Supplementary Provisions as enacted, Article 7 — Health Insurance Act — japanlaw

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Supplementary Provisions, Article 7Specified Insured Person

第七条（特定被保険者）

Notwithstanding the provisions of Article 156, paragraph (1), item (ii) and Article 157, paragraph (2), a health insurance society may, as specified by its articles of incorporation, make the amount of insurance premium relating to an insured person other than an item (ii) insured person (limited to a person who has a dependent who is an item (ii) insured person; hereinafter referred to as a "specified insured person" in this Article and the following Article) the sum of the amount of general insurance premium, etc. and the amount of long-term care insurance premium.

健康保険組合は、第百五十六条第一項第二号及び第百五十七条第二項の規定にかかわらず、規約で定めるところにより、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（介護保険第二号被保険者である被扶養者があるものに限る。以下この条及び次条において「特定被保険者」という。）に関する保険料額を一般保険料等額と介護保険料額との合算額とすることができる。

With regard to the application of Article 156, paragraph (3) to a specified insured person whose amount of insurance premium has been made the sum of the amount of general insurance premium, etc. and the amount of long-term care insurance premium pursuant to the provisions of the preceding paragraph, the phrase "the preceding two paragraphs" in that paragraph is deemed to be replaced with "Article 7, paragraphs (1) and (3) of the Supplementary Provisions".

前項の規定によりその保険料額を一般保険料等額と介護保険料額との合算額とされた特定被保険者に対する第百五十六条第三項の規定の適用については、同項中「前二項」とあるのは、「附則第七条第一項及び第三項」とする。

The provisions of Article 156, paragraph (2) apply mutatis mutandis to the case where a dependent who is an item (ii) insured person (limited to a dependent of a specified insured person whose amount of insurance premium has been made the sum of the amount of general insurance premium, etc. and the amount of long-term care insurance premium pursuant to the provisions of paragraph (1)) ceases to fall under the category of item (ii) insured person.

第百五十六条第二項の規定は、介護保険第二号被保険者である被扶養者（第一項の規定によりその保険料額を一般保険料等額と介護保険料額との合算額とされた特定被保険者の被扶養者に限る。）が介護保険第二号被保険者に該当しなくなった場合について準用する。

Necessary matters concerning special provisions on the calculation of the long-term care insurance rate of a health insurance society that has made the amount of insurance premium relating to specified insured persons the sum of the amount of general insurance premium, etc. and the amount of long-term care insurance premium pursuant to the provisions of paragraph (1) are specified by Cabinet Order.

第一項の規定により特定被保険者に関する保険料額を一般保険料等額と介護保険料額との合算額とした健康保険組合の介護保険料率の算定の特例に関して必要な事項は、政令で定める。

Cited by1

Supplementary Provisions, Article 8, paragraph (1)
(Approved Health Insurance Society)
“paragraph (1) of the preceding Article” “that paragraph”

Defined terms6

insured person
被保険者（ひほけんしゃ）
A person employed at an applicable place of business (適用事業所), or an insured person with optional and continued coverage (任意継続被保険者); the persons listed in the items of Article 3, paragraph (1) — among them some temporary, seasonal and short-time workers and persons insured under late-stage elderly medical care (後期高齢者医療) — cannot be insured persons, except as specially-insured day laborers (日雇特例被保険者).
適用事業所に使用される者及び任意継続被保険者
Article 3, paragraph (1)See it in the glossary
dependent
被扶養者（ひふようしゃ）
A person who lives in Japan — or who lives abroad but whom a Ministry of Health, Labour and Welfare Order (厚生労働省令) treats as based in Japan, such as a student studying abroad — and who is mainly supported by an insured person (including a former specially-insured day laborer, 日雇特例被保険者): the insured person's lineal ascendants, spouse (including a de facto spouse), children, grandchildren and siblings, and, if they belong to the insured person's household, other relatives within the third degree of kinship and a de facto spouse's parents and children, also after that spouse's death; persons with late-stage elderly medical care insurance (後期高齢者医療の被保険者等) and others the Order excludes are not dependents.
次に掲げる者で、日本国内に住所を有するもの又は外国において留学をする学生その他の日本国内に住所を有しないが渡航目的その他の事情を考慮して日本国内に生活の基礎があると認められるものとして厚生労働省令で定めるもの
Article 3, paragraph (7)See it in the glossary
amount of general insurance premium, etc.
一般保険料等額（いっぱんほけんりょうとうがく）
The amount found by multiplying an insured person's standard monthly remuneration (標準報酬月額) and standard bonus (標準賞与額) by the general insurance premium rate (一般保険料率: the basic insurance premium rate plus the specified insurance premium rate) plus the children and child-rearing support contribution rate (子ども・子育て支援金率).
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
Article 156, paragraph (1), item (i)See it in the glossary
amount of long-term care insurance premium
介護保険料額（かいごほけんりょうがく）
The amount found by multiplying an insured person's standard monthly remuneration (標準報酬月額) and standard bonus (標準賞与額) by the long-term care insurance premium rate (介護保険料率).
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
Article 156, paragraph (1), item (i)See it in the glossary
item (ii) insured person
介護保険第二号被保険者（かいごほけんだいにごうひほけんしゃ）
An insured person under Article 9, item (ii) of the Long-Term Care Insurance Act: a person aged 40 or over and under 65 who has their domicile in a municipality and is covered by medical insurance (医療保険加入者).
Article 156, paragraph (1), item (i)See it in the glossary
specified insured person
特定被保険者（とくていひほけんしゃ）
In Articles 7 and 8 of the supplementary provisions (附則), an insured person who is not an item (ii) insured person (介護保険第二号被保険者) but has a dependent who is, whose premium a health insurance society (健康保険組合) may by its rules set as the amount of general insurance premium, etc. (一般保険料等額) plus the amount of long-term care insurance premium (介護保険料額).
Supplementary Provisions, Article 7, paragraph (1)See it in the glossary

This version

as amended by Act Partially Amending the Medical Care Act, etc. (Act No. 87 of 2025)医療法等の一部を改正する法律

Permanent link, independent of the slug:

/l/211AC0000000070/suppl-2111-70/art-7