ORP) - Calculation of Income (Art. 14 KVGG)
Art. 5 VKP - Calculation of Income (Art. 14 KVGG) · Calculation of Income (Art. 14 KVGG)
1. Countable income is considered to be the net annual income according to the tax assessment of the Canton of Fribourg (Code 4.910); the tax period taken into account is the one that is two years prior to the year for which the eligibility for premium reductions is verified (year x - 2 years); the income is increased
a) for wage and pension recipients by
1. the insurance premiums and contributions (Codes 4.110-4.140),
2. private interest on debt, insofar as it exceeds 30,000 francs (Code 4.210),
3. maintenance costs for private real estate, insofar as they exceed 15,000 francs (Code 4.310),
4. one-twentieth (5%) of the taxable assets (Code 7.910);
b) for persons engaged in self-employment by
1. premiums for health and accident insurance (Code 4.110),
2. other premiums and contributions (Code 4.120),
3. purchase of contribution years (2nd pillar, pension fund) insofar as it exceeds 15,000 francs (Code 4.140),
4. private interest on debt, insofar as it exceeds 30,000 francs (Code 4.210),
5. maintenance costs for private real estate, insofar as they exceed 15,000 francs (Code 4.310),
6. one-twentieth (5%) of the taxable assets (Code 7.910).
2. For persons liable to withholding tax, the following provisions apply
a) The countable income corresponds to 80% of the taxable gross income from the year that is two years prior to the year for which the eligibility for premium reductions is examined (year x - 2 years), plus one-twentieth of the taxable assets.
b) If the person liable to withholding tax has just settled in the Canton of Fribourg from another canton or from abroad, the countable income corresponds to 80% of the taxable gross income since their arrival in the canton, plus one-twentieth of the taxable assets. The countable income is determined based on the actual income during the calendar year. However, the AHV Fund may review the file and adjust the income to an annual income if it is proven that the insured person has a regular and permanent income.
c) If a person liable to withholding tax is subsequently assessed under the normal procedure according to Article 73a and 73b of the Act on Direct Cantonal Taxes (DStG), the countable income is determined according to the calculation rule in Article 5 Para. 1 VKP based on the subsequent ordinary tax assessment.
3. Changes in civil status (marriage, registered partnership, divorce, and death of a spouse) as well as separations occurring from January 1 of the current year are only considered from the 1st day of the following year on the basis of the corresponding tax assessment. For the above-mentioned situations, a new application as per Article 2 must be submitted in the following year to determine the entitlement to premium reductions.
4. Changes in the number of dependent children are considered from the 1st day of the month in which the event occurs, but at the earliest from January 1 of the year in which it was reported to the AHV Fund.
5. In the event of a change of custody to either the mother or father, the child's entitlement is reviewed based on the corresponding tax assessment of one of the aforementioned persons, which is used for the calculation of the countable income.
6. Dependent children, regardless of whether they live with one parent or both parents in a shared household, are considered only once in the calculation of the income limit, either with the mother or the father; the following provisions apply
a) For separated or divorced parents with shared custody, the child is attributed to the parent with the higher countable income in the calculation of the income limit.
b) For separated or divorced parents with sole custody, the child is attributed to the parent with sole custody in the calculation of the income limit.
c) For unmarried couples, the child is attributed to the parent with the higher countable income in the calculation of the income limit.
d) If the maintenance payment in favor of the adult child is no longer taxed and can no longer be deducted from the taxes of the separated or divorced parents, the child is attributed to the parent paying the maintenance payment upon written request by the affected person.
7. For persons who have not received a premium reduction in the previous two years, the AHV Fund may, upon a justified request by the affected person, determine the entitlement based on the tax assessment of the new tax period if the financial situation from the year preceding the eligibility examination deviates by at least 30% from the countable income according to paragraph 1.
8. For persons who have recently moved to the Canton of Fribourg, the following provisions apply
a) If an insured person settles in the Canton of Fribourg from another canton or abroad, the calculation of the countable income is based on the first tax assessment issued by the Cantonal Tax Administration of the Canton of Fribourg. This is necessary for the decision.
b) If a person subject to ordinary tax, receiving material social assistance, settles in the Canton of Fribourg from abroad, a provisional decision is made based on the budget submitted by the responsible regional social service. Considering Article 20 KVGG, the AHV Fund reviews the entitlement retroactively as soon as the tax assessment in accordance with the above letter a is available.
9. If the civil status of an insured person receiving material social assistance changes (only separation or divorce), a provisional decision is issued based only on a justified request and the tax declaration submitted by the responsible regional social service. The AHV Fund retroactively reviews the entitlement, considering Article 20 KVGG, as soon as the tax assessment according to letter a of the preceding paragraph is available.