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いまの条文を読む →第七章 費用の負担（第四十四条の四から第四十五条の三まで）
健康保険法施行令等の一部を改正する政令（令和八年政令第二百四十号）による改正後の条文です。変わる言葉に印をつけています。
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各年度の出産育児交付金は、当該年度の法第百五十二条の二に規定する出産育児一時金等の支給に要する費用の一部に充てるものとする。
The childbirth and childcare grant for each fiscal year is to be applied to a portion of the expenses required for the payment of the lump-sum allowance for childbirth and childcare, etc. prescribed in Article 152-2 of the Act for that fiscal year.
法第百五十二条の六の規定により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を準用する場合においては、同法第四十一条（見出しを含む。）中「保険者」とあるのは「健康保険組合」と、同法第四十二条第一項中「、各保険者」とあるのは「、各保険者（健康保険（日雇特例被保険者（健康保険法第三条第二項に規定する日雇特例被保険者をいう。）の保険を除く。）の保険者としての全国健康保険協会及び健康保険組合をいう。以下同じ。）」と読み替えるものとする。
Where the provisions of Articles 41 and 42 of the Act on Assurance of Medical Care for Elderly People are applied mutatis mutandis pursuant to Article 152-6 of the Act, the term "Insurer" in Article 41 of that Act (including the heading) is deemed to be replaced with "health insurance society", and the phrase "to each Insurer" in Article 42, paragraph (1) of that Act with "to each Insurer (meaning the Japan Health Insurance Association and health insurance societies as insurers of health insurance (excluding insurance for specially-insured day laborers (meaning specially-insured day laborers prescribed in Article 3, paragraph (2) of the Health Insurance Act)); the same applies hereinafter)".
前期高齢者交付金及び後期高齢者医療の国庫負担金の算定等に関する政令（平成十九年政令第三百二十五号）第二条第一項から第四項までの規定は、法第百五十二条の六において準用する高齢者の医療の確保に関する法律第四十一条の規定による出産育児交付金の額の算定の特例について準用する。この場合において、次の表の上欄に掲げる同令の規定中同表の中欄に掲げる字句は、それぞれ同表の下欄に掲げる字句に読み替えるものとする。
| 第二条の見出し | 保険者 | 健康保険組合 |
| 第二条第一項 | 保険者、 | 健康保険組合、 |
| 保険者又は解散をした保険者 | 健康保険組合又は解散をした健康保険組合 | |
| 承継した保険者 | 承継した健康保険組合 | |
| 成立保険者等 | 成立健康保険組合等 | |
| 第二条第一項第一号 | 保険者 | 健康保険組合 |
| 債権の額又は前期高齢者納付金等に係る債務 | 債権 | |
| 第二条第一項第二号及び第三号 | 保険者 | 健康保険組合 |
| 次のイ及びロに掲げる額の区分に応じ、それぞれイ及びロに | イに | |
| 第二条第二項の表以外の部分 | 成立保険者等 | 成立健康保険組合等 |
| 法第三十三条第一項ただし書 | 健康保険法（大正十一年法律第七十号）第百五十二条の三第一項ただし書 | |
| 概算前期高齢者交付金 | 概算出産育児交付金 | |
| 確定前期高齢者交付金 | 確定出産育児交付金 | |
| 第二条第二項の表 | 保険者 | 健康保険組合 |
| 概算前期高齢者交付金 | 概算出産育児交付金 | |
| 確定前期高齢者交付金 | 確定出産育児交付金 | |
| 第二条第三項 | 成立保険者等 | 成立健康保険組合等 |
| 第二条第四項の表以外の部分 | 成立保険者等 | 成立健康保険組合等 |
| 法第三十三条第一項ただし書 | 健康保険法第百五十二条の三第一項ただし書 | |
| 概算前期高齢者交付金 | 概算出産育児交付金 | |
| 確定前期高齢者交付金 | 確定出産育児交付金 | |
| 第二条第四項の表 | 保険者 | 健康保険組合 |
| 概算前期高齢者交付金 | 概算出産育児交付金 | |
| 確定前期高齢者交付金 | 確定出産育児交付金 |
The provisions of Article 2, paragraphs (1) through (4) of the Cabinet Order on the Calculation, etc. of Grants for Early-Stage Elderly People and National Treasury Contributions for Latter-Stage Elderly Medical Care (Cabinet Order No. 325 of 2007) apply mutatis mutandis to the special provisions for calculation of the amount of childbirth and childcare grants under Article 41 of the Act on Assurance of Medical Care for Elderly People as applied mutatis mutandis pursuant to Article 152-6 of the Act. In this case, the words listed in the middle column of the following table in the provisions of that Cabinet Order listed in the left-hand column of the table are deemed to be replaced with the words listed in the right-hand column of the table, respectively.
| Heading of Article 2 | insurer | health insurance society |
| Article 2, paragraph (1) | insurer, | health insurance society, |
| insurer or a dissolved insurer | health insurance society or a dissolved health insurance society | |
| succeeding insurer | succeeding health insurance society | |
| newly established insurer, etc. | newly established health insurance society, etc. | |
| Article 2, paragraph (1), item (i) | insurer | health insurance society |
| the amount of claims or the obligations relating to young-old payments, etc. | claims | |
| Article 2, paragraph (1), items (ii) and (iii) | insurer | health insurance society |
| in accordance with the category of the amounts listed in (a) and (b) below, respectively in (a) and (b) | in (a) | |
| Portion of Article 2, paragraph (2) other than the table | newly established insurer, etc. | newly established health insurance society, etc. |
| the proviso to Article 33, paragraph (1) of the Act on Assurance of Medical Care for Elderly People | the proviso to Article 152-3, paragraph (1) of the Health Insurance Act (Act No. 70 of 1922) | |
| estimated young-old subsidy | estimated childbirth and childcare grant | |
| fixed young-old subsidy | fixed childbirth and childcare grant | |
| Table in Article 2, paragraph (2) | insurer | health insurance society |
| estimated young-old subsidy | estimated childbirth and childcare grant | |
| fixed young-old subsidy | fixed childbirth and childcare grant | |
| Article 2, paragraph (3) | newly established insurer, etc. | newly established health insurance society, etc. |
| Portion of Article 2, paragraph (4) other than the table | newly established insurer, etc. | newly established health insurance society, etc. |
| the proviso to Article 33, paragraph (1) of the Act on Assurance of Medical Care for Elderly People | the proviso to Article 152-3, paragraph (1) of the Health Insurance Act | |
| estimated young-old subsidy | estimated childbirth and childcare grant | |
| fixed young-old subsidy | fixed childbirth and childcare grant | |
| Table in Article 2, paragraph (4) | insurer | health insurance society |
| estimated young-old subsidy | estimated childbirth and childcare grant | |
| fixed young-old subsidy | fixed childbirth and childcare grant |
政府は、次項の場合を除き、厚生労働大臣が徴収した保険料その他法の規定による徴収金及び印紙をもつてする歳入金納付に関する法律（昭和二十三年法律第百四十二号）の規定による納付金（以下この項及び次項において「保険料等」という。）が年金特別会計の健康勘定（同項において「健康勘定」という。）において収納されたときは、その都度遅滞なく、協会に対し、当該収納された保険料等の額から厚生労働大臣が行う健康保険事業の事務の執行に要する費用に相当する額（法第百五十一条の規定による当該費用に係る国庫負担金の額を除く。）として厚生労働省令で定めるところにより算定した額を控除した額を法第百五十五条の二の規定による交付金（以下この条において「保険料等交付金」という。）として交付する。
Except in the case referred to in the following paragraph, when the premiums and other amounts collected by the Minister of Health, Labour and Welfare pursuant to the provisions of the Act and the payments pursuant to the provisions of the Act on Payment of Government Charges with Stamps (Act No. 142 of 1948) (hereinafter referred to as "premiums, etc." in this paragraph and the following paragraph) have been received in the health account of the Pension Special Account (referred to as the "health account" in that paragraph), the Government is to deliver to JHIA, on each such occasion without delay, as the grant under Article 155-2 of the Act (hereinafter referred to as the "grant from premiums, etc." in this Article), the amount obtained by deducting, from the amount of the premiums, etc. so received, the amount calculated as provided by Order of the Ministry of Health, Labour and Welfare as an amount equivalent to the expenses required for the execution of the affairs of the health insurance business administered by the Minister of Health, Labour and Welfare (excluding the amount of the national treasury share for those expenses under Article 151 of the Act).
政府は、当該年度の健康勘定に前年度の決算上の剰余金が繰り入れられたときは、遅滞なく、協会に対し、当該繰り入れられた額（保険料等に係るもの以外のものとして厚生労働大臣が定めるものを除く。）を保険料等交付金として交付する。
When the surplus in the final accounts of the previous fiscal year has been transferred to the health account for that fiscal year, the Government is to deliver to JHIA without delay, as the grant from premiums, etc., the amount so transferred (excluding the amount specified by the Minister of Health, Labour and Welfare as that other than relating to premiums, etc.).
政府は、各月ごとに、協会に対し、当該各月において交付した保険料等交付金の額の算定根拠を明らかにするものとする。
For each month, the Government is to make clear to JHIA the basis for calculating the amount of the grant from premiums, etc. delivered in that month.
前三項に定めるもののほか、保険料等交付金の交付に関し必要な事項は、厚生労働省令で定める。
Beyond what is provided for in the preceding three paragraphs, necessary matters concerning the delivery of the grant from premiums, etc. are specified by Order of the Ministry of Health, Labour and Welfare.
法第百五十六条第二項ただし書（法附則第七条第三項において準用する場合を含む。）の政令で定める場合は、介護保険第二号被保険者（介護保険法第九条第二号に規定する被保険者をいう。以下同じ。）となった月において介護保険第二号被保険者に該当しなくなった場合とする。
The cases specified by Cabinet Order as referred to in the proviso to Article 156, paragraph (2) of the Act (including as applied mutatis mutandis pursuant to Article 7, paragraph (3) of the Supplementary Provisions of the Act) are cases where a person ceases to be an item (ii) insured person (meaning an insured person prescribed in Article 9, item (ii) of the Long-Term Care Insurance Act; the same applies hereinafter) in the month in which the person became an item (ii) insured person.
協会は、厚生労働省令で定めるところにより、一の事業年度の翌事業年度における、第一号に掲げる額を予定保険料納付率（一の事業年度の三月分から当該一の事業年度の翌事業年度の二月分までの保険料（任意継続被保険者に係る保険料にあっては、当該翌事業年度の四月分から三月分までの保険料）として徴収すべき額の見込額に占める当該翌事業年度において納付が見込まれる保険料の額の総額の割合として厚生労働省令で定めるところにより算定される率をいう。次条において同じ。）で除して得た額を第二号に掲げる額で除することにより、当該一の事業年度の三月から用いる都道府県単位保険料率（法第百六十条第二項に規定する都道府県単位保険料率をいう。次条及び第四十五条の四第四項第一号において同じ。）を算定するものとする。
As specified by Order of the Ministry of Health, Labour and Welfare, JHIA is to calculate the premium rate for each prefecture (meaning the premium rate for each prefecture prescribed in Article 160, paragraph (2) of the Act; the same applies in the following Article and Article 45-4, paragraph (4), item (i)) to be used from March of a business year, by dividing the amount obtained by dividing the amount listed in item (i) by the projected premium payment rate (meaning the rate calculated, as specified by Order of the Ministry of Health, Labour and Welfare, as the proportion that the total amount of premiums expected to be paid in the business year following the business year represents of the estimated amount to be collected as premiums for the period from March of a business year to February of the business year following that business year (for premiums relating to insured persons with optional and continued coverage, premiums for the period from April to March of that following business year); the same applies in the following Article) by the amount listed in item (ii), for the business year following the business year.
次のイからハまでに掲げる額を合算した額からニに掲げる額を控除した額
the amount obtained by deducting the amount listed in (d) from the total sum of the amounts listed in (a) through (c);
法第百六十条第三項第一号に掲げる額から当該支部被保険者（同条第一項に規定する支部被保険者をいう。以下同じ。）に係る同号に規定する療養の給付等（第四十五条の四第四項第一号及び第二号において「療養の給付等」という。）に要する費用のうち法の規定により支払うべき一部負担金に相当する額の見込額を控除した額
the amount obtained by deducting, from the amount listed in Article 160, paragraph (3), item (i) of the Act, the estimated amount of the amount equivalent to the partial co-payment payable pursuant to the provisions of the Act out of the expenses required for the benefits for medical treatment, etc. prescribed in that item (referred to as "benefits for medical treatment, etc." in Article 45-4, paragraph (4), items (i) and (ii)) relating to the branch-insured person concerned (meaning the single branch-insured person prescribed in Article 160, paragraph (1) of the Act; the same applies hereinafter);
法第百六十条第三項第二号に掲げる額から当該支部被保険者に係る同号に規定する保険給付に要する費用のうち法の規定により支払うべき一部負担金に相当する額の見込額を控除した額と一の事業年度の前々事業年度の三月から当該一の事業年度の前事業年度の二月までの各月の当該支部被保険者（任意継続被保険者を除く。）の総報酬額（標準報酬月額及び標準賞与額の合計額をいう。以下この条及び次条において同じ。）の総額及び当該一の事業年度の前事業年度の四月から三月までの各月の当該支部被保険者（任意継続被保険者に限る。）の総報酬額の総額の合算額に千分の〇・一を乗じて得た額とを合算して得た額
the amount obtained by adding together the amount obtained by deducting, from the amount listed in Article 160, paragraph (3), item (ii) of the Act, the estimated amount of the amount equivalent to the partial co-payment payable pursuant to the provisions of the Act out of the expenses required for the insurance benefits prescribed in that item relating to the branch-insured person concerned, and the amount obtained by multiplying by 0.1/1,000 the total sum of the total amount of the total remuneration (meaning the total of the standard monthly remuneration and the standard bonus amount; the same applies in this Article and the following Article) of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for each month from March of the business year before the previous business year of a business year through February of the business year previous to that business year, and the total amount of the total remuneration of the branch-insured person concerned (limited to insured persons with optional and continued coverage) for each month from April through March of the business year previous to that business year;
法第百六十条第三項第三号に掲げる額
the amount listed in Article 160, paragraph (3), item (iii) of the Act; and
一の事業年度において取り崩すことが見込まれる準備金の額その他健康保険事業に要する費用のための収入の見込額のうち当該支部被保険者を単位とする健康保険の当該一の事業年度の財政においてその収入とみなすべき額として協会が定める額並びに高齢者の医療の確保に関する法律第十八条第一項に規定する特定健康診査及び同項に規定する特定保健指導の実施状況その他の当該支部被保険者及びその被扶養者の健康の保持増進並びに医療に要する費用の適正化に係る当該支部（法第七条の四第一項に規定する支部をいう。）の取組の状況を勘案して厚生労働省令で定めるところにより算定した報奨金の額
the amount specified by JHIA as the amount to be deemed revenue in the finances of a business year of health insurance on the basis of the branch-insured person concerned, out of the estimated amount of revenue for expenses required for health insurance business, such as the amount of reserves expected to be drawn down in that business year, and the amount of incentive payment calculated, as specified by Order of the Ministry of Health, Labour and Welfare, taking into account the status of implementation of the special health examination prescribed in Article 18, paragraph (1) of the Act on Assurance of Medical Care for Elderly People and the specified health guidance prescribed in the same paragraph, and other efforts of the relevant branch (meaning the branch prescribed in Article 7-4, paragraph (1) of the Act) concerning the maintenance and promotion of the health of the branch-insured person concerned and the dependents of that person and the optimization of medical expenses;
一の事業年度の三月から当該一の事業年度の翌事業年度の二月までの各月の当該支部被保険者（任意継続被保険者を除く。）の総報酬額の総額及び当該一の事業年度の翌事業年度の四月から三月までの各月の当該支部被保険者（任意継続被保険者に限る。）の総報酬額の総額の合算額の見込額
the estimated amount of the total sum of the total amount of the total remuneration of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for each month from March of a business year through February of the business year following that business year, and the total amount of the total remuneration of the branch-insured person concerned (limited to insured persons with optional and continued coverage) for each month from April through March of the business year following that business year.
協会は、前条の規定にかかわらず、その変更しようとする都道府県単位保険料率を三月以外の月から用いようとするときは、厚生労働省令で定めるところにより、第一号に掲げる額から第二号に掲げる額を控除した額を予定保険料納付率で除して得た額を第三号に掲げる額で除することにより、当該都道府県単位保険料率を算定するものとする。
Notwithstanding the provisions of the preceding Article, when JHIA intends to use a premium rate for each prefecture that it is about to change from a month other than March, JHIA is to calculate that premium rate for each prefecture, as specified by Order of the Ministry of Health, Labour and Welfare, by dividing the amount obtained by dividing the amount obtained by deducting the amount listed in item (ii) from the amount listed in item (i) by the projected premium payment rate by the amount listed in item (iii).
当該変更後の都道府県単位保険料率を用いる最初の月（次号及び第三号において「適用月」という。）の属する事業年度における前条第一号に掲げる額
the amount listed in item (i) of the preceding Article in the business year to which the first month in which the premium rate for each prefecture after the change is to be used (referred to as the "month of application" in the following item and item (iii)) belongs;
次のイからハまでに掲げる適用月の区分に応じ、それぞれイからハまでに定める額
the amount specified respectively in (a) through (c) in accordance with the classification of months of application listed in (a) through (c):
ロ又はハに掲げる月以外の月 適用月の属する事業年度の前事業年度の三月から当該適用月の前月までの各月の当該支部被保険者（任意継続被保険者を除く。）の総報酬額の総額及び当該適用月の属する事業年度の四月から当該適用月の前月までの各月の当該支部被保険者（任意継続被保険者に限る。）の総報酬額の総額の合算額の見込額に当該変更前の都道府県単位保険料率を乗じて得た額に当該適用月の属する事業年度における予定保険料納付率を乗じて得た額
a month other than a month listed in (b) or (c): the amount obtained by multiplying the estimated amount of the total sum of the total amount of the total remuneration of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for each month from March of the business year previous to the business year to which the month of application belongs through the month preceding the month of application, and the total amount of the total remuneration of the branch-insured person concerned (limited to insured persons with optional and continued coverage) for each month from April of the business year to which the month of application belongs through the month preceding the month of application, by the premium rate for each prefecture before the change, and then multiplying the amount so obtained by the projected premium payment rate in the business year to which the month of application belongs;
四月 当該四月の前月の当該支部被保険者（任意継続被保険者を除く。）の総報酬額の総額の見込額に当該変更前の都道府県単位保険料率を乗じて得た額に当該四月の属する事業年度における予定保険料納付率を乗じて得た額
April: the amount obtained by multiplying the estimated amount of the total amount of the total remuneration of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for the month preceding that April by the premium rate for each prefecture before the change, and then multiplying the amount so obtained by the projected premium payment rate in the business year to which that April belongs;
五月 当該五月の前々月及び前月の当該支部被保険者（任意継続被保険者を除く。）の総報酬額の総額並びに当該五月の前月の当該支部被保険者（任意継続被保険者に限る。）の総報酬額の総額の合算額の見込額に当該変更前の都道府県単位保険料率を乗じて得た額に当該五月の属する事業年度における予定保険料納付率を乗じて得た額
May: the amount obtained by multiplying the estimated amount of the total sum of the total amount of the total remuneration of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for the month two months before that May and the month preceding that May, and the total amount of the total remuneration of the branch-insured person concerned (limited to insured persons with optional and continued coverage) for the month preceding that May, by the premium rate for each prefecture before the change, and then multiplying the amount so obtained by the projected premium payment rate in the business year to which that May belongs;
適用月から当該適用月の属する事業年度の二月までの各月（適用月が二月の場合にあっては、当該二月）の当該支部被保険者（任意継続被保険者を除く。）の総報酬額の総額及び当該適用月から当該適用月の属する事業年度の三月までの各月の当該支部被保険者（任意継続被保険者に限る。）の総報酬額の総額の合算額の見込額
the estimated amount of the total sum of the total amount of the total remuneration of the branch-insured person concerned (excluding insured persons with optional and continued coverage) for each month from the month of application through February of the business year to which the month of application belongs (where the month of application is February, that February), and the total amount of the total remuneration of the branch-insured person concerned (limited to insured persons with optional and continued coverage) for each month from the month of application through March of the business year to which the month of application belongs.