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Article 20Drawing Down of Reserves

第二十条(準備金の取崩し)

A health insurance society must not draw down its reserves except to make up a shortfall in the expenses required for insurance benefits (including the expenses required for paying the young-old payments, etc. under the provisions of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982) (hereinafter referred to as "young-old payments, etc."), the aid for the old-old, the contribution for administrative expenses related to the old-old and the contribution for administrative expenses related to childbirth and childcare under the provisions of that Act (hereinafter referred to as "aid for the old-old, etc."), the contributions under Article 173 of the Act (hereinafter referred to as "day laborer contribution"), the Levy under the provisions of the Long-Term Care Insurance Act (Act No. 123 of 1997) (referred to as "long-term care payment" in Article 29 and Article 46), the contribution for securing medical care in the early phase of an epidemic, etc. under the provisions of the (hereinafter referred to as "contribution for securing medical care in the early phase of an epidemic, etc."), and the children and child-rearing support levy under the provisions of the (hereinafter referred to as "children and child-rearing support levy")).

健康保険組合は、保険給付に要する費用(高齢者の医療の確保に関する法律(昭和五十七年法律第八十号)の規定による前期高齢者納付金等(以下「前期高齢者納付金等」という。)、同法の規定による後期高齢者支援金、後期高齢者関係事務費拠出金及び出産育児関係事務費拠出金(以下「後期高齢者支援金等」という。)並びに法第百七十三条の規定による拠出金(以下「日雇拠出金」という。)、介護保険法(平成九年法律第百二十三号)の規定による納付金(第二十九条及び第四十六条において「介護納付金」という。)、の規定による流行初期医療確保拠出金等(以下「流行初期医療確保拠出金等」という。)並びにの規定による子ども・子育て支援納付金(以下「子ども・子育て支援納付金」という。)の納付に要する費用を含む。)の不足を補う場合を除いては、準備金を取り崩してはならない。

Article 21Temporary Diversion, etc.

第二十一条(繰替使用等)

When a health insurance society has a shortage of cash for payments, it may temporarily divert cash belonging to the reserves or make temporary borrowings.

健康保険組合は、支払上現金に不足を生じたときは、準備金に属する現金を繰替使用し、又は一時借入金をすることができる。

The amount temporarily diverted and the temporary borrowings under the preceding paragraph must be returned within that fiscal year.

前項の規定により繰替使用した金額及び一時借入金は、当該会計年度内に返還しなければならない。

Article 22Society Bonds

第二十二条(組合債)

When a health insurance society intends to issue society bonds, or to change the method of issuing bonds, the interest rate or the method of redemption, it must obtain the authorization of the Minister of Health, Labour and Welfare; provided, however, that this does not apply when it intends to make a minor change specified by Order of the Ministry of Health, Labour and Welfare.

健康保険組合は、組合債を起こし、又は起債の方法、利率若しくは償還の方法を変更しようとするときは、厚生労働大臣の認可を受けなければならない。ただし、厚生労働省令で定める軽微な変更をしようとするときは、この限りでない。

When a health insurance society has made a minor change specified by Order of the Ministry of Health, Labour and Welfare as referred to in the proviso to the preceding paragraph, it must notify the Minister of Health, Labour and Welfare to that effect without delay.

健康保険組合は、前項ただし書の厚生労働省令で定める軽微な変更をしたときは、遅滞なく、その旨を厚生労働大臣に届け出なければならない。

Article 23Disposition of Important Property

第二十三条(重要な財産の処分)

When a health insurance society intends to dispose of important property, it must obtain the authorization of the Minister of Health, Labour and Welfare.

健康保険組合は、重要な財産を処分しようとするときは、厚生労働大臣の認可を受けなければならない。

Article 24Submission of a Report

第二十四条(報告書の提出)

A health insurance society must, within six months after the end of each fiscal year, prepare a report on its business and settlement of accounts, as provided by Order of the Ministry of Health, Labour and Welfare, and submit it to the Minister of Health, Labour and Welfare.

健康保険組合は、毎年度終了後六月以内に、厚生労働省令で定めるところにより、事業及び決算に関する報告書を作成し、厚生労働大臣に提出しなければならない。

A health insurance society must keep the documents referred to in the preceding paragraph at the principal office of the health insurance society.

健康保険組合は、前項の書類を健康保険組合の主たる事務所に備え付けて置かなければならない。

Members and persons who were members may request the health insurance society to allow inspection of the documents referred to in the preceding paragraph. In this case, the health insurance society must not refuse this, except where there is a justifiable reason.

組合員及び組合員であった者は、健康保険組合に対し、前項の書類の閲覧を請求することができる。この場合において、健康保険組合は、正当な理由がある場合を除き、これを拒んではならない。

Section 4 Authorization of Specified Health Insurance Societies

第四節 特定健康保険組合の認可

Article 25

第二十五条

When a health insurance society intends to obtain the authorization under Article 3, paragraph (1) of the Supplementary Provisions of the Act, or intends to have the authorization under that paragraph rescinded, it must adopt a resolution in a society meeting by a majority of two-thirds or more of the fixed number of society meeting members.

健康保険組合は、法附則第三条第一項の認可を受けようとするとき、又は同項の認可の取消しを受けようとするときは、組合会において組合会議員の定数の三分の二以上の多数により議決しなければならない。

Section 5 Authorization of General Premium Rates of Regional Health Insurance Societies

第五節 地域型健康保険組合の一般保険料率の認可

Article 25-2

第二十五条の二

When a regional health insurance society prescribed in Article 3-2, paragraph (1) of the Supplementary Provisions of the Act intends to obtain the authorization under paragraph (2) of that Article, it is to set a non-uniform general premium rate with each health insurance society before the merger as a unit, and must adopt a resolution in the society meeting of that regional health insurance society, by a majority of two-thirds or more of the fixed number of society meeting members, on that general premium rate and the requirements for the insured persons to whom it is to apply and the period of its application.

法附則第三条の二第一項に規定する地域型健康保険組合は、同条第二項の認可を受けようとするときは、合併前の健康保険組合を単位として不均一の一般保険料率を設定することとし、当該一般保険料率並びにこれを適用すべき被保険者の要件及び期間について、当該地域型健康保険組合の組合会において組合会議員の定数の三分の二以上の多数により議決しなければならない。

Section 6 Merger and Split, and Dissolution

第六節 合併及び分割並びに解散

Article 26Public Notice of Merger or Split

第二十六条(合併又は分割の告示)

When the Minister of Health, Labour and Welfare has granted authorization for the merger or split of a health insurance society, the Minister is to give public notice of the following matters regarding the health insurance societies established or extinguished by the merger or split and the health insurance societies that continue to exist after the merger or split:

厚生労働大臣は、健康保険組合の合併又は分割の認可をしたときは、合併若しくは分割により設立し、又は消滅した健康保険組合及び合併又は分割後存続する健康保険組合について、次に掲げる事項を告示するものとする。

the name of the health insurance society;

健康保険組合の名称

the location of its office;

事務所の所在地

the name and location of the establishment;

設立事業所の名称及び所在地

the date of the authorization of the merger or split.

合併又は分割の認可の年月日

Article 27Request for Bearing of Expenses to Fully Repay Debts

第二十七条(債務を完済するための費用負担の求め)

The amount of expenses that may be requested to be borne by the employer of the establishment pursuant to Article 26, paragraph (3) of the Act is to be an amount equivalent to the whole of the expenses required to fully repay the debts; provided, however, that where that employer is unable to bear those expenses due to a decision to commence bankruptcy proceedings or other special reasons, the health insurance society may, with the approval of the Minister of Health, Labour and Welfare, reduce or waive them.

法第二十六条第三項の規定により設立事業所の事業主に負担することを求めることができる費用の額は、債務を完済するために要する費用の全部に相当する額とする。ただし、破産手続開始の決定その他特別の理由により、当該事業主が当該費用を負担することができないときは、健康保険組合は、厚生労働大臣の承認を得て、これを減額し、又は免除することができる。

Article 28Public Notice of Dissolution

第二十八条(解散の告示)

When a health insurance society has been dissolved, the Minister of Health, Labour and Welfare is to give public notice of the following matters:

厚生労働大臣は、健康保険組合が解散したときは、次に掲げる事項を告示するものとする。

the name of the health insurance society;

健康保険組合の名称

the location of its office;

事務所の所在地

the name and location of the establishment;

設立事業所の名称及び所在地

the date of the authorization of dissolution or of the order of dissolution.

解散の認可又は解散の命令の年月日

Article 29Requirements for Designation

第二十九条(指定の要件)

The requirements specified by Cabinet Order referred to in Article 28, paragraph (1) of the Act are to be that, with regard to a health insurance society for which the state in which the amount of expenditure (limited to that specified by the Minister of Health, Labour and Welfare as recurring) exceeds the amount of income (limited to that specified by the Minister of Health, Labour and Welfare as recurring) in the settlement of accounts for one fiscal year continues, and for which the state in which the rate obtained by dividing the amount obtained by deducting the amount of expenses required for the other benefits prescribed in Article 53 of the Act from the amount of expenses required for the insurance benefits of the health insurance society in one fiscal year (including the amount of expenses required for the payment of young-old payments, etc., aid for the old-old, etc. and day laborer contribution, and contribution for securing medical care in the early phase of an epidemic, etc. (where there is a young-old subsidy under the provisions of the Act on Assurance of Medical Care for Elderly People (hereinafter referred to as the "young-old subsidy" in this Article, Article 46, Article 65, paragraph (1), item (i), (a) and Article 67, paragraph (3)), the amount after deducting it), and excluding the amount of expenses required for insurance benefits relating to medical treatment that an insured person or a dependent thereof received from a hospital, clinic or pharmacy listed in Article 63, paragraph (3), item (iii) of the Act and the amount of the childbirth and childcare grant prescribed in Article 152-2 of the Act (hereinafter referred to as the "childbirth and childcare grant")) by the total sum of the total amount of the standard monthly remuneration and the total amount of the standard bonus amounts of the insured persons who are members of that health insurance society in that fiscal year exceeds 95/1,000 continues, the amount of reserves and other property specified by the Minister of Health, Labour and Welfare has fallen below the total sum of the amount equivalent to 3/12 of the average per fiscal year of the amount of expenses required for the insurance benefits provided in the three fiscal years immediately preceding the fiscal year for which the designation under Article 28, paragraph (1) of the Act is to be made (excluding the amount of expenses required for insurance benefits relating to medical treatment that an insured person or a dependent thereof received from a hospital, clinic or pharmacy listed in Article 63, paragraph (3), item (iii) of the Act and the amount of the childbirth and childcare grant), the amount equivalent to 1/12 of the average per business year of the amount of expenses required for the payment of young-old payments, etc., aid for the old-old, etc. and day laborer contribution, long-term care payment, and contribution for securing medical care in the early phase of an epidemic, etc. made in those three fiscal years (where there is a young-old subsidy, the amount after deducting it), and the amount determined by the Minister of Health, Labour and Welfare in consultation with the Prime Minister, within a range not exceeding the amount equivalent to 1/12 of the amount of expenses required for the payment of the children and child-rearing support levy made in the fiscal year immediately preceding the fiscal year for which the designation under that paragraph is to be made, taking into consideration the expenses required for the insurer's payment of the children and child-rearing support levy in that immediately preceding fiscal year.

法第二十八条第一項の政令で定める要件は、一の年度の決算において支出(経常的なものとして厚生労働大臣が定めるものに限る。)の額が収入(経常的なものとして厚生労働大臣が定めるものに限る。)の額を超える状態が継続し、かつ、一の年度における健康保険組合の保険給付に要した費用の額(前期高齢者納付金等、後期高齢者支援金等及び日雇拠出金並びに流行初期医療確保拠出金等の納付に要した費用の額(高齢者の医療の確保に関する法律の規定による前期高齢者交付金(以下この条、第四十六条、第六十五条第一項第一号イ及び第六十七条第三項において「前期高齢者交付金」という。)がある場合には、これを控除した額)を含み、被保険者又はその被扶養者が法第六十三条第三項第三号に掲げる病院若しくは診療所又は薬局から受けた療養に係る保険給付に要した費用の額及び法第百五十二条の二に規定する出産育児交付金(以下「出産育児交付金」という。)の額を除く。)から法第五十三条に規定するその他の給付に要した費用の額を控除した額を当該年度における当該健康保険組合の組合員である被保険者の標準報酬月額の総額及び標準賞与額の総額の合算額で除して得た率が千分の九十五を超える状態が継続する健康保険組合であって、準備金その他厚生労働大臣が定める財産の額が法第二十八条第一項の指定をすべき年度の直前の三箇年度において行った保険給付に要した費用の額(被保険者又はその被扶養者が法第六十三条第三項第三号に掲げる病院若しくは診療所又は薬局から受けた療養に係る保険給付に要した費用の額及び出産育児交付金の額を除く。)の一年度当たりの平均額の十二分の三に相当する額と法第二十八条第一項の指定をすべき年度の直前の三箇年度において行った前期高齢者納付金等、後期高齢者支援金等及び日雇拠出金、介護納付金並びに流行初期医療確保拠出金等の納付に要した費用の額(前期高齢者交付金がある場合には、これを控除した額)の一事業年度当たりの平均額の十二分の一に相当する額並びに同項の指定をすべき年度の直前の年度において行った子ども・子育て支援納付金の納付に要した費用の額の十二分の一に相当する額を超えない範囲内において当該直前の年度における保険者の子ども・子育て支援納付金の納付に要する費用を勘案して厚生労働大臣が内閣総理大臣と協議して定める額とを合算した額を下回ったものとする。

Article 30Soundness Improvement Plan

第三十条(健全化計画)

The soundness improvement plan prescribed in Article 28, paragraph (1) of the Act (referred to simply as the "soundness improvement plan" in the following paragraph and the following Article) is to be a three-year plan whose first fiscal year is the fiscal year following the fiscal year that includes the date of designation under Article 28, paragraph (1) of the Act.

法第二十八条第一項に規定する健全化計画(次項及び次条において単に「健全化計画」という。)は、法第二十八条第一項の規定による指定の日の属する年度の翌年度を初年度とする三箇年間の計画とする。

The following matters must be stated in the soundness improvement plan:

健全化計画には、次に掲げる事項を記載しなければならない。

the current state of operations and property;

事業及び財産の現状

the goal for improving financial soundness;

財政の健全化の目標

the specific measures necessary to achieve the goal referred to in the preceding item, and the estimated amounts of increases and decreases in revenue and expenditure that accompany them.

前号の目標を達成するために必要な具体的措置及びこれに伴う収入支出の増減の見込額

Article 31Designated Health Insurance Societies That May Be Ordered to Dissolve

第三十一条(解散を命ずることができる指定健康保険組合)

The designated health insurance societies specified by Cabinet Order as referred to in Article 29, paragraph (2) of the Act are as follows:

法第二十九条第二項の政令で定める指定健康保険組合は、次のとおりとする。

a designated health insurance society that does not apply for approval of a soundness improvement plan by the date designated by the Minister of Health, Labour and Welfare;

厚生労働大臣が指定する期日までに健全化計画の承認を申請しない指定健康保険組合

a designated health insurance society that cannot obtain approval of a soundness improvement plan.

健全化計画の承認を受けることができない指定健康保険組合

Section 7 Miscellaneous Provisions

第七節 雑則

Article 32Delegation of Authority

第三十二条(権限の委任)

Part of the authority of the Minister of Health, Labour and Welfare prescribed in this Chapter may be delegated to the Director-General of a Regional Bureau of Health and Welfare, as specified by Order of the Ministry of Health, Labour and Welfare.

この章に規定する厚生労働大臣の権限の一部は、厚生労働省令で定めるところにより、地方厚生局長に委任することができる。

The authority delegated to the Director-General of a Regional Bureau of Health and Welfare pursuant to the provisions of the preceding paragraph may be delegated to the Director-General of a Regional Branch Bureau of Health and Welfare as specified by Order of the Ministry of Health, Labour and Welfare.

前項の規定により地方厚生局長に委任された権限は、厚生労働省令で定めるところにより、地方厚生支局長に委任することができる。

Article 33Delegation to Order of the Ministry of Health, Labour and Welfare

第三十三条(厚生労働省令への委任)

In addition to what is prescribed in this Chapter, necessary matters concerning health insurance societies are specified by Order of the Ministry of Health, Labour and Welfare.

この章に規定するもののほか、健康保険組合に関して必要な事項は、厚生労働省令で定める。

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