Long-Term Care Insurance Act

A prefecture, according to the request of a Municipality which intends to implement a Municipal Mutual Fiscal Stabilization Project, is to conduct the necessary coordination among said Municipalities.

A prefecture, according to the request of a Specified Municipality, may provide necessary advice or information such as indicating standards for an adjustment percentage of insurance premiums pertaining to said Municipal Mutual Fiscal Stabilization Project.

The Organization, in order to allocate to the costs, expenses, and disbursements necessary for operation as prescribed in Article 160, paragraph (1), collects Long-Term Care Benefit Expense and supporting payments of a Community Support Project (hereinafter referred to as "Levy") from a medical insurer (in the case of National Health Insurance, a prefecture; the same applies hereinafter except in the following paragraph and Article 161) for each fiscal year (which means from April 1 to March 31 of the following year, in each year; hereinafter the same applies in this Section and the following Chapter).

A medical insurer (in the case of National Health Insurance, a Municipality), in order to allocate to the payment of the Levy, pursuant to the provisions of the Medical Insurance Acts or the Local Tax Act, is to be subject to an obligation to collect insurance premiums, contributions, or National Health Insurance tax.

A medical insurer is to be subject to an obligation to pay the Levy.

The amount of Levy to be collected from each medical insurer pursuant to the provisions of paragraph (1) of the preceding Article is to be the amount of estimated Levy in said fiscal year, however, provided that when the amount of estimated Levy of the year prior to the first preceding fiscal year exceeds the fixed Levy of the year prior to the first preceding fiscal year, the amount is to be the amount obtained by deducting the total amount of said exceeding amount and the Adjustment amount pertaining to said exceeding amount from the amount of estimated Levy of said year, and when the amount of estimated Levy of the year prior to the first preceding fiscal year is deficient with regard to the amount of fixed Levy of the year prior to the first preceding fiscal year, the amount is to be the amount obtained by adding the amount of estimated Levy of said year to the total amount of said amount of deficit and the Adjustment amount pertaining to said amount of deficit.

The Adjustment amount as set forth in the proviso of the preceding paragraph is to be the amount calculated for each medical insurer by taking into consideration the interest that is generated from the deficit or surplus amount of the amounts of estimated Levy and fixed Levy pertaining to all medical insurers in the year prior to the first preceding fiscal year and other circumstances, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare.

The amount of estimated Levy as set forth in paragraph (1) of the preceding Article is to be the amount specified in each of the following items, according to the categories of medical insurers listed in those items.

insurer of employee insurance, etc. (meaning the insurer of employee insurance, etc. prescribed in Article 7, paragraph (3) of the Act on Assurance of Medical Care for Elderly People; the same applies hereinafter): the amount obtained by multiplying the number obtained by dividing the amount obtained by multiplying the amount obtained by dividing the total prospective amount of the Amount Subject to Medical Insurance Premium Payment and the Amount Subject to Medical Insurance Premium Payment for Comprehensive Project for Long-Term Care Prevention and Daily Life Support in all Municipalities in said fiscal year by the total prospective number of Secondary Insured Persons pertaining to all medical insurers in the same fiscal year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the total prospective number of Secondary Insured Persons pertaining to all insurers of employee insurance, etc. in the same fiscal year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the amount set forth in (a) for the same fiscal year, by the amount set forth in (b) for the same fiscal year:

the total of the prospective amount of total standard remuneration of Secondary Insured Persons pertaining to all insurers of employee insurance, etc. (meaning the amount calculated as the prospective amount of total standard remuneration of Secondary Insured Persons pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare; the same applies in (b));

the prospective amount of total standard remuneration of Secondary Insured Persons pertaining to the relevant insurer of employee insurance, etc.;

medical insurers other than insurers of employee insurance, etc.: the amount obtained by multiplying the amount obtained by dividing the total prospective amount of the Amount Subject to Medical Insurance Premium Payment and Amount Subject to Medical Insurance Premium Payment for Comprehensive Project for Long-Term Care Prevention and Daily Life Support in all Municipalities in said fiscal year by the total prospective number of Secondary Insured Persons pertaining to all medical insurers in the same fiscal year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the prospective number of Secondary Insured Persons pertaining to said medical insurer in the same fiscal year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

The total standard remuneration of Secondary Insured Persons set forth in item (i), (a) of the preceding paragraph is to be the amount obtained by adjusting, respectively pursuant to the provisions of a Cabinet Order, the grand total of the total amounts specified in each of the following items for each fiscal year, according to the categories of insurers of employee insurance, etc. listed in those items:

Japan Health Insurance Association and health insurance societies: the standard monthly remuneration and standard bonus amount prescribed in the Health Insurance Act or the Mariners Insurance Act for each Insured Person who is a Secondary Insured Person;

mutual aid Associations: the monthly amount of standard remuneration and the amount of standard end-of-term allowance, etc. prescribed in the National Public Officers Mutual Aid Association Act or the Local Public Officers, etc. Mutual Aid Association Act for each member who is a Secondary Insured Person;

Promotion and Mutual Aid Corporation for Private Schools of Japan: the standard monthly remuneration and standard bonus amount prescribed in the Private School Personnel Mutual Aid Association Act for each subscriber who is a Secondary Insured Person;

National Health Insurance Societies (limited to those that are insurers of employee insurance, etc.): the amount specified by Order of the Ministry of Health, Labour and Welfare as equivalent to the amounts specified in the preceding three items for each member who is a Secondary Insured Person.

The amount of fixed Levy as set forth in the proviso of Article 151, paragraph (1) is to be the amount specified in each of the following items, according to the categories of medical insurers listed in those items.

insurer of employee insurance, etc.: the amount obtained by multiplying the number obtained by dividing the amount obtained by multiplying the amount obtained by dividing the total amount of the Amount Subject to Medical Insurance Premium Payment and the Amount Subject to Medical Insurance Premium Payment for Comprehensive Project for Long-Term Care Prevention and Daily Life Support in all Municipalities in the year prior to the first preceding fiscal year by the total number of Secondary Insured Persons pertaining to all medical insurers in the same year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the total number of Secondary Insured Persons pertaining to all insurers of employee insurance, etc. in the same year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the amount set forth in (a) for the same year, by the amount set forth in (b) for the same year:

the total of the total standard remuneration of Secondary Insured Persons (meaning the total standard remuneration of Secondary Insured Persons prescribed in paragraph (2) of the preceding Article; the same applies in (b)) pertaining to all insurers of employee insurance, etc.;

the total standard remuneration of Secondary Insured Persons pertaining to the relevant insurer of employee insurance, etc.;

medical insurers other than insurers of employee insurance, etc.: the amount obtained by multiplying the amount obtained by dividing the total amount of the Amount Subject to Medical Insurance Premium Payment and Amount Subject to Medical Insurance Premium Payment for Comprehensive Project for Long-Term Care Prevention and Daily Life Support in all Municipalities in the year prior to the first preceding fiscal year by the total number of Secondary Insured Persons pertaining to all medical insurers in the same year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, by the number of Secondary Insured Persons pertaining to said medical insurer in the same year that is calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Exceptions to the calculation of the amount of Levy pertaining to a medical insurer that is incorporated by merger or split, a medical insurer remaining after a merger or split, or a medical insurer that has succeeded to the rights and obligations of a dissolved medical insurer, are determined by a Cabinet Order.

The Organization must determine the amount of Levy to be paid by each medical insurer for each fiscal year, and notify each said medical insurer of the amount of Levy to be paid by said medical insurer, the method of payment, the due date of payment, and other necessary matters.

When the amount of Levy is required to change after an amount is determined for the Levy pursuant to the provisions of the preceding paragraph, the Organization must change the amount of Levy to be paid by each said medical insurer and notify each said medical insurer of the new amount of Levy.

The Organization, in a case when the amount of Levy paid by medical insurers is deficit with regard to the amount of Levy after a change pursuant to the provisions of the preceding paragraph, must notify the method of payment, the due date of payment, and other necessary matters for said amount of deficit together with the notification pursuant to the provisions of the same paragraph. In a case when said paid amount exceeds the revised amount of Levy after a change pursuant to the provisions of the same paragraph, when there is unpaid Levy and other levies of the Organization pursuant to the provisions of this Act, said excess amount shall be allocated to the unpaid Levy, and if there is still an excess amount remaining, the amount must be reimbursed, and in the case that there are no unpaid levies, said excess amount must be reimbursed.

The Organization, when a medical insurer does not pay the Levy by the due date of said Levy, must specify the due date and present a demand for said Levy to said medical insurer.

The Organization, when presenting a demand pursuant to the provisions of the preceding paragraph, issues a demand note to said medical insurer. In this case, the due date to be specified by the demand note must be a date ten days or more after the date of issuance of said demand note.

The Organization, when a medical insurer that is presented a demand for Levy pursuant to the provisions of paragraph (1) does not pay the full amount of the Levy pertaining to said demand note or the delinquent charge pursuant to the provisions of the following Article by said specified due date, is to demand said collection from the Minister of Health, Labour and Welfare or the prefectural governor, pursuant to the provisions of a Cabinet Order.

The Minister of Health, Labour, and Welfare or the prefectural governor, when receiving a demand for collection pursuant to the provisions of the preceding paragraph, may dispose of the demand as governed by the disposition of a matter with regard to a failure to pay a national tax.

When payment of the Levy is demanded pursuant to the provisions of paragraph (1) of the preceding Article, the Organization collects a delinquent charge that is calculated by using the percentage of 14.5 percent per annum of the amount of Levy pertaining to said demand for the number of days from the date following the due date of said Levy until the date prior to the date of full payment or an attachment of property, however, provided that this provision does not apply when the amount of Levy pertaining to said demand is less than 1,000 yen.

In a case of the preceding paragraph, when a portion of the amount of Levy is paid, the amount of Levy that is the principal amount for the calculation of the delinquent charge pertaining to the period after the date of said payment is to be the amount remaining after deducting the amount of said payment from the amount of said Levy.

In calculations of the delinquent charge, when the amount of Levy as set forth in the preceding two paragraphs contains a fractional portion that is less than 1,000 yen, said fractional portion is rounded down to the nearest 1,000 yen increment.

When the amount of delinquent charge calculated pursuant to the provisions of the preceding three paragraphs contains a fractional portion that is less than 100 yen, said fractional portion is rounded down to the nearest 100 yen increment.

A delinquent charge is not collected if any of the following items applies; provided, however, that in the case of item (iii), this is limited to the portion of the amount corresponding to the period during which the execution has been suspended or deferred:

when the Levy is paid in full by the due date specified in said demand note;

when the amount of delinquent charge is less than 100 yen;

when the disposition of the matter of said delinquency pertaining to Levy is discontinued or suspended;

when it is determined that there are compelling reasons for not paying the Levy.

The Organization, when it is determined that payment is significantly difficult for a medical insurer to pay the Levy due to compelling reasons, may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, based on the application of said medical insurer and after obtaining the approval of the Minister of Health, Labour and Welfare, defer payment of a portion of said Levy for a period within one year from the due date of said Levy.

The Organization, when granting a deferment pursuant to the provisions of the preceding paragraph, must provide notification of said fact, the amount of Levy pertaining to the deferment, the grace period, and other necessary matters to said medical insurer.

The Organization, when granting a deferment pursuant to the provisions of paragraph (1), may not, during the grace period, present additional demands for payment of said Levy pertaining to said deferment pursuant to the provisions of Article 156, paragraph (1), and may not present a demand for collection pursuant to the provisions of paragraph (3) of the same Article.

A Municipality, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must notify the Organization of the Amount Subject to Medical Insurance Premium Payment in each fiscal year and other matters as determined by Order of the Ministry of Health, Labour and Welfare.

A Municipality may entrust the affairs of said notification pursuant to the provisions of the preceding paragraph to the Association.