Long-Term Care Insurance Act

An Insurance Premium and other levies as prescribed in this Act that a Municipality collects are to be revenue as prescribed in Article 231-3, paragraph (3) of the Local Autonomy Act.

A Municipality is to maintain a register of insurance premium payments and record the name, domicile, payment status of said insurance premium of a Primary Insured Person, and other matters as prescribed by Order of the Ministry of Health, Labour, and Welfare pertaining to said register.

In addition to the provisions as prescribed in this Section, matters concerning imposition and collection, etc., of an insurance premium (except for those matters concerning special collection) are specified by Order in accordance with standards determined by a Cabinet Order, and the necessary matters concerning special collection are specified by a Cabinet Order or ordinance in accordance with standards determined by a Cabinet Order.

A Municipality is to establish a Fiscal Stability Fund in order to allocate necessary funding to a project contributing to the stabilization of the finances of Long-Term Care Insurance as listed in the following:

the amount of deficiency when the amount of insurance premiums actually received are an amount that is less than the expected insurance premiums, and for the deficit remaining when revenue subject to a fund project is an amount that is less than the disbursements subject to said fund project, pursuant to the provisions of a Cabinet Order, to allocate to a Municipality the amount which is calculated pursuant to the provisions of a Cabinet Order by taking into consideration the receipt status of insurance premiums of said Municipality and other Municipalities based on the amount equivalent to 50 percent of the amount listed in sub-item (a) (when the amount listed in sub-item (a) exceeds the amount listed in sub-item (b), the amount is to be the amount listed in sub-item (b)):

the amount of insurance premiums actually received that is forecast to be less than the amount of expected insurance premiums;

the amount of revenue subject to a fund project that is forecast to be deficient with regard to the disbursements subject to said fund project;

to lend to a Municipality with regard to the total amount of revenue subject to a fund project and grants to a fund project that is forecast to be deficient with regard to the disbursements subject to said fund project, pursuant to the provisions of a Cabinet Order, an amount within the amount which is calculated pursuant to the provisions of a Cabinet Order, by taking into consideration the receipt status of insurance premiums of said Municipality and other Municipalities based on said amounts of deficiency.

Terms used in the preceding paragraph that are listed in the following items are to be defined pursuant to the provisions of each said item:

expected insurance premiums:the amount which is calculated, pursuant to the provisions of a Cabinet Order, to be allocated for the amount of funding necessary to provide for Long-Term Care Benefits and Prevention Benefits, the amount of funding necessary for Community Support Projects, the amount of funding necessary for payment of Fiscal Stability Fund contributions, and the amount of funding necessary for repayment of borrowings from a prefecture pursuant to the provisions of item (ii) of the preceding paragraph (hereinafter referred to as "Borrowings for Fund Project" in this paragraph and in the following Article), from among the total amount of insurance premiums which are expected to be received by a Municipality as determined during the term of a Municipal Insured Long-Term Care Service Plan (hereinafter referred to as "Plan Term") specified by said Municipality;

insurance premiums actually received:the amount which is calculated pursuant to the provisions of a Cabinet Order to be allocated for the amount of funding necessary to provide for Long-Term Care Benefits and Prevention Benefits, the amount of funding necessary for Community Support Projects, the amount of funding necessary for payment of Fiscal Stability Fund contributions, and the amount of funding necessary for repayment of Borrowings for Fund Project from among the total amount of insurance premiums actually received during said Plan Term of the Municipality;

revenue subject to a fund project:the amount which is calculated pursuant to the provisions of a Cabinet Order to be allocated for the amount of funding necessary to provide for Long-Term Care Benefits and Prevention Benefits, the amount of funding necessary for Community Support Projects, the amount of funding necessary for payment of Fiscal Stability Fund contributions, and the amount of funding necessary for repayment of Borrowings for Fund Project from among the total amount which is received (excluding the amount of grants to a fund project and the amount of Borrowings for Fund Project as set forth in item (v)) during said Plan Term of a special account concerning Long-Term Care Insurance of the Municipality,;

disbursements subject to fund project:the amount which is calculated pursuant to the provisions of a Cabinet Order as the total of the amount of disbursements necessary to provide Long-Term Care Benefits and Prevention Benefits, the amount of disbursements necessary for Community Support Projects, the amount of disbursements necessary for payment of Fiscal Stability Funds contributions, and the amount of disbursements necessary for repayment of Borrowings for Fund Project, of said Municipality during said Plan Term;

grants to a fund project:the amount that said Municipality receives during said Plan Term pursuant to the provisions of item (i) of the preceding paragraph.

A prefecture is to collect a Fiscal Stability Fund contribution from a Municipality in order to allocate said contribution to said Fiscal Stability Fund, pursuant to the provisions of a Cabinet Order.

A Municipality is subject to the obligation to pay a Fiscal Stability Fund contribution pursuant to the provisions of the preceding paragraph.

A prefecture must transfer the amount equivalent to three times the total amount of Fiscal Stability Fund contribution collected from a Municipality pursuant to the provisions of paragraph (3) to a Fiscal Stability Fund, pursuant to the provisions of a Cabinet Order.

The national government, pursuant to the provisions of a Cabinet Order, defray an amount equivalent to one-third (1/3) of the amount which a prefecture transfers pursuant to the provisions of the preceding paragraph.

All revenue received by a Fiscal Stability Fund must be allocated to said Fiscal Stability Fund disbursements.

The provisions of Article 121, paragraph (2) apply mutatis mutandis to the amount of disbursements necessary to provide for Long-Term Care Benefits and Prevention Benefits as prescribed in paragraph (2), item (i) and the amount of disbursements required to provide for Long-Term Care Benefits and Prevention Benefits as prescribed in item (ii) to item (iv) of the same paragraph.

A Municipality, in order to promote fiscal stabilization of Long-Term Care Insurance, with regard to financial resources for the disbursements necessary to provide for Long-Term Care Benefits and Prevention Benefits (with regard to the disbursements necessary for said Long-Term Care Benefits and Prevention Benefits pertaining to a Municipality that has established a Municipal Ordinance based on Article 43, paragraph (3), Article 44, paragraph (7), Article 45, paragraph (6), Article 55, paragraph (3), Article 56, paragraph (7), or Article 57, paragraph (6), the disbursements necessary for said Long-Term Care Benefits and Prevention Benefits are to be those calculated pursuant to the provisions of a Cabinet Order on the assumption that the measures under said Municipal Ordinance are not taken; the same applies in the following paragraph), the disbursements necessary for Community Support Projects, the disbursements necessary for payment of Fiscal Stability Funds contribution, and the expense necessary for repayment of Borrowings for Fund Project among those disbursements to be imposed by a special account concerning said Long-Term Care Insurance, pursuant to the provisions of a Cabinet Order, in cooperation with other Municipalities based on an adjustment rate of insurance premiums, may conduct a project to provide adjustments mutually among Municipalities (hereinafter referred to as "Municipal Mutual Fiscal Stabilization Project" in this Article and the following Article).

The adjustment rate of insurance premiums as set forth in the preceding paragraph is to be a rate that, if each Municipality that participates in the Municipal Mutual Fiscal Stabilization Project (hereinafter referred to as "Specified Municipality" in this Article and paragraph (2) of the following Article) imposes upon each of its Primary Insured Persons an insurance premium according to the amount of insurance premium that is calculated by using that adjustment rate of insurance premiums, would enable the total amount of insurance premiums received by said Specified Municipality during the Project Implementation Period (which means a period of three years as one term that is provided by a Specified Municipality pursuant to the provisions of the constitution referred to in the following paragraph as the period to implement said Municipal Mutual Fiscal Stabilization Project; the same applies hereinafter in this paragraph and paragraph (4)) to maintain a balance with the total of the amount of disbursements necessary for Long-Term Care Benefits and Prevention Benefits of said Specified Municipality during said Project Implementation Period (excluding the amount borne or granted by the national government, a prefecture, the general account of a Municipality, and the Organization with regard to the amount of disbursements necessary for said Long-Term Care Benefits and Prevention Benefits pursuant to the provisions of Article 121, paragraph (1), Article 122, paragraph (1), Article 123, paragraph (1), Article 124, paragraph (1) and Article 125, paragraph (1)), the amount of disbursements necessary for Community Support Projects (excluding the amount borne or granted by the national government, a prefecture, the general account of a Municipality, and the Organization with regard to the amount of disbursements necessary for said Community Support Projects pursuant to the provisions of Article 122-2, paragraphs (1), (2) and (4), Article 123, paragraph (3) and paragraph (4), Article 124, paragraph (3) and paragraph (4), and Article 126, paragraph (1) (including the amount granted pursuant to the provisions of Article 106-8 of the Social Welfare Act (limited to the portion pertaining to items (i) through (iii)), Article 106-9 of the same Act (limited to the portion pertaining to items (i) and (ii)), Article 106-9-2 of the same Act (limited to the portion pertaining to items (i) through (iii)) and Article 106-9-3 of the same Act (limited to the portion pertaining to items (i) and (ii)))), the amount of disbursements necessary for payment of Fiscal Stability Fund contributions, and the amount of disbursements necessary for repayment of Borrowings for Fund Project, and that is determined by said Specified Municipality in accordance with the standards provided by a Cabinet Order.

A Municipality, when it intends to implement a Municipal Mutual Fiscal Stabilization Project, must prescribe a constitution by deliberations held per a resolution of said municipal council and provide notification of said fact to the prefectural governor.

The constitution as set forth in the preceding paragraph must establish provisions for the matters listed in the following:

Specified Municipality;

adjustment rate of insurance premiums;

Project Implementation Period;

method of imposition and grant of financial resources pertaining to said Municipal Mutual Fiscal Stabilization Project;

in addition to the matters listed in each of the preceding items in this paragraph, other necessary matters for implementation of said Municipal Mutual Fiscal Stabilization Project.

The provisions as set forth in paragraph (3) apply mutatis mutandis to a change of said constitution as set forth in the same paragraph or when rescinding said Municipal Mutual Fiscal Stabilization Project.

In a case when a Specified Municipality, pursuant to the provisions of Article 129, paragraph (2), and provisions of paragraph (3) of the same Article, applies a rate of insurance premium provided by said ordinance, the phrase "approximate amount of the disbursements necessary for repayment" in the same paragraph is to be deemed to be replaced with "approximate amount of the disbursements necessary for repayment, the prospective amount of disbursements imposed by said Municipal Mutual Fiscal Stabilization Project as prescribed in Article 148, paragraph (1)," and the phrase "approximated through three years in consideration of..., and the amount of national treasury impositions, etc." is to be deemed to be replaced with "approximated during the Project Implementation Period as prescribed in Article 148, paragraph (2) in consideration of..., and the amount of national treasury impositions, etc., and prospective amount, etc., granted by said Municipal Mutual Fiscal Stabilization Project as prescribed in the same paragraph."

In a case when applying the provisions of paragraph (2) of the preceding Article to a Specified Municipality, the phrase "and the amount of disbursements necessary for repayment of borrowings from a prefecture pursuant to the provisions of item (ii) of the preceding paragraph (hereinafter referred to as "Borrowings for Fund Project")" in item (i) of the same paragraph is deemed to be replaced with "the amount of disbursements necessary for repayment of borrowings from a prefecture pursuant to the provisions of item (ii) of the preceding paragraph (hereinafter referred to as "Borrowings for Fund Project"), and the expense to be imposed by the Municipal Mutual Fiscal Stabilization Project (which means the Municipal Mutual Fiscal Stabilization Project as prescribed in paragraph (1) of the following Article; the same applies hereinafter in this paragraph)," the phrase "and the amount of disbursements required for repayment of Borrowings for Fund Project" in item (ii) of the same paragraph is deemed to be replaced with "the amount of disbursements required for repayment of Borrowings for Fund Project, and the expense imposed by the Municipal Mutual Fiscal Stabilization Project," the phrase "revenue (except for the amount of grants for a fund project and Borrowings for Fund Project as set forth in item (v))" in item (iii) of the same paragraph is deemed to be replaced with "revenue (including the amount granted by said Municipal Mutual Fiscal Stabilization Project, but except for the amount of grants to a fund project and Borrowings for Fund Project as set forth in item (v))," the phrase "and the amount of disbursements necessary for repayment of Borrowings for Fund Project" is deemed to be replaced with "..., the amount of disbursements required for repayment of Borrowings for Fund Project and the amount imposed by said Municipal Mutual Fiscal Stabilization Project," the phrase "and the amount of disbursements necessary for repayment of Borrowings for Fund Project" in item (iv) of the same paragraph shall be deemed to be replaced with "the amount of disbursements required for repayment of Borrowings for Fund Project and the amount imposed by said Municipal Mutual Fiscal Stabilization Project."

A Specified Municipality, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, may entrust a portion of affairs concerning imposition and grant of funds among a Municipal Mutual Fiscal Stabilization Project to a not-for-profit juridical person in which said Municipality is a contributing participant or a member and which is defined by requirements as prescribed in Order of the Ministry of Health, Labour, and Welfare;

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.