How to file Korea NHIS Form 39 after leaving a job

Eight checks on Form 39

1. Eligibility and deadline before writing: confirm that employment ended, status changed from employee to regional subscriber, and the applicant paid remuneration-based premiums while holding employee coverage for at least 365 total days in the 18 months counted backward from the end of employment. The application must reach NHIS within two months from the due date of the first regional premium billed after the change—not two months from retirement.
2. Enrollment or withdrawal: for a new application, tick 가입 (enrollment), not 탈퇴 (withdrawal). The same Form 39 handles both actions. Dark fields for receipt number, receipt date and processing are completed by NHIS.
3. Member fields: enter the legal name, alien registration or domestic residence number, current address and reachable phone numbers. Use the current record and protect the full identification number in any learning copy.
4. Former workplace: enter the official former workplace or institution name and exact employment start/end dates. NHIS uses the coverage history rather than the applicant’s rough month count, so reconcile the dates before filing.
5. Dependants and foreign-status fields: list only people who meet dependant requirements. Enter relationship, name and identifier; for a foreign dependant, also enter nationality, status of stay and stay period. Provide family-relationship proof when the relationship is not verifiable, disability or veteran proof where applicable, and the specified foreign-registration or domestic-residence documents.
6. Payment and refund: automatic transfer is optional. Enter bank, account, holder, holder identifier, relationship and preferred debit date only when applying. A refund account must be the continuing member’s own account and is cancelled when that status ends. Confirm account restrictions with NHIS rather than entering an employer or unrelated person’s account.
7. Electronic notice and declaration: choose email, website, mobile or another supported electronic channel only if wanted, then enter the corresponding address or receiver details. Read the declaration about retroactive loss, date and sign the application addressed to the NHIS chairperson.
8. After submission: confirm the receipt and coverage-acquisition date, the premium amount and the first due date. Coverage can run from the day after employment ended for up to 36 months, subject to earlier status change. The premium uses the average monthly remuneration from the latest 12 assessed months. If the first premium remains unpaid through two months after its due date, employee status can be lost retroactively and regional status restored from the day after retirement.

Example only — do not submit: Minh T. leaves example employer Hanbit Parts on 31 July 2026. NHIS records—not his estimate—confirm at least 365 employee-insured days in the preceding 18 months. After receiving his first regional bill, he records its due date and applies within two months from that due date. He asks NHIS to compare the two premium amounts, then ticks enrollment on Form 39, enters his legal identity, exact former-workplace dates and one eligible spouse with verified foreign-registration and stay data. He chooses mobile notice, leaves optional banking blank until confirming account rules, dates and signs, and retains the receipt and first bill. Replace every name, identifier, date, dependant, employer and option with verified facts.