Health Insurance Annual Report for the Self-Employed: A Complete Guide
The annual income and expenses report for your health insurance provider is a document that every self-employed person (OSVČ) must submit each year. Based on this report, your insurer calculates how much you will pay in advance payments in the coming period, and also determines whether you have underpaid or overpaid your insurance contributions for the previous year. This guide will walk you through the entire process step by step — from gathering the necessary documents, through completing the form, to submitting it and paying any outstanding balance. All information reflects the legislation currently in force for submitting the report for the 2025 tax year.
Who is required to submit the health insurance annual report?
The report must be submitted by every OSVČ who carried out self-employed activity for at least part of 2025. It makes no difference whether this was a primary or secondary activity, or what your income level was. The obligation also applies to self-employed individuals who had zero income or reported a loss.
Exception: OSVČ who were enrolled in the flat-rate tax scheme (paušální daň) for the entire 2025 year and met all of its conditions are not required to submit the report.
Deadlines for Submitting the Report in 2026
The deadline for submitting the report depends on when you filed (or were required to file) your personal income tax return. The rule is that you must submit the report within one month of the expiry of the deadline for filing your tax return.
| Situation | Tax Return Deadline | Health Insurance Report Deadline | Balance Payment Deadline | |---------|---------------------------|----------------------|---------------------| | OSVČ not required to file a tax return | -- | 8 April 2026 | Within 8 days of submitting the report | | Tax return filed in paper form | 1 April 2026 | 4 May 2026 | Within 8 days of submitting the report | | Tax return filed electronically | 4 May 2026 | 4 June 2026 | Within 8 days of submitting the report | | Tax return processed by a tax advisor | 1 July 2026 | 3 August 2026 | Within 8 days of submitting the report |
New from 2026: mandatory electronic submission
From 2026, all OSVČ must submit their health insurance annual report exclusively in electronic form. This requirement applies regardless of whether you have a data mailbox (datová schránka) or not. Paper forms are no longer accepted by insurers. Electronic submission can be completed via your health insurer's web portal or through your data mailbox.
Where to Submit Your Report — by Insurer
You always submit your report to the health insurer with which you were registered in the given year. If you changed insurer during 2025, you must submit a report to both insurers — each covering the relevant portion of the year.
📊Health insurer online portals
What You Will Need to Complete the Report
Before you start filling in the form, prepare the following documents:
📋Documents needed to complete the report
How to Complete the Report — Step by Step
The report form looks slightly different depending on your insurer, but all forms require the same information. The following process applies universally.
Step 1: Personal Details
Enter your first name, surname, national identification number (rodné číslo), permanent address, and policy number (which is the same as your national identification number). Also state the period covered by the report (year 2025).
Step 2: Income and Expenses
Here you enter:
- Income from self-employed activity — this is your total income under Section 7 of the Income Tax Act. This figure must match the amount in your tax return (line 101 of Annex No. 1).
- Expenses incurred to generate income — either actual expenses from your tax records, or flat-rate expenses (line 102 of Annex No. 1 of your tax return).
Step 3: Calculating the Assessment Base
The assessment base for health insurance is calculated as 50% of the difference between income and expenses (i.e. 50% of your tax base).
Calculating the assessment base and insurance contribution for 2025
Step 1: Tax base = Business income − Expenses
Step 2: Assessment base = 50% of the tax base
Step 3: Annual insurance contribution = Assessment base × 13.5%
Step 4: Balance due / overpayment = Annual insurance contribution − Total advance payments made in 2025
Example — primary OSVČ, full year 2025:
- Income: 1,200,000 Kč
- Expenses (60% flat rate): 720,000 Kč
- Tax base: 480,000 Kč
- Assessment base (50%): 240,000 Kč
- Annual insurance contribution (13.5%): 32,400 Kč
- Advance payments made (12 × 2,968 Kč): 35,616 Kč
- Result: overpayment of 3,216 Kč
Minimum assessment base
If your calculated assessment base falls below the minimum threshold, you must pay contributions based on at least the minimum assessment base. For 2025, the minimum monthly assessment base is 22,229.50 Kč (half of the average wage of 44,459 Kč). The minimum assessment base does not apply to OSVČ who are also employees and whose self-employed activity is not their primary source of income.
Step 4: Summary of Advance Payments Made
Enter the total amount of advance payments you made towards health insurance during 2025. Note that what counts is the payments actually made within that calendar year, not the payments attributable to specific months.
Step 5: Balance Due or Overpayment
If your annual insurance contribution is higher than the total advance payments you made, you have a balance due. This must be paid within 8 days of the date on which you submitted (or were required to submit) the report. If your advance payments exceed your annual contribution, you have an overpayment, and you can request a refund.
Step 6: New Advance Payment Amount
Based on your submitted report, your insurer will calculate a new monthly advance payment amount. The new advance payments apply from the month following the month in which you submitted your report.
How New Advance Payments for 2026 Are Calculated
Your new advance payment is derived from your assessment base for 2025:
Calculating the new monthly advance payment
Step 1: Monthly assessment base = Annual assessment base ÷ Number of months of activity
Step 2: Monthly advance payment = Monthly assessment base × 13.5%
Example (continuing from above):
- Annual assessment base: 240,000 Kč
- Number of months: 12
- Monthly assessment base: 20,000 Kč
- New advance payment: 20,000 × 13.5% = 2,700 Kč/month
Watch out! The minimum advance payment for 2026 is 3,306 Kč. Since the calculated payment (2,700 Kč) is below the minimum, you will pay 3,306 Kč per month.
Minimum health insurance advance payment for 2026
From 1 January 2026, the minimum monthly health insurance advance payment for primary OSVČ is 3,306 Kč. This figure is based on a minimum assessment base of 24,483.50 Kč (half of the average wage of 48,967 Kč). Even if your calculated advance payment works out lower, you must pay at least this minimum amount.
Payment Deadlines and Bank Details
Health insurance advance payments are made monthly and are due from the 1st day of the calendar month they relate to, through to the 8th day of the following month.
📋Example payment deadlines
Pay your advance payments by bank transfer to your health insurer's account. From January 2026, VZP and some other insurers no longer accept cash payments. Use your national identification number (without the slash) as the variable symbol.
Common Mistakes When Completing the Report
Things to watch out for
-
Inconsistency with the tax return — income and expense figures in the report must match exactly what appears in your tax return (Annex No. 1). Insurers carry out cross-checks.
-
Incorrect number of months — months during which you were self-employed for only part of the month still count. If you started trading on 15 March, March counts as a full month.
-
Confusing primary and secondary activity status — an OSVČ who is also an employee is not required to meet the minimum assessment base, but must correctly reflect this in the report.
-
Forgetting about an insurer change — if you changed health insurer during 2025, you must submit a report to both insurers covering their respective periods.
-
Late submission — your insurer may charge a penalty of 0.0322% of the outstanding amount for each day of delay.
The Report for Secondary OSVČ
If you are self-employed while also being an employee (with employment as your primary source of income), you benefit from several advantages when submitting the report:
- You are not required to meet the minimum assessment base — you pay contributions based on your actual assessment base, even if it falls below the minimum.
- You are not required to pay advance payments — you pay the full year's contributions as a single lump sum after submitting the report. You may pay advances voluntarily, but it is not obligatory.
- Your employer pays contributions on your employment income — for your self-employed activity, you only pay contributions on income that exceeds the contributions already paid through your employment.
When are you classified as a secondary OSVČ?
For health insurance purposes, you are classified as a secondary OSVČ if you are also an employee and your employer pays contributions on at least the minimum employee assessment base on your behalf. Simply having employment income is not sufficient — your employer must be paying contributions on at least the minimum assessment base.
Amended Report
If you discover an error after submitting your report (for example, because you later filed an amended tax return), you must submit an amended report. The deadline for doing so is within 8 days of becoming aware of the change. An amended report is submitted in the same way as the original — electronically through your insurer's portal.
What Happens If You Don't Submit the Report
If you fail to submit the report at all, your health insurer may:
- Assess your contributions based on the maximum assessment base — the insurer is entitled to calculate your contributions using the highest possible base, which for 2025 would be significantly higher than your actual income.
- Charge a penalty on the outstanding contributions.
- Refer the debt for enforcement — the insurer may issue a payment order and pursue the debt through enforcement proceedings.
Be aware of the insurer's powers
A health insurer can assess a probable contribution amount without your report. The figure they arrive at is typically far higher than what you would have paid based on a properly submitted report. Once you do submit your report, the contributions are recalculated to the correct amount — but in the meantime, penalties may have accrued on the higher (estimated) figure.
Practical Example: Freelance Graphic Designer (Primary OSVČ)
Let's walk through a complete example from start to finish.
Complete example — freelance graphic designer (OSVČ)
Input data:
- Business income for 2025: 850,000 Kč
- Applying flat-rate expenses at 60%: 510,000 Kč
- Primary OSVČ for the full year (12 months)
- Paid minimum advance payments in 2025: 2,968 Kč/month
- Insured with VZP (code 111)
Calculation:
- Tax base: 850,000 − 510,000 = 340,000 Kč
- Assessment base (50%): 170,000 Kč
- Annual insurance contribution (13.5%): 22,950 Kč
- Advance payments made: 12 × 2,968 = 35,616 Kč
- Result: overpayment of 12,666 Kč
New advance payments from the date of report submission:
- Monthly assessment base: 170,000 ÷ 12 = 14,167 Kč
- Calculated advance payment: 14,167 × 13.5% = 1,913 Kč
- Minimum advance payment for 2026: 3,306 Kč
- Will pay the minimum: 3,306 Kč/month
Frequently Asked Questions (FAQ)
Can I submit the report before filing my tax return?
Yes, you can submit the report at any time after the end of the year, even before filing your tax return. The key requirement is that the figures in the report match those you subsequently declare in your tax return.
What if I was only self-employed for a few months during the year?
You only include income and expenses for the period during which you were self-employed. The number of months affects the calculation of your monthly assessment base and, by extension, your new advance payment amount.
Do I need to submit a report if I had zero income?
Yes, you must submit the report even if your income was zero. The insurer needs this information to correctly calculate your contributions.
How do I request a refund of an overpayment?
You request a refund directly in the report form — most forms include a field where you tick a box to indicate that you are requesting a refund, and enter your bank account number for the transfer. The insurer will return the overpayment within 30 days of receiving your request, provided you have no other outstanding obligations.
What if I am on the flat-rate tax scheme (paušální daň)?
OSVČ enrolled in the flat-rate tax scheme do not submit a health insurance report. Health insurance is included in the flat-rate payment, and the insurer receives the relevant information directly from the tax authority.
Can I have the report prepared by a tax advisor?
Yes, a tax advisor or accountant can complete and submit the report on your behalf. In that case, the submission deadline follows the deadline applicable to your tax return.
Let DokladBot Help You with Your Report
Completing the health insurance annual report doesn't have to be complicated — but it's easy to make a mistake that could cost you unnecessary penalties. DokladBot can help you prepare your documents, calculate your assessment base, and check that everything is correct. Just send a message via WhatsApp and get an instant answer to any question about your report.
Try DokladBot for free — your AI accounting assistant that understands Czech tax and insurance rules.
Official Sources and Forms
- VZP — OSVČ annual report and current deadlines
- VZP — health insurance payments in 2026
- OZP — guidelines for completing the OSVČ report
- ČPZP — information for OSVČ
- ZP MV ČR — information for OSVČ
This article is intended as a general information guide and does not replace individual tax advice. The information is accurate as of February 2026. For advice on your specific situation, we recommend consulting a tax advisor or contacting your health insurer directly.
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