This Act comes into effect as of July 1, 1926; provided, however, that the provisions on insurance benefits and sharing of costs are enforced from January 1, 1927.

①In order to adjust the imbalance in financial resources for the benefits relating to medical care of health insurance administered by health insurance societies, the provision of healthcare services and welfare services, or the expenses required for the payment of young-old payments, etc., aid for the old-old, etc., day laborer contributions, the long-term care payment, the contribution for securing medical care in the early phase of an epidemic, etc. or the children and child-rearing support levy pertaining to health insurance societies, the federation is to, as specified by Cabinet Order, conduct a project of granting subsidies to health insurance societies that are its members (hereinafter referred to as "societies" in this Article and the following Article).

②A society is to contribute funds to federations as specified by Cabinet Order in order to allocate the funds for expenses required for the business referred to in the previous paragraph.

③A society collects adjusted insurance premiums to allocate for the expenses required for the funds contributed pursuant to the provisions of the preceding paragraph.

④The adjusted insurance premium amount for an insured person is the amount obtained per month by multiplying both the person's standard monthly remuneration and the person's amount of standard bonus amount by the adjustment rate for insurance premiums.

⑤The adjustment rate for insurance premiums is specified by Cabinet Order based on expenses required for granting subsidies as well as the number of society members who are insured persons and their standard remunerations.

⑥The provisions of Article 7-39, Article 29, paragraph (2), and Article 185, paragraph (3) apply to the business referred to in paragraph (1). In this case, "business or assets" in Article 7-39, paragraph (1) is deemed to be replaced with "business", "articles of incorporation" in the same paragraph is deemed to be replaced with "constitution", "the preceding paragraph, or if it is found that the continuation of business of a designated health insurance society which has violated the provisions of paragraph (2) of the preceding Article, of a designated health insurance society which fails to follow the request referred to in paragraph (3) of the same Article, or of another designated health insurance society as specified by Cabinet Order is difficult due to the status of services or property or other reasons" in Article 29, paragraph (2) is deemed to be replaced with "Article 2, paragraph (6) of the Supplementary Provisions", and "promoting the common welfare of insured persons who are members of a health insurance society" in Article 185, paragraph (3) is deemed to be replaced with "promoting the business referred to in Article 2, paragraph (1) of the Supplementary Provisions".

⑦The provisions of Article 158, Article 159, Article 159-3, Article 161, Article 162, Article 164, Article 165, Article 167 and Article 193 apply mutatis mutandis to the adjusted insurance premium pursuant to the provisions of paragraph (3).

⑧Notwithstanding the provisions of Article 160, paragraph (8) as applied mutatis mutandis to paragraph (13) of the same article, the authorization referred to in Article 160, paragraph (8) is not required for the determination of a change in the general insurance rate that does not cause a change in the combined rate of the general insurance rate and adjustment rate for insurance premiums.

⑨When a determination is made pursuant to the provisions of the preceding paragraph, the Minister of Health, Labour and Welfare must be notified of the general insurance rate after the change.

The national government is to, as specified by Cabinet Order, bear, with respect to the federation, part of the expenses required for the granting of the subsidies under paragraph (1) of the preceding Article to the societies specified by Cabinet Order, within the scope of the budget.

①A person who was an insured person with membership in a health insurance society authorized by the Minister of Health, Labour and Welfare as meeting the requirements specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as a "specified health insurance society" in this Article) and who is specified by the specified health insurance society among those who should be persons with retirement insurance as prescribed in Article 8-2, paragraph (1) of the National Health Insurance Act before amendment pursuant to the provisions of Article 13 of the Amending Act may become an insured person of the specified health insurance society (hereinafter referred to as a "special retired insured person") by submitting a request to the specified health insurance society; provided, however, that this does not apply in cases of an insured person with optional and continued coverage.

②A special retired insured person may not be insured by two or more insurers (including mutual aid associations) at the same time.

③A special retired insured person acquires such eligibility on the date on which the request referred to in paragraph (1) is accepted.

④With regard to the standard monthly remuneration of a special retired insured person, notwithstanding the provisions of Articles 41 through 44, when the amount specified by the specified health insurance society in the range of the average standard monthly remuneration for the same month of all insured persons other than special retired insured persons administered by the specified health insurance society on September 30 in the preceding year (for the standard monthly remuneration from January to March, the year prior to the preceding year) is deemed to be the monthly remuneration amount forming the basis of the standard monthly remuneration, that standard monthly remuneration is applied.

⑤Notwithstanding the provisions of Article 104, injury and sickness allowance is not paid to a special retired insured person.

⑥A special retired insured person is deemed to be an insured person with optional and continued coverage for the purpose of the application of the provisions of this Act (excluding Article 38, items (ii), (iv) and (v)). In this case, the phrase "two years have elapsed since the day on which the person became an insured person with optional and continued coverage" in item (i) of that Article is deemed to be replaced with "the person ceases to fall under those who should be persons with retirement insurance as prescribed in Article 8-2, paragraph (1) of the National Health Insurance Act before amendment pursuant to the provisions of Article 13 of the Amending Act", the term "insurer" in item (iii) of that Article with "specified health insurance society prescribed in Article 3, paragraph (1) of the Supplementary Provisions", and the phrase "to the insurer" in item (vii) of that Article with "to the specified health insurance society prescribed in Article 3, paragraph (1) of the Supplementary Provisions".

⑦Special provisions concerning insurance benefits for special retired insured persons and other necessary matters concerning special retired insured persons are specified by Cabinet Order.

①A health insurance society established by a merger referred to in Article 23, paragraph (3) or a health insurance society that remains after a merger falling under all of the following requirements (hereinafter referred to as "regional health insurance society " in this Article) may determine unequal general insurance rates in the range prescribed in Article 160, paragraph (1) as applied mutatis mutandis to paragraph (13) of the same paragraph within the fiscal year in which the merger occurred and the subsequent five years:

②Authorization must be obtained from the Minister of Health, Labour and Welfare for the determination of the insurance premium rate referred to in the preceding paragraph.

③The authorization procedure for the general insurance premium rate of a regional health insurance society and other necessary matters concerning a regional health insurance society are specified by Cabinet Order.

①A corporation organized by an employer of insured persons (excluding employers of a place of business at which a health insurance society is organized) and those insured persons or another organization specified by Cabinet Order (referred to as a "corporation") and approved by the Minister of Health, Labour and Welfare as one that meets the requirements prescribed by Cabinet Order (hereinafter referred to as an "approved corporation" in this Article) may provide payment to an insured person for insurance benefits relating to medical treatment for the insured person up to an amount equivalent to the amount of co-payment paid by the insured person pursuant to the provisions of Article 74, paragraph (1).

②When a corporation referred to in the preceding paragraph intends to receive approval, it must obtain consent from JHIA in advance.

③An approved corporation may collect expenses to allocate for payment referred to in paragraph (1) from employers or insured persons as specified by Order of the Ministry of Health, Labour and Welfare.

④Necessary matters concerning the business of approved corporations are specified by Order of the Ministry of Health, Labour and Welfare.

Until the date specified by Cabinet Order prescribed in Article 2 of the Supplementary Provisions of the Act on Assurance of Medical Care for Elderly People, in Article 7-2, paragraph (3), the phrase "and the same Act" is deemed to be replaced with ", the same Act" and the phrase ", the Long-Term Care Insurance Act" with "and the bed conversion support payment, etc. prescribed in Article 7, paragraph (1) of the Supplementary Provisions of the same Act (hereinafter referred to as "bed conversion support payment, etc."), the Long-Term Care Insurance Act"; in Article 151, the phrase "the contributions under the provisions of Article 173" with "bed conversion support payment, etc. and the contributions under the provisions of Article 173"; in Article 154, paragraph (2) as replaced pursuant to Article 5 of the Supplementary Provisions, the phrase "the aid for the old-old under the provisions of the Act on Assurance of Medical Care for Elderly People" with "the aid for the old-old under the provisions of the Act on Assurance of Medical Care for Elderly People and the bed conversion support payment prescribed in Article 7, paragraph (1) of the Supplementary Provisions of that Act"; in Article 155, paragraph (1) and Article 160, paragraph (3), item (ii), the phrase "aid for the old-old, etc." with "aid for the old-old, etc. and bed conversion support payment, etc."; in paragraph (14) of Article 160, the phrase "the amount of aid for the old-old, etc." with "the amount of aid for the old-old, etc. and bed conversion support payment, etc."; in Article 173, paragraph (1) and Article 176, the phrase "aid for the old-old, etc." with "aid for the old-old, etc. and bed conversion support payment, etc."; and in Article 2, paragraph (1) of the Supplementary Provisions, the phrase "aid for the old-old, etc." with "aid for the old-old, etc., bed conversion support payment, etc.".

In fiscal year 2024 and fiscal year 2025, in Article 152-4, the phrase "multiplying the amount calculated" is deemed to be replaced with "multiplying an amount equivalent to one half of the amount calculated", and in Article 152-5, the phrase "multiplying the amount of expenses required" with "multiplying an amount equivalent to one half of the amount of expenses required".

For the time being, the phrase "a rate specified by Cabinet Order within a range from 0.13 to 0.20" in Article 153, the phrase "the rate specified by Cabinet Order prescribed in the preceding Article" in Article 154, paragraph (1), the phrase "the rate specified by Cabinet Order prescribed in that Article" in paragraph (2) of that Article, and the phrase "the rate specified by Cabinet Order prescribed in Article 153" in the following Article are deemed to be replaced with "0.164".

Until the date specified by Cabinet Order prescribed in Article 2 of the Supplementary Provisions of the Act on Assurance of Medical Care for Elderly People, in addition to the expenses prescribed in Articles 151, 153 and 154, the national treasury subsidizes the amount obtained by multiplying the amount of expenses required for the payment of the bed conversion support payment prescribed in Article 7, paragraph (1) of the Supplementary Provisions of that Act that JHIA is to contribute (excluding that pertaining to specially-insured day laborers) by the rate specified by Cabinet Order prescribed in Article 153.