Article 151Share of National Treasury
第百五十一条(国庫負担)
The national treasury bears the expenses required for the execution of the affairs of health insurance services each fiscal year (including affairs concerning the payment of young-old payments, etc., aid for the old-old, etc., the contributions under the provisions of Article 173, the long-term care payment, the contribution for securing medical care in the early phase of an epidemic under the provisions of the Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases (referred to as "contribution for securing medical care in the early phase of an epidemic" in Article 153 and Article 154, paragraph (1)), and the children and child-rearing support levy), within the scope of the budget.
第百五十二条
The share of the national treasury delivered to a health insurance society is calculated by the Minister of Health, Labour and Welfare based on the number of insured persons in that health insurance society.
健康保険組合に対して交付する国庫負担金は、各健康保険組合における被保険者数を基準として、厚生労働大臣が算定する。
The share of the national treasury referred to in the preceding paragraph may be paid based on an estimation.
前項の国庫負担金については、概算払をすることができる。
Article 152-2Childbirth and Childcare Grants
第百五十二条の二(出産育児交付金)
Part of the expenses required for payment of the lump-sum allowance for childbirth and childcare and the lump-sum allowance for dependent's childbirth and childcare (referred to as "lump-sum allowance for childbirth and childcare, etc." in Article 152-4 and Article 152-5) (limited to the portion pertaining to the amount specified by Cabinet Order in Article 101; the same applies in Article 152-4) is to be covered, as specified by Cabinet Order, by the childbirth and childcare grant that the Infrastructure Organization grants to insurers pursuant to the provisions of Article 124-4, paragraph (1) of the Act on Assurance of Medical Care for Elderly People.
Article 152-3Amount of Childbirth and Childcare Grants
第百五十二条の三(出産育児交付金の額)
The amount of the childbirth and childcare grant prescribed in the preceding Article is the amount of the estimated childbirth and childcare grant for the relevant fiscal year; provided, however, that where the amount of the estimated childbirth and childcare grant for the fiscal year before last exceeds the amount of the finalized childbirth and childcare grant for that fiscal year, it is to be the amount obtained by deducting from the amount of the estimated childbirth and childcare grant for the relevant fiscal year the total amount of the excess amount and the childbirth and childcare grant adjustment amount pertaining to the excess amount, and where the amount of the estimated childbirth and childcare grant for the fiscal year before last falls short of the amount of the finalized childbirth and childcare grant for that fiscal year, it is to be the amount obtained by adding to the amount of the estimated childbirth and childcare grant for the relevant fiscal year the total amount of the shortfall and the childbirth and childcare grant adjustment amount pertaining to the shortfall.
前条に規定する出産育児交付金の額は、当該年度の概算出産育児交付金の額とする。ただし、前々年度の概算出産育児交付金の額が同年度の確定出産育児交付金の額を超えるときは、当該年度の概算出産育児交付金の額からその超える額とその超える額に係る出産育児交付調整金額との合計額を控除して得た額とするものとし、前々年度の概算出産育児交付金の額が同年度の確定出産育児交付金の額に満たないときは、当該年度の概算出産育児交付金の額にその満たない額とその満たない額に係る出産育児交付調整金額との合計額を加算して得た額とする。
The childbirth and childcare grant adjustment amount in the proviso to the preceding paragraph is the amount calculated for each insurer, as specified by Order of the Ministry of Health, Labour and Welfare, taking into consideration interest and other circumstances arising from the excess or shortfall between the amount of the estimated childbirth and childcare grant and the amount of the finalized childbirth and childcare grant for all insurers prescribed in Article 7, paragraph (2) of the Act on Assurance of Medical Care for Elderly People (in the case of national health insurance operated by a prefecture together with the municipalities (including special wards) within that prefecture as provided for in the National Health Insurance Act, the prefecture) in the fiscal year before last.
前項ただし書の出産育児交付調整金額は、前々年度における高齢者の医療の確保に関する法律第七条第二項に規定する保険者(国民健康保険法の定めるところにより都道府県が当該都道府県内の市町村(特別区を含む。)とともに行う国民健康保険にあっては、都道府県)の全てに係る概算出産育児交付金の額と確定出産育児交付金の額との過不足額につき生ずる利子その他の事情を勘案して厚生労働省令で定めるところにより各保険者ごとに算定される額とする。
Article 152-4Estimated Childbirth and Childcare Grants
第百五十二条の四(概算出産育児交付金)
The amount of the estimated childbirth and childcare grant in paragraph (1) of the preceding Article is the amount obtained by multiplying the amount calculated as specified by Order of the Ministry of Health, Labour and Welfare as the prospective amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the relevant fiscal year by the childbirth and childcare support payment rate under Article 124-3, paragraph (1) of the Act on Assurance of Medical Care for Elderly People for that fiscal year (referred to simply as the "childbirth and childcare support payment rate" in the following Article).
前条第一項の概算出産育児交付金の額は、当該年度における当該保険者に係る出産育児一時金等の支給に要する費用の見込額として厚生労働省令で定めるところにより算定した額に同年度における高齢者の医療の確保に関する法律第百二十四条の三第一項の出産育児支援金率(次条において単に「出産育児支援金率」という。)を乗じて得た額とする。
Article 152-5Finalized Childbirth and Childcare Grants
第百五十二条の五(確定出産育児交付金)
The amount of the finalized childbirth and childcare grant in the proviso to Article 152-3, paragraph (1) is the amount obtained by multiplying the amount of expenses required for payment of the lump-sum allowance for childbirth and childcare, etc. pertaining to the insurer in the fiscal year before last (limited to the portion pertaining to the amount specified by Cabinet Order in Article 101) by the childbirth and childcare support payment rate for that fiscal year.
第百五十二条の三第一項ただし書の確定出産育児交付金の額は、前々年度における当該保険者に係る出産育児一時金等の支給に要した費用(第百一条の政令で定める金額に係る部分に限る。)の額に同年度における出産育児支援金率を乗じて得た額とする。
Article 152-6Application Mutatis Mutandis
第百五十二条の六(準用)
The provisions of Articles 41 and 42 of the Act on Assurance of Medical Care for Elderly People apply mutatis mutandis to childbirth and childcare grants. In this case, the necessary technical replacement of terms is specified by Cabinet Order.
高齢者の医療の確保に関する法律第四十一条及び第四十二条の規定は、出産育児交付金について準用する。この場合において、必要な技術的読替えは、政令で定める。
第百五十三条(国庫補助)
In addition to the expenses prescribed in Article 151, the national treasury subsidizes the amount obtained by multiplying, by a rate specified by Cabinet Order within a range from 0.13 to 0.20, the sum (or, if there is a young-old subsidy under the provisions of the Act on Assurance of Medical Care for Elderly People (hereinafter referred to as "young-old subsidy"), the amount obtained by deducting from that sum the amount specified by Cabinet Order on the basis of the amount of that young-old subsidy) of the following, from among the expenses required for the execution of health insurance services administered by JHIA: the amount of expenses required for payment of benefits for medical treatment pertaining to insured persons and of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, injury and sickness allowance, childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care (in the case of benefits for medical treatment, an amount equivalent to the amount of co-payment is to be deducted) (excluding an amount equivalent to one third of the estimated benefit expenses subject to adjustment in each item of Article 34, paragraph (1) of that Act (referred to as "estimated benefit expenses subject to adjustment" in item (i) and Article 154, paragraph (1))); the amount obtained by multiplying the amount of expenses required for payment of the young-old payment under the provisions of that Act (hereinafter referred to as "young-old payment") by the ratio of the amount listed in that item to the amount listed in item (ii); and the amount of expenses required for payment of the contribution for securing medical care in the early phase of an epidemic.
国庫は、第百五十一条に規定する費用のほか、協会が管掌する健康保険の事業の執行に要する費用のうち、被保険者に係る療養の給付並びに入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、傷病手当金、出産手当金、家族療養費、家族訪問看護療養費、家族移送費、高額療養費及び高額介護合算療養費の支給に要する費用(療養の給付については、一部負担金に相当する額を控除するものとする。)の額(高齢者の医療の確保に関する法律第三十四条第一項各号の調整対象給付費見込額(第一号及び次条第一項において「調整対象給付費見込額」という。)の三分の一に相当する額を除く。)、同法の規定による前期高齢者納付金(以下「前期高齢者納付金」という。)の納付に要する費用の額に同号に掲げる額の第二号に掲げる額に対する割合を乗じて得た額並びに流行初期医療確保拠出金の納付に要する費用の額の合算額(同法の規定による前期高齢者交付金(以下「前期高齢者交付金」という。)がある場合には、当該合算額から当該前期高齢者交付金の額を基準として政令で定める額を控除した額)に千分の百三十から千分の二百までの範囲内において政令で定める割合を乗じて得た額を補助する。
the amount obtained by deducting an amount equivalent to two thirds of the estimated benefit expenses subject to adjustment from the amount obtained by multiplying an amount equivalent to two thirds of the estimated benefit expenses subject to adjustment by the estimated participant adjustment rate prescribed in Article 34, paragraph (7) of the Act on Assurance of Medical Care for Elderly People (if that amount is less than zero, zero);
調整対象給付費見込額の三分の二に相当する額に高齢者の医療の確保に関する法律第三十四条第七項に規定する概算加入者調整率を乗じて得た額から調整対象給付費見込額の三分の二に相当する額を控除した額(当該額が零を下回る場合には、零とする。)
the total amount of the amounts listed in Article 38, paragraph (2), item (i), (a) and (b) of the Act on Assurance of Medical Care for Elderly People.
高齢者の医療の確保に関する法律第三十八条第二項第一号イ及びロに掲げる額の合計額
第百五十四条
In addition to the expenses prescribed in Article 151 and the preceding Article, the national treasury subsidizes every fiscal year the amount obtained by multiplying, by the rate specified by Cabinet Order prescribed in the preceding Article, the amount obtained by multiplying by the following ratio the sum (or, if there is a young-old subsidy, the amount obtained by deducting from that sum the amount obtained by multiplying the amount of that young-old subsidy by the benefit expense ratio) of the amount of expenses required for payment of benefits for medical treatment pertaining to specially-insured day laborers and of dietary treatment expenses for inpatients, living support expenses for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, transport expenses, injury and sickness allowance, childbirth allowance, dependent's medical expenses, dependent's medical expenses for home-nursing, dependent's transport expenses, special medical expenses, high-cost medical expenses and expenses for high-cost medical treatment combined with long-term care (in the case of benefits for medical treatment, an amount equivalent to the amount of co-payment is to be deducted), from among the expenses required for the execution of health insurance services, the amount obtained by multiplying the amount of expenses required for payment of the young-old payment by the benefit expense ratio (meaning the ratio of the estimated benefit expenses subject to adjustment to the total amount of the estimated benefit expenses subject to adjustment and the estimated amount of aid for the old-old pertaining to the young-old prescribed in Article 34, paragraph (1), item (i), (a)(2) of the Act on Assurance of Medical Care for Elderly People; the same applies hereinafter in this Article), and the amount of expenses required for payment of the contribution for securing medical care in the early phase of an epidemic: the ratio obtained by dividing the total number of payment days of insurance premiums relating to specially-insured day laborers paid in the relevant fiscal year by employers other than employers who establish a health insurance society (including insurers of national health insurance providing national health insurance to persons who have obtained the approval referred to in Article 3, paragraph (1), item (viii); the same applies in Article 171, paragraphs (2) and (3)) by the total number of payment days of insurance premiums relating to specially-insured day laborers paid in that fiscal year.
国庫は、第百五十一条及び前条に規定する費用のほか、毎年度、健康保険事業の執行に要する費用のうち、日雇特例被保険者に係る療養の給付並びに入院時食事療養費、入院時生活療養費、保険外併用療養費、療養費、訪問看護療養費、移送費、傷病手当金、出産手当金、家族療養費、家族訪問看護療養費、家族移送費、特別療養費、高額療養費及び高額介護合算療養費の支給に要する費用(療養の給付については、一部負担金に相当する額を控除するものとする。)の額、前期高齢者納付金の納付に要する費用の額に給付費割合(調整対象給付費見込額及び高齢者の医療の確保に関する法律第三十四条第一項第一号イ(2)に規定する前期高齢者に係る後期高齢者支援金の概算額の合計額に対する調整対象給付費見込額の割合をいう。以下この条において同じ。)を乗じて得た額並びに流行初期医療確保拠出金の納付に要する費用の額の合算額(前期高齢者交付金がある場合には、当該合算額から当該前期高齢者交付金の額に給付費割合を乗じて得た額を控除した額)に健康保険組合(第三条第一項第八号の承認を受けた者の国民健康保険を行う国民健康保険の保険者を含む。第百七十一条第二項及び第三項において同じ。)を設立する事業主以外の事業主から当該年度に納付された日雇特例被保険者に関する保険料の総延べ納付日数を当該年度に納付された日雇特例被保険者に関する保険料の総延べ納付日数で除して得た率を乗じて得た額に前条に規定する政令で定める割合を乗じて得た額を補助する。
In addition to the expenses prescribed in Article 151, the preceding Article and the preceding paragraph, the national treasury subsidizes the amount obtained by multiplying, by the rate specified by Cabinet Order prescribed in that Article, the amount obtained by multiplying by the ratio prescribed in that paragraph the sum of the amounts of expenses required for payment of those, among the young-old payment that JHIA is to contribute, the aid for the old-old under the provisions of the Act on Assurance of Medical Care for Elderly People, the long-term care payment and the children and child-rearing support levy, that pertain to specially-insured day laborers (excluding the amount obtained by multiplying the amount of that young-old payment by the benefit expense ratio, and, if there is a young-old subsidy, the amount obtained by deducting from that sum the amount obtained by deducting from the amount of that young-old subsidy the amount obtained by multiplying that amount by the benefit expense ratio).
第百五十四条の二
Beyond he expenses prescribed in Article 151 and the preceding two Articles, the national treasury may assist by providing a portion of the expenses required for the provision of specific health checkups from among the expenses required for the execution of health insurance businesses, within the scope of the budget.
第百五十五条(保険料)
An insurer, etc. collects insurance premiums to be allocated for the expenses required for health insurance services (including the expenses required for the payment of young-old payments, etc., aid for the old-old, etc., the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. and the children and child-rearing support levy, and, in the case of a health insurance society, the contributions pursuant to the provisions of Article 173).
保険者等は、健康保険事業に要する費用(前期高齢者納付金等及び後期高齢者支援金等、介護納付金、流行初期医療確保拠出金等並びに子ども・子育て支援納付金並びに健康保険組合においては、第百七十三条の規定による拠出金の納付に要する費用を含む。)に充てるため、保険料を徴収する。
Notwithstanding the provisions of the preceding paragraph, insurance premiums related to insured persons with optional and continued coverage administered by JHIA are collected by JHIA.
Article 155-2Delivery of Insurance Premiums
第百五十五条の二(保険料等の交付)
The Government, as specified by Cabinet Order, delivers the amount obtained by deducting an amount equivalent to the expenses required for the execution of affairs concerning health insurance services administered by the Minister of Health, Labor and Welfare (excluding the amount of the national treasury benefits pertaining to expenses pursuant to the provisions of Article 151) from the sum of the amount of insurance premiums collected by the Minister of Health, Labor and Welfare, other amounts collected pursuant to this Act, and an amount equivalent to the payments pursuant to the provisions of the Act on Payment of Government Charges with Revenue Stamps (Act No. 142 of 1948) to JHIA in order to allocate that amount for expenses required for health insurance services provided by JHIA.
Article 156Insured Person's Amount of Insurance Premiums
第百五十六条(被保険者の保険料額)
The amount of insurance premium relating to an insured person is the amount per month prescribed respectively in the following items in accordance with the classification of persons listed in the items:
被保険者に関する保険料額は、各月につき、次の各号に掲げる被保険者の区分に応じ、当該各号に定める額とする。
an insured person who is an insured person prescribed in Article 9, item (ii) of the Long-Term Care Insurance Act (hereinafter referred to as an "item (ii) insured person"): the sum of the amount of general insurance premium, etc. (meaning the amount obtained by multiplying the standard monthly remuneration and standard bonus amount of each insured person respectively by the combined rate of the general insurance rate (meaning the combined rate of the basic insurance rate and the specified insurance rate) and the children and child-rearing support payment rate; hereinafter the same applies) and the amount of long-term care insurance premium (meaning the amount obtained by multiplying the standard monthly remuneration and standard bonus amount of each insured person respectively by the long-term care insurance rate; hereinafter the same applies); or
介護保険法第九条第二号に規定する被保険者(以下「介護保険第二号被保険者」という。)である被保険者 一般保険料等額(各被保険者の標準報酬月額及び標準賞与額にそれぞれ一般保険料率(基本保険料率と特定保険料率とを合算した率をいう。)と子ども・子育て支援金率とを合算した率を乗じて得た額をいう。以下同じ。)と介護保険料額(各被保険者の標準報酬月額及び標準賞与額にそれぞれ介護保険料率を乗じて得た額をいう。以下同じ。)との合算額
an insured person other than an item (ii) insured person: the amount of general insurance premium, etc.
介護保険第二号被保険者である被保険者以外の被保険者 一般保険料等額
Notwithstanding the provisions of item (i) of the preceding paragraph, when an insured person who is an item (ii) insured person ceases to fall under the category of item (ii) insured person, the amount of insurance premium for that month is the amount of general insurance premium, etc.; provided, however, that this does not apply if the person becomes an item (ii) insured person again within the same month or in other cases specified by Cabinet Order.
前項第一号の規定にかかわらず、介護保険第二号被保険者である被保険者が介護保険第二号被保険者に該当しなくなった場合においては、その月分の保険料額は、一般保険料等額とする。ただし、その月に再び介護保険第二号被保険者となった場合その他政令で定める場合は、この限りでない。
Notwithstanding the provisions of the preceding two paragraphs, when a person who continues to be insured from the previous month loses the eligibility, the insurance premium for the month is not included in the calculation of premium amount.