NEWS IN HEALTH INSURANCE FROM 2026: What employers, employees and self-employed persons need to know

1) Changes in who is and who is not an employee

The list of persons who are not considered employees for health insurance purposes is being amended – e.g.:

• persons who only have income from dependent activity that is not subject to tax or is exempt from tax (Section 6(7) and (9) of the Income Tax Act),
• pupils or students who only have income from dependent activity for practical training work,
• agreements to perform work up to CZK 12,000,
• members of cooperatives with income up to CZK 4,500,
• members of a community of unit owners who perform work for the community for which they are remunerated and who did not reach the taxable income of CZK 4,500 in a calendar month,
• fixed work agreements, or multiple such agreements with one employer, if the total income from such agreements in a calendar month did not reach the creditable income of CZK 4,500,
• volunteer care workers who did not reach the creditable income of CZK 4,500 in a calendar month,
• persons with income exempt from tax or not subject to tax,
• persons who have been awarded witness fees or compensation for lost earnings for participating in proceedings. 

2) Change in the conditions for not applying the minimum assessment base to employees for whom the state pays insurance premiums on the basis of childcare

From 1 January 2026, only those insured persons who personally and properly care for at least one child under the age of 7 will be eligible for state insurance. Inclusion will only be possible on the basis of a notification submitted directly to the health insurance company. The insured person will also be obliged to inform their employer of their entitlement to state insurance premium payments.

Entitlement will arise at the earliest on the date on which the health insurance company receives the notification and cannot be claimed retroactively.

The current rules valid until 31 December 2025 remain unchanged: the minimum assessment base does not apply to employees who provide full-time care for at least one child under the age of 7 or two children under the age of 15. 

3) Employer's reporting obligation

With effect from 1 January 2026, employers will only be required to report two situations to the health insurance company that are decisive for the payment of insurance premiums by the state:

• an employee on maternity leave,
• an employee on parental leave.

All other data necessary to assess whether the state pays the insurance premiums will now be obtained by the health insurance company itself from available information sources. The existing set of codes on the Employer's Collective Report form and their meaning will not change; for facts that will no longer be subject to the employer's reporting obligation, they will mainly be used to report data relating to the period up to 31 December 2025. 

4) Increase in the minimum wage from 1 January 2026 to CZK 22,400

This amount is decisive for determining the minimum assessment base for health insurance.

5) Job seekers at the employment office

If they do not receive unemployment benefits, they may simultaneously perform dependent work (employment or fixed work agreement) if their income for the calendar month does not exceed half of the minimum wage, i.e. CZK 11,200. 

6) Participation in insurance for agreements to perform work: now only from an income of CZK 12,000

For agreements to perform work, participation in health insurance arises only when monthly income reaches CZK 12,000. This is a fundamental change from the perspective of both employers and employees.

7) Health insurance payments by cashless means only

From 1 January 2026, it will only be possible to pay insurance premiums by bank transfer to the health insurance company's account.

Cash payments will be completely abolished.

8) Health insurance companies will now transfer data themselves when changing insurance companies

It is no longer the responsibility of the insured person to submit documents on the amount of advance payments to the new insurance company. The insurance companies will transfer all information between themselves.

Insured persons are therefore not required to submit proof of advance premium payments to their new insurer, as was the case until the end of 2025. The new definition states that if an insured person is not staying at their place of permanent residence, they are required to notify the relevant health insurance company of their delivery address. 

9) Changes for state-insured persons and deductions for employers

The state assessment base for 2026 is increased to CZK 16,206 → from 1 January 2026, the relevant health insurance companies will receive CZK 2,188 per month for each state insured person.

The deduction of CZK 16,206 can now only be claimed by employers who employ more than 50% of persons with disabilities out of the total average converted number of their employees, and only if they employ a person who has been granted a disability pension. 

10) Persons without taxable income will pay CZK 3,024 per month from 2026

This is based on the minimum wage, which will increase to CZK 22,400 from 1 January 2026. 

11) Probable insurance premium for 2026

It will now be set at 1.5 times the average wage if the employer or self-employed person does not submit an overview. 

12) New deadlines: everything is reduced to 6 years

The limitation period for prescribing and enforcing insurance premiums is shortened from 10 years to 6 years, as is the deadline for refunding overpayments.

This also applies to penalties and related procedures. 

13) New definition of self-employed person: performance of activity is no longer decisive

From 2026, anyone who receives income under Section 7 of the Income Tax Act will be considered self-employed, even if they do not actually perform any activity.

This applies, for example, to:

• income from the provision or use of rights (patents, trademarks, industrial designs), other income from self-employment without performing business activities.

14) Significant changes for self-employed persons: advance payments, minimum amounts and administrative relief

The minimum advance payment for self-employed persons is increased to CZK 3,306 from the current CZK 3,143.

This is based on the new average wage of CZK 48,967 and the assessment base of CZK 24,483.50.

Advance payments in 2026 do not have to be paid by self-employed persons who:

• are not required to comply with the minimum assessment base,
• have a business as a secondary source of income,
• were on sick leave or in quarantine for the entire month.

Starting a business without advance payments for everyone

From 1 January 2026, every self-employed person who does not have a minimum base will not have to pay advance payments in the first year – not just state-insured persons (as is the case until the end of 2025).

Long-term care allowance now reduces the minimum base

Self-employed persons caring for a close relative will be able to reduce the minimum assessment base to an aliquot part, as is the case when receiving sickness benefits or maternity benefits. 

15) Self-employed persons must submit their overview electronically only

Self-employed persons will only be able to submit the "Overview" (both regular and corrective) electronically.

16) Transfer of the obligation to pay insurance premiums and liability newly regulated

The new provisions of Sections 15b and 15c clearly stipulate:

• the transfer of the obligation to pay insurance premiums and penalties to the legal successor,
• guarantee for debts incurred by the predecessor.

Authors: Aneta Nováková, Martina Farářová

Revision: Martina Farářová